NG198 Evidence Review F2
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Centre for Reviews and Dissemination
Management of acne Lehmann H P, Andrews J S, Robinson K A, Holloway V L, Goodman S N Authors' objectives To provide a comprehensive review on the management of acne. Searching The search utilised several electronic databases from inception to 1999, including the CENTRAL Register in the Cochrane Library, MEDLINE, OLDMEDLINE (from 1960 to 1965), EMBASE, CINAHL and PsycINFO amongst others. Details of the searches were given in the report. In addition, the reference lists from key articles were checked and key experts were consulted. Only full articles published in English were eligible for the review. Study selection Study designs of evaluations included in the review Only randomised controlled trials (RCTs) or quasi-RCTs were considered for the review. There were 259 (94%) studies of a parallel-group design, 15 (5%) crossover, 30 (11%) 'split-face', and 22 (8%) parallel studies with matched controls. Specific interventions included in the review Studies of first-, second- and third-line treatments for acne were eligible for inclusion in the review. The included studies were of 140 different treatments, which were classified as: cleansers, keratolytics, topical antibacterials, keratolytic/topical antibacterial combinations, topical retinoids, topical antibacterial/retinoid combinations, oral antibacterials, oral antibacterial/keratolytics, oral antibacterial/topical retinoids, oral retinoids, anti-androgens and other. All individual treatments are listed in the review. No single control intervention was specified as an inclusion criterion; 250 different pairwise comparisons were included in the review. Participants included in the review Patients with acne were included in the review. Studies of patients with complicating co-morbidities such as endocrinopathies, and specifically, chloracne, rosacea, acne venanta, acne fulminans and acne necroticans, were excluded. -
)&F1y3x PHARMACEUTICAL APPENDIX to THE
)&f1y3X PHARMACEUTICAL APPENDIX TO THE HARMONIZED TARIFF SCHEDULE )&f1y3X PHARMACEUTICAL APPENDIX TO THE TARIFF SCHEDULE 3 Table 1. This table enumerates products described by International Non-proprietary Names (INN) which shall be entered free of duty under general note 13 to the tariff schedule. The Chemical Abstracts Service (CAS) registry numbers also set forth in this table are included to assist in the identification of the products concerned. For purposes of the tariff schedule, any references to a product enumerated in this table includes such product by whatever name known. Product CAS No. Product CAS No. ABAMECTIN 65195-55-3 ACTODIGIN 36983-69-4 ABANOQUIL 90402-40-7 ADAFENOXATE 82168-26-1 ABCIXIMAB 143653-53-6 ADAMEXINE 54785-02-3 ABECARNIL 111841-85-1 ADAPALENE 106685-40-9 ABITESARTAN 137882-98-5 ADAPROLOL 101479-70-3 ABLUKAST 96566-25-5 ADATANSERIN 127266-56-2 ABUNIDAZOLE 91017-58-2 ADEFOVIR 106941-25-7 ACADESINE 2627-69-2 ADELMIDROL 1675-66-7 ACAMPROSATE 77337-76-9 ADEMETIONINE 17176-17-9 ACAPRAZINE 55485-20-6 ADENOSINE PHOSPHATE 61-19-8 ACARBOSE 56180-94-0 ADIBENDAN 100510-33-6 ACEBROCHOL 514-50-1 ADICILLIN 525-94-0 ACEBURIC ACID 26976-72-7 ADIMOLOL 78459-19-5 ACEBUTOLOL 37517-30-9 ADINAZOLAM 37115-32-5 ACECAINIDE 32795-44-1 ADIPHENINE 64-95-9 ACECARBROMAL 77-66-7 ADIPIODONE 606-17-7 ACECLIDINE 827-61-2 ADITEREN 56066-19-4 ACECLOFENAC 89796-99-6 ADITOPRIM 56066-63-8 ACEDAPSONE 77-46-3 ADOSOPINE 88124-26-9 ACEDIASULFONE SODIUM 127-60-6 ADOZELESIN 110314-48-2 ACEDOBEN 556-08-1 ADRAFINIL 63547-13-7 ACEFLURANOL 80595-73-9 ADRENALONE -
NG198 Evidence Review F2
FINAL Management options for moderate to severe acne – pairwise comparisons GRADE tables for review question: What is the effectiveness and acceptability of interventions for the treatment of moderate to severe acne (side effects and participant reported improvement)? Oral antibiotics Table 5: Clinical evidence profile for comparison of oral antibiotic versus placebo in participants with moderate to severe acne Quality assessment No of patients Effect Importanc Quality e No of Risk of Other Oral Placeb Relative Design Inconsistency Indirectness Imprecision Absolute studies bias considerations antibiotic o (95% CI) Skin irritation - Minocycline versus placebo 11 randomised serious7 no serious no serious very serious8 none 5/119 1/55 RR 2.31 (0.28 to 24 more per 1000 (from 13 ⊕ΟΟΟ CRITICAL trials inconsistency indirectness (4.2%) (1.8%) 19.31) fewer to 333 more) VERY LOW GI side effects 51,2,3,4,5 randomised very serious10 no serious very serious8 none 82/1543 41/1177 RR 1.11 (0.62 to 4 more per 1000 (from 13 ⊕ΟΟΟ CRITICAL trials serious9 indirectness (5.3%) (3.5%) 2) fewer to 35 more) VERY LOW Thrush / candiasis - Sarecyline versus placebo 24,5 randomised serious7 no serious no serious serious11 none 4/994 0/996 Peto OR 7.44 - ⊕⊕ΟΟ CRITICAL trials inconsistency indirectness (0.4%) (0%) (1.05 to 52.86) LOW Patient reported improvement - Tetracycline versus placebo 16 randomised very no serious no serious no serious none 21/29 1/29 RR 21 (3.02 to 690 more per 1000 (from ⊕⊕ΟΟ CRITICAL trials serious9 inconsistency indirectness imprecision (72.4%) (3.4%) 145.98) 70 more to 1000 more) LOW CI: confidence interval; GI: gastrointestinal; POR: peto odds ratio; RR: risk ratio 1 Stewart 2006 Acne vulgaris: evidence reviews for management options for moderate to severe acne – pairwise comparisons FINAL (June 2021) 143 FINAL Management options for moderate to severe acne – pairwise comparisons 2 Dubertret 2003 3 Leyden 2018 4 Moore 2018 (SC1401) 5 Moore 2018 (SC1402) 6 Braathen 1984 7 Overall risk of bias judgement: serious risk of bias. -
General Agreement on Tariffs Andtrade
RESTRICTED GENERAL AGREEMENT TAR/W/87/Rev.1 16 June 1994 ON TARIFFS AND TRADE Limited Distribution (94-1266) Committee on Tariff Concessions HARMONIZED COMMODITY DESCRIPTION AND CODING SYSTEM (Harmonized System) Classification of INN Substances Revision The following communication has been received from the Nomenclature and Classification Directorate of the Customs Co-operation Council in Brussels. On 25 May 1993, we sent you a list of the INN substances whose classification had been discussed and decided by the Harmonized System Committee. At the time, we informed you that the classification of two substances, clobenoside and meclofenoxate, would be decided later. Furthermore, for some of the chemicals given in that list, one of the contracting parties had entered a reservation and the Harmonized System Committee therefore reconsidered its earlier decision in those cases. I am therefore sending you herewith a revised complete list of the classification decisions of the INN substances. In this revised list, two substances have been added and the classifications of two have been revised as explained below: (a) Addition Classification of clobenoside, (subheading 2940.00) and meclofenoxate (subheading 2922.19). (b) Amendment Etafedrine and moxidentin have now been reclassified in subheadings 2939.40 and 2932.29 respectively. The list of INN substances reproduced hereafter is available only in English. TAR/W/87/Rev. 1 Page 2 Classification of INN Substances Agreed by the Harmonized System Committee in April 1993 Revision Description HS Code -
Control of the Formation and the Action of Androgens in Peripherai, Tissues
Cailin Chen Docteur en Médecine Hunan Medical University CONTROL OF THE FORMATION AND THE ACTION OF ANDROGENS IN PERIPHERAI, TISSUES These présentée B la Faculté des études supérieures de 11Universit4Laval pour l'obtention du grade de Philosophiae Doctor (PhD.) Départment de Physiologie (Endocrinologie moléculaire) FACULTÉ DE MÉDECINE UNIVERSITÉ LAVAL QUÉBEC MAI 1996 8 Cailin Chen, 1996 Biblioth ue naaionale du Cana"ei a Acquisitions and Acquisitions et Bibliographie Services services bibliographiques 395 Wellington Street 395. me Wellington MEawaON KlA ON4 OrtewaOkl KtAON4 Caneda Canada The author has granted a non- L'auteur a accordé une licence non exclusive licence ailowing the exclusive permettant a la National Library of Canada to Bibhotheque nationale du Canada de reproduce, loan, distn'bute or seii reproduire, prêter, distribuer ou copies of this thesis in microfonn, vendre des copies de cette thèse sous paper or electronic formats. la forme de microfiche/fdm, de reproduction sur papier ou sur format électronique. The author retains ownership of the L'auteur conserve la propriété du copyright in this thesis. Neither the droit d'auteur qui protège cette thèse. thesis nor substantial extracts fiom it Ni la thèse ni des extraits substantiels may be printed or otherwise de celle-ci ne doivent être imprimés reproduced without the author's ou autrement reproduits sans son permission. autorisation. To: Xun, Chenchen, and My parents L'andtoghe actif 5a-dihydrotestost6rone (Dm joue un r61e prédominant tan physiologique important dans la peau et la prostate. Afin de mieux comprendrd les mécanismes impliqués dans la formation et l'action de la Dïïï, nous avon 4tu&4 la distribution tissulaire de certaines enzymes de la stéroïdogénèse chez 1r hamster et nous avons démontré la psesence des enzymes nécessaires h li biosynthbe de la DHT dans tous les tissus stdroidogéniques et une series dr tissus périphériques. -
Topical Cyproterone Acetate Treatment in Women with Acne a Placebo-Controlled Trial
STUDY Topical Cyproterone Acetate Treatment in Women With Acne A Placebo-Controlled Trial Doris M. Gruber, MD; Michael O. Sator, MD; Elmar A. Joura, MD; Eva Maria Kokoschka, MD; Georg Heinze, MSc; Johannes C. Huber, MD, PhD Objective: To evaluate the clinical and hormonal re- Results: After 3 months of therapy with topical cypro- sponse of topically applied cyproterone acetate, oral cy- terone acetate, the decrease of mean facial acne grade from proterone acetate, and placebo lotion in women with 1.57 to 0.67 was significantly better (P<.05) compared with acne. placebo (which showed a change from 1.57 to 1.25), but not compared with oral medication (1.56 to 0.75) (P >.05). Design: Placebo-controlled, randomized study. Lesion counts also decreased from 35.9 to 9.1 in the topi- cal cyproterone acetate group compared with oral medi- Setting: Patients were recruited from the Institute of En- cation (45.4 to 15.5) (P..05) and placebo (38.2 to 23.1) docrine Cosmetics, Vienna, Austria. (P,.05). After topical cyproterone acetate treatment, se- rum cyproterone acetate concentrations were 10 times lower Patients: Forty women with acne. than those found after oral cyproterone acetate intake. Interventions: Treatment with oral medication con- Conclusions: The therapeutic effect of topically ap- sisting of 0.035 mg of ethinyl estradiol and 2 mg of cy- plied cyproterone acetate for acne treatment was clearly proterone acetate (n=12), 20 mg of topical cyproterone demonstrated. Topically applied sexual steroids in com- acetate lotion (n=12), and placebo lotion (n=16) was of- bination with liposomes are as effective as oral antian- fered. -
A Comprehensive Review of Acne Vulgaris AK Mohiuddin1* 1Department of Pharmacy, World University of Bangladesh
Symbiosis ISSN Online: 2378-1726 www.symbiosisonlinepublishing.com Review Article Clinical Research in Dermatology: Open Access Open Access A Comprehensive Review of Acne Vulgaris AK Mohiuddin1* 1Department of Pharmacy, World University of Bangladesh Received: May 25, 2019; Accepted: June 6, 2019; Published: June 17, 2019 *Corresponding author: AK Mohiuddin, Assistant Professor, Department of Pharmacy, World University of Bangladesh, 151/8, Green Road, Dhanmondi, Dhaka – 1205, Bangladesh. E-mail: [email protected]; Orcid Id: https://orcid.org/0000-0003-1596-9757. Abstract Acne, also known as acne vulgaris (AV), is a long-term skin disease that occurs when hair follicles are clogged with dead skin cells and oil from the skin. It is characterized by blackheads or whiteheads, pimples, oily skin, and possible scarring. An intact stratum corneum and barrier, normal natural moisturizing factor and hyaluronic acid levels, normal Aquaporin-3 (AQP3) expression (localized at the basal lateral membranes of collecting duct cells in the kidney), and balanced sebum secretion are qualities of the skin that fall in the middle of the oily–dry spectrum. Patients rarely, if ever, complain about reduced sebum production, but elevated sebum production, yielding oily skin that can be a precursor to acne, is a common Propionibacterium acnes in adolescence, under the complaint. Several factors are known to influence sebum production. AV is mostly triggered by impact,influence as of sebum normal levels circulating are usually dehydroepiandrosterone low in childhood, rise (DHEA). in the middle-to-late It is a very common teen years, skin disorder and remain which stable can presentinto the withseventh inflammatory and eighth and decades non- untilinflammatory endogenous lesions androgen chiefly synthesis on the face dwindles. -
Pairwise Comparisons
National Institute for Health and Care Excellence Final Acne vulgaris: management [E2] Management options for mild to moderate acne – pairwise comparisons NG198 Evidence review underpinning recommendations 1.5.1, 1.5.2 and 1.5.5 to 1.5.14 (excluding 1.5.6 which is underpinned by evidence review L, 1.5.10 and bullet points 2 and 3 of recommendation 1.5.12 which are underpinned by evidence review F1 and 3 research recommendations in the NICE guideline - see evidence review E1 for the committee’s discussion of the evidence) June 2021 Final These evidence reviews were developed by the National Guideline Alliance which is a part of the Royal College of Obstetricians and Gynaecologists FINAL Error! No text of specified style in document. Disclaimer The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian. Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. -
Federal Register / Vol. 60, No. 80 / Wednesday, April 26, 1995 / Notices DIX to the HTSUS—Continued
20558 Federal Register / Vol. 60, No. 80 / Wednesday, April 26, 1995 / Notices DEPARMENT OF THE TREASURY Services, U.S. Customs Service, 1301 TABLE 1.ÐPHARMACEUTICAL APPEN- Constitution Avenue NW, Washington, DIX TO THE HTSUSÐContinued Customs Service D.C. 20229 at (202) 927±1060. CAS No. Pharmaceutical [T.D. 95±33] Dated: April 14, 1995. 52±78±8 ..................... NORETHANDROLONE. A. W. Tennant, 52±86±8 ..................... HALOPERIDOL. Pharmaceutical Tables 1 and 3 of the Director, Office of Laboratories and Scientific 52±88±0 ..................... ATROPINE METHONITRATE. HTSUS 52±90±4 ..................... CYSTEINE. Services. 53±03±2 ..................... PREDNISONE. 53±06±5 ..................... CORTISONE. AGENCY: Customs Service, Department TABLE 1.ÐPHARMACEUTICAL 53±10±1 ..................... HYDROXYDIONE SODIUM SUCCI- of the Treasury. NATE. APPENDIX TO THE HTSUS 53±16±7 ..................... ESTRONE. ACTION: Listing of the products found in 53±18±9 ..................... BIETASERPINE. Table 1 and Table 3 of the CAS No. Pharmaceutical 53±19±0 ..................... MITOTANE. 53±31±6 ..................... MEDIBAZINE. Pharmaceutical Appendix to the N/A ............................. ACTAGARDIN. 53±33±8 ..................... PARAMETHASONE. Harmonized Tariff Schedule of the N/A ............................. ARDACIN. 53±34±9 ..................... FLUPREDNISOLONE. N/A ............................. BICIROMAB. 53±39±4 ..................... OXANDROLONE. United States of America in Chemical N/A ............................. CELUCLORAL. 53±43±0 -
Acne Protection: Measures and Miseries
Vol 8, Issue 1, 2020 ISSN - 2347-5536 Review Article ACNE PROTECTION: MEASURES AND MISERIES ABDUL KADER MOHIUDDIN* Secretary and Treasurer, Dr. M. Nasirullah Memorial Trust, Tejgaon, Dhaka 1215, Bangladesh. Email: [email protected] Received: 14 October 2019, Revised and Accepted: 23 December 2019 ABSTRACT Acne, also known as acne vulgaris (AV), is a long-term skin disease that occurs when hair follicles are clogged with dead skin cells and oil from the skin. It is characterized by blackheads or whiteheads, pimples, oily skin, and possible scarring. An intact stratum corneum and barrier, normal natural moisturizing factor and hyaluronic acid levels, normal Aquaporin-3 expression (localized at the basal lateral membranes of collecting duct cells in the kidney), and balanced sebum secretion are qualities of the skin that fall in the middle of the oily-dry spectrum. Patients rarely, if ever, complain about reduced sebum production, but elevated sebum production, yielding oily skin that can be a precursor to acne, is a common complaint. Several factors are known to influence sebum production. AV is mostly triggered by Propionibacterium acnes in adolescence, under the influence of normal circulating dehydroepiandrosterone (DHEA). It is a very common skin disorder which can present with inflammatory and non-inflammatory lesions chiefly on the face but can also occur on the upper arms, trunk, and back. Age, in particular, has a significant and well-known impact, as sebum levels are usually low in childhood, rise in the middle to late teen years, and remain stable into the seventh and eighth decades until endogenous androgen synthesis dwindles. -
NG198 Evidence Review F1
FINAL Management options for people with moderate to severe acne vulgaris - network meta-analyses Clinical studies The excluded studies list below relates to all evidence reviews that used the same search output and these are studies that are excluded from all of the following reviews: mild-to- moderate NMA, moderate-to-severe NMA, mild-to-moderate pairwise and moderate-to- severe pairwise reports, as well as from refractory acne, maintenance of acne and polycystic ovary syndrome reports. Table 24: Excluded clinical studies and reasons for their exclusion Reference Reason for exclusion Abbasi, M. A. K., A., Aziz ur, Rehman, Saleem, H.,Jahangir, S. No relevant study M.,Siddiqui, S. Z.,Ahmad, V. U.Preparation of new formulations of population - sample anti-acne creams and their efficacy. 2010. African Journal of includes people with mild Pharmacy and Pharmacology to severe acne and study is not relevant for PCOS, maintenance or refractory treatments Abdel Hay, R. H., R.,Abdel Hady, M.,Saleh, N.Clinical and Reported outcomes dermoscopic evaluation of combined (salicylic acid 20% and azelaic relevant for the network acid 20%) versus trichloroacetic acid 25% chemical peel in acne: an meta-analysis but not in RCT. 2019. Journal of Dermatological Treatment enough detail to include in the analysis. Outcomes were not relevant for pairwise comparisons - including PCOS, maintenance and refractory treatments Abdel Meguid, A. M. A. E. A. A., D.,Omar, H.Trichloroacetic acid Reported outcomes versus salicylic acid in the treatment of acne vulgaris in dark-skinned relevant for the network patients. 2015. Dermatologic Surgery meta-analysis but not in enough detail to include in the analysis. -
(12) Patent Application Publication (10) Pub. No.: US 2003/0068365A1 Suvanprakorn Et Al
US 2003.0068365A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2003/0068365A1 Suvanprakorn et al. (43) Pub. Date: Apr. 10, 2003 (54) COMPOSITIONS AND METHODS FOR Related U.S. Application Data ADMINISTRATION OF ACTIVE AGENTS USING LIPOSOME BEADS (60) Provisional application No. 60/327,643, filed on Oct. 5, 2001. (76) Inventors: Pichit Suvanprakorn, Bangkok (TH); Tanusin Ploysangam, Bangkok (TH); Publication Classification Lerson Tanasugarn, Bangkok (TH); Suwalee Chandrkrachang, Bangkok (51) Int. Cl." .......................... A61K 9/127; A61K 35/78 (TH); Nardo Zaias, Miami Beach, FL (52) U.S. Cl. ............................................ 424/450; 424/725 (US) (57) ABSTRACT Correspondence Address: Law Office of Eric G. Masamori Compositions and methods for administration of active 6520 Ridgewood Drive agents encapsulated within liposome beads to enable a wider Castro Valley, CA 94.552 (US) range of delivery vehicles, to provide longer product shelf life, to allow multiple active agents within the composition, (21) Appl. No.: 10/264,205 to allow the controlled use of the active agents, to provide protected and designable release features and to provide (22) Filed: Oct. 3, 2002 Visual inspection for damage and inconsistency. US 2003/0068365A1 Apr. 10, 2003 COMPOSITIONS AND METHODS FOR toxic degradation of the products, leakage of the drug from ADMINISTRATION OF ACTIVE AGENTS USING the liposome and the modifications of the Size and morphol LPOSOME BEADS ogy of the phospholipid liposome vesicles through aggre gation and fusion. Liposome vesicles are known to be CROSS REFERENCE TO OTHER thermodynamically relatively unstable at room temperature APPLICATIONS and can Spontaneously fuse into larger, leSS Stable altered liposome forms.