#dermJC Transcript
Healthcare social media transcript of the #dermJC hashtag.
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See #dermJC Influencers/Analytics.
| Profile | Tweet |
|---|---|
 | Dermatology Journal Club @DermatologyJC Welcome everyone to #dermjc! Just a reminder, our paper is here: https://t.co/uMtOhLhIfx And some thoughts from our @NephJC #nephjc colleagues: https://t.co/kSTixtk1q2 |
| Dermatology Journal Club @DermatologyJC Feel free to introduce yourself (even if lurking) and mention any financial COI. Please use #dermjc on all tweets so we can follow along! |
| Dermatology Journal Club @DermatologyJC Just a reminder that we LOVE having input from trainees and medical students! #dermjc |
 | Roxana Daneshjou MD/PhD @RoxanaDaneshjou @DermatologyJC Roxana, derm resident! #dermjc COI in profile, not related to this paper. |
| Dermatology Journal Club @DermatologyJC Q1: How do you currently approach uremic pruritus? #dermjc |
| Dermatology Journal Club @DermatologyJC For any nephrologists who might be around, this paper mentions 20% to 40% of patients undergoing hemodialysis experience moderate to severe pruritus. How often do you involve dermatology? #dermjc #nephjc |
 | Swapnil Hiremath @hswapnil@bsky.social @hswapnil Swapnil Hiremath #NephJC cofounder from @OttawaRenal Sorry late to the party! Pic from @rolandbastphoto #DermJC https://t.co/jK4NI2Gd4E |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @DermatologyJC Moisturizers Gentle soap Optimize uremic numbers Then Gabapentin or rarely antihistamines #DermJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @DermatologyJC Very rarely - in Canada wait times for Dermatology consults is many months Usually involve if we suspect some nefarious stuff like perforating dermatoses etc #DermJc |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @DermatologyJC: Welcome everyone to #dermjc! Just a reminder, our paper is here: Welcome everyone to #dermjc! Just a reminder, our paper is here: https://t.co/uMtOhLhIfx And some thoughts from our @NephJC #nephjc colleagues: https://t.co/kSTixtk1q2 |
| Dermatology Journal Club @DermatologyJC KALM-1 was a randomized, double-blind, placebo-controlled, phase 3 trial that was conducted at 56 sites in the United States. Patients were on HD TID for at least 3 months and had moderate to severe pruritus. #dermjc |
 | Nephrology Journal Club @NephJC Happening now! #DermJC |
| Dermatology Journal Club @DermatologyJC A total of 378 patients underwent randomization. A total of 82 of 158 patients (51.9%) in the difelikefalin group had a decrease of at least 3 points in the WI-NRS score (primary outcome), as compared with 51 of 165 (30.9%) in the placebo group. #dermjc |
| Dermatology Journal Club @DermatologyJC Difelikefalin (CR845) is a peripherally restricted, selective kappa opioid receptor agonist that exerts antipruritic effects by means of activation of kappa opioid receptors on peripheral neurons and immune cells. #dermjc |
| Dermatology Journal Club @DermatologyJC The hydrophilic small-peptide structure restricts passive diffusion across membranes, thereby limiting access to kappa opioid receptors in the central nervous system. #dermjc |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @DermatologyJC My senior colleague @petermagner2 suggests a mixture of - camphor + menthol + hydrocortisone which we ask pharmacists to mix up Seems to help some #DermJC |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @hswapnil @DermatologyJC Woah! We definitely have had some cases referred here to derm in the States. We even had a case where the patient had scabies, and that’s actually why they were itchy! #dermjc |
| Dermatology Journal Club @DermatologyJC RT @hswapnil: @DermatologyJC My senior colleague @petermagner2 suggests a mixture of - camphor + menthol + hydrocortisone which we ask pharmacists to mix up Seems to help some #DermJC |
| Dermatology Journal Club @DermatologyJC RT @hswapnil: @DermatologyJC Very rarely - in Canada wait times for Dermatology consults is many months Usually involve if we suspect some nefarious stuff like perforating dermatoses etc #DermJc |
| Dermatology Journal Club @DermatologyJC RT @RoxanaDaneshjou: @hswapnil @DermatologyJC Woah! We definitely have had some cases referred here to derm in the States. We even had a case where the patient had scabies, and that’s actually why they were itchy! #dermjc |
| Dermatology Journal Club @DermatologyJC Q2: How do you feel about the study demographics? Representative? #dermjc https://t.co/HoI27403Yj |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @hswapnil @DermatologyJC @petermagner2 I always tell patients to put any camphor based creams in the fridge, helps with that cooling sensation. #dermjc |
| Dermatology Journal Club @DermatologyJC RT @RoxanaDaneshjou: @hswapnil @DermatologyJC @petermagner2 I always tell patients to put any camphor based creams in the fridge, helps with that cooling sensation. #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou RT @DermatologyJC: For any nephrologists who might be around, this paper mentions 20% to 40% of patients undergoing hemodialysis experience moderate to severe pruritus. How often do you involve dermatology? #dermjc #nephjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @DermatologyJC I don’t think I realized until I started derm residency just how debilitating pruritus or itch can be. I believe @DrStevenTChen told a great story last year @AADskin about helping a patient! #dermjc |
 | Nissreen Elfadawy MD, MS, FASN, FAST @ElfadawyN Hello All, Nissreen - nephrologist from CLEVELAND and #nephjc fan. Glad to catch up #DermJC |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @hswapnil @DermatologyJC @petermagner2 We have also use narrowband UVB, which has few negative side effects for uremic pruritus. Big downside is needing to come in 3 times a week. Patients already overburdened with appointments. #dermjc https://t.co/bnA6IaFT8d |
 | John Barbieri, MD, MBA @DrJohnBarbieri John Barbieri from @PennMedicine. No COI. #dermjc |
| John Barbieri, MD, MBA @DrJohnBarbieri This study made me wonder if something like naltrexone might be a helpful option as well #dermjc |
| Dermatology Journal Club @DermatologyJC Q3: How do you feel about the improvement in itch? #dermjc https://t.co/ySBnuRDQ7O |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @RoxanaDaneshjou: @hswapnil @DermatologyJC @petermagner2 We have also use narrowband UVB, which has few negative side effects for uremic pruritus. Big downside is needing to come in 3 times a week. Patients already overburdened with appointments. #dermjc https://t.co/bnA6IaFT8d |
| John Barbieri, MD, MBA @DrJohnBarbieri @RoxanaDaneshjou @hswapnil @DermatologyJC @petermagner2 I find nbUVB works very well. Logistics can be challenging, but home phototherapy is a potential approach #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou Does anyone know how much difelikefalin will cost? #dermjc |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @RoxanaDaneshjou @DermatologyJC @DrStevenTChen @AADskin This is the most powerful story I have read, from the inimitable @atulgawande https://t.co/no800i1PYa #DermJC https://t.co/tQ2UpFp7wC |
| Dermatology Journal Club @DermatologyJC RT @RoxanaDaneshjou: @DermatologyJC I don’t think I realized until I started derm residency just how debilitating pruritus or itch can be. I believe @DrStevenTChen told a great story last year @AADskin about helping a patient! #dermjc |
| Dermatology Journal Club @DermatologyJC RT @hswapnil: @RoxanaDaneshjou @DermatologyJC @DrStevenTChen @AADskin This is the most powerful story I have read, from the inimitable @atulgawande https://t.co/no800i1PYa #DermJC https://t.co/tQ2UpFp7wC |
| Dermatology Journal Club @DermatologyJC RT @DrJohnBarbieri: @RoxanaDaneshjou @hswapnil @DermatologyJC @petermagner2 I find nbUVB works very well. Logistics can be challenging, but home phototherapy is a potential approach #dermjc |
| Dermatology Journal Club @DermatologyJC RT @DrJohnBarbieri: This study made me wonder if something like naltrexone might be a helpful option as well #dermjc |
| Dermatology Journal Club @DermatologyJC RT @RoxanaDaneshjou: Does anyone know how much difelikefalin will cost? #dermjc |
| Dermatology Journal Club @DermatologyJC Mean change in worst itching. Q4: What do you think about the placebo results here? #dermjc https://t.co/khwfOzMdgD |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @RoxanaDaneshjou Not yet It has a brand name (Korsuva) Probably will be $$$ #DermJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @DermatologyJC Regression to mean? Some placebo effect? Hawthorne effect? Or as @Nephro_Sparks sez, if they keep making you fill out a scale, maybe you say things are better? #DermJC |
| John Barbieri, MD, MBA @DrJohnBarbieri @DermatologyJC The effect sizes seemed pretty meaningful to me. ~20-30% absolute difference in achieving >3 point improvement approaches what I’ve seen in dupilumab trials for atopic dermatitis #dermjc |
| John Barbieri, MD, MBA @DrJohnBarbieri @hswapnil @DermatologyJC @Nephro_Sparks I think that can be side effect of the inclusion criteria. By trying to recruit more severe patients, many will improve just with time. Similar issues arise in acne, psoriasis, and atopic dermatitis trials. #dermjc |
| Dermatology Journal Club @DermatologyJC sorry, wrong table. #dermjc https://t.co/5Ah65gFSPL https://t.co/9iNKGcays0 |
| Dermatology Journal Club @DermatologyJC RT @hswapnil: @DermatologyJC Regression to mean? Some placebo effect? Hawthorne effect? Or as @Nephro_Sparks sez, if they keep making you fill out a scale, maybe you say things are better? #DermJC |
| Dermatology Journal Club @DermatologyJC RT @DrJohnBarbieri: @DermatologyJC The effect sizes seemed pretty meaningful to me. ~20-30% absolute difference in achieving >3 point improvement approaches what I’ve seen in dupilumab trials for atopic dermatitis #dermjc |
| Dermatology Journal Club @DermatologyJC RT @DrJohnBarbieri: @hswapnil @DermatologyJC @Nephro_Sparks I think that can be side effect of the inclusion criteria. By trying to recruit more severe patients, many will improve just with time. Similar issues arise in acne, psoriasis, and atopic dermatitis trials. #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @hswapnil That's what I was afraid of. That it'll help but our patients won't be able to afford it. #dermjc |
 | Fadua Besil Eguia @Faduabe RT @DermatologyJC: For any nephrologists who might be around, this paper mentions 20% to 40% of patients undergoing hemodialysis experience moderate to severe pruritus. How often do you involve dermatology? #dermjc #nephjc |
| John Barbieri, MD, MBA @DrJohnBarbieri @RoxanaDaneshjou @hswapnil At least it is a new mechanism and eventually will become less expensive (even if it will be $$$ initially). I’d rather we develop these kind of medications than yet another topical retinoid preparation. #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @DrJohnBarbieri @hswapnil @DermatologyJC @Nephro_Sparks Interesting! Was also wondering if there was some placebo effect since itch is so much about how you perceive it. I hate having bug bites, especially at night. #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @DrJohnBarbieri @hswapnil @DermatologyJC @Nephro_Sparks As an aside, if thinking about itch makes you itchy, does filling out an itch questionnaire make you feel itchier? Has anyone looked at that before? #dermjc |
| Roxana Daneshjou MD/PhD @RoxanaDaneshjou @DrJohnBarbieri @hswapnil Agreed! This is an area with a huge need. #dermjc |
| Dermatology Journal Club @DermatologyJC Q5: Thoughts on adverse events? #dermjc https://t.co/RP2JEwM7dw |
| Fadua Besil Eguia @Faduabe RT @DermatologyJC: Welcome everyone to #dermjc! Just a reminder, our paper is here: Welcome everyone to #dermjc! Just a reminder, our paper is here: https://t.co/uMtOhLhIfx And some thoughts from our @NephJC #nephjc colleagues: https://t.co/kSTixtk1q2 |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @DrJohnBarbieri: @RoxanaDaneshjou @hswapnil At least it is a new mechanism and eventually will become less expensive (even if it will be $$$ initially). I’d rather we develop these kind of medications than yet another topical retinoid preparation. #dermjc |
| John Barbieri, MD, MBA @DrJohnBarbieri There is also a similar drug available in Japan, nalfurafine https://t.co/z6hcYiSntk #dermjc |
| Dermatology Journal Club @DermatologyJC RT @RoxanaDaneshjou: @DrJohnBarbieri @hswapnil @DermatologyJC @Nephro_Sparks Interesting! Was also wondering if there was some placebo effect since itch is so much about how you perceive it. I hate having bug bites, especially at night. #dermjc |
| Dermatology Journal Club @DermatologyJC RT @RoxanaDaneshjou: @DrJohnBarbieri @hswapnil @DermatologyJC @Nephro_Sparks As an aside, if thinking about itch makes you itchy, does filling out an itch questionnaire make you feel itchier? Has anyone looked at that before? #dermjc |
| Dermatology Journal Club @DermatologyJC RT @DrJohnBarbieri: There is also a similar drug available in Japan, nalfurafine https://t.co/z6hcYiSntk #dermjc |
 | Leo Shmuylovich, MD PhD @leoshmu @DrJohnBarbieri @hswapnil @DermatologyJC @Nephro_Sparks And to be clear, it was @itchdoctor himself that did the teaching:) #dermjc |
| Dermatology Journal Club @DermatologyJC RT @leoshmu: @DrJohnBarbieri @hswapnil @DermatologyJC @Nephro_Sparks And to be clear, it was @itchdoctor himself that did the teaching:) #dermjc |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @leoshmu @DrJohnBarbieri @DermatologyJC @Nephro_Sparks @itchdoctor That’s classic Hawthorne effect! #DermJC |
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