The Organizing Committee for Iasi Dermatological Spring 2019 wishes to thank the following partners in the pharmaceutical industry for their support in organizing the event:

Biologic therapies with focus on ustekinumab: global data from clinical studies and patient registries
Speaker: Daciana Brănișteanu

The recently updated British Association of Dermatologists guideline for biologic therapies in psoriasis, widely used by dermatologists around the world, recommends adalimumab and ustekinumab as first-line biologic therapies (along with secukinumab) and relegates etanercept to use as a second-line biologic therapy (Smith et al., 2017). This decision was based predominantly on evidence for efficacy from clinical trials (Jabbar-Lopez et al., 2017).
Treatment with ustekinumab every 12 weeks is effective for most patients with moderate-to-severe psoriasis PHOENIX 2.
Through 5 years of continuous treatment, ustekinumab demonstrated stable clinical response and a safety profile consistent with previous reports. PHOENIX 1.
Lack of effectiveness was the most common reason for discontinuation across biologic therapies. Drug survival was superior for ustekinumab compared with infliximab, adalimumab and etanercept in patients with psoriasis. PSOLAR.
No statistically significant increases in the risk of serious infection for any biologic therapy versus non-biologic systemic therapies in patients with psoriasis. BADBIR.
Biologic therapies are associated with a lower rate of discontinuation-related AEs than are classic therapies in real clinical practice. Ustekinumab showed the lowest incidence. Biobadaderm Project.
As a conclusion, the attributes that most patients found to be most important or relevant to their preferred regimen included the risk of SAEs, the duration of response, and the route and frequency of administration. “The Protimisis” study 2017.

From global data to local practice, focus on ustekinumab: clinical cases
Speaker: Carmen Curea

Psoriasis has substantial negative impact on the life course of affected patients. However, their quality of life is also considerably influenced by the treatment prescribed. Clinical Report Acta Derm Venereol 2015 Patients’ medication satisfaction is an important element of overall treatment experience.
A study of 213 estimated patient satisfaction on ustekinumab (UST) treatment compared with prior biologic therapy when used in the treatment of moderate-to-severe plaque PsO revealed that Global treatment satisfaction scores, including indices of Effectiveness and Convenience, were higher for patients on UST compared with prior biologic treatment.
Improvements in satisfaction between prior treatment and UST were significant for each of the 3 indices (p<0.001). There were no significant interactions or differences in satisfaction with time on treatment. Optimising satisfaction is essential to improve adherence and outcome. In 200 patients examined under real-life clinical conditions with validated scores, we show high preferences for biologicals, particularly ustekinumab, but also a good satisfaction with certain traditional medications. Remarkably, 93.5% of the participants experienced with biologicals considered these medications as their best treatment ever. Again, ustekinumab was ranked best, followed by golimumab, infliximab and adalimumab.and may be attributed to the high efficacy, favourable risk-benefit profile and convenient application mode of biologicals
Clinical Report Acta Derm Venereol 2015:
Real life clinical experience with ustekinumab in pso patients:
Multivariate analysis controlling for age, gender, disease severity, disease duration and number of previous systemic therapies confirmed greater satisfaction with biologicals compared to mere topical therapy, phototherapy, or traditional systemic therapy.

A&D Pharma

Melascreen – Prevention and treatment of hyperpigmentation and photo-aging
Speaker: Sanda Mirela Cherciu

Melanin, the main pigment responsible for coloring of the skin, hair and eyes is present into the skin, in various quantities, depending on the skin phototype. Melanin quantity is increasing as an protection answer to the harmful actions of UV rays.
Hyperpigmentation is very common, affecting more than 90% of women, Photo-aging, as hyperpigmentation, affects women in particular, being the most important factor in the aging of the skin. UV rays affects cellular DNA and are generating increased amounts of oxidizing compounds that initiate histological and clinical changes of the skin, Ducray Dermatological Laboratories have created the Melascreen Range, which contains dedicated products to the care of photo-aging, acnetic lentigo and pigmentation spots (melasma, chloasma).
The Melascreen range includes 8 products, representing a complete care program, which:
• PROTECTS against photo-aging: Melascreen UV SPF50 +
o these products prevent the harmful effects of UV rays on the skin
• IMPROVES THE UNPLEASANT ASPECT of localized brown spots: Melascreen depigmenting cream
o helps to reduce hyperpigmentation spots and provides brightness to localized pigmentation areas
• UNIFORMS the skin: Melascreen Eclat products
o uniformizes the color of the skin, has anti-oxidizing action and moisturizes
• • CORRECTION of the browns: Melascreen Hand Cream, Melascreeen Global Serum and Melascreen Night Cream
o it acts against photo-aging and moisturizes.
Melascreen products contains active reference depigmentation ingredients (including azelaic acid used in medicines), precisely dosed, for increased efficacy.
Clinical studies support the action of Melascreen products on melasma and lentigo.

Speaker: Daciana Brănișteanu

The sun brings benefits to the skin, it synthetizes Vitamin D and creates well-being. The sun can also have negative effects on the body not only on short term, like sun burns and insolation, but also on long term, being caused by the prolonged exposure to the sun, without using sun protection products, according to the skin type. Thus, we may add to the list DNA lesions, which can lead to skin cancer.
Photo-aging represents another effect of chronical sun exposure, without using sun protection products, the UVA rays distroy collagen and elastin fibers. The consequence is that the skin structure is affected.
Eau Thermale Avène Sun care range comes to the aid of the skin need, with new technologies:
 SWOPTM technology (present in the Sun care products dedicated to children) – represents the transformation of the oily phase to the emollient phase, during the application. The result is that we have an easy application and a higher sun care protection.
 Nude Skin (present in all the Sun care range) – represents the association of 2 active ingredients, ensuring the absorbtion of not only perspiration, but also of the sebum
Eau Thermale Avène Sun care range brings novelties in 2019:
 Sport Fluid SPF50+, dedicated to sports persons, ensuring very high sun protection, being, also, very resistant to water and perspiration
 B-Protect SPF50+, especially developed for sun protection in urban areas. The 3 in 1 formula of this product had anti-UV, anti-pollution action, ensuring, at the same time, a radiant complexion
In the Eau Thermale Avène Sun care range, we also have a class I medical device – Sunsimed, which offers a very broad UVA – UVB protection spectrum, ensuring efficacy, safety and high degree of tolerance.
The usage of Sunsimed represents and excellent DNA protection mechanism, in case of repeated solar iradiation. SUSNSIMED prevents actinic keratosis, skin cancer (except melanoma) and photo-aging.

Let’s think beyond clinical indicators of skin clearance
Speakers: Prof. Daciana Elena Brănișteanu, Dr. Carmen Curea

For moderate to severe psoriasis, scientific evidence show a significant burden of the disease, which is connected not only with the signs and symptoms of psoriasis, but also with emotional, psychosocial and functional elements that are corelated with the ”noticeability” specific to dermatological diseases and with the localisation in hard-to-treat areas (scalp, nails, palmo-plantar, genital).
Also, we know from medical literature that achieving complete/almost complete skin clearance generates an increase in the QoL of the patients and DLQI score continues to improve beyond PASI 75. That is why, achieving a complete skin clearance status diminishes the burden of the disease for these patients and has favourable implications at all levels. These are reasons for setting elevated treatment goals and for choosing therapies that allow achieving complete skin clearance and improvement of hard-to-treat areas for patients with psoriasis.
Prior to biological therapies for psoriasis, achieving elevated treatment goals like PASI 90 or PASI 100 was difficult to achieve and sustain in daily clinical practice. Nowadays, there are different biological therapies, with distinct MoAs, that can induce a complete/almost complete skin clearance and the evaluation of their efficacy can be measured by using scores like PASI, PSSI, PPASI or NAPSI.
IL-17A inhibitors represent a new therapeutical class which targets specifically the physiopatological responses of psoriasis and offers a high therapeutic efficacy, with a rapid onset of action and maintenance of response in time. Ixekizumab has demonstrated through it’s clinical studies and from the results in daily clinical practice (real life results) that it can offer high efficacy for the majority of patients with moderate to severe psoriasis and inhibition on psoriasis in hard-to-treat areas.

Dupilumab: A new standard in the treatment of moderate to severe atopic dermatitis
Speaker: Prof. Dr. Daciana Brănişteanu

Atopic Dermatitis (AD) is a serious disease affecting both children and adults. AD is a chronic systemic inflammatory disease and not only an intermittent skin disease as previously thought. Non-lesional (normal looking) skin is not normal skin due to a persistent underlying inflammation. IL 4 and IL13, as part of the Type 2/Th2 pathway, are key cytokines in AD pathophysiology. Dupilumab is the first therapy in AD that provides continuous, long term and safe disease control by targeting 2 key cytokines of underlying inflammation. Unique mechanism of action that inhibits the dual signalling of IL4 and IL13. Consistent, rapid and sustained long-term efficacy on signs and symptoms, as seen on lesion extent and severity pruritus intensity, quality of life, including sleep, anxiety and depression. Strong safety and tolerability profile with an overall rate of adverse events comparable to placebo and no laboratory monitoring required.

Speaker: R.F. Popa

The history of deep vein thrombosis increases the risk of chronic venous insufficiency by 25.7 times. Treatment with glycosaminoglycans, for example Vessel Due F, considered a natural precursor of glycocalix, 80% heparan sulphate glycosaminoglycan and 20% dermatan sulfate, can restore and maintain the integrity of endothelial glycocalix. Vessel Due F reduces vascular inflammation, decreases plasma thrombogenic properties and stops the progression of the disease. Patients should be kept on the original biological product, Vessel Due F initiated by the specialist as much as possible if they respond well in terms of therapeutic efficacy and safety. Being a biological product, it has a complex action at both micro and macrovascular level. In 2018, the European Venous Forum, the International Union of Angiology, the International Phlebology Union and the National Guide for Chronic Venous Disease recommend Vessel Due F starting with mild stage of the disease due to action in the endothelium and pleiotrops effects. Very important is the level of high-grade evidence (A) for complete healing of the ulcers in combination with elastic compression. In prevention, Vessel Due F plays an important role in reducing the risk of recurrence of unprovoked deep vein thrombosis. The clinical implications of the results of the SURVET study confirm the benefits of extended Vessel Due F treatment in patients with unprovoked deep vein thrombosis to reduce the risk of recurrence and the low risk of bleeding similar to placebo.
Keywords: original biological product, recurrence of deep vein thrombosis, prevent progression of the disease.

Innovative sun care – infrared and visible light photoprotection
Authors: E. Trznadel-Grodzka MD, PhD, S.Grzegorzewska PhD, K. Bazela PhD
Speaker: K. Bazela PhD, Research and Development Institute Biogened, Dermedic, Poland

Introduction: In the past few years it was demonstrated that electromagnetic radiation in the UV, visible and infrared ranges all produce biologic effects. For this reason, safe and effective sun care products should provide protection against exposure to the entire solar spectrum. Ultraviolet filters have been well established to be effective against the adverse effects of ultraviolet radiation, while antioxidants are believed to provide additional modalities for protection against the effects of visible light and infrared radiation.
Materials and methods: The presentation shows safety and efficacy tests of sun care products created according to the concept of broad-spectrum protection.
Results: In the first stage innovative formulas based on UV filters and additional active substances, including antioxidants have been created. In vitro studies proved the efficacy of actives on key pathways involved in the generation of damage caused by infrared and visible light exposure (e.g. inhibition of cytokines and inflammatory mediators production (IL-1α, IL-6, TNFα, PGE2, COX-2), stimulation of antioxidant enzymes activity and collagen biosynthesis). Then, the efficacy of broad-spectrum protection was demonstrated. UVB and UVA protection factors were evaluated in accordance with ISO methods. The effects of product application on the temperature of skin surface exposed to infrared radiation was studied (the average increase measured on cream protected skin was 0.8C lower than on unprotected skin). Finally, products safety and application properties were confirmed on the volunteers’ skin.
Conclusion: In modern cosmetology, a scientific approach is essential to create effective sun care products. Nevertheless, further studies and standardized methods are needed to provide consumers’ protection, in particular with regard to visible light and infrared radiation.

CICADERM Regenerator Spray with Mimosa Tenuiflora – a new option for healing of lesions with loss of substance on large surfaces or hardly accessible areas
Speaker: Daciana Brănișteanu

CICADERM Spray absorbs exudate and quickly heals the skin.
CICADERM Spray with enriched content in Mimosa Tenuiflora, and new active ingredients, as well as a new administration vehicle – bottle spray, enlarges the area of indications to extensive post dermatocosmetic procedures lesions or lesions with loss of substance, with maceration areas, in hard-to-reach areas where creams are difficult to be applied.
Mimosa Tenuiflora is a natural ingredient, extracted from the “skin tree”, known from ancient practices. Introduced in dermatocosmetic preparations, it intervenes in all four phases of wound healing with a complex mechanism of action: it produces haemostasis, reduces inflammation, stimulates cell proliferation, accelerates skin reconstruction.
Mimosa Tenuiflora as well as the addition of new active ingredients with astringent, siccative, and antiseptic properties (Smectite, Cu and Zn Sulfate) and Herculane Thermal Water, with proven anti-inflammatory effect, provide remarkable results for CICADERM Spray.
The study demonstrates an increased efficacy in accelerating healing, without risk of scar formation, in the following indications: post-excisional lesions (electrocautery, electroexcision), post dermatocosmetic procedures (chemical peeling, microneedling), as well as the wide cosmetic acceptability reported by the enrolled patients.

Hyperpigmentation – the unique expertise for a spotless result
Speaker: Dana Andreea Molodoi

Hyperpigmentation is a disorder of the natural process, leading to excessive accumulation of melanin at the surface of the skin, which is shown by the appearance of brown spots. Hyperpigmentation affects 90% of women, mostly with phototypes III or IV. The manifestations can vary depending on the trigger factors: melasma, actinic lentigo, senile lentigo, PIH. The new hyperpigmentation expertise proposes a dermatologically-cosmetic alternative to a reference molecule, based on three new mechanisms that affects the normal pigmentation process: palmo-plantar pigmentation, vascularization and blue light. Recent research on the complex causes of hyperpigmentation has led to the creation of a patented synergistically active complex, DEPI-ACT COMPLEX, which acts before, during and after melanin synthesis. DEPI-ACT associates WNT inhibitor, diacetyl boldin, pure licorice extract and niacinamide with synergistic action in the melanogenesis process. Likewise, a major role in the appearance of hyperpigmentation is the exposure to ultraviolet radiation and blue light that favors oxidative stress and stimulates melanin synthesis. The new therapeutic approach associates UVA / UVB filters with fractionated melanin to inhibit melanin synthesis. The excellent clinical results have demonstrated that the association of active ingredients is an innovative and effective solution in the therapeutic treatment of hyperpigmentation, also having optimal tolerance for all types of hyperpigmentation, for all patients (including pregnant women or breast-feeding) and at the same time recover the skin homeostasis.

Contact PDI 2019's PCO

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PCO of PDI 2019

Address: A. Panu St. no. 13, Iasi
Tel.: +40 332.40.88.00-05