PA14 Spironolactone for the treatment of acne vulgaris affecting female patients aged 18 years and under: results from a UK and Irish survey
Notice bibliographique
Résumé
Abstract Acne vulgaris (acne) is a common condition that causes psychological and social morbidity, with peak prevalence from 15 to 20 years (Layton AM, Ravenscroft J. Adolescent acne vulgaris: current and emerging treatments. Lancet Child Adolesc Health 2023; 7: 136–44). Spironolactone is effective for acne in adult women [Santer M, Lawrence M, Renz S et al. Effectiveness of spironolactone for women with acne vulgaris (SAFA) in England and Wales: pragmatic, multicentre, phase 3, double blind, randomised controlled trial. BMJ 2023; 381: e074349]. Our aim was to establish current practice of healthcare practitioners prescribing spironolactone for adult women and those aged < 18 years, and to determine safety concerns to inform a future clinical trial. A 39-question survey was sent to dermatology healthcare professionals through the UK Dermatology Clinical Trials Network (UKDCTN), the British Society for Paediatric and Adolescent Dermatologists (BSPAD), the Irish Association of Dermatologists (IAD) and regional groups. It was open for 6 weeks (December 2024 to January 2025). In total, 116 responses were received from doctors, nurses and pharmacists (82% from the UK and 18% from the Republic of Ireland). Of these, 66% had > 6 years of clinical experience treating skin conditions in patients aged ≤ 18 years. Of the 91% who had prescribed spironolactone for adult women nearly all found it effective (61% somewhat effective, 37% very effective). Prescribing uncertainties for adult patients include duration (48%), weaning and stopping (44%), monitoring requirements (28%) and dose (21%). Over one-third (n = 43, 37%) had prescribed spironolactone for female patients aged ≤ 18 years, almost exclusively for adolescents aged > 11 years (98%). Dosing, baseline blood tests, monitoring renal function, and uptitrating the dose varied. Nearly half (44%) prescribed 50 mg once daily, with most (72%) uptitrating the dose. Overall, 70% check baseline bloods and 60% monitor bloods. Advice provided regarding contraception varied. Safety concerns among those prescribing for patients aged < 18 years included teratogenicity. Of those prescribing for patients aged < 18 years, 5% described spironolactone as not at all effective, 59% slightly or moderately effective, and 14% very or extremely effective, while 5% were unsure. Side-effects reported included postural hypotension, headaches, menstrual irregularities and polyuria. Nearly all thought it would be helpful to investigate spironolactone use for female patients aged ≤ 18 years (92%, 105 of 114). This survey shows variation in clinical practice treating acne with spironolactone. Nearly all respondents reported some effectiveness in adults, but there was less certainty in those aged ≤ 18 years, although the number of respondents was smaller. The main safety concerns were regarding fertility, teratogenicity, hormonal implications and lack of long-term data. L.O. and Z.M. are first coauthors.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».