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Company
Myung In’s Parkinson’s Tx demonstrates efficacy
by
Dec 20, 2021 06:12am
A Parkinson’s disease treatment that Myung In Pharm has acquired an exclusive licensing agreement from an Israeli pharmaceutical company - 'P2B001 (Fixed-dose combination of pramipexole+rasagiline)’ – has demonstrated its safety and efficacy at a global Phase III clinical trial. According to the topline results announced by the Israeli pharmaceutical company Pharma Two B Ltd. (P2B), P2B001 successfully met its primary and key secondary endpoints and demonstrated statistically significant benefit over existing treatments. A total of 544 patients with early-stage Parkinson's disease in 70 centers in the US, Europe, and Canada were randomized to four treatment arms: P2B001 (pramipexole 0.6mg + rasagiline 0.75mg combination); pramipexole ER capsule (pramipexole 0.6 mg); rasagiline ER capsule (rasagiline 0.75mg); and the currently marketed pramipexole ER capsules titrated to an optimal dose for each individual. Patients in each treatment arm were administered their respective dose once a day for 12 weeks. The primary endpoint was the change in the total Unified Parkinson's Disease Rating Scale (UPDRS, defined as the sum of parts II and III) for P2B001 as compared to each of its components over 12 weeks. Results showed that P2B001 improved the total UPDRS score by 2.66 points compared to the pramipexole 0.6mg-treated arm (p=0.0018) and by 3.30 points compared to the rasagiline-treated arm (p=0.0001). Also, P2B001 showed significant improvement over its comparators in the secondary endpoint, Epworth Sleepiness Scale (ESS) score. From a safety prospect, P2B001 significantly reduced adverse events including sleepiness and orthostatic hypotension compared to the pramipexole ER capsule. The company explained that the trial results support the use of P2B001 as first-line treatment in patients with early-stage Parkinson's disease, once a day, without the need for titration. Hang Myung Lee, CEO/President of Myung In Pharm, said, “With the Phase III clinical trial results, we have now secured data that P2B001 has superior efficacy and a more significant safety profile over each of its individual components as well as the currently marketed pramipexole ER capsules. We believe that P2B001 could become an important new option when considering the long-term care plan that needs to be set for early-stage Parkinson's disease and the superior efficacy demonstrated in the trial.” P2B plans to submit a New Drug Application to the FDA next year. Myung In Pharm also plans to apply for marketing authorization of P2B001 to the Ministry of Food and Drug Safety in 2022 and release the drug in Korea in 2023. Myung In Pharm had acquired the exclusive license for the commercialization of P2B001 in Korea through an equity investment in P2B in November this year.
Company
Expectations rise for Lilly’s Alzheimer drug
by
Eo, Yun-Ho
Dec 20, 2021 06:11am
Expectations have been rising for the commercialization of Lilly’s new drug candidate for Alzheimer’s. On the 15th (local time), Eli Lilly announced that it will complete filing for approval of its new Alzheimer’s candidate ‘donanemab’ within the first quarter of 2022. The news was announced at an investor meeting while introducing plans for five new drugs that will be launched within the next two years. Lilly had previously said that an application for approval of donanemab would be made sometime next year. if Lilly’s donanemab is approved, the addition of donanemab to the market following Biogen’s accelerated approval of Aduhelm in June is expected to intensify competition. Although the information available on donanemab is limited, a head-to-head study against Aduhelm is ongoing, and initial data from the study is expected to roll out in the second half of next year. Based on the initial data from a Phase II trial announced earlier this year, the FDA granted Breakthrough Therapy designation for donanemab in June. Results of Lilly’s Phase II TRAILBLAZER-ALZ trial on donanemab is a monoclonal antibody that targets a modified form of beta-amyloid called N3pG that was released in July demonstrated that the reduced beta-amyloid deposits slowed the decline of cognitive function in Alzheimer patients. Donanemab Patients with early symptoms of Alzheimer’s who were administered donanemab in the trial showed a rapid reduction in amyloid plaque at 24 weeks and showed the most rapid amyloid plaque removal in patients who had the most severe plaque burden at baseline. At the meeting, Lilly also announced its release plans for its antidiabetic tirzepatide, mantle cell lymphoma treatment pirtobrutinib, ulcerative colitis treatment mirikizumab, and atopic dermatitis treatment lebrikizumab.
Policy
Korea tightens social distancing measures again
by
Kim, Jung-Ju
Dec 20, 2021 06:11am
The surge in COVID-19 cases in Korea has led the government to once again tighten the reins on social distancing while focusing on encouraging booster shot vaccinations. Private gatherings will be once again limited to no more than four people in all areas regardless of region, and a ‘vaccine pass’ that differs the level of restrictions imposed based on vaccination status will be applied. On the 16th, the COVID-19 Central Disaster and Safety Countermeasures Headquarters (Prime Minister Kim Boo-kyum) held a meeting with central ministries and 17 regional governments at the video conference room in the video conference room of the Central Government Complex in Seoul to discuss strengthening the social distancing measures by expanding booster vaccination and expanding medical capacity to establish a continuous basis for the phased recovery to daily life. Currently, Korea’s COVID-19 urgency assessment showed Korea to be at ‘very-high’ risk in all regions - nationwide, metropolitan, and non-metropolitan areas – for two consecutive weeks since last week. The intensive care bed operation rate reached 81.6% nationwide, 86.4% in metropolitan areas, and 72.9% in non-metropolitan areas. In particular, the surge in intensive care operation rate in non-metropolitan areas with relatively low medical response capacity was deemed a major risk factor that could lead to a nationwide medical collapse. With the number of non-vaccinated people over the age of 60 that have a high probability of infection still nearing 910,000 (6.9%) and the number of cases of severe and critical COVID-19 and deaths similar in the vaccinated and non-vaccinated groups, it is necessary to protect the elderly who are not vaccinated through vaccination. With booster vaccination rates nearing 87%, the rate of mass infection is falling in long-term care hospitals and facilities, but the booster vaccination rate in those 60 years or older is still low at 46.4%. Therefore, the government decided to implement strengthened social distancing measures to block further transmission of COVD-19 in non-vaccinated people that account for half of the severe and critical COVID-19 patients and deaths and minimize individual contact to ultimately remove the overall risk factors remaining in society. The strengthened social distancing measures will be implemented for 16 days from the 18th of this month to January 2nd. The authorities readjusted the number of people allowed for private gatherings to reduce contact between individuals in consideration of the seasonal factor and the increased risk of transmission from year-end and new year gatherings and other indoor activities. Therefore, the number of people allowed for social gatherings that were 6 in metropolitan and 8 in non-metropolitan areas was reduced to 4 regardless of an individual’s vaccination status. However, the existing exclusion that was applied to immediate families in cohabitation, individuals in need of care (children, elderly, and the disabled), etc. remain effective. Also, under the changed measures, non-vaccinated individuals may now only use restaurants and cafes alone. Also, taking into account the increased risk of COVID-19 transmission if activities extend to late-night hours and are associated with alcohol consumption and non-mask use, the authorities restricted the operation hours of multi-use facilities to 9 or 10 p.m. for the next 2 weeks. Operation hours for Group 1 facilities (entertainment facilities) and Group 2 facilities (restaurants, cafes, singing rooms, public baths, indoor sports facilities) will be restricted to 9:00 p.m., and the hours for Group 3 and other facilities (movie theaters, performance centers, game arcade, multi-rooms, casinos, internet café(PC rooms), private academies, massage salons, party rooms) will be restricted to 10 p.m. Sizes of events and assemblies will also be restricted. Currently, events and assemblies with less than 100 participants are allowed regardless of vaccination status, and up to 499 vaccinated individuals may gather for events, and assemblies with over 100 participants are allowed. However, the strengthened measures restrict the number of participants to 50 regardless of vaccination status, and up to 299 vaccinated individuals may gather for events and assemblies with over 50 participants. Although events with over 300 participants (limited to those held in non-regular performance centers, sports competitions, festivals) are prohibited in principle, they may be held as an exception with prior approval from relevant ministries. For the next two weeks, all events other than essential events will be disapproved in consideration of the severe COVID-19 situation. Also, official duties and events related to essential corporate activities that were exempted from being applied the vaccine pass will be subject to the same restrictions if there are more than 50 participants (no increase in participants allowed), and exhibitions, expos, and international conferences that had been managed with a separate regulation is also applied the vaccine pass if there are more than 50 participants (no increase in participants allowed).
Company
Ildong signed for Nexium worth ₩50 billion
by
Dec 20, 2021 06:11am
AstraZeneca Korea announced on the 14th that it has signed a partnership contract with Ildong for gastroesophageal reflux disease treatment "Nexium (Esomeprazole)" and type 2 diabetes treatment "Qtern (Dapagliflozin/Saxagliptin Monohydrate)." Through this, Ildong Pharmaceutical will jointly sell Nexium and Qtern with AstraZeneca Korea from January 1 next year. In 2014, the two companies promoted Onglyza and Komblyze XR (Metformin HCl/Saxaglipin Monohydrate). Ildong Pharmaceutical has succeeded in marketing H2 receptor antagonists, PPI drugs, and functional dyspepsia treatments. Ildong Pharmaceutical plans to grow Nexium into an item with annual sales of more than 50 billion won in the future. Last year, Nexium's domestic sales were estimated at about 49.4 billion won. Nexium was jointly sold by Daewoong Pharmaceutical, and the contract ends on December 31. Daewoong Pharmaceutical plans to focus on selling its own P-CAB-based gastroesophageal reflux disease treatments Fexuprazan and Nexium. Kim Sang-pyo, CEO of AstraZeneca Korea, said, "We are happy that the two companies, which have been maximizing each other's strengths in the diabetes treatment field for the past eight years, are seeking opportunities for a new leap forward in the digestive field." He said, "We hope to provide differentiated treatment benefits of 'Nexium' and 'Qtern' to more medical staff and patients." Yoon Woong-seop, vice chairman of Ildong Pharmaceutical, said, "We are looking forward to strengthening our partnership with AstraZeneca Korea through Nexium and Qtern following Onglyza and Kombiglyze XR." He said, "We plan to do our best not only for the health of patients but also for the smooth medical activities of medical staff, but also to create synergy between the two companies and expand market performance."
Company
New depression drug Spravato lands in the 'Big 5' Hospitals
by
Eo, Yun-Ho
Dec 16, 2021 05:52am
Janssen’s new drug for depression, ‘Spravato,’ can now be prescribed at general hospitals in Korea. According to industry sources, Spravato (esketamine) that is used in combination with an oral antidepressant, has passed the review of drug committees (DC) of 80 medical institutions in the nation including the 'Big-5' general hospitals - Samsung Medical Center (SMC), Seoul National University Hospital (SNUH), Seoul St. Mary’s Hospital, and Severance Hospital - as well as the Kyung Hee University Medical Center, Kyungpook National University Hospital, Inje University Paik Hospital, Seoul National University Bundang Hospital, Chung-Ang University Hospital, Jeju National University Hospital, Inje University Haeundae Paik Hospital. Spravato, which was approved in June last year in Korea, was the first-ever prescription nasal spray with a new mechanism of action that was introduced in the field of treatment-resistant depression (TRD) and the first in 30 years introduced in the field of major depressive disorder. Spravato’s esketamine modulates the glutamate receptor called an N-methyl D-aspartate (NMDA) receptor in the brain and restores synaptic function and increases neurotrophic signaling to improve depression symptoms. Last year, the drug added an indication for the treatment of major depressive disorder with suicidal thoughts or actions. The approval of the depression with suicidal ideation indication was based on results of the global Phase III ASPIRE I and ASPIRE II study. In both ASPIRE I and ASPIRE II, Spravato met the primary endpoint as defined as the reduction in depressive symptoms from baseline in the Montgomery Åsberg Depression Rating Scale (MADRS) at 24 hours after the first dose when taken in conjunction with standard of care therapy (including oral antidepressants and hospitalization). Efficacy for the initial indication of treatment-resistant depression was demonstrated through a Phase 3 clinical trial consisting of short- and long-term trials that were conducted on 1,700 adult patients with treatment-resistant depression. In the short-term clinical trial on patients aged 18 to 65 years with treatment-resistant depression, the MADRS score of patients who were administered Spravato in combination with oral antidepressants was lowered by 19.8 points during the 4-week treatment period. Patients who were administered a placebo showed a 15.8 point reduction in the MADRS score, demonstrating a statistically significant improvement in symptoms of patients who used Spravato with an oral antidepressant. In the long-term trial, the probability of recurrent depressive symptoms was 51% percent lower in the Spravato +oral antidepressant-treated group that achieved stable remission than that of the placebo+oral antidepressant-treated group. Jong-woo Paik, Professor of Mental Health and Medicine at Kyunghee University, said, “Unlike other antidepressants that take several days for symptoms to improve after intake, Spravato showed immediate improvement in depressive symptoms. Such a characteristic is particularly effective in treating and managing patients in emergencies such as those who had attempted suicides.”
Policy
Jeil's JP-1366 has been approved for phase 3 in Korea
by
Lee, Tak-Sun
Dec 16, 2021 05:51am
Jeil's new drug candidate JP-1366 for GERD has been approved for phase 3 clinical trials and is speeding up commercialization. Currently, sales of HK inno.N's P-CAB-based new drug K-Cab are high in Korea. On the 14th, the MFDS approved a phase 3 clinical trial plan for JP-1366 applied by Onconic Theapeutics, a subsidiary of Jeil Pharmaceutical. This clinical trial is a randomized, double-blind, parallel design, activity contrast, non-isomeric, multi-organ phase 3 clinical trial that compares and evaluates the efficacy and safety of JP-136620 mg or Esomeprazole 40 mg administration in erosive esophagitis patients. JP-1366 is a treatment for gastroesophageal reflux disease in the P-CAB mechanism and is expected to be a drug that improves the limitations of existing PPI formulations. It is more effective and lasts longer than PPI. It was selected as a high-tech medical technology development project by the MOHW in 2017 and received about 2 billion won in research funds, and is being fostered as a global new drug in public-private cooperation. Clinical trials are being conducted not only in Korea but also in Europe. Onconic Theapeutics is a subsidiary of the new drug development established in May last year with 100% investment in Jeil Pharmaceutical. Currently, Jeill is developing new drug candidates such as JP-1366, a treatment for GERD, and "JPI-547," a next-generation dual-target anticancer drug. The company aims to be listed in 2024. The P-CAB-based new drug was developed by HK inno.N as K-cab for the first time in Korea in 2018. K-cab has become a treatment for GERD as soon as it is released in 2019. Sales are expected to exceed 100 billion won this year. Accordingly, not only Jeil but also other domestic companies such as Daewoong Pharmaceutical are spurring the development of new P-CAB drugs. Fexuprazan, which is being developed by Daewoong Pharmaceutical, is known to have completed clinical trials in Korea and is undergoing approval procedures.
Policy
The KDCA has set aside ₩299.2 billion for COVID-19 tx
by
Kim, Jung-Ju
Dec 16, 2021 05:51am
The KDCA (Chief Jeong Eun-kyeong) announced that it had decided at a Cabinet meeting on the 14th to ₩299.2 billion as a reserve for additional purchases of COVID-19 treatments. It is equivalent to ₩192 billion for oral treatment of COVID-19, ₩107.2 billion for antiviral drugs (Remdesivir) and antibody therapy (Regkirona), which are existing tx. It is aimed at pre-purchasing oral treatments and purchasing additional existing treatments as the number of confirmed patients continues to increase to 7,000 recently. Currently, the COVID-19 oral treatment has completed a pre-purchase contract for 3.12 million people (242 million people for MSD and 70,000 people for Pfizer) with global pharmaceutical companies, and an additional purchase contract will be signed in December to reflect the increase in confirmed cases. It plans to induce active use of domestic antibody treatments by expanding prescription agencies and subjects. In the case of Regkirona, prescription institutions have further expanded residential treatment centers, hospitals, general hospitals, and elderly care facilities from inpatient treatment institutions. Subject to administration were also taken so that home caregivers could be administered at short-term and outpatient treatment centers. The government expects to contribute to maintaining the medical and quarantine system by reducing the prevalence of severe patients in mild patients by introducing oral treatments and actively utilizing domestic antibody treatments in preparation for the home treatment-oriented medical system.
Policy
Exempt PVA for drugs with claims less than ₩10 billion
by
Lee, Hye-Kyung
Dec 16, 2021 05:51am
The pharmaceutical industry officially delivered its position that it cannot accept any of the measures set for the improvement of the detailed guidelines for the Price-Volume Agreement negotiations that were disclosed by the National Health Insurance Service. The NHIS had collected industry opinion until the 14th after disclosing the proposed revisions to the KPBMA, KRPIA, and KOBIA at the 10th public-private consultative meeting that was held on the 2nd. In particular, the KPBMA opposed both the revision of Article 6.1.1 of the guideline that calls for expanding the total claims amount set for a product group from 'less than ₩1.5 billion' to 'less than ₩2 billion,' and Article 6.1.2 that reduces 'items with an upper limit of less than the arithmetic average of drugs with the same ingredient' to 'less than 90% of the arithmetic average.' In addition, the industry added that the items that were initially listed at a low price should be added to subjects eligible for exclusion from price cuts or price cut rate reductions. The main reason why the industry opposed the improvement in the PVA guidelines was that the financial savings gained on the NHIS's part were insignificant. If the revision that expands the amount of the annual claims from less than ₩1.5 billion to less than ₩2 billion is applied, drugs that have an annual claims amount of ₩1.2 billion will also be subject to PVA negotiations if their use volume increases by over ₩800 million. If the amount is calculated at the discount rate of 6.0% in line with the reference formula, the savings amount will be around ₩120 million. The industry pointed out that “₩120 million is an insignificant amount of savings on the NHIS’s part. However, from the small-and-mid-sized pharmaceutical company’s viewpoint, a 6% drop in a drug’s price will be discouraging as the company will not invest in such a product as its main item, which will then become an obstacle to corporate growth that can be achieved from sales expansions. Therefore, from the industry’s viewpoint, the government's negotiations should be focused on mid-to-large sized items whose use exceeds ₩10 billion in line with the PVA system's purpose, and the amount subject to exclusion from PVA to be increased to be set at ₩10 billion or less. Also, on changing the ‘same ingredient’ term to ‘main component code’ for all items other than the disposable eye drops and reducing the limit from the arithmetic average to 90% of the arithmetic average, the industry requested the government retain the current guideline. The industry said, “The arithmetic average is a social convention and an absolute standard for judging whether the insurance finances can be saved, and therefore, it is in line with the system's purpose to exclude drugs that cost under the arithmetic average from negotiations. Abuse of the system, such as evading negotiations by voluntarily reducing the price to less than the arithmetic average may be well prevented by changing the time of application of the arithmetic average to the time when the monitoring starts.” With the opinion that the arithmetic average will be adjusted with the graded system for pricing generic drugs and the reevaluations planned to be implemented in July 2023 for already-listed drugs, the industry expressed concerns that enforcing the revisions will rather diminish the companies’ efforts to save NHI finances through voluntary low price listing or voluntary price cuts. In addition, the industry requested the ‘low-priced drugs’ to be added to drugs eligible for price cut rate reductions as proposed by the public-private consultative body. The currently announced guideline allows companies that voluntarily cut the price of drugs (if the 1-year period from the voluntary price cut is included in the period of analysis) may be exempted from a single negotiation under the PV guidelines or be calculated for a negotiation reference price that takes into account the voluntary price cut rate. The industry said, “Although drugs that were initially announced at a lower price (scheduled sales price) than what can be calculated have a positive effect on health insurance finances from the time of its listing, the reduced rate is not reflected during PVA negotiations. We ask that new drugs that are initially listed at a low price also be applied the exemption for one single negotiation or be reflected for its low price when assessing eligibility for PVA negotiations and in calculating the negotiation reference price.”
Policy
Janssen keeps the Tylenol name for its imported product
by
Lee, Tak-Sun
Dec 16, 2021 05:51am
As expected, Janssen is keeping its brand name, ‘Tylenol,' for its antipyretic analgesic. The company had dropped the license of its domestically manufactured Tylenol Tab. 500mg in line with the shutdown of its Hyangnam plant and changed the name of its imported item that was approved in August to ‘Tylenol Tab. 500mg.’ The expectations held by frontline pharmacies that the company may give up the use of its brand name and use the ingredient name, INN (International Nonproprietary Name), had been let down. According to the Ministry of Food and Drug Safety on the 14th, the product name of ‘Janssen Acetaminophen Tab.’ was changed to ‘Tylenol Tab. 500mg’ on the 13th. The product was approved for import on August 23rd. Janssen had obtained the approval for the imported item that can substitute its manufactured item in advance before the shutdown of its Hyangnam manufacturing plant that was planned for the end of this year. At the time of approval, the company had obtained approval for the drug as ‘Janssen Acetaminophen,' according to its INN mark. However, industry prospects were that this was just a temporary measure made because another approved product had existed under the ‘Tylenol Tab. 500mg’ name, As expected, the company had dropped the license for its manufactured ‘Tylenol Tab. 500mg’ since then and changed the name of its Janssen Acetaminophen to the existing brand name. Frontline pharmacies had once hoped that the drug would be released as Janssen Acetaminophen. When the COVID-19 vaccinations began in Korea, the Korea Disease Control and Prevention Agency had referred to the ‘Tylenol’ name as the medicine to use to alleviate the side effects of vaccinations, leading to the heavy purchase of only Tylenol among the various acetaminophen drugs. As a result, frontline pharmacies had faced difficulties because they could not keep up with the demand and had experienced Tylenol shortages. At the time, pharmacists had criticized KDCA for mentioning a specific brand rather than a generic name. The pharmacies had expected that the release of Janssen Acetaminophen, not Tylenol, would resolve the Tylenol-concentrated market demand. However, as companies follow profits, it would have been difficult for the company to give up its brand name as the booster COVID-19 vaccinations starting in earnest is expected to further increase Tylenol sales. According to IQVIA, Tylenol recorded ₩50.1 billion in cumulative sales by Q3 this year and recorded No.1 in the OTC market.
Company
Dupixent can be used by all age groups
by
Dec 16, 2021 05:51am
Dupixent, atopic dermatitis (Eczema) treatment that marks its third anniversary, is becoming the only biological agent available for all ages. Doctors agreed, "It is time to show flexibility in applying Dupixent benefits that have secured long-term effectiveness and safety." At an online seminar held by Sanofi to mark the 3rd anniversary of its launch in Korea on the 13th, Ahn Ji-young, a dermatologist at the National Medical Center, and Na Chan-ho, a dermatologist at Chosun University Hospital, shared their long-term Dupixent administration experience in 52 weeks (1 year) in domestic adult atopic dermatitis patients. Professor Ahn's 52-week long-term data is a study that analyzed the medical records of patients treated with Dupixent from September 2018 to December 2020, targeting 99 adult patients with moderate-severe symptoms. In the 52nd week of administration, EASI improved 88.1% compared to 30.02 points in the baseline. 89.9% of the administered group achieved EASI-75, and the itching NRS score also improved by 76.6% compared to the baseline of 8.37 points. The POEM score also improved 67.21% compared to the baseline (23.73 points) in week 52, and DLQI improved 69.02% compared to the baseline (22.37 points). Even in long-term administration for 52 weeks, it was consistent with the safety profile shown in phase 3 clinical trials. The main adverse reactions improved as both symptoms were treated, including facial erythema (19.9%) and conjunctivitis (17.17%). Professor Ahn said, "Atopic dermatitis is a chronic disease, and long-term symptom improvement requires safe and continuous treatment," and added, "Dupixent was able to confirm the long-term effectiveness and safety profile up to 52 weeks consistent with clinical trials in domestic patients." Professor Na then announced the results of an analysis of moderate-severe youth patients treated with Dupixent for one year from October last year. He explains that children and adolescents suffering from severe atopic dermatitis are burdened with serious diseases such as study, sleep, and outdoor activities. Until Dupixent received indications for children and adolescents, treatment options such as systemic immunosuppressants were limited. Dupixent improved the EASI score by 82.9% compared to the baseline (25.1 points) in the 16th week of administration, and the CDLQI related to childhood skin also increased by 57.2% compared to the baseline (13.1 points). POEM scores and itching NRS scores improved 54.4% and 53%, respectively, compared to baseline. Like adults, it showed similar effects in domestic youth patients in the actual clinical environment. Furthermore, the EASI-75 achievement rate was 77.8%, which was better than that of phase 3 (41.5%). Recently, Sanofi also confirmed the effectiveness and safety of Dupixent in phase 3 clinical trials for infants and toddlers aged 6 months to 5 years. If the indications expand to that age, Dupixent is expected to be the only biological agent available to patients of all ages suffering from moderate-severe atopic dermatitis. Experts said it was time to give flexibility to Dupixent's conditions, which secured a variety of data. Professor Ahn said, "It is necessary to study whether patients undergoing long-term administration maintain their effectiveness even if the administration interval is increased. At the same time, it would be nice to expand benefits to patients who are initially administered by reflecting subjective indicators in addition to objective indicators, she said. Professor Na also added, "As the guidelines of the Association of Atopic Dermatitis have recently been revised to reflect subjective indicators such as DLQI, it seems necessary to refer to the standards."
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