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Psoriasis, ustekinumab, biologics

M Talamonti, M Galluzzo, N Bernardini, G Caldarola, S Persechino, F Cantoresi, C G Egan, C Potenza, K Peris, L Bianchi
BACKGROUND: Few studies have compared the efficacy of switching to adalimumab in the real-life setting in plaque psoriasis patients. OBJECTIVE: To evaluate the effect of adalimumab in psoriasis patients previously treated with other biologics. METHODS: In this multicentre study, psoriasis patients (N=262) treated with an anti-TNF alpha agent, ustekinumab or naïve to biologics then switched to adalimumab were included. Disease severity was assessed by the Psoriasis Area and Severity Index (PASI) at baseline and after 3, 6, 12, 24 and 36 months...
May 18, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Ayelet Ollech, Alex Zvulunov, Lev Pavlovsky, Emmilia Hodak, Dan Ben Amitai
BACKGROUND: There is a paucity of data on the use of biologic therapy in recalcitrant pediatric psoriasis. The current study presents pediatric psoriasis cases treated with biologic agents in a tertiary referral center. METHODS: In this retrospective case series, data was collected on all patients ≤ 18 years old with severe psoriasis treated with biological therapy from 2010 through 2016 in a tertiary children's hospital. We included demographic data, previous systemic treatments, reason for discontinuation or switch to other systemic treatments, efficacy and side effects...
May 14, 2018: Journal of Dermatological Treatment
Matthias Augustin, Doreen McBride, Isabelle Gilloteau, Caitriona O'Neill, Katja Neidhardt, Christopher N Graham
BACKGROUND: Secukinumab, a fully human monoclonal antibody that selectively neutralizes interleukin-17A, has demonstrated strong and sustained efficacy in adults with moderate to severe psoriasis in clinical trials. OBJECTIVE: This analysis compared the cost per responder of secukinumab as first biologic treatment of moderate to severe psoriasis, with adalimumab, infliximab, etanercept, and ustekinumab in Germany. METHODS: A 52-week decision-tree model was developed...
May 5, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Tomaz Lunder, Pij Marko, Natasa Koser Kolar, Boris Kralj, Nada Kecelj Leskovec
The study was designed as observational retrospective analysis of the data from Slovenian Registry of patients with moderate and severe psoriasis treated with adalimumab, etanercept, infliximab or ustekinumab from 2005 to 2015. The survival rates of biologics were compared using survival analysis, and predictors of discontinuation were evaluated using a Cox regression model. All biologics have been prescribed as a first line therapy for moderate or severe psoriasis; 650 (94.9%) adalimumab, 254 (72.0%) ustekinumab, 76 (69...
April 26, 2018: Biologicals: Journal of the International Association of Biological Standardization
M Galluzzo, S D'Adamio, L Bianchi, M Talamonti
Psoriasis tends to improve for approximately half of patients during pregnancy, but an equal number of patients report no change or worsening during this period, when lots of medications, like biologics, are not indicated. The aim of our study was to review data of patient that had been pregnant during ustekinumab treatment, analyzing data of our data set between September 2010 and February 2018. We found data of three patients that had been pregnant during ustekinumab treatment. All three patients successfully completed the pregnancy without complications...
April 20, 2018: Journal of Dermatological Treatment
Chika Ohata, Bungo Ohyama, Aya Nanri, Takako Shintani, Takekuni Nakama
BACKGROUND: In Japan, more than 5 years have passed since emergence of the first 3 biologics, infliximab, adalimumab, and ustekinumab, became available in daily practice; however, no data for drug survival was reported from Japan. OBJECTIVE: To study the long-term drug survival of infliximab, adalimumab, and ustekinumab used for Japanese psoriatic patients. METHODS: We retrieved data on all patients treated with biological agents and calculated the long-term drug survival for infliximab, adalimumab, and ustekinumab using our psoriasis registry (Kurume Psoriasis Registry: KURUPR) consisted of 343 patients by the end of March 2017...
April 20, 2018: Journal of Dermatological Treatment
Rosa M Romero-Jimenez, Vicente Escudero-Vilaplana, Ofelia Baniandres Rodriguez, Estela García Martín, Ana Mateos Mayo, Maria Sanjurjo Saez
PURPOSE: The aim of this study was to identify clinical factors associated with dose reduction and dose escalation in the treatment with ustekinumab in patients with moderate-to-severe plaque psoriasis. MATERIALS AND METHODS: An observational, longitudinal and retrospective study was conducted using patients with moderate-to-severe plaque psoriasis. We reviewed clinical histories and variables were recorded on a database (patients' characteristics, pharmacotherapeutics, effectiveness and safety)...
May 7, 2018: Journal of Dermatological Treatment
Shin Morizane, Saeko Sugimoto, Takayuki Motoki, Norihisa Katayama, Masako Omori, Keiji Iwatsuki
Psoriasis is a common chronic inflammatory skin disorder that is characterized by scaly, erythematous, sharply demarcated plaques. The treatment for psoriasis has dramatically changed over the last 10 years with the introduction of biologics. However, the risk of cancer induced by biologics for psoriasis has not been fully analyzed, since these agents have such a short history of use. Here we report the case of a 74-year-old woman with psoriasis vulgaris and psoriatic arthritis complicated by breast cancer after systemic treatments including etretinate, cyclosporine, methotrexate, adalimumab, and ustekinumab...
April 2018: Acta Medica Okayama
Jashin J Wu, Steven R Feldman, Shipra Rastogi, Brandy Menges, Melissa Lingohr-Smith, Jay Lin
PURPOSE: To compare the cost-effectiveness of the newly approved biologic drug, brodalumab, with other commonly used biologics for the treatment of moderate-to-severe psoriasis in the U.S. METHODS: An economic model was constructed in Excel to compare average costs to achieve Psoriasis Area and Severity Index (PASI) 75, 90, and 100 among moderate-to-severe psoriasis patients treated with biologics. Total annual costs to health plans associated with treatment with 5 different biologics were estimated and cost-effectiveness compared using the estimated average cost per PASI 75, PASI 90, and PASI 100...
April 16, 2018: Journal of Dermatological Treatment
April W Armstrong, Keith A Betts, James E Signorovitch, Murali Sundaram, Junlong Li, Arijit X Ganguli, Eric Q Wu
BACKGROUND: The clinical benefits of biologic therapies for moderate-to-severe psoriasis are well established, but wide variations exist in patient response. OBJECTIVES: To determine the number needed to treat (NNT) to achieve a 75% and 90% reduction in the Psoriasis Area and Severity Index (PASI-75/90) with FDA-approved agents and evaluate the incremental cost per PASI-75 or PASI-90 responder. METHODS: The relative probabilities of achieving PASI-75 and PASI-90, as well as NNTs, were estimated using a network meta-analysis...
April 23, 2018: Current Medical Research and Opinion
Guy Shalom, Luigi Naldi, Mark Lebwohl, Arjen Nikkels, Elke M G J de Jong, Steven Fakharzadeh, Kavitha G Goyal, Bhaskar Srivastava, Wayne Langholff, Claudia Galindo, Arnon D Cohen
PURPOSE: To describe the risk of herpes zoster (HZ) in patients with psoriasis and its relation to non-biologic systemic therapies or biologic treatment. MATERIALS AND METHODS: Psoriasis Longitudinal Assessment and Registry (PSOLAR) is an international, prospective, registry that follows adult patients with psoriasis eligible to receive non-biologic systemic therapies or biologic therapies. Mutually exclusive therapy cohorts were defined. HZ incident rates were calculated for each therapy cohort and rates between cohorts were compared using hazard ratios (HR) adjusted for potential confounders, in new users and prevalent-exposure patients...
April 5, 2018: Journal of Dermatological Treatment
Ippei Miyagawa, Shingo Nakayamada, Kazuhisa Nakano, Satoshi Kubo, Shigeru Iwata, Yusuke Miyazaki, Maiko Yoshikawa, Hiroko Yoshinari, Yoshiya Tanaka
Objectives: We sought to investigate the selection of specific biological DMARDs (bDMARDs) based on characteristic lymphocyte phenotypes for treating PsA. Methods: Of 64 patients with PsA resistant to MTX, 26 underwent bDMARDs therapy selected according to phenotypic differences in peripheral helper T cells on 8-colour flow cytometry. The efficacies of this strategic treatment and the standard treatment administered to the other 38 patients were evaluated at 6 months...
April 2, 2018: Rheumatology
Chong Won Choi, Ji Young Choi, Bo Ri Kim, Sang Woong Youn
Background: The continuous use of biologic agents in the treatment of psoriasis has been reported to result in successful and sustained therapeutic effects and safety. However, some patients choose intermittent and repetitive treatment. Objective: To determine the factors for selecting intermittent and repetitive ustekinumab treatment for the management of psoriasis. Methods: From January 2011 to October 2016, we enrolled 30 psoriasis patients who discontinued ustekinumab treatment and were followed up for psoriasis treatment...
April 2018: Annals of Dermatology
F D'Amico, M Granata, E Skarmoutsou, C Trovato, G Lovero, P Gangemi, V Longo, M Pettinato, M C Mazzarino
The pathophysiology of psoriasis is very complex and involves an interplay between immune cells and keratinocytes. The keratinocyte production of calprotectin (S100A8/A9), induced by the inflammatory psoriatic milieu, may be involved in initiating immune cell invasion, as well as in propagating inflammation. However, the exact role of calprotectin in psoriasis remains unclear. Therapeutic approaches utilizing adalimumab, etanercept and ustekinumab are widely used in psoriatic treatment, but their anti-inflammatory mechanisms are not fully understood...
March 31, 2018: Inflammation Research: Official Journal of the European Histamine Research Society ... [et Al.]
Kayleigh J Mason, Jonathan N W N Barker, Catherine H Smith, Philip J Hampton, Mark Lunt, Kathleen McElhone, Richard B Warren, Zenas Z N Yiu, Christopher E M Griffiths, A David Burden
Importance: Patients with psoriasis enrolled in clinical trials of biologics may not be representative of the real-world population. There is evidence that patients ineligible for such trials have a greater risk of serious adverse events (SAEs), but the effect on drug discontinuation and effectiveness are unknown. Objective: To determine whether (1) drug discontinuation, (2) effectiveness, and (3) rates of SAEs differ in patients with psoriasis categorized as eligible or ineligible for clinical trials...
March 28, 2018: JAMA Dermatology
Ilaria Marcianò, Maria P Randazzo, Paolo Panagia, Rosanna Intelisano, Carmela Sgroi, Valentina Ientile, Serafinella Cannavò, Claudio Guarneri, Paolina Reitano, Edoardo Spina, Gianluca Trifirò
BACKGROUND: Biological drugs, such as infliximab, etanercept, adalimumab, ustekinumab, golimumab and certolizumab are third-line therapy for psoriasis (PsO) and psoriatic arthritis (PsA), but they may be used at earlier stage in severe forms. This study investigated the pattern of use and costs of biological drugs for PsO/PsA in a large population from Southern Italy during the years 2010-2014. METHODS: This was a retrospective, population-based, drug-utilization study, using healthcare administrative databases of the Local Health Unit and two hospitals of Messina Province (Sicily) in the years 2010-2014...
March 26, 2018: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
Yozo Ishiuji, Yoshinori Umezawa, Akihiko Asahina, Hirotaka Fukuta, Norie Aizawa, Koichi Yanaba, Hidemi Nakagawa
Psoriasis is a chronic inflammatory skin disease mainly mediated by a T-helper cell subset, Th17 cells. Recently, increased levels of total serum immunoglobulin (Ig)E have been reported in a subset of psoriatic patients. Ustekinumab (UST) is one of the most commonly used biologic agents for the treatment of moderate to severe plaque psoriasis, and a previous report also documented effectiveness of UST for psoriatic patients with high serum IgE levels. We experienced two psoriatic patients with high serum IgE levels, in whom UST completely improved psoriasis but paradoxically provoked or exacerbated atopic dermatitis (AD)-like symptoms...
March 22, 2018: Journal of Dermatology
Jose-Manuel Carrascosa, Ira Jacobs, Danielle Petersel, Robert Strohal
Psoriasis is a chronic, inflammatory, lifelong disease with a high prevalence (afflicting approximately 1-5% of the population worldwide) and is associated with significant morbidity. The introduction of biologic therapies has improved the management of this disease. Multiple biologic medicines that block cytokine signaling, including tumor necrosis factor (TNF) antagonists (adalimumab, etanercept, and infliximab) and inhibitors of interleukin (IL)-17 (brodalumab, ixekizumab, and secukinumab), IL-23 (guselkumab), or IL-12/23 (ustekinumab), are approved for the treatment of psoriasis...
March 16, 2018: Dermatology and Therapy
Mio Nakamura, Michael Abrouk, Benjamin Farahnik, Tian H Zhu, Tina Bhutani
The management of psoriatic disease in the human immunodeficiency virus (HIV)-positive population is challenging. The clinical course often is progressive and refractory; therefore, first- and second-line therapies including topical agents, phototherapy, and oral retinoids often are inadequate. Most other currently available systemic therapies for psoriatic disease are immunosuppressive, which poses a distinct clinical challenge. A comprehensive systematic review of the literature via a PubMed search of articles indexed for MEDLINE using the terms psoriasis and HIV and psoriatic arthritis and HIV combined with several systemic immunosuppressive agents yielded a total of 25 reported cases of systemic immunosuppressive therapies used to treat psoriatic disease in HIV-positive patients including methotrexate, cyclosporine, etanercept, adalimumab, infliximab, and ustekinumab...
January 2018: Cutis; Cutaneous Medicine for the Practitioner
K A Papp, K B Gordon, R G Langley, M G Lebwohl, A B Gottlieb, S Rastogi, R Pillai, R J Israel
BACKGROUND: Biologics used increasingly used for treating moderate-to-severe psoriasis. Efficacy may differ in patients with previous biologics exposure. OBJECTIVE: To investigate the impact of previous biologic exposure on efficacy and safety of brodalumab and ustekinumab in moderate-to-severe plaque psoriasis. METHODS: Two placebo- and ustekinumab-controlled phase 3 clinical trials. Initial 12-week induction phase where patients were treated with brodalumab (210mg Q2W or 140mg Q2W), ustekinumab or placebo...
February 28, 2018: British Journal of Dermatology
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