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Psoriasis, ustekinumab, biologics

A Bonhomme, E Fréling, M Reigneau, C Poreaux, A Valois, F Truchetet, A Barbaud, J-L Schmutz
OBJECTIVES: To evaluate the vaccine coverage of psoriasis patients prior to initiating or changing immunosuppressant therapy, and to verify that the prescribed vaccines have been administered. PATIENTS AND METHODS: We conducted a bi-centre, observational, cross-sectional study over 9 months. Psoriasis patients in whom immunosuppressant therapy (comprising cyclosporine, methotrexate, etanercept, infliximab, adalimumab or ustekinumab) was indicated were included. Medical history, previous treatments, vaccination status, viral serology results (for hepatitis B, measles, and chickenpox), and reasons for non-vaccination were assessed via questionnaire...
October 19, 2016: Annales de Dermatologie et de Vénéréologie
Insa Joost, Johannes Steinfurt, Philipp T Meyer, Winfried V Kern, Siegbert Rieg
BACKGROUND: Ustekinumab (Stelara®), a human monoclonal antibody targeting the p40-subunit of interleukin (IL)-12 and IL-23, is indicated for moderate to severe plaque psoriasis and psoriatic arthritis. In large multicenter, prospective trials assessing efficacy and safety of ustekinumab increased rates of severe infections have not been observed so far. CASE PRESENTATION: Here, we report the case of a 64-year old woman presenting with chills, pain and swelling of her right foot with dark maculae at the sole, and elevated inflammatory markers...
October 20, 2016: BMC Infectious Diseases
Tao Gu, Neel Shah, Gaurav Deshpande, Derek H Tang, Debra F Eisenberg
BACKGROUND: The relative cost of biologics in the treatment of autoimmune disorders, including rheumatoid arthritis, psoriatic arthritis, psoriasis, and ankylosing spondylitis, is a key consideration for managed care payers. OBJECTIVES: Our objective was to estimate biologic costs and treatment patterns in US managed care patients with rheumatoid arthritis, psoriatic arthritis, psoriasis, and/or ankylosing spondylitis. METHODS: This retrospective study used administrative claims data from the HealthCore Integrated Research Database (HIRD(SM)) for adults with rheumatoid arthritis, psoriatic arthritis, psoriasis, and/or ankylosing spondylitis who received abatacept, adalimumab, certolizumab, etanercept, golimumab, infliximab, rituximab, tocilizumab, or ustekinumab between 1 July 2009 and 31 January 2013...
October 18, 2016: Drugs—Real World Outcomes
Maddalena Napolitano, Nicola Balato, Francesco Caso, Luisa Costa, Matteo Megna, Teresa Cirillo, Anna Balato, Raffaele Scarpa
OBJECTIVES: To evaluate the incidence of new cases of psoriatic arthritis (PsA) in patients with plaque psoriasis receiving biologic drugs. METHODS: A retrospective study was performed on 434 psoriatic patients under biologic treatment, attending the Psoriasis Care Centre of Dermatology at the University Federico II of Naples from January 2011 to November 2015. As part of the routine clinical practice, assessment of disease activity was made at baseline, and every 3 months...
September 8, 2016: Clinical and Experimental Rheumatology
Ai Matsumoto, Mayumi Komine, Masaru Karakawa, Megumi Kishimoto, Mamitaro Ohtsuki
We report a case of a 70-year-old woman with generalized pustular psoriasis (GPP) who responded well to infliximab therapy and adalimumab therapy after secondary failure of infliximab therapy, but did not respond to ustekinumab therapy. We speculate that the pathogenic factor in this case favored anti-tumor necrosis factor (TNF)-α therapy to anti-interleukin-12/23 therapy. Herein, we also briefly present three additional cases of treatment with adalimumab after secondary failure of infliximab. GPP is often difficult to treat, and no placebo-controlled trials have been conducted to guide the use of biologics against it because of a paucity of cases...
October 15, 2016: Journal of Dermatology
Paula Dávila-Seijo, Esteban Dauden, M A Descalzo, Gregorio Carretero, José-Manuel Carrascosa, Francisco Vanaclocha, Francisco-José Gómez-García, Pablo De la Cueva-Dobao, Enrique Herrera-Ceballos, Isabel Belinchón, José-Luis López-Estebaranz, Merce Alsina, José-Luis Sánchez-Carazo, Marta Ferrán, Rosa Torrado, Carlos Ferrandiz, Raquel Rivera, Mar Llamas, Rafael Jiménez-Puya, Ignacio García-Doval
Information regarding the safety of biological drugs prescribed to psoriasis patients on daily and long-term bases is insufficient. We used data from the BIOBADADERM registry (Spanish Registry of Adverse Events for Biological Therapy in Dermatological Diseases) to generate crude rates of infection during therapy with systemic drugs, including biological drugs (infliximab, etanercept, adalimumab, and ustekinumab) and non-biological drugs (acitretin, cyclosporine, and methotrexate). We also calculated unadjusted and adjusted risk ratios (RR) (with propensity score adjustment) of infection, serious infections, and recurrent infections of systemic therapies compared with methotrexate, using Poisson regression...
September 24, 2016: Journal of Investigative Dermatology
Joel Correa da Rosa, Jaehwan Kim, Suyan Tian, Lewis E Tomalin, James G Krueger, Mayte Suárez-Fariñas
There is an 'assessment gap' between the moment patient treatment-response is biologically determined and when response can actually be determined clinically. Patients' biochemical profiles are a major determinant of clinical outcome for a given treatment. It is therefore feasible that molecular-level patient information could be used to decrease the assessment gap. Due to clinically accessible biopsies, high-quality molecular data for psoriasis patients is widely available. Psoriasis is therefore an excellent disease for testing the prospect of predicting treatment outcome from molecular data...
September 22, 2016: Journal of Investigative Dermatology
F Bardazzi, M Lambertini, M A Chessa, M Magnano, A Patrizi, B M Piraccini
BACKGROUND: Psoriasis (Pso) has a strong impact on quality of life and a positive association has been reported between nail psoriasis (NP) and more severe disease, together with a longer duration of skin lesions. The treatment of NP represents a challenge and biological therapy can be recommended for severe disease. OBJECTIVE: The first end point of this retrospective study was to evaluate the time to achieve Psoriasis Area Severity Index (PASI) 75 in patients with and without NP treated with biological therapy...
September 23, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Claudio Bonifati, Viviana Lora, Dario Graceffa, Lorenzo Nosotti
The systemic therapies available for the management of Psoriasis (PsO) patients who cannot be treated with more conservative options, such as topical agents and/or phototherapy, with the exception of acitretin, can worsen or reactivate a chronic infection. Therefore, before administering immunosuppressive therapies with either conventional disease-modifying drugs (cDMARDs) or biological ones (bDMARDs) it is mandatory to screen patients for some infections, including hepatitis B virus (HBV) and hepatitis C virus (HCV)...
July 28, 2016: World Journal of Gastroenterology: WJG
I Y K Iskandar, D M Ashcroft, R B Warren, I Evans, K McElhone, C M Owen, A D Burden, C H Smith, N J Reynolds, C E M Griffiths
BACKGROUND: Treatment modifications, including dose-escalations, dose-reductions, switches, discontinuations and restarts of biologics may be necessary in the management of psoriasis but the patterns of usage are incompletely defined. OBJECTIVES: To examine the treatment utilisation patterns of adalimumab, etanercept and ustekinumab among biologic-naïve and non-naïve psoriasis patients enrolled in the British Association of Dermatologists Biologic Interventions Register (BADBIR)...
September 2, 2016: British Journal of Dermatology
J Zweegers, J M M Groenewoud, J M P A van den Reek, M E Otero, P C M van de Kerkhof, R J B Driessen, P P M van Lümig, M D Njoo, P M Ossenkoppele, J M Mommers, M I A Koetsier, W P Arnold, M P M Andriessen, A L A Kuijpers, M A M Berends, W Kievit, E M G J de Jong
BACKGROUND: The efficacy of etanercept and ustekinumab in psoriasis has been compared in one randomized controlled trial. Comparison of the long-term effectiveness of biologics in daily practice psoriasis treatment is currently lacking. OBJECTIVES: To compare the effectiveness between the three widely used outpatient biologics adalimumab, etanercept and ustekinumab in daily practice psoriasis treatment and to correct for confounders. METHODS: Data were extracted from the prospective, multicenter BioCAPTURE registry...
August 31, 2016: British Journal of Dermatology
J M P A van den Reek, M J H Coenen, M van de L'Isle Arias, J Zweegers, D Rodijk-Olthuis, J Schalkwijk, S H Vermeulen, I Joosten, P C M van de Kerkhof, M M B Seyger, P L J M Zeeuwen, E M G J de Jong
BACKGROUND: The effectiveness of biologics for psoriasis shows heterogeneity among patients. With pharmacogenetic markers, it might be possible to predict treatment response. OBJECTIVES: We aimed to test the association between genetic markers and the response to biologics in psoriasis (etanercept, adalimumab, ustekinumab) in a prospective cohort. METHODS: We investigated the copy number variation in LCE3B and 3C genes, and eight single nucleotide polymorphisms (SNPs) in HLA-C*06, CD84, IL12b, IL23R, TRAF3IP2, ERAP1, IFIH1 and TNFAIP3...
August 26, 2016: British Journal of Dermatology
W Rungapiromnan, Z Z N Yiu, R B Warren, C E M Griffiths, D M Ashcroft
BACKGROUND: Concerns have been raised regarding an increased risk of major adverse cardiovascular events (MACEs) (myocardial infarction, cerebrovascular accident, or cardiovascular death) in patients treated with anti-interleukin (IL)-12/23 agents for moderate-to-severe psoriasis. OBJECTIVE: To examine the risk of MACEs in adult patients with plaque psoriasis that are exposed to biologic therapies via a meta-analysis of randomised controlled trials (RCTs). METHODS: (i) Data sources: Systematic searches were performed in the Cochrane Library, MEDLINE and EMBASE, US Food and Drug Administration, European Medicines Agency, individual pharmaceutical companies online search platforms and 5 trials registers (until 31 March 2016)...
August 12, 2016: British Journal of Dermatology
J Zweegers, B Roosenboom, P C M van de Kerkhof, J M P A van den Reek, M E Otero, S Atalay, A L A Kuijpers, M I A Koetsier, W P Arnold, M A Berends, L Weppner-Parren, M Bijen, M D Njoo, J M Mommers, P P M van Lümig, R J B Driessen, W Kievit, E M G J de Jong
BACKGROUND: It is important to assess which patients with psoriasis are more likely to achieve high clinical responses on biologics. OBJECTIVES: To assess the number of treatment episodes (TEs) that achieve a 100% improvement in Psoriasis Area and Severity Index (PASI 100), PASI 90 or PASI ≤ 5 at week 24 of biological treatment, and which baseline patient characteristics predict treatment response. METHODS: Data from patients with psoriasis treated with adalimumab, etanercept, infliximab or ustekinumab were extracted from a prospective cohort...
July 25, 2016: British Journal of Dermatology
Tawnya Hansen, Laura E Targownik
INTRODUCTION: Ustekinumab is a human monoclonal antibody directed against the shared p40 subunit of interleukins 12 and 23. Ustekinumab is currently approved for the treatment of psoriatic arthritis (PsA) and moderate to severe plaque psoriasis, and is being evaluated in Crohn's disease (CD). AREAS COVERED: The first evidence supporting the efficacy of ustekinumab in the treatment of moderate to severe CD was published in 2008. Results from subsequent phase II and phase III randomized controlled trials (RCTs) have shown promising data on the clinical efficacy of induction and remission of moderate to severe CD...
September 2016: Expert Review of Gastroenterology & Hepatology
Mandy Gutknecht, Magdalene Krensel, Matthias Augustin
In the course of the chronic skin disease psoriasis, where a variety of treatment interventions is available, a strong growth of health economic studies comparing treatment costs and benefits can be noticed. The objective was to identify health economic evaluations of psoriasis treatments that have been published to date. Of particular interest were the mostly used analysis and outcome parameters, the compared treatments, and the question, if available health economic studies may be used to perform a meta-analysis of qualitative findings...
November 2016: Archives of Dermatological Research
C Fotiadou, E Lazaridou, E Sotiriou, A Kyrgidis, Z Apalla, D Ioannides
BACKGROUND: The scalp is a frequent and difficult-to-treat localization of psoriasis. Little evidence exists regarding the use of biologic agents in recalcitrant cases of scalp psoriasis that are resistant to other treatment options. OBJECTIVES: To evaluate and compare the efficacy of currently available biologic agents (infliximab, etanercept, adalimumab, ustekinumab) in the treatment of scalp symptoms in patients suffering from moderate to severe plaque psoriasis...
July 13, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Kasper Fjellhaugen Hjuler, Morten Bøttcher, Christian Vestergaard, Hans Erik Bøtker, Lars Iversen, Knud Kragballe
Importance: Inflammatory pathways of psoriasis share similarities with the mechanisms identified in atherosclerosis, and the association between psoriasis and cardiovascular disease due to accelerated coronary artery disease is well established. The effect of anti-inflammatory drugs on the development of coronary atherosclerosis remains essentially unknown. Objective: To investigate the association of biological therapy with changes in coronary artery disease progression, measured by repeated coronary computed tomography (CT)...
July 7, 2016: JAMA Dermatology
Giacomo Caldarola, Alessandro Sgambato, Caterina Fanali, Gaia Moretta, Marisa Farina, Donatella Lucchetti, Ketty Peris, Clara De Simone
OBJECTIVE: This retrospective study aimed to evaluate the role of NFKB1-94 insertion/deletion ATTG (rs28362491) and NFkBIA 2758 A>G (rs696) polymorphisms and HLA-Cw6 allele in predicting the response to etanercept, a TNF-α blocker, in a population of psoriatic patients naive to biologics. METHODS: Genomic DNA was extracted from whole blood in a series of 96 psoriatic patients who received etanercept for at least 3 months. Patients were classified as responders if they achieved a Psoriasis Area and Severity Index improvement of at least 75% after 12 weeks of etanercept treatment and as nonresponders if Psoriasis Area and Severity Index improvement was less than 75%...
September 2016: Pharmacogenetics and Genomics
P Dávila-Seijo, E Dauden, G Carretero, C Ferrandiz, F Vanaclocha, F-J Gómez-García, E Herrera-Ceballos, P De la Cueva-Dobao, I Belinchón, J-L Sánchez-Carazo, M Alsina, J-L López-Estebaranz, M Ferrán, R Torrado, J-M Carrascosa, M Llamas, R Rivera, R Jiménez-Puya, I García-Doval
BACKGROUND: Few reported studies compare drug survival in moderate-to-severe psoriasis vulgaris. OBJECTIVES: To describe and compare drug survival of systemic drugs, including biologic agents (infliximab, etanercept, adalimumab and ustekinumab) and classical drugs (acitretin, ciclosporin and methotrexate) in moderate-to-severe psoriasis. METHODS: This was a multicenter, prospective, cohort study of patients receiving systemic therapies between 2008 and 2013 in 12 hospitals in Spain...
June 22, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
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