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2.
Expert Opin Drug Saf ; 21(10): 1249-1257, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2134364

ABSTRACT

INTRODUCTION: Since Anti-IL-17s availability, concerns about their safety have been raised due to the inhibition of physiological activities that IL-17A plays in the immune response against infections. Ixekizumab is a humanized monoclonal antibody specifically targeting IL-17A approved for the treatment of moderate-to-severe psoriasis. AREAS COVERED: The aim of this review is to evaluate the safety profile of ixekizumab in moderate-to-severe psoriasis patients. A compressive literature review has included articles since March 2022. EXPERT OPINION: In our analysis, most of the reported AEs were mild or moderate and rarely required treatment discontinuation. Among the class-specific AEs to consider during ixekizumab treatment, there are the risk of Candida infections and the risk of IBD, both of which were reported more frequently than placebo or other biologics (etanercept, ustekinumab, and guselkumab). However, the reported candidiasis resulted in mild-to-moderate and easily managed. The risk of IBD (both exacerbation and de novo diagnosis) represents a class effect of IL-17 inhibitors, which should be well evaluated before considering starting ixekizumab treatment. The most common AEs were represented by nasopharyngitis, upper respiratory tract infection, and injection-site reactions. The analyzed studies confirmed the favorable safety profile of ixekizumab even in more recently published studies.


Subject(s)
Dermatologic Agents , Inflammatory Bowel Diseases , Psoriasis , Humans , Interleukin-17 , Psoriasis/drug therapy , Ustekinumab , Inflammatory Bowel Diseases/drug therapy , Treatment Outcome , Severity of Illness Index
9.
Dermatol Ther ; 35(7): e15524, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1956743

ABSTRACT

Recent knowledge on the key role of interleukin (IL) 23/17 axis in psoriasis pathogenesis, led to development of new biologic drugs. Risankizumab is a humanized immunoglobulin G1 monoclonal antibody specifically targeting IL23. Its efficacy and safety were showed by both clinical trials and real-life experiences. However, real-life data on effectiveness and safety of risankizumab in patients who previously failed anti-IL17 are scant. To assess the efficacy and safety of risankizumab in patients who previously failed anti-IL17. A 52-week real-life retrospective study was performed to assess the long-term efficacy and safety of risankizumab in patients who previously failed anti-IL17. A total of 39 patients (26 male, 66.7%; mean age 50.5 ± 13.7 years) were enrolled. A statistically significant reduction of psoriasis area severity index (PASI) and body surface area (BSA) was assessed at each follow-up (PASI at baseline vs. week 52: 13.7 ± 5.8 vs. 0.9 ± 0.8, p < 0.0001; BSA 21.9 ± 14.6 vs. 1.9 ± 1.7, p < 0.0001). Nail psoriasis severity index improved as well, being statistically significative only at week 16 and thereafter [9.3 ± 4.7 at baseline, 4.1 ± 2.4 (p < 0.01) at week 16, 1.4 ± 0.8 (p < 0.0001) at week 52]. Treatment was discontinued for primary and secondary inefficacy in 1(2.6%) and 3(7.7%) patients, respectively. No cases of serious adverse events were assessed. Our real-life study confirmed the efficacy and safety of risankizumab, suggesting it as a valuable therapeutic weapon among the armamentarium of biologics, also in psoriasis patients who previously failed anti-IL17 treatments.


Subject(s)
Antibodies, Monoclonal, Humanized , Psoriasis , Adult , Antibodies, Monoclonal, Humanized/therapeutic use , Female , Humans , Interleukin-23 , Male , Middle Aged , Psoriasis/chemically induced , Psoriasis/diagnosis , Psoriasis/drug therapy , Retrospective Studies , Severity of Illness Index , Treatment Outcome
10.
Psoriasis (Auckl) ; 12: 199-204, 2022.
Article in English | MEDLINE | ID: covidwho-1951832

ABSTRACT

Purpose: To determine the efficacy and safety of adalimumab (ADA) and etanercept (ETA) biosimilars in elderly and children with psoriasis. Methods: A real-life retrospective observational study was conducted on pediatric (<18 years) and geriatric (≥65 years) psoriasis patients treated with anti-TNF biosimilar agents referring to the Psoriasis Unit of the University of Naples Federico II, Italy, from January 2018 to January 2022. At baseline, demographic characteristics (age and sex), data on psoriasis duration and severity (measured by Psoriasis Area Severity Index [PASI] and body surface area [BSA]), presence of psoriatic arthritis if applicable, comorbidities, and previous psoriasis treatments were recorded. Patients were monitored by regular follow-ups (week 12, 24, 48 and 72) through clinical and haematological assessments and adverse events (AEs) were registered. Results: A total of 11 children and 23 elderly psoriasis patients were enrolled. Concerning children, 6 (54.5%) were under ADA biosimilar and 5 (45.5%) under ETA biosimilar. ETA and ADA biosimilars were equally effective and safe for up to 72 weeks (mean PASI and BSA < 3). No significant AEs were reported, and none discontinued treatment. In the elderly, 15 (65.2%) were treated with ADA biosimilar and 8 (34.8%) with ETA biosimilar. ETA and ADA biosimilars were equally effective up to 72 weeks (mean PASI < 4 and mean BSA < 5%). AEs (mainly mild) were registered in 9 subjects (39.1%). Also, 4 (17.4%) patients discontinued biologicals for secondary lack of efficacy (3, 75%) or AEs (1, 25%). Conclusion: Our study found that ADA and ETA biosimilars are effective and safe for the treatment of moderate-to-severe psoriasis in children and the elderly. No statistically significant efficacy and safety differences were found between ADA and ETA biosimilars in both children and the elderly. Geriatric patients displayed a higher discontinuation rate and side effects than the pediatric counterpart even if without approaching statistical significance.

14.
J Clin Med ; 11(6)2022 Mar 10.
Article in English | MEDLINE | ID: covidwho-1742498

ABSTRACT

BACKGROUND: The most frequent inflammatory skin diseases are psoriasis, atopic dermatitis, hidradenitis suppurativa, and acne. Their management is challenging for dermatologists since their relapsing chronic clinical course is associated with a great impact on quality of life. Nevertheless, the recent introduction of novel therapies, such as biological drugs and small molecules has been changing the history of these diseases. METHODS: A systematic review of the scientific literature of case reports, case series, epidemiological studies, reviews, and systematic reviews regarding teledermatology and inflammatory skin disease. Studies were identified, screened, and extracted for relevant data following the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines. RESULTS: A total of 69 cases articles were included in the review. CONCLUSIONS: As we have shown in the review, several experiences of teledermatology for patients affected by inflammatory skin diseases have been demonstrated to increase due to clinical access to hospital and specialized health care services, allowing better access to specialized dermatology care for people living in remote areas, and saving costs and money with health care.

17.
Ital J Dermatol Venerol ; 156(3): 366-373, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1207967

ABSTRACT

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has become pandemic on March 11th, 2020. COVID-19 has a range of symptoms that includes fever, fatigue, dry cough, aches, and labored breathing to acute respiratory distress and possibly death. Health systems and hospitals have been completely rearranged since March 2020 in order to limit the high rate of virus spreading. Hence, a great debate on deferrable visits and treatments including phototherapy for skin diseases is developing. In particular, as regards phototherapy very few data are currently available regarding the chance to continue it, even if it may be a useful resource for treating numerous dermatological patients. However, phototherapy has an immunosuppressive action possibly facilitating virus infection. In the context of COVID-19 infection risk it is important to pointed out whether sunlight, phototherapy and in particular ultraviolet radiation (UV-R) constitute or not a risk for patients. In this review we aimed to focus on the relationship between UV-R, sunlight, phototherapy, and viral infections particularly focusing on COVID-19.


Subject(s)
COVID-19/epidemiology , Pandemics , SARS-CoV-2/radiation effects , Sunlight , Ultraviolet Rays , Vitamin D/physiology , Adaptive Immunity/radiation effects , Animals , Antimicrobial Cationic Peptides/biosynthesis , Antimicrobial Cationic Peptides/physiology , Cytokines/metabolism , Disease Models, Animal , Disease Susceptibility , Humans , Immunity, Innate/radiation effects , Interleukin-6/blood , Pathogen-Associated Molecular Pattern Molecules , SARS-CoV-2/genetics , SARS-CoV-2/pathogenicity , Skin Diseases/radiotherapy , Sunlight/adverse effects , Toll-Like Receptors/physiology , Ultraviolet Rays/adverse effects , Ultraviolet Therapy/adverse effects , Viruses/radiation effects , Vitamin D/biosynthesis , Vitamin D/therapeutic use
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