Real-life experience with dimethylfumarate in palmoplantar psoriasis: A multicentre retrospective Italian study.

Palmoplantar (PP) psoriasis is considered one of the most hard-to-treat areas with important impact on patients' quality of life, and few data are available about the efficacy of dimethylfumarate (DMF) on these areas. In our noninterventional multicentre retrospective cohort study of patients with PP psoriasis treated with DMF, effectiveness was evaluated as mean pp Psoriasis Area and Severity Index (ppPASI) reduction and as proportion of patients that reach ppPASI 75 at 4, 12, 24 and 48 weeks. The reduction in ppPASI was 23.5% at w4, 49.7% at w12, 69.1% at w24 and 81.1% at w48. pp Investigator's Global Assessment (ppIGA) 0/1 was reached by 5 patients (10.64%) at w4, 10 patients (23.8%) at w12, 11 patients (40.7%) at w24 and 12 patients (60%) at w48 confirming that DMF could represent an effective therapy in patients affected by PP psoriasis. Overall, the treatment was well tolerated although only 24 patients made it to 24 weeks of therapy and 28 patients completed the observation period at 48 weeks. None of the patients reported adverse events requiring discontinuation of the drug. However, this discontinuation rate is in line with clinical trials and real-world evidence.

Pleiotropic effect of Lactoferrin in the prevention and treatment of COVID-19 infection: in vivo, in silico and in vitro preliminary evidences

Lactoferrin, a multifunctional cationic glycoprotein, secreted by exocrine glands and neutrophils, possesses an antiviral activity extendable to SARS-CoV-2. We performed in vitro assays proving lactoferrin antiviral activity through direct attachment to both virus and cell surface components. This activity varied according to concentration (100/500g/ml), multiplicity of infection (0.1/0.01) and cell type (Vero E6/Caco-2 cells). Interestingly, the in silico results strongly supported the hypothesis of a direct recognition between the lactoferrin and the Spike S glycoprotein, thus hindering the viral entry into the cells. Hence, we conducted a clinical trial to investigate effect and tolerability of a liposomal lactoferrin formulation as a supplementary nutraceutical agent in mild-to-moderate and asymptomatic COVID-19 patients. A total of 92 mild-to-moderate (67/92) and asymptomatic (25/92) COVID-19 patients were recruited and divided in 3 groups according to the administered regimen. Thirty-two patients, 14 hospitalised and 18 in home-based insolation received oral and intranasal liposomal bovine lactoferrin (bLf), 32 hospitalised patients were treated with standard of care treatment (hydroxychloroquine, azitromicin and lopinavir/darunavir), and 28, in home-based isolation, did not take any medication. Furthermore, 32 COVID-19 negative, not-treated, healthy subjects were added as a control group for ancillary analysis. bLf-supplemented COVID-19 patients obtained an earlier and significant (p < 0,0001.) median rRT-PCR SARS-COV-2 RNA negative conversion than standard of care-treated and non-treated COVID-19 patients (14.25 vs 27.13 vs 32.61 days, respectively). In addition, bLf-supplemented COVID-19 patients showed significant fast clinical symptoms recovery than standard of care-treated and non-treated COVID-19 patients. Moreover, in bLf-supplemented patients, a significant decrease of either serum ferritin or IL-6 levels or host iron overload, all parameters characterizing inflammatory processes, were observed. Serum D-dimers was also found significantly decreased following bLf supplement. No adverse events were reported. These in vitro and in vivo observations led us to speculate a potential and safe supplementary role of Blf in the management of mild-to-moderate and asymptomatic COVID-19 patients.