Long-term drug survival of risankizumab in psoriasis: insights from a real-life multicenter study on hard-to-treat areas.

Psoriasis, a chronic inflammatory condition, often presents challenges in treatment, particularly in areas such as nails, palms/soles, scalp/face, and genitalia. Monoclonal antibodies (mAb) like risankizumab targeting interleukin-23 (IL-23) have emerged as promising treatments, yet data on long-term efficacy remain limited. This multicenter retrospective study aimed to evaluate the drug survival at 12 and 36 months of 191 psoriasis patients treated with risankizumab, focusing on critical areas. Patients, previously unresponsive to first-line therapies, were treated according to Italian Guidelines. Survival analysis revealed a 97.6% one-year and 95% three-year drug survival rate. Secondary ineffectiveness was the primary reason for discontinuation, particularly in palmoplantar involvement cases. Factors such as BMI, gender, age, disease duration, baseline severity, and previous biologic exposure did not significantly impact drug survival, except for palmoplantar psoriasis (HR 4.72). Risankizumab demonstrated prolonged response with low treatment switch requirements, especially notable in challenging areas. Understanding such factors can aid in optimizing therapeutic approaches for improved patient care and long-term outcomes in managing psoriasis. Further research is warranted to refine treatment strategies in difficult-to-treat areas.

Relevance of in vitro 3-D skin models in dissecting cytokine contribution to psoriasis pathogenesis.

Psoriasis is a chronic skin disease characterized by the activation of various T cell subsets secreting IFNγ, IL-17, and IL-22, dendritic cells producing TNFα and IFNα, and other immune cells including neutrophils and mast cells. Keratinocytes respond to different cytokine signals orchestrating innate and adaptive immune responses. In vitro studies sought to clarify the cytokine effects on keratinocytes in order to evaluate the centrality of these mediators in psoriasis pathogenesis. The aim of this review is to highlight the relevance of this peculiar in vitro approach in investigating cytokine effects on skin or multilayered epidermis. Particularly, we reported keynfindings supporting the cytokine role in psoriasis pathogenesis.

The use of a collagen matrix in hard-to-heal venous leg ulcers.

OBJECTIVE: The effects of a collagen dressing on hard-to-heal venous leg ulcers (vlUs) were evaluated in this prospective, randomised, controlled study. METHOD: Patients with hard-to-heal vlU were included and divided into two groups using the block randomisation method. The first group was treated with a collagen and an alginate dressing (group A), and the second group with an alginate dressing alone (group b). both groups also had a short-stretch compression system applied at every dressing change. The dressings were changed twice a week for 12 weeks or until the ulcer was healed. Granulation tissue improvement, wound size, overall dressing performance and dressing comfort were evaluated and recorded. RESULTS: A total of 40 patients completed the study evaluation period. Group A had a 65% increase in granulation tissue compared to 38% in group b. The mean ulcer area was reduced to 45% in group A compared to 20% in group b at 12 weeks. no significant side effects were detected in either group. Patients of both groups were satisfied with their treatment and healing progress. CONCLUSION: The results of this study showed the effectiveness and safety of a collagen dressing in hard-to-heal vlUs as an adjunctive therapy with compression bandaging. These encouraging results may positively affect the quality of life of patients with chronic wounds.