ABSTRACT
Background Basal cell carcinoma (BCC) is the most prevalent cancer. A minority of BCCs have an aggressive behaviour (laBCC) and may require hedgehog pathway inhibitors such as sonidegib as its treatment. Objective To describe the use of sonidegib in a large number of patients and provide more data on its real-life efficacy and safety profile. Methods We conducted a retrospective and multicentric study that included patients treated with sonidegib. Epidemiological, effectiveness and safety data were collected. Results A total of 82 patients with a mean age of 73.9 years were included. Ten patients had Gorlin syndrome. Median treatment duration was 6 months. Median follow-up duration was 34.2 months. Globally, 81.7% of the patients showed clinical improvement (52.4% partial response and 29.3% complete response), 12.2% clinical stability and 6.1% disease progression. There was no statistically significant difference in clinical improvement between the 24h and 48h sonidegib posology. After 6 months of treatment, 48.8% of the patients discontinued sonidegib. Prior vismodegib treatment and recurrent primary BCC were associated with a poorer response to sonidegib. At 6 months of treatment, 68.3% of the patients experienced at least one adverse effect. Conclusion Sonidegib shows good effectiveness and acceptable safety profile in usual clinical practice (AU)
Antecedentes El carcinoma de células basales (CBC) es el cáncer más prevalente. Una minoría de CBC tiene un comportamiento agresivo (laBCC) y puede requerir inhibidores de la vía del erizo, como sonidegib como tratamiento. Objetivo Describir el uso de sonidegib en un gran número de pacientes y aportar más datos sobre su perfil de eficacia y seguridad en la vida real. Métodos Realizamos un estudio retrospectivo y multicéntrico que incluyó pacientes tratados con sonidegib. Se recogieron datos epidemiológicos, de eficacia y de seguridad. Resultados Se incluyeron un total de 82 pacientes con una edad media de 73,9 años. Diez pacientes tenían síndrome de Gorlin. La mediana de duración del tratamiento fue de 6 meses. La mediana de duración del seguimiento fue de 34,2 meses. Globalmente, el 81,7% de los pacientes mostró mejoría clínica (52,4% respuesta parcial y 29,3% respuesta completa), el 12,2% estabilidad clínica y el 6,1% progresión de la enfermedad. No hubo diferencias estadísticamente significativas en la mejoría clínica entre la posología de sonidegib de 24horas y de 48horas. Después de 6 meses de tratamiento, el 48,8% de los pacientes suspendió sonidegib. El tratamiento previo con vismodegib y el CBC primario recurrente se asociaron con una peor respuesta a sonidegib. A los 6 meses de tratamiento el 68,3% de los pacientes experimentó al menos un efecto adverso. Conclusión Sonidegib muestra un perfil de eficacia y seguridad mejor de lo esperado en la práctica clínica habitual (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Carcinoma, Basal Cell/drug therapy , Skin Neoplasms/drug therapy , Biphenyl Compounds/therapeutic use , Pyridines/therapeutic use , Treatment Outcome , Retrospective StudiesABSTRACT
Antecedentes El carcinoma de células basales (CBC) es el cáncer más prevalente. Una minoría de CBC tiene un comportamiento agresivo (laBCC) y puede requerir inhibidores de la vía del erizo, como sonidegib como tratamiento. Objetivo Describir el uso de sonidegib en un gran número de pacientes y aportar más datos sobre su perfil de eficacia y seguridad en la vida real. Métodos Realizamos un estudio retrospectivo y multicéntrico que incluyó pacientes tratados con sonidegib. Se recogieron datos epidemiológicos, de eficacia y de seguridad. Resultados Se incluyeron un total de 82 pacientes con una edad media de 73,9 años. Diez pacientes tenían síndrome de Gorlin. La mediana de duración del tratamiento fue de 6 meses. La mediana de duración del seguimiento fue de 34,2 meses. Globalmente, el 81,7% de los pacientes mostró mejoría clínica (52,4% respuesta parcial y 29,3% respuesta completa), el 12,2% estabilidad clínica y el 6,1% progresión de la enfermedad. No hubo diferencias estadísticamente significativas en la mejoría clínica entre la posología de sonidegib de 24horas y de 48horas. Después de 6 meses de tratamiento, el 48,8% de los pacientes suspendió sonidegib. El tratamiento previo con vismodegib y el CBC primario recurrente se asociaron con una peor respuesta a sonidegib. A los 6 meses de tratamiento el 68,3% de los pacientes experimentó al menos un efecto adverso. Conclusión Sonidegib muestra un perfil de eficacia y seguridad mejor de lo esperado en la práctica clínica habitual (AU)
Background Basal cell carcinoma (BCC) is the most prevalent cancer. A minority of BCCs have an aggressive behaviour (laBCC) and may require hedgehog pathway inhibitors such as sonidegib as its treatment. Objective To describe the use of sonidegib in a large number of patients and provide more data on its real-life efficacy and safety profile. Methods We conducted a retrospective and multicentric study that included patients treated with sonidegib. Epidemiological, effectiveness and safety data were collected. Results A total of 82 patients with a mean age of 73.9 years were included. Ten patients had Gorlin syndrome. Median treatment duration was 6 months. Median follow-up duration was 34.2 months. Globally, 81.7% of the patients showed clinical improvement (52.4% partial response and 29.3% complete response), 12.2% clinical stability and 6.1% disease progression. There was no statistically significant difference in clinical improvement between the 24h and 48h sonidegib posology. After 6 months of treatment, 48.8% of the patients discontinued sonidegib. Prior vismodegib treatment and recurrent primary BCC were associated with a poorer response to sonidegib. At 6 months of treatment, 68.3% of the patients experienced at least one adverse effect. Conclusion Sonidegib shows good effectiveness and acceptable safety profile in usual clinical practice (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Carcinoma, Basal Cell/drug therapy , Skin Neoplasms/drug therapy , Biphenyl Compounds/therapeutic use , Pyridines/therapeutic use , Treatment Outcome , Retrospective StudiesABSTRACT
BACKGROUND: Basal cell carcinoma (BCC) is the most prevalent cancer. A minority of BCCs have an aggressive behaviour (laBCC) and may require hedgehog pathway inhibitors such as sonidegib as its treatment. OBJECTIVE: To describe the use of sonidegib in a large number of patients and provide more data on its real-life efficacy and safety profile. METHODS: We conducted a retrospective and multicentric study that included patients treated with sonidegib. Epidemiological, effectiveness and safety data were collected. RESULTS: A total of 82 patients with a mean age of 73.9 years were included. Ten patients had Gorlin syndrome. Median treatment duration was 6 months. Median follow-up duration was 34.2 months. Globally, 81.7% of the patients showed clinical improvement (52.4% partial response and 29.3% complete response), 12.2% clinical stability and 6.1% disease progression. There was no statistically significant difference in clinical improvement between the 24 h and 48 h sonidegib posology. After 6 months of treatment, 48.8% of the patients discontinued sonidegib. Prior vismodegib treatment and recurrent primary BCC were associated with a poorer response to sonidegib. At 6 months of treatment, 68.3% of the patients experienced at least one adverse effect. CONCLUSION: Sonidegib shows good effectiveness and acceptable safety profile in usual clinical practice.
Subject(s)
Antineoplastic Agents , Carcinoma, Basal Cell , Skin Neoplasms , Humans , Aged , Skin Neoplasms/drug therapy , Skin Neoplasms/pathology , Retrospective Studies , Hedgehog Proteins/metabolism , Hedgehog Proteins/therapeutic use , Carcinoma, Basal Cell/drug therapy , Carcinoma, Basal Cell/pathology , Antineoplastic Agents/adverse effects , Anilides/adverse effectsABSTRACT
BACKGROUND: Basal cell carcinoma (BCC) is the most prevalent cancer. A minority of BCCs have an aggressive behaviour (laBCC) and may require hedgehog pathway inhibitors such as sonidegib as its treatment. OBJECTIVE: To describe the use of sonidegib in a large number of patients and provide more data on its real-life efficacy and safety profile. METHODS: We conducted a retrospective and multicentric study that included patients treated with sonidegib. Epidemiological, effectiveness and safety data were collected. RESULTS: A total of 82 patients with a mean age of 73.9 years were included. Ten patients had Gorlin syndrome. Median treatment duration was 6 months. Median follow-up duration was 34.2 months. Globally, 81.7% of the patients showed clinical improvement (52.4% partial response and 29.3% complete response), 12.2% clinical stability and 6.1% disease progression. There was no statistically significant difference in clinical improvement between the 24h and 48h sonidegib posology. After 6 months of treatment, 48.8% of the patients discontinued sonidegib. Prior vismodegib treatment and recurrent primary BCC were associated with a poorer response to sonidegib. At 6 months of treatment, 68.3% of the patients experienced at least one adverse effect. CONCLUSION: Sonidegib shows good effectiveness and acceptable safety profile in usual clinical practice.
Subject(s)
Antineoplastic Agents , Carcinoma, Basal Cell , Skin Neoplasms , Humans , Aged , Skin Neoplasms/drug therapy , Skin Neoplasms/pathology , Retrospective Studies , Hedgehog Proteins/metabolism , Hedgehog Proteins/therapeutic use , Carcinoma, Basal Cell/drug therapy , Carcinoma, Basal Cell/pathology , Antineoplastic Agents/adverse effects , Anilides/adverse effectsABSTRACT
Background Patients with severe psoriasis have an increased cardiovascular (CV) risk and prevalence of subclinical coronary artery disease (CAD). Coronary artery calcium (CAC) testing can detect subclinical CAD and improve cardiovascular risk assessment beyond clinical scores. Objectives Evaluate the presence and magnitude of subclinical CAD determined by CAC score among the different ESC/EAS CV risk categories, as well as the potential for risk reclassification, in patients with severe psoriasis from a low CV risk population. Methods Unicentric cross-sectional study in 111 patients with severe chronic plaque psoriasis from a low CV risk population in the Mediterranean region. Patients were classified into four CV risk categories according to the ESC/EAS guideline recommendations and HeartScore/SCORE calibrated charts. Patients underwent coronary computed tomography to determine their CAC scores. Patients in the moderate-risk category with a CAC score of ≥100 were considered to be reclassified as recommended by the 2019 ESC/EAS guidelines. Reclassification was also considered for patients in the low-risk category with a CAC score>0. Results Presence of subclinical CAD was detected in 46 (41.4%) patients. These accounted for 86.2% of patients in high/very-high-risk categories and 25.6% of patients in non-high-risk categories. Fourteen (17.1%) of the patients in non-high-risk categories were reclassifiable due to their CAC score. This percentage was higher (25%) when considering the moderate-risk category alone and lower (13.8%) in the low-risk category. Age was the only variable associated with presence of subclinical CAD and reclassification. Conclusions Over 40% of patients with severe psoriasis from a low-risk region and up to 25% of those in non-high-risk categories have subclinical CAD (AU)
Antecedentes Los pacientes con psoriasis severa tienen riesgo cardiovascular (CV) incrementado, así como prevalencia de la enfermedad de las arterias coronarias (EAC) subclínica. El examen de calcio en las arterias coronarias (CAC) puede detectar la EAC subclínica y mejorar la evaluación del riesgo CV más allá de las puntuaciones clínicas. Objetivos Evaluar la presencia y magnitud de la EAC subclínica determinadas mediante la puntuación CAC entre las diferentes categorías de riesgo CV de ESC/EAS, así como el potencial de reclasificación del riesgo, en pacientes con psoriasis severa, procedentes de una población de riesgo CV bajo. Métodos Estudio transversal unicéntrico de 111 pacientes con psoriasis crónica en placa procedentes de una población de bajo riesgo CV de la región mediterránea. Los pacientes fueron clasificados en cuatro categorías de riesgo CV conforme a las recomendaciones de la guía ESC/EAS y la tabla de calibración HeartScore/SCORE. Se realizó a los pacientes una tomografía computarizada para determinar sus puntuaciones CAC. Se consideró que los pacientes de la categoría de riesgo moderado con una puntuación CAC≥100 debían ser reclasificados, conforme a las guías ESC/EAS de 2019. También se reconsideró la reclasificación para aquellos pacientes de la categoría de riesgo bajo con una puntuación CAC>0. Resultados La presencia de EAC subclínica fue detectada en 46 pacientes (41,4%), que representaron el 86,2% de los pacientes incluidos en las categorías de riesgo alto/muy alto, y el 25,6% de los pacientes de las categorías de riesgo no alto. Catorce pacientes (17,1%) de las categorías de riesgo no alto no fueron reclasificables debido a su puntuación CAC. Este porcentaje fue más alto (25%) al considerar la categoría de riesgo moderado en solitario, y más bajo (13,8%) en la categoría de riesgo bajo. La edad fue la única variable asociada a la presencia de EAC subclínica y reclasificación (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Cardiovascular Diseases/etiology , Risk Assessment , Psoriasis/complications , Calcium/analysis , Coronary Vessels/chemistry , Severity of Illness Index , Cross-Sectional Studies , Biomarkers/analysis , Risk FactorsABSTRACT
Antecedentes Los pacientes con psoriasis severa tienen riesgo cardiovascular (CV) incrementado, así como prevalencia de la enfermedad de las arterias coronarias (EAC) subclínica. El examen de calcio en las arterias coronarias (CAC) puede detectar la EAC subclínica y mejorar la evaluación del riesgo CV más allá de las puntuaciones clínicas. Objetivos Evaluar la presencia y magnitud de la EAC subclínica determinadas mediante la puntuación CAC entre las diferentes categorías de riesgo CV de ESC/EAS, así como el potencial de reclasificación del riesgo, en pacientes con psoriasis severa, procedentes de una población de riesgo CV bajo. Métodos Estudio transversal unicéntrico de 111 pacientes con psoriasis crónica en placa procedentes de una población de bajo riesgo CV de la región mediterránea. Los pacientes fueron clasificados en cuatro categorías de riesgo CV conforme a las recomendaciones de la guía ESC/EAS y la tabla de calibración HeartScore/SCORE. Se realizó a los pacientes una tomografía computarizada para determinar sus puntuaciones CAC. Se consideró que los pacientes de la categoría de riesgo moderado con una puntuación CAC≥100 debían ser reclasificados, conforme a las guías ESC/EAS de 2019. También se reconsideró la reclasificación para aquellos pacientes de la categoría de riesgo bajo con una puntuación CAC>0. Resultados La presencia de EAC subclínica fue detectada en 46 pacientes (41,4%), que representaron el 86,2% de los pacientes incluidos en las categorías de riesgo alto/muy alto, y el 25,6% de los pacientes de las categorías de riesgo no alto. Catorce pacientes (17,1%) de las categorías de riesgo no alto no fueron reclasificables debido a su puntuación CAC. Este porcentaje fue más alto (25%) al considerar la categoría de riesgo moderado en solitario, y más bajo (13,8%) en la categoría de riesgo bajo. La edad fue la única variable asociada a la presencia de EAC subclínica y reclasificación (AU)
Background Patients with severe psoriasis have an increased cardiovascular (CV) risk and prevalence of subclinical coronary artery disease (CAD). Coronary artery calcium (CAC) testing can detect subclinical CAD and improve cardiovascular risk assessment beyond clinical scores. Objectives Evaluate the presence and magnitude of subclinical CAD determined by CAC score among the different ESC/EAS CV risk categories, as well as the potential for risk reclassification, in patients with severe psoriasis from a low CV risk population. Methods Unicentric cross-sectional study in 111 patients with severe chronic plaque psoriasis from a low CV risk population in the Mediterranean region. Patients were classified into four CV risk categories according to the ESC/EAS guideline recommendations and HeartScore/SCORE calibrated charts. Patients underwent coronary computed tomography to determine their CAC scores. Patients in the moderate-risk category with a CAC score of ≥100 were considered to be reclassified as recommended by the 2019 ESC/EAS guidelines. Reclassification was also considered for patients in the low-risk category with a CAC score>0. Results Presence of subclinical CAD was detected in 46 (41.4%) patients. These accounted for 86.2% of patients in high/very-high-risk categories and 25.6% of patients in non-high-risk categories. Fourteen (17.1%) of the patients in non-high-risk categories were reclassifiable due to their CAC score. This percentage was higher (25%) when considering the moderate-risk category alone and lower (13.8%) in the low-risk category. Age was the only variable associated with presence of subclinical CAD and reclassification. Conclusions Over 40% of patients with severe psoriasis from a low-risk region and up to 25% of those in non-high-risk categories have subclinical CAD (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Cardiovascular Diseases/etiology , Risk Assessment , Psoriasis/complications , Calcium/analysis , Coronary Vessels/chemistry , Severity of Illness Index , Cross-Sectional Studies , Biomarkers/analysis , Risk FactorsABSTRACT
BACKGROUND: Patients with severe psoriasis have an increased cardiovascular (CV) risk and prevalence of subclinical coronary artery disease (CAD). Coronary artery calcium (CAC) testing can detect subclinical CAD and improve cardiovascular risk assessment beyond clinical scores. OBJECTIVES: Evaluate the presence and magnitude of subclinical CAD determined by CAC score among the different ESC/EAS CV risk categories, as well as the potential for risk reclassification, in patients with severe psoriasis from a low CV risk population. METHODS: Unicentric cross-sectional study in 111 patients with severe chronic plaque psoriasis from a low CV risk population in the Mediterranean region. Patients were classified into four CV risk categories according to the ESC/EAS guideline recommendations and HeartScore/SCORE calibrated charts. Patients underwent coronary computed tomography to determine their CAC scores. Patients in the moderate-risk category with a CAC score of ≥100 were considered to be reclassified as recommended by the 2019 ESC/EAS guidelines. Reclassification was also considered for patients in the low-risk category with a CAC score>0. RESULTS: Presence of subclinical CAD was detected in 46 (41.4%) patients. These accounted for 86.2% of patients in high/very-high-risk categories and 25.6% of patients in non-high-risk categories. Fourteen (17.1%) of the patients in non-high-risk categories were reclassifiable due to their CAC score. This percentage was higher (25%) when considering the moderate-risk category alone and lower (13.8%) in the low-risk category. Age was the only variable associated with presence of subclinical CAD and reclassification. CONCLUSIONS: Over 40% of patients with severe psoriasis from a low-risk region and up to 25% of those in non-high-risk categories have subclinical CAD. CAC appears to be useful for reclassification purposes in CV risk assessment of patients with severe psoriasis. Further research is required to elucidate how CAC could be implemented in everyday practice at outpatient dermatology clinics dedicated to severe psoriasis.
Subject(s)
Cardiovascular Diseases , Coronary Artery Disease , Psoriasis , Calcium , Coronary Angiography , Cross-Sectional Studies , Heart Disease Risk Factors , Humans , Risk Assessment , Risk FactorsABSTRACT
Structural disorder has been shown to be responsible for profound changes of the interaction-energy landscapes and collective dynamics of two-dimensional (2D) magnetic nanostructures. Weakly-disordered 2D ensembles have a few particularly stable magnetic configurations with large basins of attraction from which the higher-energy metastable configurations are separated by only small downward barriers. In contrast, strongly-disordered ensembles have rough energy landscapes with a large number of low-energy local minima separated by relatively large energy barriers. Consequently, the former show good-structure-seeker behavior with an unhindered relaxation dynamics that is funnelled towards the global minimum, whereas the latter show a time evolution involving multiple time scales and trapping which is reminiscent of glasses. Although these general trends have been clearly established, a detailed assessment of the extent of these effects in specific nanostructure realizations remains elusive. The present study quantifies the disorder-induced changes in the interaction-energy landscape of two-dimensional dipole-coupled magnetic nanoparticles as a function of the magnetic configuration of the ensembles. Representative examples of weakly-disordered square-lattice arrangements, showing good structure-seeker behavior, and of strongly-disordered arrangements, showing spin-glass-like behavior, are considered. The topology of the kinetic networks of metastable magnetic configurations is analyzed. The consequences of disorder on the morphology of the interaction-energy landscapes are revealed by contrasting the corresponding disconnectivity graphs. The correlations between the characteristics of the energy landscapes and the Markovian dynamics of the various magnetic nanostructures are quantified by calculating the field-free relaxation time evolution after either magnetic saturation or thermal quenching and by comparing them with the corresponding averages over a large number of structural arrangements. Common trends and system-specific features are identified and discussed.
ABSTRACT
ANTECEDENTES: La asociación entre los inhibidores de la dipeptidil peptidasa 4 (iDPP-4) y el penfigoide ampolloso (PA) se ha demostrado en varios estudios. El objetivo principal de este estudio era estimar el uso del tratamiento con iDPP-4i en pacientes diagnosticados de PA en nuestro entorno. MATERIAL Y MÉTODOS: Seleccionamos pacientes diagnosticados histológicamente de PA en nuestro departamento entre octubre de 2015 y octubre de 2018. Realizamos una revisión retrospectiva para evaluar los datos clínicos-epidemiológicos y los patrones de inmunofluorescencia directa (IFD). RESULTADOS: De los 70 pacientes diagnosticados con PA durante el período de estudio, el 50% eran diabéticos y el 88,57% de ellos estaban siendo tratados con un iDPP-4 en el momento del diagnóstico de PA. El iDPP-4 más frecuente era la linagliptina (utilizada en el 18,6% de los pacientes), seguida de la vildagliptina (el 17,1%). La mediana de tiempo de latencia entre el inicio del tratamiento con iDPP-4 y el diagnóstico de PA fue de 27,5 meses, siendo de 16 meses para la linagliptina y 39 meses para la vildagliptina (log Rank < 0,01). La IFD fue negativaUn resultado negativo de DIF fue significativamente más común en pacientes que no fueron tratados con un DPP-4i. El patrón DIF más fuertemente (y significativamente) asociado con el tratamiento con DPP-4i fueron los depósitos lineales de inmunoglobulina G a lo largo de la unión dermoepidérmica. El tratamiento con DPP-4i se retiró en el 87% de los pacientes y el 96% de ellos logró una respuesta completa. CONCLUSIÓN: El tratamiento con DPP-4i es muy común en pacientes con BP en nuestro entorno. El período de latencia entre el inicio del tratamiento y el inicio de la PA parece ser más corto con linagliptina que con otros tipos de gliptinas. Los pacientes que reciben tratamiento con DPP-4i pueden mostrar patrones DIF diferentes a los que no reciben tratamiento
BACKGROUND: The association between dipeptidyl peptidase 4 inhibitors (DPP-4i) and bullous pemphigoid (BP) has been demonstrated in several studies. The main aim of this study was to estimate the use of DPP-4i treatment in patients diagnosed with BP in our setting. METHODS: We selected patients histologically diagnosed with BP in our department between October 2015 and October 2018 and performed a retrospective chart review to assess clinical and epidemiological data and direct immunofluorescence (DIF) patterns. RESULTS: Of the 70 patients diagnosed with BP during the study period, 50% were diabetic and 88.57% of these were being treated with a DPP-4i when diagnosed with BP. The most common DPP-4i was linagliptin (used in 18.6% of patients), followed by vildagliptin (17.1%). The median latency period between initiation of DPP-4i treatment and diagnosis of BP was 27.5 months for all treatments, 16 months for linagliptin, and 39 months for vildagliptin (log rank < 0.01). A negative DIF result was significantly more common in patients not being treated with a DPP-4i. The DIF pattern most strongly (and significantly) associated with DPP-4i treatment was linear immunoglobulin G deposits along the dermal-epidermal junction. DPP-4i treatment was withdrawn in 87% of patients and 96% of these achieved a complete response. CONCLUSIONS: DPP-4i treatment is very common in patients with BP in our setting. The latency period between start of treatment and onset of BP seems to be shorter with linagliptin than with other types of gliptins. Patients receiving DPP-4i treatment may show different DIF patterns to those not receiving treatment
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Pemphigoid, Bullous/epidemiology , Fluorescent Antibody Technique, Direct/standards , Pemphigoid, Bullous/chemically induced , Retrospective Studies , Dipeptidyl-Peptidase IV Inhibitors/administration & dosageABSTRACT
INTRODUCCIÓN Y OBJETIVO: Se ha constatado un cambio en la epidemiología del herpes genital en los últimos años con un aumento de la incidencia del virus herpes (VHS) tipo 1. El objetivo de nuestro estudio es analizar las características clínico-epidemiológicas de los pacientes diagnosticados de un herpes genital. MATERIAL Y MÉTODOS: Se diseñó un estudio observacional retrospectivo donde se incluyeron todos los pacientes diagnosticados de herpes genital entre enero de 2016 y enero de 2019 en una Unidad de Infecciones de Transmisión Sexual (ITS) en Valencia, España. RESULTADOS: Se diagnosticaron 895 ITS, de las cuales 126 fueron un herpes genital (14%), 68 (54%) en mujeres y 58 (46%) en hombres. En 110 de ellos (87,3%) se confirmó el herpes genital por la detección de ADN viral por técnicas moleculares. Se diagnosticaron 52 casos de VHS tipo 1 (47,3%) y 58 casos de VHS tipo 2 (52,7%). En el 69,5% de los hombres se detectó el VHS tipo 2, mientras que en el 59,3% de las mujeres se detectó el VHS tipo 1. La edad media de las mujeres diagnosticadas de VHS tipo 1 fue de 26 años, mientras que la de las mujeres diagnosticadas de VHS tipo 2 fue de 34 años (p = 0,015). Las recurrencias de las lesiones en los pacientes con VHS tipo 1 y VHS tipo 2 fue del 13% y del 40%, respectivamente. CONCLUSIÓN: Destacamos un aumento de la prevalencia del VHS tipo 1 en nuestro medio como agente causante de herpes genital, especialmente en mujeres jóvenes. Esto tiene un valor pronóstico importante dado el menor riesgo de recurrencias que tiene
INTRODUCTION AND OBJECTIVE: The epidemiology of genital herpes has changed in recent years with an increase in the incidence of herpes simplex virus type 1 (HSV-1) infection. The aim of this study was to analyze the clinical and epidemiological characteristics of patients diagnosed with genital herpes. MATERIAL AND METHODS: A retrospective observational study was designed. All patients diagnosed with genital herpes between January 2016 and January 2019 in a Sexually Transmitted Infections Unit (ITS) in Valencia, Spain, were included. RESULTS: We identified 895 STI diagnoses. Of these, 126 (14%) were genital herpes; 68 (54%) of these cases were in women and 58 (46%) in men. Diagnosis was confirmed by molecular detection of HSV DNA in 110 cases (87.3%). Of these, 52 were cases of HSV-1 infection (47.3%) and 58 were HSV-2 infection (52.7%). HSV-2 was more common in men (69.5%), while HSV-1 was more common in women (59.3%). In the subgroup of women, mean age at diagnosis was 26 years for HSV-1 and 34 years for HSV-2 (P = .015). Recurrent genital herpes rates were 13% for HSV-1 and 40% for HSV-2. CONCLUSIONS: There has been an increase in the number of cases of genital herpes caused by HSV-1 in our setting, with young women in particular being affected. This has important prognostic implications because genital herpes caused by HSV-1 is less likely to recur
Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Herpes Genitalis/epidemiology , Herpes Genitalis/diagnosis , Herpesvirus 2, Human/isolation & purification , Herpesvirus 1, Human/isolation & purification , Retrospective Studies , Spain/epidemiology , Herpes Genitalis/microbiology , DNA, Viral/analysis , Homosexuality, Male/statistics & numerical data , Polymerase Chain Reaction/methodsABSTRACT
INTRODUCTION AND OBJECTIVE: The epidemiology of genital herpes has changed in recent years with an increase in the incidence of herpes simplex virus type 1 (HSV-1) infection. The aim of this study was to analyze the clinical and epidemiological characteristics of patients diagnosed with genital herpes. MATERIAL AND METHODS: A retrospective observational study was designed. All patients diagnosed with genital herpes between January 2016 and January 2019 in a Sexually Transmitted Infections Unit (ITS) in Valencia, Spain, were included. RESULTS: We identified 895 STI diagnoses. Of these, 126 (14%) were genital herpes; 68 (54%) of these cases were in women and 58 (46%) in men. Diagnosis was confirmed by molecular detection of HSV DNA in 110 cases (87.3%). Of these, 52 were cases of HSV-1 infection (47.3%) and 58 were HSV-2 infection (52.7%). HSV-2 was more common in men (69.5%), while HSV-1 was more common in women (59.3%). In the subgroup of women, mean age at diagnosis was 26 years for HSV-1 and 34 years for HSV-2 (P=.015). Recurrent genital herpes rates were 13% for HSV-1 and 40% for HSV-2. CONCLUSIONS: There has been an increase in the number of cases of genital herpes caused by HSV-1 in our setting, with young women in particular being affected. This has important prognostic implications because genital herpes caused by HSV-1 is less likely to recur.
Subject(s)
Herpes Genitalis/epidemiology , Herpes Genitalis/virology , Herpesvirus 1, Human , Herpesvirus 2, Human , Adult , Female , Humans , Male , Middle Aged , Retrospective Studies , Spain/epidemiology , Young AdultABSTRACT
BACKGROUND: The association between dipeptidyl peptidase 4 inhibitors (DPP-4i) and bullous pemphigoid (BP) has been demonstrated in several studies. The main aim of this study was to estimate the use of DPP-4i treatment in patients diagnosed with BP in our setting. METHODS: We selected patients histologically diagnosed with BP in our department between October 2015 and October 2018 and performed a retrospective chart review to assess clinical and epidemiological data and direct immunofluorescence (DIF) patterns. RESULTS: Of the 70 patients diagnosed with BP during the study period, 50% were diabetic and 88.57% of these were being treated with a DPP-4i when diagnosed with BP. The most common DPP-4i was linagliptin (used in 18.6% of patients), followed by vildagliptin (17.1%). The median latency period between initiation of DPP-4i treatment and diagnosis of BP was 27.5 months for all treatments, 16 months for linagliptin, and 39 months for vildagliptin (log rank < 0.01). A negative DIF result was significantly more common in patients not being treated with a DPP-4i. The DIF pattern most strongly (and significantly) associated with DPP-4i treatment was linear immunoglobulin G deposits along the dermal-epidermal junction. DPP-4i treatment was withdrawn in 87% of patients and 96% of these achieved a complete response. CONCLUSIONS: DPP-4i treatment is very common in patients with BP in our setting. The latency period between start of treatment and onset of BP seems to be shorter with linagliptin than with other types of gliptins. Patients receiving DPP-4i treatment may show different DIF patterns to those not receiving treatment.
Subject(s)
Dipeptidyl-Peptidase IV Inhibitors , Pemphigoid, Bullous , Dipeptidyl-Peptidase IV Inhibitors/adverse effects , Humans , Linagliptin/adverse effects , Pemphigoid, Bullous/chemically induced , Retrospective Studies , VildagliptinABSTRACT
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