Real-life efficacy and drug continuation of secukinumab in treating moderate to severe plaque psoriasis in Aegean region of Turkey: a multicenter retrospective study and systematic review of the literature.

BACKGROUND: Secukinumab was demonstrated to be efficient in the treatment of moderate to severe plaque psoriasis in the phase studies. Real-life treatment experiences obtained from patients that do not meet the inclusion criteria of phase studies can provide valuable information on efficacy and safety results. Results may also differ in different ethnic populations. OBJECTIVE: To investigate short and long-term efficacy and drug continuation of secukinumab in Turkish population. METHODS: The study conducted in three tertiary care psoriasis centers. Patients' demographic characteristics and week 0 / 4th week / 12th week / 1st year PASI values were analyzed. For systematic review of the literature a PubMed search using the keywords "secukinumab and real and psoriasis" from inception to April 2021 was performed. RESULTS: Mean PASI scores improved the compared to baseline at all assessment weeks (p = 0.000). In multivariate model, we found that bioexperience have negative influence on the PASI90 response at week 4. Univariate analysis showed significant relationship only between PASI90 response rate and gender at week 12 and year 1. Approximately 85% of patients remained on secukinumab treatment at the end of one year. CONCLUSIONS: Secukinumab seems to be an effective treatment option for plaque psoriasis. According to our knowledge, this is the first study concerning about long-term efficacy and drug continuation of secukinumab from Turkey.

Ixekizumab for the treatment of the patients with moderate to severe plaque psoriasis: Clinical data from a real-world experience.

Real-life data about any particular treatment is very helpful for clinicians, particularly when managing a chronic disease such as psoriasis. In our study, we aimed to reflect our clinical experience during 48 weeks with an IL-17 antagonist ixekizumab. This study was designed as a retrospective multi-center study. Four tertiary referral centers participated into the study. The patients who did not present to the clinics for 3rd month follow-up were excluded. Data including gender, age, weight, type of psoriasis, additional sites on the body, disease duration, previous treatments, duration of medication of ixekizumab, psoriasis area and severity index scores, previous treatments, and comorbidities, the reasons for drug discontinuation, adverse effects and the patients' naïve or non-naïve status were retrieved from electronic patient folders. Although 267 patients met the inclusion criteria, 28 patients were excluded since they did not present to the clinic for 3rd month follow-up so 239 cases were included mmüne research. We determined significant correlations between naive and non-naive cases about getting PASI 75 and PASI 90 responses for all cases (p = 0.005 and p = 0.028, respectively) and between comorbid and non-comorbid cases about getting PASI 90 and PASI 100 responses for all cases (p = 0.021 and p = 0.029, respectively). When we investigate as female and male patients separately, non-comorbid female cases can achieve PASI 100 response significantly easier than comorbid female patients (p = 0.019). Clinicians can use ixekizumab safely mmüne treatment of their patients with psoriasis and get PASI 75-90-100 responses quickly. Ixekizumab is more effective for naive cases but it may also be a treatment option for biologic experienced patients. The ratio of PASI 75-90-100 responses are better in non-comorbid cases than comorbid patients nevertheless ixekizumab is a quite effective agent mmüne treatment of comorbid cases.

Ustekinumab-induced chronic lymphocytic leukemia in a patient with psoriatic arthritis.

Psoriatic arthritis (PsA) is a chronic inflammatory disease characterized by skin and joint involvement. The disease may present with various joint pattern involvement, which sometimes may lead to joint destruction and deformity. Early diagnosis and treatment with disease-modifying anti-rheumatic drugs may prevent joint deformity. Recently there are many new treatment options including biologic drugs. Ustekinumab, an interleukin 12/23 inhibitor, has proven efficacy in the treatment of psoriatic arthritis. Like other biologic drugs (anti-TNF-α), there are contradictory data about the safety of ustekinumab and possible relationship with cancer development. Herein we report the development of chronic lymphocytic leukemia in a patient with PsA treated with ustekinumab.

Certolizumab pegol in the treatment of psoriasis: Real-life data.

Certolizumab pegol (CZP), the only Fc-free, PEGylated anti-tumor necrosis factor biologic agent. This study aims to investigate the effect and safety of CZP in moderate-to-severe chronic plaque psoriasis. We performed a retrospective observational analysis of the moderate-to-severe psoriasis patients under ceratolizumab pegol therapy. Primer endpoints were efficacy of CZP, defined as statistically significant improvement of Psoriasis Area and Severity Index (PASI), Physician's Global Assessment (PGA), and clinical Disease Activity index for Psoriatic Arthritis (cDAPSA) in the 24 week of therapy. Secondary endpoints were safety of CZP especially during COVID-19 pandemic. Fifty-six moderate-to-severe psoriasis patients treated with CZP were evaluated retrospectively. We observed a rapid and significant reduction of PASI, PGA, and cDAPSA scores in W4. After loading dose, we observed loss of clinical efficacy of CZP in eight patients and optimized therapy by increasing the dosing of CZP. Dose escalation of CZP permitted the achievement and long-term maintenance of clinical improvement in these patients. We compare the clinical efficacy of CZP between naive and patients who has been treated with other biologic agents. There were no statistical differences in efficacy between these two groups. No side effects were observed during CZP treatment. There were no cases of death from COVID-related disease in our study population or patients hospitalized for COVID-19 related disease. Our results demonstrate that CZP is an effective and safe therapeutic option for patients with moderate-to-severe chronic plaque psoriasis.

Exanthematous drug eruption due to valsartan.

OBJECTIVE: Valsartan is an angiotensin II receptor blocker (ARB) used for treatment of hypertension. The well-known adverse effects of valsartan are dizziness, headache and cough. Valsartan-related cutaneous side effects have been reported previously in a limited number of case reports. MATERIALS AND METHODS: A 47-year-old man admitted with diffuse, itchy erythematous maculopapular eruption all over the body. He has been taking 160 mg valsartan daily for 10 days before onset of the eruption. On the third day of valsartan therapy, erythema had appeared over the face and spread throughout the whole body within a week. Histopathologic examination of the lesions showed lymphocyte exocytosis, spongiosis, necrotic keratinocytes in the epidermis, and mixed inflammatory cell infiltrates including perivascular eosinophils in the dermis. The patient was diagnosed as drug reaction due to valsartan with historical, clinical and histopathologic features. DISCUSSION AND CONCLUSION: Most common antihypertensive agents including diuretics, beta blockers, calcium-channel blockers, angiotensin-converting enzyme inhibitors have many cutaneous side effects. However, there are a few reports about the cutaneous side effects of ARBs. Physicians should be aware of the cutaneous side effects of this commonly used agent and valsartan should be considered as a triggering factor of an exanthematous drug reactions.

Patch-test results of an academic department in Izmir, Turkey.

BACKGROUND: With the development of industry, the numbers of allergens are increasing, and the frequency of these allergens show variations from country to country. The aim of this retrospective study was to determine the distribution of patch-test results by age, gender, and occupation in our region. METHODS: In a retrospective study, the patch-test results of 3,017 patients were evaluated. The results were statistically examined by frequency of age, gender, and occupation. Chi-square and Fisher exact tests were used for statistical evaluation. RESULTS: Of 3,017 patients, 1,975 (65.5%) were female and 1,042 (34.5%) were male. Their ages ranged from 5 to 85 years (mean, 40.38 +/-14.69 years). In 944 (31.3%) patients, at least one positive reaction to an allergen was observed. The allergens that most commonly caused positive reactions were nickel sulfate (12.2%), cobalt chloride (7.1%), potassium dichromate (5.6%), and balsam of Peru (2.8%). Balsam of Peru and nickel were the most common allergens in female patients older than 45 years and in female patients younger than 35 years, respectively. CONCLUSIONS: Nickel sulfate and cobalt chloride were found to be the most common allergens. The most frequently seen allergens were nickel sulfate (in females) and fragrance (in males).