Evaluating the risk of infections under interleukin 23 and interleukin 17 inhibitors relative to tumour necrosis factor inhibitors - A population-based study.

BACKGROUND: The risk of infections among patients with psoriasis undergoing interleukin (IL)-23 inhibitors (IL-23i) and IL-17 inhibitors (IL-17i) is yet to be exhaustively determined. OBJECTIVE: To assess the risk of infectious complications in patients with psoriasis managed by IL-23i and IL-17i with tumour necrosis factor inhibitors (TNFi) as a comparator. METHODS: A global cohort study comprised two distinct analyses comparing patients with psoriasis under different therapeutic modalities; (i) new users of IL-23i (n = 5272) versus TNFi (n = 5272) and (ii) new users of IL-17i (n = 15,160) versus TNFi (n = 15,160). Study groups were compared regarding the risk of 26 different infections. Propensity score matching was conducted to optimize between-group comparability. RESULTS: Patients under IL-23i had a lower risk of otitis media (HR, 0.66; 95% CI, 0.44-0.97), encephalitis (HR, 0.18; 95% CI, 0.04-0.78), herpes zoster (HZ; HR, 0.58; 95% CI, 0.41-0.82), hepatitis B virus (HBV) reactivation (HR, 0.24; 95% CI, 0.12-0.47), cytomegalovirus (HR, 0.25; 95% CI, 0.07-0.86), influenza (HR, 0.52; 95% CI, 0.38-0.71) and parasitic diseases (HR, 0.78; 95% CI, 0.64-0.95). IL-17i was associated with a decreased risk of pneumonia (HR, 0.76; 95% CI, 0.68-0.85), septicaemia (HR, 0.84; 95% CI, 0.72-0.97), upper respiratory tract infection (HR, 0.84; 95% CI, 0.77-0.92), HZ (HR, 0.79; 95% CI, 0.67-0.92), HBV (HR, 0.59; 95% CI, 0.46-0.76) and hepatitis C virus (HR, 0.71; 95% CI, 0.57-0.88) reactivation, cytomegalovirus (HR, 0.58; 95% CI, 0.36-0.93), Epstein-Barr virus (HR, 0.38; 95% CI, 0.19-0.75), influenza (HR, 0.70; 95% CI, 0.61-0.81) and parasitic diseases (HR, 0.80; 95% CI, 0.72-0.88). CONCLUSION: Compared with TNFi, IL-23i and IL-17i are associated with decreased risk of several infectious diseases. These agents might be preferred in patients with susceptibility to infections.

Infecção experimental de gerbis (Meriones unguiculatus) com nematódeos de ovinos: eficiência bionutricional / Experimental infection of jirds (Meriones unguiculatus) with larve of sheep nematodes: bio-nutritional efficiency

O parasitismo por nematódeos gastrintestinais constitui uma importante causa de danos à saúde e de perdas econômicas na produção de pequenos ruminantes. O modelo laboratorial para estudos de nematódeos de ruminantes utilizando gerbis (Meriones unguiculatus) torna-se mais adequado quando estes animais são imunossuprimidos. Os corticosteróides são drogas freqüentemente usadas na imunossupressão de animais de biotério. O índice de eficiência bionutricional é considerado um parâmetro efetivo para avaliar os efeitos de tratamentos sobre a performance nutricional dos animais. O objetivo deste trabalho foi avaliar a eficiência bionutricional de gerbis imunossuprimidos e infectados experimentalmente com larvas de nematódeos de ovinos. Os resultados indicaram que os animais que receberam a droga apresentaram maior número de nematódeos à necropsia que o grupo de animais apenas infectados. Não foi observado efeito nocivo da infecção sobre a performance dos animais. Os animais não infectados e que receberam a droga metilprednisolona tiveram performance significativamente menor que os não infectados que não receberam a mesma.

The gastrointestinal parasitism by nematodes constitutes an important cause of damages to the health and of economical losses in the production of small ruminants. Studies with nematodes of ruminants using jirds (Meriones unguiculatus) as a laboratorial model become more appropriate when the animals are immunossupressed. Corticosteroids are drugs quite used in the immunossuppression of biotery animals. The bio-nutritional efficiency index is considered an effective parameter to evaluate the effect of treatments on the animal nutritional performance. The objective of this work was to evaluate the bio-nutritional efficiency index of jirds immunossupressed and infected experimentally with larves of sheep nematodes. The results indicated that the animals that received the drug presented a major number of nematodes in necropsia in relation to the group of animals just infected. There was not harmful effect of infection on the performance of animals. The noninfected animals and treated with the drug methylprednisolone had a performance significantly lower than the noninfected animals and without drug application.

Safety and tolerability of omalizumab (Xolair), a recombinant humanized monoclonal anti-IgE antibody.

Omalizumab (Xolair) is a humanized monoclonal antibody designed to bind specifically to immunoglobulin (Ig)E. It is indicated in the United States for the treatment of adolescent and adult patients (>or=12 yr) with moderate-to-severe persistent asthma who have a positive skin test or in vitro reactivity to a perennial aeroallergen, and whose symptoms are inadequately controlled with inhaled corticosteroids. Omalizumab was evaluated in an extensive clinical development program that included 12 controlled phase IIB/III clinical trials with more than 5,243 patients who were appropriate for inclusion in the safety analysis (all ages in all controlled studies). In these studies, omalizumab had an adverse event profile comparable to that of the control group (i.e., placebo or standard therapy). Data presented in this article supports omalizumab as a safe and well-tolerated agent for the treatment of IgE-mediated asthma.