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Johnson A, Paul C, Duckers J, Bridges C. P329 To evaluate adherence to NIV for airways clearance at the All Wales Adult Cystic Fibrosis Centre (AWACFC). J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30658-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Seneschal J, Lacour JP, Bewley A, Faurby M, Paul C, Pellacani G, De Simone C, Horne L, Sohrt A, Augustin M, Hammond E, Reich K. A multinational, prospective, observational study to estimate complete skin clearance in patients with moderate-to-severe plaque PSOriasis treated with BIOlogics in a REAL world setting (PSO-BIO-REAL). J Eur Acad Dermatol Venereol 2020; 34:2566-2573. [PMID: 32364296 PMCID: PMC7818467 DOI: 10.1111/jdv.16568] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 03/27/2020] [Indexed: 12/16/2022]
Abstract
Background Anti‐tumour necrosis factor (TNF) and anti‐interleukin (IL)‐12/23 biologics revolutionized plaque psoriasis treatment by enabling ≥75% improvement in the Psoriasis Area and Severity Index (PASI 75) in clinical trials. Modern biologics are now reported to achieve PASI 100 (complete skin clearance) in clinical trials. However, real‐world evidence of skin clearance rates with biologics is limited. PSO‐BIO‐REAL was conducted to understand the real‐world burden of plaque psoriasis. Objective The primary objective of this observational study was to estimate the proportion of patients who achieved complete skin clearance at 6 months. Secondary objectives included maintenance of response and evaluation of complete skin clearance at 12 months. Methods PSO‐BIO‐REAL was a multinational, prospective, real‐world, non‐interventional study of skin clearance and patient‐reported outcomes (PROs) with biologics. A total of 846 patients from the United States (32%), France (28%), Italy (22%), the United Kingdom (11%) and Germany (8%) were enrolled and followed for one year. Eligible patients were aged ≥18 years with moderate‐to‐severe plaque psoriasis who had initiated a biologic for plaque psoriasis. Patients could be biologic‐naïve or switching biologics (biologic‐experienced). Assessments were made at baseline and at months 6 and 12. Results At 6 and 12 months, 23% and 26% of patients achieved complete skin clearance, respectively. Prior to study entry, 60% were biologic‐naïve. The proportion of patients achieving complete skin clearance was lower among biologic‐experienced patients (20% at both months 6 and 12) compared with biologic‐naïve patients (25% at month 6, 30% at month 12). The rate of complete skin clearance decreased as the number of prior biologics and baseline comorbidities increased. Conclusion Only one in four patients achieved complete skin clearance after 6 months of treatment with biologics. The study indicates there still is an unmet need for more efficacious biologics for patients with psoriasis.
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Chen D, Odueyungbo A, Csinady E, Gearhart L, Lehane P, Cheu M, Maho‐Vaillant M, Prost‐Squarcioni C, Hebert V, Houivet E, Calbo S, Caillot F, Golinski M, Labeille B, Picard‐Dahan C, Paul C, Richard M, Bouaziz J, Duvert‐Lehembre S, Bernard P, Caux F, Alexandre M, Ingen‐Housz‐Oro S, Vabres P, Delaporte E, Quereux G, Dupuy A, Debarbieux S, Avenel‐Audran M, D'Incan M, Bedane C, Bénéton N, Jullien D, Dupin N, Misery L, Machet L, Beylot‐Barry M, Dereure O, Sassolas B, Benichou J, Musette P, Joly P. Rituximab is an effective treatment in patients with pemphigus vulgaris and demonstrates a steroid-sparing effect. Br J Dermatol 2020; 182:1111-1119. [PMID: 31487383 PMCID: PMC7317434 DOI: 10.1111/bjd.18482] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Corticosteroids (CS) with or without adjuvant immunosuppressant agents are standard treatment for pemphigus vulgaris (PV). The efficacy of adjuvant therapies in minimizing steroid-related adverse events (AEs) is unproven. OBJECTIVES To utilize data collected in a French investigator-initiated, phase III, open-label, randomized controlled trial to demonstrate the efficacy and safety of rituximab and seek approval for its use in PV. METHODS This was an independently conducted post hoc analysis of the moderate-to-severe PV subset enrolled in the Ritux 3 study. Patients were randomized to rituximab plus 0·5 or 1·0 mg kg-1 per day prednisone tapered over 3 or 6 months, or 1·0 or 1·5 mg kg-1 per day prednisone alone tapered over 12 or 18 months, respectively (according to disease severity). The primary end point was complete remission at month 24 without CS (CRoff) for ≥ 2 months, and 24-month efficacy and safety results were also reported. RESULTS At month 24, 34 of 38 patients (90%) on rituximab plus prednisone achieved CRoff ≥ 2 months vs. 10 of 36 patients (28%) on prednisone alone. Median total cumulative prednisone dose was 5800 mg in the rituximab plus prednisone arm vs. 20 520 mg for prednisone alone. Eight of 36 patients (22%) who received prednisone alone withdrew from treatment owing to AEs; one rituximab-plus-prednisone patient withdrew due to pregnancy. Overall, 24 of 36 patients (67%) on prednisone alone experienced a grade 3/4 CS-related AE vs. 13 of 38 patients (34%) on rituximab plus prednisone. CONCLUSIONS In patients with moderate-to-severe PV, rituximab plus short-term prednisone was more effective than prednisone alone. Patients treated with rituximab had less CS exposure and were less likely to experience severe or life-threatening CS-related AEs. What's already known about this topic? Pemphigus vulgaris (PV) is the most common type of pemphigus. Corticosteroids, a standard first-line treatment for PV, have significant side-effects. Although their effects are unproven, adjuvant corticosteroid-sparing agents are routinely used to minimize steroid exposure and corticosteroid-related side-effects. There is evidence that the anti-CD20 antibody rituximab is effective in the treatment of patients with severe recalcitrant pemphigus and in patients with newly diagnosed pemphigus. What does this study add? This study provides a more detailed analysis of patients with PV enrolled in an investigator-initiated trial. Rituximab plus prednisone had a steroid-sparing effect and more patients achieved complete remission off prednisone. Fewer patients experienced grade 3 or grade 4 steroid-related adverse events than those on prednisone alone. This collaboration between academia and industry, utilizing independent post hoc analyses, led to regulatory authority approvals of rituximab in moderate-to-severe PV.
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Casassa E, Riffaud L, Sibaud V, Boulinguez S, Chira C, Gangloff D, Montastruc M, Lamant L, Paul C, Meyer N. [Efficacy of combined paclitaxel/cetuximab in cutaneous squamous-cell carcinoma: A retrospective analysis of 14 patients]. Ann Dermatol Venereol 2020; 147:303-306. [PMID: 32145990 DOI: 10.1016/j.annder.2019.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 11/03/2018] [Accepted: 07/12/2019] [Indexed: 11/16/2022]
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Tauber M, Bérard E, Lourari S, Questel E, Redoules D, Paul C, Simon M. Latent class analysis categorizes chronic hand eczema patients according to skin barrier impairment. J Eur Acad Dermatol Venereol 2019; 34:1529-1535. [DOI: 10.1111/jdv.16083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/24/2019] [Indexed: 12/14/2022]
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Vestergaard C, Thyssen J, Barbarot S, Paul C, Ring J, Wollenberg A. Quality of care in atopic dermatitis – a position statement by the European Task Force on Atopic Dermatitis (
ETFAD
). J Eur Acad Dermatol Venereol 2019; 34:e136-e138. [DOI: 10.1111/jdv.16092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Richard MA, Seneschal J, Paul C, Mahe E, Bachelez H, De Pouvourville G, Aubert R, Joly P, Reguiai Z, Heas S, Ezzedine K, Jullien D, Shourick J, Taïeb C, Misery L. Psoriasis : prises en charge alternatives et complémentaires. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Richard MA, Paul C, Mahé E, Bachelez H, De Pouvourville G, Seneschal J, Aubert R, Joly P, Reguiai Z, Misery L, Heas S, Ezzedine K, Shourick J, Taïeb C, Jullien D. Psoriasis et absence au travail. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Touhouche A, Cassagne M, Berard E, Marguery M, Fournié P, Giordano-Labadie F, Paul C, Tauber M. Incidence et nature des complications oculaires associées au dupilumab chez les patients atteints de dermatite atopique: première étude prospective. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Jendoubi F, Severino-Freire M, Negretto M, Paul C, Bulai Livideanu C. Prévalence des troubles neuro-psychiatriques, cognitifs et sexuels chez les patients atteints de mastocytose. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Salomon G, Severino M, Casassa E, Bulai Livideanu C, Meyer N, Lamant L, Tournier E, Paul C. Les manifestations cutanées du syndrome hyperéosinophilique sont polymorphes et difficiles à traiter : étude de cohorte rétrospective. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Richard M, De Pouvourville G, Paul C, Jullien D, Mahe E, Bachelez H, Seneschal J, Aubert R, Joly P, Reguiai Z, Misery L, Heas S, Shourick J, Taïeb C, Ezzedine K. Psoriasis cutané : évaluation du reste à charge. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Assan F, Giboin C, Viguier M, Beylot-Barry M, Dupuy A, Bénéton N, Joly P, Jullien D, Mahé E, Paul C, Richard MA, Bachelez H, Tubach F, Chosidow O, Sbidian E. Impact de l’obésité sur l’efficacité et la tolérance du premier biomédicament : analyse à partir de la cohorte nationale Psobioteq. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Konstantinou M, Blauvelt A, Vender R, Spelman L, Paul C, Eyerich K, Flavin S, Randazzo B, Li S, Langley R. Efficacité du guselkumab par rapport au sécukinumab chez les patients atteints de psoriasis en plaques modéré à sévère selon les traitements antérieurs du psoriasis : résultats de l’étude ECLIPSE. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Severino Freire M, Jendoubi F, Negretto M, Paul C, Livideanu CB. Mastocytoses systémiques sans lésions cutanées chez les adultes atteints de mastocytose : analyse d’une cohorte. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Cura P, Livideanu CB, Godillot C, Casassa E, Freire MS, Paul C, Marguery MC. Réaction photoallergique lichénoïde induite par la midostaurine. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Costa Mendes L, Laurencin-Dalicieux S, Paul C, Bulai Livideanu C, Cousty S. Vascular Nd:YAG laser: a therapeutic alternative for large venous lakes of the oral mucosa. J Eur Acad Dermatol Venereol 2019; 34:e164-e165. [PMID: 31774577 DOI: 10.1111/jdv.16110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lebwohl MG, Gordon KB, Gallo G, Zhang L, Paul C. Ixekizumab sustains high level of efficacy and favourable safety profile over 4 years in patients with moderate psoriasis: results from UNCOVER-3 study. J Eur Acad Dermatol Venereol 2019; 34:301-309. [PMID: 31479549 PMCID: PMC7028252 DOI: 10.1111/jdv.15921] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 08/12/2019] [Indexed: 12/26/2022]
Abstract
Background Psoriasis, a chronic disease usually requires long‐term disease management. Objective This study evaluates the efficacy and safety of recommended ixekizumab (IXE) dose over 4 years (204 weeks) from UNCOVER‐3 study. Methods UNCOVER‐3 was a randomised, double‐blind, multicenter, phase 3 study wherein patients with moderate‐to‐severe plaque psoriasis received placebo, IXE 80 mg every 2 weeks (Q2W), IXE 80 mg every 4 weeks (Q4W) (both IXE groups had 160 mg starting dose) or etanercept 50 mg twice weekly. At week 12, all patients switched to IXE Q4W dose for the long‐term extension (264 weeks). After week 60 and at investigator's discretion, patients could receive dose adjustment to IXE Q2W. The efficacy endpoints at week 204 were percentage of patients achieving PASI 75/90/100, sPGA score of 1 or 0, and those achieving PSSI = 0, NAPSI = 0 and PPASI 100. Efficacy data were summarised through 204 weeks using as‐observed, multiple imputation (MI) and modified non‐responder imputation (mNRI) methods. Results The proportion of patients achieving PASI 75/90/100 at week 204 using mNRI method were 82.8%, 66.4% and 48.3%, respectively. Using as‐observed and MI methods, 98.2% and 94.8% patients achieved PASI 75, 87.8% and 73.3% achieved PASI 90, and 67.1% and 52.7% achieved PASI 100 response, respectively, at week 204. The response rates for sPGA (0, 1) were 88.7%, 76.2% and 68.5% and for sPGA (0) were 68.9%, 54.6% and 49.7% using as‐observed, MI and mNRI methods, respectively. Similar trends were observed with NAPSI = 0, PSSI = 0, PPASI 100 and itch NRS = 0. There were no new safety concerns through year 4. Conclusions This study demonstrated sustained high‐efficacy response through 4 years of continuous treatment with ixekizumab in patients with moderate‐to‐severe plaque psoriasis. The safety profile remained consistent with prior findings, with no new or unexpected safety concerns.
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Kellner P, Abendroth M, Beckmann S, Paul C, Burbelko M. Eine außergewöhnliche Ursache von Rückenschmerzen. Notf Rett Med 2019. [DOI: 10.1007/s10049-019-0628-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Masson Regnault M, Castañeda-Sanabria J, Diep Tran MHT, Beylot-Barry M, Bachelez H, Beneton N, Chosidow O, Dupuy A, Joly P, Jullien D, Mahé E, Richard MA, Viguier M, Tubach F, Sbidian E, Paul C. Users of biologics in clinical practice: would they be eligible for phase III clinical studies? Cohort Study in the French Psoriasis Registry PSOBIOTEQ. J Eur Acad Dermatol Venereol 2019; 34:293-300. [PMID: 31419355 DOI: 10.1111/jdv.15878] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Accepted: 07/17/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Numerous inclusion and exclusion criteria are involved in phase III moderate to severe psoriasis trials investigating the safety and efficacy of biologics. This questions the generalization of results. METHODS In this cohort study, we applied inclusion/exclusion criteria for phase III trials from original protocols (adalimumab - REVEAL, ustekinumab - PHOENIX, brodalumab - AMAGINE, secukinumab FIXTURE) to all patients enrolled in the PsoBioTeq prospective registry who received a biological agent for the first time between July 2012 and November 2017. We then compared the efficacy, drug survival and occurrence of adverse events between patients who satisfied/did not satisfy the eligibility criteria for these phase III trials. RESULTS A total of 1267 patients were enrolled, of whom 993 (78.4%) were not eligible for at least one RCT (randomized controlled trial) and 251 (19.1%) did not meet the PASI/PGA severity requirements. Apart from disease severity, the most frequent criteria resulting in exclusion were as follows: non-plaque psoriasis (12.6%), significant cardiac disease (8.4%), significant liver disease (7.3%), elevated liver enzymes (4.9-9.6%) and personal history of diabetes (9.2%). There was no difference in drug survival between the two groups. The incidence ratio of adverse events was significantly lower in eligible versus non-eligible patients [0.78 (95% CI 0.62-0.97) (P = 0.03)]. CONCLUSION The majority of patients treated with biologics in the PsoBioTeq real-life registry would not have been eligible for phase III moderate to severe psoriasis trials. Patients not eligible for psoriasis phase III clinical trials have a higher incidence of adverse events.
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Reich K, Puig L, Szepietowski J, Paul C, Lacour J, Tsianakas A, Sieder C, Rissler M, Pournara E, Orsenigo R. Secukinumab dosing optimization in patients with moderate‐to‐severe plaque psoriasis: results from the randomized, open‐label
OPTIMISE
study. Br J Dermatol 2019; 182:304-315. [DOI: 10.1111/bjd.18143] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2019] [Indexed: 12/12/2022]
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Bulai Livideanu C, Severino-Freire M, Jendoubi F, Tournier E, Commont T, Hermine O, Paul C. Image Gallery: The vulva: an atypical localization of mastocytosis in adulthood. Br J Dermatol 2019; 181:e33. [PMID: 31240694 DOI: 10.1111/bjd.17897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Vestergaard C, Wollenberg A, Barbarot S, Christen-Zaech S, Deleuran M, Spuls P, Flohr C, Trzeciak M, von Kobyletzki L, Seneschal J, Paul C, Bieber T, Werfel T, Fölster-Holst R, Darsow U, Gieler U, Svensson Å, Cork M, Stalder JF, De Raeve L, Kunz B, Simon D, Chernyshov P, Hijnen D, Gelmetti C, Ring J, Taieb A, de Bruin-Weller M, Thyssen JP. European task force on atopic dermatitis position paper: treatment of parental atopic dermatitis during preconception, pregnancy and lactation period. J Eur Acad Dermatol Venereol 2019; 33:1644-1659. [PMID: 31231864 DOI: 10.1111/jdv.15709] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 05/07/2019] [Indexed: 12/14/2022]
Abstract
Atopic dermatitis (AD) is a common inflammatory skin disease that affects both children and adults, including a large number of adults of reproductive age. Several guidelines for the treatment of AD exist, yet specific recommendations for the treatment of pregnant or lactating women and for adults planning to have a child are often lacking. This position paper from the European Task force on Atopic Dermatitis (ETFAD) is based on up-to-date scientific literature on treating pregnant and lactating women as wells as adults with AD planning to have a child. It is based on the expert opinions of members of the ETFAD and on existing safety data on the proposed treatments, many of which are derived from patients with other inflammatory diseases or from transplantation medicine. For treating future parents, as well as pregnant and lactating women with AD, the use of topical treatments including moisturizers, topical corticosteroids, tacrolimus, antiseptics such as chlorhexidine, octenidine, potassium permanganate and sodium hypochlorite (bleach) is deemed to be safe. Ultraviolet (UV) therapy may also be used. Systemic treatment should be prescribed only after careful consideration. According to the opinion of the ETFAD, treatment should be restricted to systemic corticosteroids and cyclosporine A, and, in selected cases, azathioprine.
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Degboé Y, Eischen M, Apoil PA, Mailhol C, Dubreuil P, Hermine O, Paul C, Bulai Livideanu C, Laroche M. Higher prevalence of vertebral fractures in systemic mastocytosis, but not in cutaneous mastocytosis and idiopathic mast cell activation syndrome. Osteoporos Int 2019; 30:1235-1241. [PMID: 30847528 DOI: 10.1007/s00198-019-04918-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 02/26/2019] [Indexed: 01/08/2023]
Abstract
UNLABELLED Little is known about osteoporosis in mast cell disorders (MCDs) not related to systemic mastocytosis. We described osteoporosis and fractures in MCDs and showed that systemic mastocytosis was the only studied MCDs associated with osteoporotic vertebral fractures. INTRODUCTION To describe osteoporosis (OP) and fragility fractures in mast cell disorders (MCDs). METHODS We retrospectively analyzed data concerning all successive patients with systemic mastocytosis (SM), cutaneous mastocytosis (CM), and mast cell activation syndromes (MCAS) diagnosed in our mastocytosis expert center between 2004 and 2015. We collected data concerning demographic profiles, clinical signs of MCD, osteoporosis, fractures, densitometry, and biological assessment of MCD. We compared CM and MCAS patients with SM patients with regard to the characteristics of OP and fragility fractures. RESULTS We assessed 89 SM patients, 20 CM patients, and 20 MCAS patients. Osteoporosis was less frequent in CM (15.0%) and MCAS (10.0%) than in SM (44.9%). Similarly, fractures were less frequent in non-SM MCDs, respectively 5.0%, 5.0%, and 28.1%. SM patients displayed high prevalence of vertebral fractures (22.5%), mostly multiple. Conversely, in non-SM patients, vertebral fractures appeared to be uncommon (5%) and more frequently associated with risk factors for osteoporosis. CONCLUSIONS SM is associated with multiple vertebral osteoporotic fractures, whereas CM and MCAS do not appear to be associated with this phenotype.
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Ferrières L, Konstantinou MP, Bulai Livideanu C, Hegazy S, Tauber M, Amelot F, Paul C. Long-term continuation with secukinumab in psoriasis: association with patient profile and initial psoriasis clearance. Clin Exp Dermatol 2019; 44:e230-e234. [PMID: 31055846 DOI: 10.1111/ced.13999] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND There are limited data regarding the long-term continuation with biological therapy for patients with psoriasis. In particular, the reasons for secukinumab discontinuation have not been thoroughly investigated. AIM To better ascertain the real-life continuation of secukinumab in psoriasis, we conducted a retrospective study to evaluate the incidence, causes and factors of secukinumab discontinuation in patients with psoriasis. METHODS All patients treated with secukinumab for psoriasis in the Department of Dermatology (Toulouse University and Larrey Hospital, Toulouse, France), between September 2011 and June 2017, were enrolled in the study. RESULTS Of the 91 patients in the study, 22 (24.2%) discontinued secukinumab. In 14 (15%) patients, the discontinuation was due to loss of efficacy. Two patients stopped treatment because they planned a pregnancy and five patients stopped because of adverse events. A longer disease duration (P = 0.01) and presence of palmoplantar psoriasis (P = 0.01) seem to be predictive factors for treatment failure. Patients reaching 90 or 100% improvement in Psoriasis Area and Severity Index (PASI90 and PASI100, respectively) at weeks 12-16 had a lower risk of long-term treatment discontinuation compared with patients who had less complete clearance (P = 0.04). CONCLUSION Long-term persistence of secukinumab appears to be good, as only 24.2% (n = 22) of the patients in this study discontinued secukinumab over the follow-up period. Loss of efficacy prompted discontinuation in about 14% of patients by the 2-year follow-up. Persistence appears to be lower in patients with palmoplantar psoriasis and in patients previously exposed to many systemic treatments. Optimal therapeutic response at 12-16 weeks as defined by reaching PASI90-100 seems to be predictive of long-term treatment persistence.
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