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Tolson H, Kikuchi R, Yamamoto RK, Sadrolashrafi K, Guo L, Hao A, Bilimoria S, Yee D, Armstrong AW. Comparing antibiotic prescribing patterns for hidradenitis suppurativa between dermatology and non-dermatology ambulatory providers. SKIN HEALTH AND DISEASE 2024; 4:e451. [PMID: 39355735 PMCID: PMC11442064 DOI: 10.1002/ski2.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 08/10/2024] [Accepted: 08/14/2024] [Indexed: 10/03/2024]
Abstract
Background Oral antibiotics are a mainstay of treatment for hidradenitis suppurativa (HS) primarily due to their anti-inflammatory and anti-microbial properties. Because antibiotics are frequently prescribed to treat HS, concerns exist regarding antibiotic stewardship. There is a paucity of literature comparing how antibiotic prescribing patterns for HS differ between dermatology and non-dermatology clinicians in the ambulatory setting. Objective This study aims to compare the antibiotic prescribing patterns of dermatology versus non-dermatology clinicians treating HS in the ambulatory setting. Methods We utilised the National Ambulatory Medical Care Survey (NAMCS) to identify visits for HS patients from 2005 to 2016. We performed multivariate logistic regression analysis to compare the likelihood of prescribing (1) antibiotics and (2) tetracyclines between dermatology and non-dermatology clinicians in the ambulatory setting. Results We identified a total of 2 424 125 (weighted) HS visits. Approximately 28.0% of visits were conducted by dermatology clinicians, while 72.0% were conducted by non-dermatology clinicians. Antibiotics were prescribed in 51.9% of visits. Tetracyclines were the most commonly prescribed antibiotics among visits with dermatology clinicians (33.4%), while penicillins/cephalosporins were the most commonly prescribed antibiotic among visits with non-dermatology clinicians (14.9%). Multivariate logistic regression analysis demonstrated no difference in the overall likelihood of prescribing antibiotic therapy between dermatology and non-dermatology clinicians (p = 0.35). However, dermatology clinicians were significantly more likely to prescribe tetracyclines than non-dermatology clinicians (OR 5.48, 95% CI 1.19-25.26, p = 0.03). Conclusion In conclusion, dermatology clinicians were significantly more likely to prescribe tetracyclines than non-dermatology clinicians for HS patient visits.
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Affiliation(s)
- Hannah Tolson
- University of Arizona College of MedicinePhoenixArizonaUSA
| | - Robin Kikuchi
- Keck School of Medicine of University of Southern CaliforniaLos AngelesCaliforniaUSA
| | | | | | - Lily Guo
- Duke University School of MedicineDurhamNorth CarolinaUSA
| | - Audrey Hao
- Keck School of Medicine of University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Sara Bilimoria
- Division of DermatologyDepartment of MedicineDavid Geffen School of Medicine at the University of CaliforniaLos AngelesCaliforniaUSA
| | - Danielle Yee
- Division of DermatologyDepartment of MedicineDavid Geffen School of Medicine at the University of CaliforniaLos AngelesCaliforniaUSA
| | - April W. Armstrong
- Division of DermatologyDepartment of MedicineDavid Geffen School of Medicine at the University of CaliforniaLos AngelesCaliforniaUSA
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2
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Kwee KV, Murk JL, Yin Q, Visch MB, Davidson L, de Jong EMGJ, van den Reek JMPA, Tjioe M. Prevalence, risk and severity of SARS-CoV-2 infections in psoriasis patients receiving conventional systemic, biologic or topical treatment during the COVID-19 pandemic: a cross-sectional cohort study (PsoCOVID). J DERMATOL TREAT 2023; 34:2161297. [PMID: 36545844 DOI: 10.1080/09546634.2022.2161297] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The risk of SARS-CoV-2 infection does not appear to be increased for psoriasis patients using biologics compared to those on other treatments, but evidence is still limited. OBJECTIVES (1) to estimate the prevalence of SARS-CoV-2 infection in patients with psoriasis, (2) to compare SARS-CoV-2 infection rates for different psoriasis treatments groups (biologic vs. systemic conventional vs. topical therapy) corrected for confounders and (3) to describe patients with severe COVID-19 for all treatment groups. METHODS In this cross-sectional cohort study all patients received a questionnaire to gather data on psoriasis treatment, SARS-CoV-2 infections and related risk factors. Simultaneously, they underwent a blood test to screen for antibodies to SARS-CoV-2 N-antigen. Prevalence of SARS-CoV-2 infections was calculated and logistic regression and Cox proportional-hazards models were performed to determine the association between treatment group and SARS-CoV-2 infection risk, corrected for confounders. Patients with severe COVID-19 disease were described and the mortality rate per treatment group was calculated for the target population. RESULTS Patients were included between April 12 2021 and October 31 2021. Of 551 patients, 59 (10.7% (CI95% 8.3-13.6)) had experienced a SARS-CoV-2 infection, based on questionnaire data combined with serological data. In our study cohort, corrected for confounders, biologic or non-biologic systemic therapy users did not appear to have increased SARS-CoV-2 infection risk compared to patients using other treatment. Only 4 hospitalizations (0.7% (CI95% 0.2-1.0) were reported in our study population and no ICU admissions were reported. The rough mortality rate in the target cohort was 0.32% (CI95% 0.13-0.66) in all treatment groups. CONCLUSIONS Corrected for risk-mitigating behavior and vaccination status, a higher SARS-CoV-2 incidence for biologics or non-biologics systemics compared to other treatments could not be proven. Severe cases were infrequent in all treatment groups. This finding further strengthens treatment recommendations that systemic therapies for patients with psoriasis do not require preventive cessation for reduction of SARS-CoV-2 infection risk.
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Affiliation(s)
- Kevin V Kwee
- Department of Dermatology/DermaTeam Research, Bravis Hospital, Roosendaal, The Netherlands
| | - Jean-Luc Murk
- Elisabeth Tweesteden Hospital, Microvida, Tilburg, The Netherlands
| | - Qiqi Yin
- Department of Dermatology/DermaTeam Research, Bravis Hospital, Roosendaal, The Netherlands
| | - M Birgitte Visch
- Department of Dermatology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Linda Davidson
- Independent Infectious Disease specialist, Nijmegen, The Netherlands
| | - Elke M G J de Jong
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Milan Tjioe
- Department of Dermatology/DermaTeam Research, Bravis Hospital, Roosendaal, The Netherlands
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3
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Tang SW, Helmeste DM, Leonard BE. COVID-19 as a polymorphic inflammatory spectrum of diseases: a review with focus on the brain. Acta Neuropsychiatr 2023; 35:248-269. [PMID: 36861428 DOI: 10.1017/neu.2023.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
There appear to be huge variations and aberrations in the reported data in COVID-19 2 years now into the pandemic. Conflicting data exist at almost every level and also in the reported epidemiological statistics across different regions. It is becoming clear that COVID-19 is a polymorphic inflammatory spectrum of diseases, and there is a wide range of inflammation-related pathology and symptoms in those infected with the virus. The host's inflammatory response to COVID-19 appears to be determined by genetics, age, immune status, health status and stage of disease. The interplay of these factors may decide the magnitude, duration, types of pathology, symptoms and prognosis in the spectrum of COVID-19 disorders, and whether neuropsychiatric disorders continue to be significant. Early and successful management of inflammation reduces morbidity and mortality in all stages of COVID-19.
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Affiliation(s)
- Siu Wa Tang
- Department of Psychiatry, University of California, Irvine, Irvine, CA, USA
- Institute of Brain Medicine, Hong Kong, China
| | - Daiga Maret Helmeste
- Department of Psychiatry, University of California, Irvine, Irvine, CA, USA
- Institute of Brain Medicine, Hong Kong, China
| | - Brian E Leonard
- Institute of Brain Medicine, Hong Kong, China
- Department of Pharmacology, National University of Ireland, Galway, Ireland
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4
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Wang X, Yuan L, Qiu X, Yang B, Man MQ. Psoriasis and COVID-19 Infection Negatively Impact Each Other: An Analysis of 3581 Cases. Clin Cosmet Investig Dermatol 2023; 16:1933-1936. [PMID: 37519938 PMCID: PMC10386852 DOI: 10.2147/ccid.s421394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Abstract
Objective To determine whether COVID-19 infection and psoriasis impact each other. Methods WeChat app was used to carry out a questionnaire survey in individuals aged 18 years and over. Results A total of 3581 individuals, including 2515 individuals without psoriasis and 1066 psoriatic patients completed the survey. The rate of COVID-19 infection was significantly higher in psoriatic patients than in those without psoriasis (89.59% vs 77.93%, p < 0.0001). Moreover, the rate of relapse and/or worsening of psoriasis was higher in psoriatic patients with COVID-19 infection than in that without COVID-19 infection (75.29% vs 47.75%, p < 0.0001). Conclusion COVID-19 infection and psoriasis negatively impact each other.
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Affiliation(s)
- Xiaohua Wang
- Dermatology Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Liyan Yuan
- Dermatology Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Xiaoyu Qiu
- Dermatology Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Bin Yang
- Dermatology Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Mao-Qiang Man
- Dermatology Hospital, Southern Medical University, Guangzhou, People’s Republic of China
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5
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Messas T, Lim RK, Burns L, Yumeen S, Kroumpouzos G. A critical review of COVID-19 course and vaccination in dermatology patients on immunomodulatory/biologic therapy: recommendations should not differ between non-pregnant and pregnant individuals. Front Med (Lausanne) 2023; 10:1121025. [PMID: 37332768 PMCID: PMC10272467 DOI: 10.3389/fmed.2023.1121025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 04/24/2023] [Indexed: 06/20/2023] Open
Abstract
COVID-19 can have detrimental effects on immunosuppressed patients. Here, we evaluate the evidence regarding continuing immunomodulatory/biologic (IMBI) therapy in pregnant dermatology patients during the COVID-19 pandemic. Also, we discuss the risks of COVID-19 vaccination in pregnant dermatology patients on IMBI therapy. As indicated in this review, regarding continuing IMBI therapy in pregnant dermatology patients during the pandemic, there is no compelling reason for treating them differently than non-pregnant. The body of evidence indicates that mRNA COVID-19 vaccines are safe during pregnancy. Studies on rheumatology patients, a group that overlaps significantly with the dermatology group, provided essential findings. IMBI in a non-pregnant rheumatology patient was not associated with COVID-19 mortality (except for rituximab), and vaccination of the rheumatology patient during pregnancy improved the obstetric outcomes compared to the unvaccinated patient. Based on this data, it can be stated that after weighing the benefit-risk profile of the available COVID-19 vaccines, the recommendation for the pregnant dermatology patient speaks in favor of the COVID-19 vaccination. COVID-19 vaccine recommendations in pregnant dermatology patients on IMBI should not differ from those for their non-pregnant counterparts.
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Affiliation(s)
- Tassahil Messas
- Department of Dermatology, University Hospital Centre, University of Constantine III, Constantine, Algeria
| | - Rachel K. Lim
- Alpert Medical School, Brown University, Providence, RI, United States
| | - Laura Burns
- Department of Dermatology, Alpert Medical School, Brown University, Providence, RI, United States
| | - Sara Yumeen
- Department of Dermatology, Alpert Medical School, Brown University, Providence, RI, United States
| | - George Kroumpouzos
- Department of Dermatology, Alpert Medical School, Brown University, Providence, RI, United States
- GK Dermatology, PC, South Weymouth, MA, United States
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6
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Cirone K, Vender R. Under-Reporting of COVID-19 Infections in Psoriasis Patients on Biologics. J Cutan Med Surg 2023; 27:75-76. [PMID: 36471623 DOI: 10.1177/12034754221143085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Katrina Cirone
- 70384 Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
| | - Ronald Vender
- 3710 Department of Medicine, McMaster University, Hamilton, Ontario, Canada.,Dermatrials Research Inc, Hamilton, Ontario, Canada
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Borgia F, Li Pomi F, Vaccaro M, Alessandrello C, Papa V, Gangemi S. Oxidative Stress and Phototherapy in Atopic Dermatitis: Mechanisms, Role, and Future Perspectives. Biomolecules 2022; 12:1904. [PMID: 36551332 PMCID: PMC9775940 DOI: 10.3390/biom12121904] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022] Open
Abstract
Atopic dermatitis is a chronic inflammatory skin disease in which the overproduction of reactive oxygen species plays a pivotal role in the pathogenesis and persistence of inflammatory lesions. Phototherapy represents one of the most used therapeutic options, with benefits in the clinical picture. Studies have demonstrated the immunomodulatory effect of phototherapy and its role in reducing molecule hallmarks of oxidative stress. In this review, we report the data present in literature dealing with the main signaling molecular pathways involved in oxidative stress after phototherapy to target atopic dermatitis-affected cells. Since oxidative stress plays a pivotal role in the pathogenesis of atopic dermatitis and its flare-up, new research lines could be opened to study new drugs that act on this mechanism, perhaps in concert with phototherapy.
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Affiliation(s)
- Francesco Borgia
- Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, 98125 Messina, Italy
| | - Federica Li Pomi
- Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, 98125 Messina, Italy
| | - Mario Vaccaro
- Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, 98125 Messina, Italy
| | - Clara Alessandrello
- Department of Clinical and Experimental Medicine, School and Operative Unit of Allergy and Clinical Immunology, University of Messina, 98125 Messina, Italy
| | - Vincenzo Papa
- Department of Clinical and Experimental Medicine, School and Operative Unit of Allergy and Clinical Immunology, University of Messina, 98125 Messina, Italy
| | - Sebastiano Gangemi
- Department of Clinical and Experimental Medicine, School and Operative Unit of Allergy and Clinical Immunology, University of Messina, 98125 Messina, Italy
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8
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Wu JJ, Liu J, Thatiparthi A, Martin A, Egeberg A. The risk of COVID-19 in patients with psoriasis: A retrospective cohort study. J Am Acad Dermatol 2022; 87:1395-1398. [PMID: 36305697 PMCID: PMC9484859 DOI: 10.1016/j.jaad.2022.07.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/14/2022] [Accepted: 07/19/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Jashin J. Wu
- University of Miami Miller School of Medicine, Miami, Florida,Correspondence and reprint requests to: Jashin J. Wu, MD, University of Miami Miller School of Medicine, 1600 N.W. 10th Avenue, RMSB, Room 2023-A, Miami, FL 33136
| | - Jeffrey Liu
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | | | - Amylee Martin
- School of Medicine, University of California Riverside, Riverside, California
| | - Alexander Egeberg
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
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9
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Gisondi P, Geat D, Bellinato F, Girolomoni G. Use of biologics during the COVID-19 pandemic: lessons learned from psoriasis. Expert Opin Biol Ther 2022; 22:1521-1529. [PMID: 35930356 DOI: 10.1080/14712598.2022.2110467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Given the increased infectious risk associated with biologics, particularly with TNFα inhibitors, concerns were raised over the safety of these agents in relation to SARS-CoV-2 infection. Furthermore, the impact of biologics on SARS-CoV-2 vaccination was questioned. AREAS COVERED In this review, studies conducted on patients with moderate to severe plaque psoriasis treated with biologics during the COVID-19 pandemic have been analyzed, including 1) the safety of biologics in psoriatic patients in terms of increased risk and/or worse outcome of SARS-CoV-2 infection; and 2) whether biologic agents could affect the safety and response to SARS-CoV-2 vaccines in psoriatic patients. EXPERT OPINION Current evidence indicates that the use of biologics in psoriatic patients does not seem to be associated with an increased COVID-19 infection risk or worse outcome, with TNFα inhibitors being even protective of severe COVID-19 relative to other treatments or no treatment at all. Furthermore, biologic treatment does not seem to have a significant impact on the response and safety of vaccines in patients with psoriasis treated with biologics. However, uncertainty remains given the limitations of current studies which are often of short duration, limited sample sizes and do not stratify on specific biologic classes.
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Affiliation(s)
- Paolo Gisondi
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - Davide Geat
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - Francesco Bellinato
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - Giampiero Girolomoni
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
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10
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Bostan E, Jarbou A, Karaduman A, Gulseren D, Yalici-Armagan B, Akdogan N. Impact of COVID-19 Pandemic on Hidradenitis Suppurativa Patients: a Cross-Sectional Study From Tertiary Referral Hospital. Dermatol Pract Concept 2022; 12:e2022192. [PMID: 36534566 PMCID: PMC9681235 DOI: 10.5826/dpc.1204a192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Hidradenitis suppurativa (HS) is a chronic, disabling skin disorder which is characterized by recurrent attacks of nodule, abscess, sinus tract formation and scarring. Oral/topical antibiotics, oral retinoids and TNF-alpha inhibitors are used for the treatment of HS. OBJECTIVES In the present study, we aimed to determine the prevalence of coronavirus disease 2019 (COVID-19) real-time polymerase chain reaction (real-time PCR) positivity and the presence of COVID-19 related symptoms in relation to the age, gender, body mass index, disease duration, treatment used for HS, treatment duration and smoking. METHODS We conducted a comparative, cross-sectional study of 178 patients diagnosed with HS in a referral hospital. Age, gender, smoking status, body mass index, treatment modalities used for HS, the presence of COVID-19 related symptoms, history of close contact to a person with COVID-19 and COVID-19 real time-PCR results were determined by a telephone questionnaire. RESULTS Sixty-three patients were female, whereas 115 patients were male. During COVID-19 pandemic, 94 out of 178 patients had COVID-19 related symptoms; COVID-19 real time-PCR test was performed in 109 (61.2%) patients. Thirty (27.5%) cases tested positive for COVID-19 whereas 79 (72.5%) tested negative. CONCLUSIONS Patients having COVID-19 related symptoms were shown to have statistically significantly higher mean age compared to the ones who did not have any symptoms (P = 0.031). No statistically significant relationship was found COVID-19 real time-PCR positivity and the type of treatment administered for HS when categorized as tumor necrosis factor-alpha inhibitor, oral retinoid, topical antibiotic and oral antibiotic group (P > 0.05).
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Affiliation(s)
- Ecem Bostan
- Department of Dermatology and Venereology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Adam Jarbou
- Department of Dermatology and Venereology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Aysen Karaduman
- Department of Dermatology and Venereology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Duygu Gulseren
- Department of Dermatology and Venereology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Basak Yalici-Armagan
- Department of Dermatology and Venereology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Neslihan Akdogan
- Department of Dermatology and Venereology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
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11
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Alcendor DJ, Matthews-Juarez P, Smoot D, Hildreth JEK, Lamar K, Tabatabai M, Wilus D, Juarez PD. Breakthrough COVID-19 Infections in the US: Implications for Prolonging the Pandemic. Vaccines (Basel) 2022; 10:755. [PMID: 35632512 PMCID: PMC9146933 DOI: 10.3390/vaccines10050755] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/27/2022] [Accepted: 05/06/2022] [Indexed: 02/04/2023] Open
Abstract
The incidence of COVID-19 breakthrough infections-an infection that occurs after you have been vaccinated-has increased in frequency since the Delta and now Omicron variants of the SARS-CoV-2 coronavirus have become the dominant strains transmitted in the United States (US). Evidence suggests that individuals with breakthrough infections, though rare and expected, may readily transmit COVID-19 to unvaccinated populations, posing a continuing threat to the unvaccinated. Here, we examine factors contributing to breakthrough infections including a poor immune response to the vaccines due to the fact of advanced age and underlying comorbidities, the natural waning of immune protection from the vaccines over time, and viral variants that escape existing immune protection from the vaccines. The rise in breakthrough infections in the US and how they contribute to new infections, specifically among the unvaccinated and individuals with compromised immune systems, will create the need for additional booster vaccinations or development of modified vaccines that directly target current variants circulating among the general population. The need to expedite vaccination among the more than 49.8 million unvaccinated eligible people in the US is critical.
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Affiliation(s)
- Donald J. Alcendor
- Department of Microbiology, Immunology and Physiology, Center for AIDS Health Disparities Research, School of Medicine, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA;
- Center for AIDS Health Disparities Research, Department of Microbiology, Immunology, and Physiology, School of Medicine, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Hubbard Hospital, 5th Floor, Rm. 5025, Nashville, TN 37208, USA
| | - Patricia Matthews-Juarez
- Department of Family & Community Medicine, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA; (P.M.-J.); (P.D.J.)
| | - Duane Smoot
- Department of Internal Medicine, School of Medicine, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA;
| | - James E. K. Hildreth
- Department of Microbiology, Immunology and Physiology, Center for AIDS Health Disparities Research, School of Medicine, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA;
- Center for AIDS Health Disparities Research, Department of Microbiology, Immunology, and Physiology, School of Medicine, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Hubbard Hospital, 5th Floor, Rm. 5025, Nashville, TN 37208, USA
- Department of Internal Medicine, School of Medicine, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA;
| | - Kimberly Lamar
- Office of Health Disparities Elimination, Tennessee Department of Health, Nashville, TN 37243, USA;
| | - Mohammad Tabatabai
- School of Graduate Studies and Research, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA; (M.T.); (D.W.)
| | - Derek Wilus
- School of Graduate Studies and Research, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA; (M.T.); (D.W.)
| | - Paul D. Juarez
- Department of Family & Community Medicine, Meharry Medical College, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA; (P.M.-J.); (P.D.J.)
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12
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El-Qushayri AE, Mahmoud MA, Salman S, Sarsik S, Nardone B. Dupilumab therapy in Atopic Dermatitis is safe during COVID-19 infection era: A systematic review and meta-analysis of 1611 patients. Dermatol Ther 2022; 35:e15476. [PMID: 35357060 PMCID: PMC9111465 DOI: 10.1111/dth.15476] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/09/2022] [Accepted: 03/29/2022] [Indexed: 11/30/2022]
Abstract
The aim of this meta‐analysis is to evaluate the safety of dupilumab use in the management of atopic dermatitis (AD) during the current pandemic regarding the risk and the hazards of COVID‐19 infection. Seven databases (Google Scholar, Web of Science, Scopus, Virtual Health Library, PubMed, System for Information on Gray Literature in Europe, and The New York Academy of Medicine) were searched for eligible studies from inception until November 24, 2021. The quality of evidence was rated using the National Institute of Health and the Joanna Briggs Institute Critical Appraisal tool. Meta‐analysis was performed when the outcome is presented ≥2 studies. A total of 12 papers including 1611 AD patients were included in the study. The prevalence of COVID‐19 in AD treated with dupilumab was 3.2% (95% confidence interval [CI]: 1.7–5.8). COVID‐19 symptoms were reported by five patients who were presented with one or more of the following symptoms (fatigue, loss of taste and smell, runny nose, conjunctivitis, gastrointestinal symptoms, fever, cough, and dyspnea). Only three cases of COVID‐19 were hospitalized with a prevalence of 4.5%, while no patients with COVID‐19 died. Dupilumab is safe regarding the risk and the hazards of COVID‐19 in AD patients. Thus, based on these results continuation of dupilumab in AD patients is recommended, since dupilumab seems to be safe and crucial for a better disease outcome.
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Affiliation(s)
| | | | - Samar Salman
- Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Sameh Sarsik
- Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Beatrice Nardone
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
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Findeisen KE, Östör AJK. The Role of Interleukin-23 Inhibition in the Treatment of Psoriatic Arthritis. Rheumatology (Oxford) 2022. [DOI: 10.17925/rmd.2022.1.1.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Psoriatic arthritis is a chronic inflammatory autoimmune disease with varied manifestations, including functional limitation and reduced quality of life. Improved understanding of the immunopathogenesis of psoriatic arthritis, particularly the role of the interleukin-23 and interleukin-17 axis, has led to the development of therapeutic targets to alter the natural history of the condition. In this article, we review the role of monoclonal antibodies targeting the p19 subunit of interleukin-23 in the treatment of psoriatic arthritis.
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Marcuzzi A, Melloni E, Zauli G, Romani A, Secchiero P, Maximova N, Rimondi E. Autoinflammatory Diseases and Cytokine Storms-Imbalances of Innate and Adaptative Immunity. Int J Mol Sci 2021; 22:11241. [PMID: 34681901 PMCID: PMC8541037 DOI: 10.3390/ijms222011241] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/06/2021] [Accepted: 10/12/2021] [Indexed: 02/07/2023] Open
Abstract
Innate and adaptive immune responses have a well-known link and represent the distinctive origins of several diseases, many of which may be the consequence of the loss of balance between these two responses. Indeed, autoinflammation and autoimmunity represent the two extremes of a continuous spectrum of pathologic conditions with numerous overlaps in different pathologies. A common characteristic of these dysregulations is represented by hyperinflammation, which is an exaggerated response of the immune system, especially involving white blood cells, macrophages, and inflammasome activation with the hyperproduction of cytokines in response to various triggering stimuli. Moreover, hyperinflammation is of great interest, as it is one of the main manifestations of COVID-19 infection, and the cytokine storm and its most important components are the targets of the pharmacological treatments used to combat COVID-19 damage. In this context, the purpose of our review is to provide a focus on the pathogenesis of autoinflammation and, in particular, of hyperinflammation in order to generate insights for the identification of new therapeutic targets and strategies.
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Affiliation(s)
- Annalisa Marcuzzi
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (A.M.); (G.Z.); (A.R.)
| | - Elisabetta Melloni
- LTTA Centre, Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (E.M.); (E.R.)
| | - Giorgio Zauli
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (A.M.); (G.Z.); (A.R.)
| | - Arianna Romani
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (A.M.); (G.Z.); (A.R.)
| | - Paola Secchiero
- LTTA Centre, Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (E.M.); (E.R.)
| | - Natalia Maximova
- Bone Marrow Transplant Unit, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, 34137 Trieste, Italy;
| | - Erika Rimondi
- LTTA Centre, Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy; (E.M.); (E.R.)
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