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Langley RG, Sofen H, Dei-Cas I, Reich K, Sigurgeirsson B, Warren RB, Paul C, Szepietowski JC, Tsai TF, Hampele I, You R, Charef P, Papavassilis C. Secukinumab long-term efficacy and safety in psoriasis through to year 5 of treatment: results of a randomized extension of the phase III ERASURE and FIXTURE trials. Br J Dermatol 2023; 188:198-207. [PMID: 36763857 DOI: 10.1093/bjd/ljac040] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 09/22/2022] [Accepted: 09/24/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND In the long-term extension study of the ERASURE and FIXTURE trials, the efficacy of secukinumab (a fully human anti-interleukin-17A monoclonal antibody) was demonstrated to have been maintained through to year 3 of treatment in moderate-to-severe plaque psoriasis. OBJECTIVES To assess the efficacy and safety of secukinumab through to year 5 of treatment in moderate-to-severe plaque psoriasis. METHODS Responders with ≥ 75% improvement in Psoriasis Area and Severity Index (PASI 75) from two core trials - ERASURE and FIXTURE - were randomized 2 : 1 at year 1 (end of core trials) to either the same dose (300 or 150 mg, continuous treatment) or placebo (treatment withdrawal) every 4 weeks, until year 3 or relapse (> 50% reduction in maximal PASI from core study baseline). Partial responders (achieving PASI 50 but not PASI 75) at year 1 continued at the same dose as in the core trials. At year 3, all patients received open-label secukinumab treatment, with those on secukinumab 300 mg continuing on their dose, while those on secukinumab 150 mg or placebo received secukinumab 150 or 300 mg based on the physician's discretion. The study is registered on ClinicalTrials.gov with the identifier NCT01544595. RESULTS Most patients randomized to placebo at year 1 relapsed, but the response was rapidly recaptured upon reinitiation of treatment. PASI responses were sustained with secukinumab through to year 5. The PASI responses for the 300 mg responders + partial responders group at year 1 (PASI 75/90/100: 86.8%/72.8%/45.9%) trended downwards until year 3 (PASI 75/90/100: 82.3%/58.4%/32.7%) and then remained stable through year 4 (PASI 75/90/100: 83.3%/60.1%/32.2%) until year 5 (PASI 75/90/100: 81.1%/62.8%/35.1%). Dermatology Life Quality Index showed sustained benefit up to year 5. Absolute PASI responses were maintained throughout the study. The most common adverse events (AEs) were infections and infestations, nasopharyngitis, and upper respiratory tract infections (URTIs). The overall exposure-adjusted incidence rate (EAIR; with 95% confidence interval) for all AEs was 139.9 (130.3-149.9). EAIRs for Crohn's disease and neutropenia were 0.1 (0.0-0.3) and 0.5 (0.3-0.8), respectively. CONCLUSIONS The 4-year extension of two pivotal phase III trials demonstrated that secukinumab treatment was effective through to year 5 and improved quality of life in patients with moderate-to-severe plaque psoriasis. The most common AEs were infections and infestations, nasopharyngitis, and URTIs. The safety profile was consistent with that in the secukinumab phase II/III clinical development programme.
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Affiliation(s)
| | - Howard Sofen
- Department of Medicine (Dermatology) UCLA, Los Angeles, CA, USA
| | - Ignacio Dei-Cas
- Facultad de Medicina de la Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Kristian Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Richard B Warren
- Centre for Dermatology Research, University of Manchester, Manchester, UK.,Salford Royal NHS Foundation Trust, Manchester, UK
| | - Carle Paul
- Department of Dermatology, Paul Sabatier University, Toulouse, France
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | | | | | - Ruquan You
- China Novartis Institutes for BioMedical Research, Shanghai, China
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Yu C, Zhang F, Ding Y, Li Y, Zhao Y, Gu J, Guo S, Pan W, Jin H, Sun Q, Kang X, Yang Q, Jiang X, Song Z, Lu Q, Pang X, Kuang Y, Deng D, Li Y, Zhang C, Tao J, Xie L, Wang Y, Wang J, Wang G. A randomized, double-blind phase III study to demonstrate the clinical similarity of biosimilar SCT630 to reference adalimumab in Chinese patients with moderate to severe plaque psoriasis. Int Immunopharmacol 2022; 112:109248. [PMID: 36126411 DOI: 10.1016/j.intimp.2022.109248] [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: 05/31/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION This phase III study aimed to compare the efficacy, safety, and immunogenicity of SCT630 with the reference adalimumab. METHODS A total of 367 Chinese patients with moderate-to-severe plaque psoriasis were randomly assigned to receive 80 mg of SCT630 or adalimumab subcutaneously at week 1, 40 mg at week 2, then 40 mg biweekly. At week 16, those with 50 % or more improvement in psoriasis area and severity index (PASI) were eligible to enter an extension period up to week 52. Patients on SCT630 continued the same treatment, whereas patients receiving adalimumab were re-randomized at a ratio of 1:1 to adalimumab or SCT630 group. The primary endpoint was percentage improvement in PASI at week 16. Other endpoints included PASI 50/75/90/100, Physician's Global Assessment, Dermatology Life Quality Index, safety, and immunogenicity. RESULTS PASI improvement at week 16 was 85.07 % for SCT630 and 84.82 % for adalimumab. The mean difference (3.10 %, 95 % CI: -1.875 %, 8.066 %) was within the equivalence interval. Other efficacy endpoints, safety and immunogenicity profiles were similar across the two groups. There were no safety or immunogenicity difference between switched/continued groups. CONCLUSION This phase III study demonstrated the equivalences in efficacy, safety and immunogenicity of SCT630 to adalimumab in patients with moderate to severe psoriasis.
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Affiliation(s)
- Chen Yu
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Furen Zhang
- Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Yangfeng Ding
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yumei Li
- Department of Dermatology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
| | - Yi Zhao
- Department of Dermatology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Jun Gu
- Department of Dermatology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Shuping Guo
- Department of Dermatology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Weili Pan
- Department of Dermatology, Zhejiang provincial People's Hospital, Hangzhou, Zhejiang, China
| | - Hongzhong Jin
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qing Sun
- Department of Dermatology, Qilu Hospital of Shandong University, Jinan, Shangdong, China
| | - Xiaojing Kang
- Department of Dermatology and Venereology, People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Research Center for Dermatologic Diseases, Xinjiang Key Laboratory of Dermatology Research, Urumqi, Xinjiang, China
| | - Qinping Yang
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xian Jiang
- Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhiqiang Song
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Qianjin Lu
- Department of Dermatology, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaowen Pang
- Department of Dermatology, Air Force Medical Center, Chinese People's Liberation Army, Beijing, China
| | - Yehong Kuang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Danqi Deng
- Department of Dermatology, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yuzhen Li
- Department of Dermatology, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Chunlei Zhang
- Department of Dermatology, Peking Union Medical College Hospital, Beijing, China
| | - Juan Tao
- Department of Dermatology, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Liangzhi Xie
- Beijing Engineering Research Center of Protein and Antibody, Sinocelltech Ltd., No.31 Kechuang 7th Street, BDA, Beijing, China; Beijing Protein and Antibody R&D Engineering Center, Sinocelltech Ltd., No.31 Kechuang 7th Street, Beijing, China
| | - Yan Wang
- Beijing Protein and Antibody R&D Engineering Center, Sinocelltech Ltd., No.31 Kechuang 7th Street, Beijing, China
| | - Jieying Wang
- Beijing Protein and Antibody R&D Engineering Center, Sinocelltech Ltd., No.31 Kechuang 7th Street, Beijing, China
| | - Gang Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
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Semaka A, Salopek TG. Risk of Developing Melanoma With Systemic Agents Used to Treat Psoriasis: A Review of the Literature. J Cutan Med Surg 2021; 26:87-92. [PMID: 34392725 PMCID: PMC8750137 DOI: 10.1177/12034754211038509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Psoriasis is a chronic inflammatory skin disease induced by
autoimmune-like dysregulation of the immune system. Treatment
options have drastically evolved in recent years, and treatment
advances that target specific cytokines and other molecules
involved in dysregulation have had a profound effect in
controlling the disease. Objective We reviewed the literature to assess the risk of developing
melanoma with conventional therapies and newer agents used to
treat psoriasis. Methods A comprehensive literature search using Medline (via Ovid) and
Embase was conducted. Results The majority of studies reviewed reported insignificant results.
Potential risk for melanoma was identified for only 3 out of 15
anti-psoriatic treatments analyzed: adalimumab (relative risk
1.8, 95% CI 1.06-3.00), etanercept (relative risk 2.35, 95% CI
1.46-3.77) and infliximab (Empirical Bayes Geometric Mean 7.90,
95% CI 7.13-8.60). The confidence intervals provided are from
prior studies. There are not enough collective data on newer
agents to make any conclusions on risk. Conclusions We were unable to identify any substantial risk for developing
melanoma due to the use of anti-psoriatic treatments. Until
additional long-term registry data become available, it would be
prudent to continue screening patients with psoriasis at
baseline and periodically for melanoma when these agents are
used.
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Affiliation(s)
- Amy Semaka
- 3158 Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Thomas G Salopek
- Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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Crisafulli S, Bertino L, Fontana A, Calapai F, Ingrasciotta Y, Berretta M, Trifirò G, Guarneri C. Incidence of Skin Cancer in Patients With Chronic Inflammatory Cutaneous Diseases on Targeted Therapies: A Systematic Review and Meta-Analysis of Observational Studies. Front Oncol 2021; 11:687432. [PMID: 34150655 PMCID: PMC8209509 DOI: 10.3389/fonc.2021.687432] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/12/2021] [Indexed: 12/25/2022] Open
Abstract
Cancer is one of the several comorbidities that have been linked with chronic cutaneous inflammatory diseases namely psoriasis/psoriatic arthritis and hidradenitis suppurativa. Although the chronic inflammatory state, typical of the diseases, may induce pro-tumorigenic effects, the debate whether or not the drugs currently used in clinical practice do in facts increase a patient's risk of malignancy remains largely unsolved. The therapeutic armamentarium has been greatly enhanced at least in the last two decades with the advent of biologics, a heterogeneous group of laboratory-engineered agents with more in the pipeline, and other targeted small molecules. Among the organ systems, skin results as one of the most commonly affected, non-melanoma skin cancers being the main drug-induced manifestations as side effect in course of these treatments. The objective of the study is to systematically review the cutaneous malignancy risk of the newer therapies through an overview of meta-analyses and observational studies on the topic.
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Affiliation(s)
- Salvatore Crisafulli
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Lucrezia Bertino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Andrea Fontana
- Unit of Biostatistics, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Fabrizio Calapai
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Ylenia Ingrasciotta
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Massimiliano Berretta
- Department of Clinical and Experimental Medicine, Section of Infectious Diseases, University of Messina, Messina, Italy
| | - Gianluca Trifirò
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Claudio Guarneri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
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Feldman SR, Poulos C, Gilloteau I, Mange B, Boehm K, Boeri M, Naatz M, Augustin M. Exploring determinants of psoriasis patients' treatment choices: a discrete-choice experiment study in the United States and Germany. J DERMATOL TREAT 2021; 33:1511-1520. [PMID: 33535847 DOI: 10.1080/09546634.2020.1839007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Biologic psoriasis treatments are differentiated by efficacy, side effects, and other attributes. OBJECTIVE Determine attributes of biologic psoriasis treatments that drive patients' treatment choices. METHODS Respondents (USA: n = 300; Germany: n = 300) with moderate-to-severe psoriasis completed a discrete-choice-experiment survey, choosing between hypothetical treatments characterized by attributes with varying levels: chance of clear skin after 1 year, number of first-year treatments, first-year risks of mild-to-moderate injection site reaction (ISR) and serious infection, and years of proven efficacy/safety. RESULTS U.S. respondents most valued clear skin (conditional relative importance, 1.88; p < .05). While other attributes were of generally equivalent importance, ISR risk outweighed serious-infection risk (1.06 vs. 0.70; p < .05). German respondents placed greatest importance on ISR risk (1.61; p < .05) and clear skin (1.49; p < .05). LIMITATIONS Respondents evaluated hypothetical treatments and were recruited from web panels. CONCLUSIONS Clear skin and ISR risk are stronger drivers of treatment choice than injection frequency and infection risk.
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Affiliation(s)
- Steven R Feldman
- Departmemt of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | | | | | - Brennan Mange
- RTI Health Solutions, Research Triangle Park, NC, USA
| | | | | | - Mandy Naatz
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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6
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Examples of adverse effects after biological therapy. Postepy Dermatol Alergol 2020; 37:712-718. [PMID: 33240011 PMCID: PMC7675069 DOI: 10.5114/ada.2020.100482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 03/06/2019] [Indexed: 12/01/2022] Open
Abstract
Psoriasis is one of the most common, chronic skin diseases of as yet unexplained etiopathogenesis. In the recent years it has been proven that an immunological factor plays an important role in the dermatosis onset. This has led to introduction of biological drugs to the disease treatment regimen, which include, inter alia, adalimumab and ustekinumab. New therapy has become an alternative for patients with psoriasis resistant to standard treatment methods as well as an alternative form of treatment in case of occurrence of severe adverse drug reactions after administration of standard treatment. Despite good treatment results the administration of these drugs is associated with the occurrence of adverse reactions. This article presents cases of 4 patients who have been administered biological treatment and in whom there have been observed, inter alia, the occurrence of hypersensitivity reactions in the form of acute urticaria as well as skin lesions of erythema multiforme nature or positive antinuclear antibodies titre. The symptoms experienced by the presented patients posed no direct threat to life and the benefits of the drugs’ administration had a significant therapeutic importance.
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7
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Reich K, Papp KA, Armstrong AW, Wasfi Y, Li S, Shen YK, Randazzo B, Song M, Kimball AB. Safety of guselkumab in patients with moderate-to-severe psoriasis treated through 100 weeks: a pooled analysis from the randomized VOYAGE 1 and VOYAGE 2 studies. Br J Dermatol 2020; 180:1039-1049. [PMID: 30485400 DOI: 10.1111/bjd.17454] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Long-term evaluation is required to confirm the safety profile of newer biologic agents. OBJECTIVES To report on pooled safety data from the ongoing VOYAGE 1 (NCT02207231) and VOYAGE 2 (NCT02207244) trials through 100 weeks of follow-up. METHODS Patients were randomized to either guselkumab 100 mg at weeks 0 and 4 and every 8 weeks thereafter; placebo at weeks 0, 4, 12 followed by guselkumab 100 mg at weeks 16 and 20 and every 8 weeks thereafter; or adalimumab 80 mg at week 0, 40 mg at week 1, and 40 mg every 2 weeks thereafter. Patients who received adalimumab crossed over to guselkumab at week 52 (VOYAGE 1) and at/after week 28 based on clinical response (VOYAGE 2). Open-label extensions, in which all patients received guselkumab, started at week 52 (VOYAGE 1) and week 76 (VOYAGE 2). Rates of adverse events (AEs) per 100 patient-years (PYs) are presented through 100 weeks of follow-up. RESULTS Through week 52, observed rates for guselkumab- and adalimumab-treated patients, respectively, were 262·45 per 100 PYs and 328·28 per 100 PYs for AEs, 6·20 per 100 PYs and 7·77 per 100 PYs for serious AEs (SAEs), 1·22 per 100 PYs and 1·79 per 100 PYs for serious infections (SIs), 0·28 per 100 PYs and 0·40 per 100 PYs for malignancies other than nonmelanoma skin cancers (NMSCs), 0·56 per 100 PYs and 0·40 per 100 PYs for NMSCs, and 0·47 per 100 PYs and 0·40 per 100 PYs for major adverse cardiovascular events (MACEs). Rates among patients treated with guselkumab through week 52 and week 100, respectively, were 262·45 per 100 PYs and 210·41 per 100 PYs for AEs, 6·20 and 6·29 per 100 PYs, for SAEs, 1·22 per 100 PYs and 1·06 per 100 PYs for SIs, 0·28 per 100 PYs and 0·38 per 100 PYs for malignancies, 0·56 per 100 PYs and 0·39 per 100 PYs for NMSCs, and 0·47 per 100 PYs and 0·38 per 100 PYs for MACEs. Among patients treated with adalimumab, rates of AEs, SAEs, SIs, malignancies, NMSCs, and MACEs showed some variability before and after crossover to guselkumab, although no new safety signals were noted after crossover. CONCLUSIONS The safety profile for guselkumab remains favourable through 100 weeks of treatment in patients with moderate-to-severe psoriasis.
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Affiliation(s)
- K Reich
- Dermatologikum Berlin and SCIderm Research Institute, Hamburg, Germany
| | - K A Papp
- K Papp Clinical Research and Probity Research, Inc., Waterloo, Canada
| | - A W Armstrong
- University of Southern California, Los Angeles, CA, U.S.A
| | - Y Wasfi
- Janssen Research & Development, LLC, Spring House, PA, U.S.A
| | - S Li
- Janssen Research & Development, LLC, Spring House, PA, U.S.A
| | - Y K Shen
- Janssen Research & Development, LLC, Spring House, PA, U.S.A
| | - B Randazzo
- Janssen Research & Development, LLC, Spring House, PA, U.S.A
| | - M Song
- Janssen Research & Development, LLC, Spring House, PA, U.S.A
| | - A B Kimball
- Harvard Medical School and Beth Israel Deaconess Medical Center, Inc., Boston, MA, U.S.A
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Matsumoto Y, Abe N, Tobita R, Kawakami H, Nakayama H, Setoguchi Y, Tsuboi R, Okubo Y. The risk of interstitial lung disease during biological treatment in Japanese patients with psoriasis. Clin Exp Dermatol 2020; 45:853-858. [PMID: 32356612 DOI: 10.1111/ced.14259] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/18/2020] [Accepted: 04/21/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND With the increasing use of biological agents for the treatment of psoriasis, the numbers of patients with interstitial lung disease (ILD) associated with biologics have also increased. Many of these cases were associated with tumour necrosis factor (TNF)-α inhibitors, but cases associated with other families of biologics have also been reported in Japan. AIM To analyse the background factors of patients who developed ILD, and to discuss better management of biological treatment. METHOD We reviewed 246 patients with psoriasis who were treated with biological agents in our department to identify any pulmonary adverse events (AEs). Data on patients who developed ILD were extracted to analyse background factors, clinical type of psoriasis, time to onset of ILD, pre-existing ILD, smoking habit and prescribed drugs. RESULTS Pulmonary AEs were seen in 22 cases, of which 11 were diagnosed as drug-induced ILD. The causative drugs were mainly TNF-α inhibitors, accounting for eight cases (six treated with infliximab, two with adalimumab). The remaining three cases were associated with secukinumab, ustekinumab and ixekizumab (n = 1 each). Notably, these three cases also had a history of drug-induced ILD. CONCLUSION Patients with a history of drug-induced ILD seem to be more susceptible to developing another ILD induced by biologics, even if treated with interleukin-17 inhibitors. Thorough screening of risk factors and evaluation for eligibility, and careful monitoring during treatment are the best solutions to avoid serious pulmonary AE. Early detection and precise diagnosis of pulmonary AEs, especially differentiation from infectious diseases, is essential for managing biological treatment.
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Affiliation(s)
- Y Matsumoto
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - N Abe
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - R Tobita
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - H Kawakami
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - H Nakayama
- Department of Respiratory Medicine, Tokyo Medical University, Tokyo, Japan
| | - Y Setoguchi
- Department of Pulmonology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - R Tsuboi
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Y Okubo
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
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Farah RA, Alduaij A, Ugas C, Navarro R. Primary Central Nervous System Lymphoma in a Patient on Adalimumab Therapy for Chronic Plaque Psoriasis. World Neurosurg 2020; 139:260-263. [PMID: 32247793 DOI: 10.1016/j.wneu.2020.03.155] [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: 02/10/2020] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Adalimumab (Humira) is a recombinant human monoclonal antibody against tumor necrosis factor alpha, which works by blocking the interaction of tumor necrosis factor alpha with its cell-surface receptors, thereby limiting the progression of inflammatory pathways. Its use is approved for several autoimmune conditions, including chronic plaque psoriasis, for which it has been prescribed as a first-line biologic treatment. Increased risks of malignancy, particularly nonmelanoma skin cancer and non-central nervous system lymphomas, have been reported with use of this drug; however, there have been no reports of central nervous system lymphomas. CASE DESCRIPTION A 43-year-old man presented for evaluation following recent speech difficulty and a generalized tonic-clonic seizure. His medical history was significant for plaque psoriasis, for which he had been receiving treatment with adalimumab for 4 months. Magnetic resonance imaging scan of the brain with contrast agent showed a well-defined rounded enhancing lesion in the left temporal lobe with circumferential vasogenic edema. Mass effect was noted. Computed tomography scan of the chest, abdomen, and pelvis was unremarkable. He underwent excisional biopsy, and the preliminary intraoperative pathology report revealed a diagnosis of high-grade lymphoma. Subsequent analysis of morphology and immunophenotyping was consistent with primary diffuse large B-cell lymphoma of the central nervous system. Use of adalimumab was discontinued. Following combination therapy with high-dose methotrexate and rituximab along with 20 sessions of cranial radiation therapy, the patient was disease-free at 14-month follow-up. CONCLUSIONS We report the first case to our knowledge showing a possible association of central nervous lymphoma and adalimumab.
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Affiliation(s)
| | - Ahmad Alduaij
- Pathology Department, Cleveland Clinic Abu Dhabi, Abu Dhabi
| | - Carlos Ugas
- Neurosurgery Department, Cleveland Clinic Abu Dhabi, Abu Dhabi
| | - Ramon Navarro
- Neurosurgery Department, American Hospital, Dubai, United Arab Emirates.
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10
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Shirolikar M, Parasramani S, Pillai J. Viva voce: Adalimumab. INDIAN JOURNAL OF DRUGS IN DERMATOLOGY 2020. [DOI: 10.4103/ijdd.ijdd_5_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Huang YW, Tsai TF. Remission Duration and Long-Term Outcomes in Patients with Moderate-to-Severe Psoriasis Treated by Biologics or Tofacitinib in Controlled Clinical Trials: A 15-Year Single-Center Experience. Dermatol Ther (Heidelb) 2019; 9:553-569. [PMID: 31270683 PMCID: PMC6704191 DOI: 10.1007/s13555-019-0310-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Relapse is common after treatment discontinuation for patients with moderate-to-severe psoriasis. The objective of this study was to understand the remission duration and long-term outcomes in psoriasis patients after biologic withdrawal. METHODS We retrospectively included the follow-up data of 184 patients with moderate-to-severe psoriasis after the end of 11 biologic or tofacitinib trials conducted between 2004 and 2016. RESULTS Among the 232 treatment courses, 95 achieved (psoriasis area and severity index) PASI 75 at the end of the studies. At 6 months after treatment discontinuation, the systemic treatment-free rates of our patients who entered the PRESTA, PRISTINE, PEARL, ERASURE, CLEAR, the global tofacitinib study, and the IXORA-P study were 66.7%, 66.7%, 75.0%, 16.7%, 22.2%, 33.3%, and 29.2%, respectively. Pooled data showed a serious adverse event incidence rate of 1.5/100 person-years. The proportions of systemic treatment-free episodes were 16.8%, 7.4%, 4.3%, 3.2%, and 3.2% at 1, 2, 3, 4, and 5 years, respectively. Biologics were reinitiated in 41.9%, 66.7%, 77.1%, 83.5%, and 86.1% at 1, 2, 3, 4, and 5 years, respectively. Multivariate generalized estimating equation (GEE) regression analysis demonstrated that predictors for a longer relapse-free duration were baseline PASI, PASI improvement, biologic naivety, and early biologic intervention. Patients who received early biologic intervention, who achieved PASI 90, and who were biologic naive showed significantly higher relapse-free rate by Kaplan-Meier analysis with log rank test. CONCLUSIONS Systemic treatment was required in 86.1% of patients within 12 months after biologic withdrawal and biologics were reinitiated in 77.1% of patients after 3 years. However, early biologic administration within 2 years after diagnosis demonstrated a lower risk of relapse in patients with moderate-to-severe psoriasis.
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Affiliation(s)
- Yi-Wei Huang
- National Taiwan University Hospital, Taipei, Taiwan
| | - Tsen-Fang Tsai
- Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan.
- Department of Dermatology, National Taiwan University College of Medicine, Taipei, Taiwan.
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12
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Thaçi D, Papp K, Marcoux D, Weibel L, Pinter A, Ghislain PD, Landells I, Hoeger PH, Unnebrink K, Seyger MMB, Williams DA, Rubant S, Philipp S. Sustained long-term efficacy and safety of adalimumab in paediatric patients with severe chronic plaque psoriasis from a randomized, double-blind, phase III study. Br J Dermatol 2019; 181:1177-1189. [PMID: 31017657 PMCID: PMC6916374 DOI: 10.1111/bjd.18029] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Adalimumab (ADA) (Humira® , AbbVie Inc., U.S.A.) is approved by the European Medicines Agency for children aged ≥ 4 years with severe plaque psoriasis. OBJECTIVES To evaluate the long-term efficacy and safety of ADA in children with severe plaque psoriasis. METHODS Results are presented from the 52-week long-term extension (LTE) of the randomized, double-blind, double-dummy, phase III trial, in children with severe plaque psoriasis (results from prior periods have been published). Patients aged ≥ 4 and < 18 years were randomized 1 : 1 : 1 to ADA 0·8 mg kg-1 (40 mg maximum) or 0·4 mg kg-1 (20 mg maximum) every other week or to methotrexate (MTX) 0·1-0·4 mg kg-1 (25 mg maximum) weekly. The 16-week initial treatment (IT) period was followed by a 36-week withdrawal period and a 16-week retreatment period. Patients could enter the LTE at prespecified time points to receive ADA 0·8 mg kg-1 (blinded or open label) or ADA 0·4 mg kg-1 (blinded), or to remain off treatment. Efficacy is reported for patient groups according to doses received in the IT and LTE periods. RESULTS Of the 114 patients randomized in the IT period, 108 entered the LTE (n = 36 in each group); 93 received ADA 0·8 mg kg-1 . Efficacy (≥ 75% improvement from baseline in Psoriasis Area and Severity Index) was maintained or improved from entry to the end of the LTE: MTX(IT)/ADA 0·8(LTE) 31-86% of patients; ADA 0·4(IT)/0·4 or 0·8(LTE) 28-47%; ADA 0·8(IT)/0·8(LTE) 50-72%. No serious infections occurred in the LTE. CONCLUSIONS After 52 weeks of long-term ADA treatment in children aged 4-18 years with severe plaque psoriasis, disease severity was reduced and maintained or further improved, as demonstrated by efficacy outcomes. No new safety risks were identified. What's already known about this topic? The results from the first three periods of this phase III trial in children aged 4-18 years with severe plaque psoriasis suggest that adalimumab is a safe and efficacious treatment option in this population. What does this study add? This is the first study to evaluate long-term treatment of adalimumab in children with severe psoriasis, and the first to evaluate switching from methotrexate to adalimumab in this population.
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Affiliation(s)
- D Thaçi
- Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Ratzeburger Allee 160, 23435, Lübeck, Germany
| | - K Papp
- K Papp Clinical Research and Probity Medical Research, University of Western Ontario, Waterloo, ON, Canada
| | - D Marcoux
- CHU Sainte-Justine Montreal, Montreal, QC, Canada
| | - L Weibel
- Pediatric Dermatology Department, University Children's Hospital Zurich, and Dermatology Department, University Hospital Zurich, Zurich, Switzerland
| | - A Pinter
- University Clinic of Frankfurt am Main, Department of Dermatology, Venereology and Allergology, Frankfurt am Main, Germany
| | | | - I Landells
- Nexus Clinical Research and Memorial University of Newfoundland, St John's, NL, Canada
| | - P H Hoeger
- Department of Pediatric Dermatology, Catholic Children's Hospital, Hamburg, Germany
| | - K Unnebrink
- AbbVie Deutschland GmbH & Co. KG, Ludwigshafen, Germany
| | - M M B Seyger
- Department of Dermatology and Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - S Rubant
- AbbVie Deutschland GmbH & Co. KG, Ludwigshafen, Germany
| | - S Philipp
- Department of Dermatology, Venerology and Allergy, Charité Universitätsmedizin Berlin, Berlin, Germany
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Strober B, Greenberg JD, Karki C, Mason M, Guo N, Hur P, Zhao Y, Herrera V, Lin F, Lebwohl M. Impact of psoriasis severity on patient-reported clinical symptoms, health-related quality of life and work productivity among US patients: real-world data from the Corrona Psoriasis Registry. BMJ Open 2019; 9:e027535. [PMID: 31005939 PMCID: PMC6500315 DOI: 10.1136/bmjopen-2018-027535] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES This analysis examined the association between psoriasis severity, assessed by body surface area (BSA) and the Investigator's Global Assessment (IGA; previously used only in clinical trials), and patient-reported outcomes (PROs) in a real-world setting. DESIGN Cross-sectional analysis within the Corrona Psoriasis Registry, an independent, prospective registry. SETTING 70 dermatology practices in the USA. PARTICIPANTS 1529 adult patients with psoriasis being treated with biological or non-biological systemic psoriasis treatment by 31 May 2016. PRIMARY AND SECONDARY OUTCOME MEASURES Psoriasis severity was assessed by percentage of affected BSA (mild (0%-5%), moderate (>5%-10%), severe (>10%-15%), very severe (>15%)) and IGA scores (clear/almost clear (0-1), mild (2), moderate (3), severe (4)). PROs (pain, itch, fatigue; Dermatology Life Quality Index [DLQI]; EuroQoL Visual Analogue Scale [EQ-VAS]; Work Productivity and Activity Impairment [WPAI]) were compared across BSA and IGA levels using analysis of variance and X2 tests. The association between psoriasis severity and PROs was examined using multivariable regression models. RESULTS The mean age was 50.6 years and 47% of patients were female. Consistently with more severe psoriasis, symptoms worsened, DLQI scores increased (p<0.05 for each level of BSA and IGA), EQ-VAS decreased (p<0.05 for each level of BSA and IGA) and WPAI scores increased. By BSA score, moderate to very severe psoriasis was associated with poorer outcomes for the 'impairment while working' and 'daily activities impaired' WPAI domains (all p<0.05 vs mild psoriasis). Very severe psoriasis was associated with increased 'work hours missed' and 'work hours affected' (both p<0.05 vs mild psoriasis) Findings were similar by IGA. Results were confirmed by multivariable regression analyses. CONCLUSIONS In a real-world setting, more severe psoriasis, assessed by BSA and IGA, was consistently associated with worse PROs.
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Affiliation(s)
- Bruce Strober
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut, USA
- Probity Medical Research, Waterloo, Ontario, Canada
| | - Jeffrey D Greenberg
- Corrona, LLC, Waltham, Massachusetts, USA
- Department of Medicine, NYU School of Medicine, New York City, New York, USA
| | | | - Marc Mason
- Corrona, LLC, Waltham, Massachusetts, USA
| | - Ning Guo
- Corrona, LLC, Waltham, Massachusetts, USA
| | - Peter Hur
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | - Yang Zhao
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | - Vivian Herrera
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | - Feng Lin
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | - Mark Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
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Leonardi C, Papp K, Strober B, Thaçi D, Warren RB, Tyring S, Arikan D, Karunaratne M, Valdecantos WC. Comprehensive long-term safety of adalimumab from 18 clinical trials in adult patients with moderate-to-severe plaque psoriasis. Br J Dermatol 2018; 180:76-85. [PMID: 30169904 DOI: 10.1111/bjd.17084] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Adalimumab (Humira® , AbbVie Inc., North Chicago, IL, U.S.A.) is a fully human monoclonal antibody specific for tumour necrosis factor-α that is approved to treat adults with moderate-to-severe chronic plaque psoriasis. OBJECTIVES To assess long-term safety for patients with psoriasis receiving adalimumab in clinical studies. METHODS Adalimumab safety data from adults with psoriasis who received at least one adalimumab dose in 18 clinical trials were evaluated. Adalimumab was delivered subcutaneously in all treatment regimens. Treatment-emergent adverse events (AEs) were collected from the first dose to 70 days after the last dose or cut-off date (31 December 2015). AE incidence rates were expressed as events per 100 patient-years (E/100 PYs) of adalimumab exposure. Standardized incidence ratios (SIRs) for malignancies and standardized mortality ratios (SMRs) were calculated. RESULTS Cumulative exposure was 5429·7 PYs in 3727 patients. Overall, there were 16 536 AEs (304·6 E/100 PYs). The most common AEs were nasopharyngitis, upper respiratory infection and headache (23·7, 12·9 and 7·9 E/100 PYs, respectively). Incidence rates for serious infections, tuberculosis and opportunistic infections were 1·8, 0·3 and 0·02 E/100 PYs, respectively. Incidence of malignancy excluding nonmelanoma skin cancer (NMSC) was 0·8 E/100 PYs [SIR 0·86, 95% confidence interval (CI) 0·58-1·23]. Incidences of NMSC and melanoma were 0·6 and 0·2 E/100 PYs, respectively. The SIR was 1·55 (95% CI 1·10-2·13) for NMSC and 3·04 (95% CI 1·11-6·62) for melanoma. The SMR was 0·34 (95% CI 0·16-0·65). CONCLUSIONS AE rates remained stable in this analysis of patients with psoriasis receiving adalimumab; no new safety signals were identified compared with earlier analyses.
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Affiliation(s)
- C Leonardi
- Department of Dermatology, St. Louis University, St. Louis, MO, U.S.A
| | - K Papp
- Probity Medical Research and K. Papp Clinical Research, Waterloo, ON, Canada
| | - B Strober
- Department of Dermatology and Probity Medical Research, University of Connecticut, Farmington, CT, U.S.A
| | - D Thaçi
- Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany
| | - R B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, NIHR Manchester Biomedical Research Centre, The University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PT, U.K
| | - S Tyring
- Department of Dermatology, University of Texas Health Science Center at Houston, Houston, TX, U.S.A
| | - D Arikan
- AbbVie Inc., North Chicago, IL, U.S.A
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15
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Strober B, Crowley J, Langley RG, Gordon K, Menter A, Leonardi C, Arikan D, Valdecantos WC. Systematic review of the real-world evidence of adalimumab safety in psoriasis registries. J Eur Acad Dermatol Venereol 2018; 32:2126-2133. [PMID: 30067882 DOI: 10.1111/jdv.15203] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 07/06/2018] [Indexed: 12/27/2022]
Abstract
Long-term safety of adalimumab in psoriasis clinical studies has been established. The objective of this research was to review real-world evidence of adalimumab safety from registries of adult patients with psoriasis treated in clinical practice. Databases (BIOSIS Previews, Current Contents Search, Derwent Drug File, EMBASE, EMBASE Alert, EMCare, MEDLINE, SciSearch) were searched for psoriasis registries with adalimumab safety data. Eligible papers were English language manuscripts (conference abstracts excluded) from psoriasis registries presenting safety data for adult patients with psoriasis receiving adalimumab. The incidence and rate (events/100 patient-years [PY]) of adverse events (AEs), serious AEs (SAEs) and AEs of special interest are reported. Abstracts of 425 publications were screened, and 401 publications excluded (208 conference abstracts; 193 papers). Remaining manuscripts were fully screened; 14 were excluded (no adalimumab data, n = 10; no safety data, n = 2; no on-treatment data, n = 1; not English, n = 1), and 10 selected. Overall rates of AEs (4273 [22.2/100PY]) and SAEs (827 [4.3/100PY]) were reported in the ESPRIT registry (N = 6059). Rates of infections (7.7-14.7/100PY) and serious infections (<0.6-2.0/100PY) were reported in four studies. Cardiovascular-related events were reported in three studies: ≤0.1/100PY per major cardiac event in ESPRIT, <0.5/100PY major cardiac events in PsoBest and serious cardiovascular events in two patients (<1%) in DERMBIO. Malignancies were reported in three studies (any malignancy, 0.9/100PY; malignancies excluding non-melanoma skin cancer [NMSC], <0.6/100PY; NMSC, 0.6-<0.5/100PY). These findings suggest that real-world safety of adalimumab is consistent across different psoriasis registries, which supports the existing long-term safety profile of adalimumab from clinical studies.
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Affiliation(s)
- B Strober
- Department of Dermatology, University of Connecticut, Farmington, CT, USA.,Probity Medical Research, Waterloo, ON, Canada
| | - J Crowley
- Bakersfield Dermatology, Bakersfield, CA, USA
| | | | - K Gordon
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - A Menter
- Baylor University Medical Center, Dallas, TX, USA
| | - C Leonardi
- Saint Louis University, St. Louis, MO, USA
| | - D Arikan
- AbbVie Inc., North Chicago, IL, USA
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16
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Armstrong AW, Betts KA, Signorovitch JE, Sundaram M, Li J, Ganguli AX, Wu EQ. Number needed to treat and costs per responder among biologic treatments for moderate-to-severe psoriasis: a network meta-analysis. Curr Med Res Opin 2018; 34:1325-1333. [PMID: 29619856 DOI: 10.1080/03007995.2018.1457516] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND The clinical benefits of biologic therapies for moderate-to-severe psoriasis are well established, but wide variations exist in patient response. OBJECTIVES To determine the number needed to treat (NNT) to achieve a 75% and 90% reduction in the Psoriasis Area and Severity Index (PASI-75/90) with FDA-approved agents and evaluate the incremental cost per PASI-75 or PASI-90 responder. METHODS The relative probabilities of achieving PASI-75 and PASI-90, as well as NNTs, were estimated using a network meta-analysis. Costs (2017 USD) included drug acquisition and administration. The incremental cost per PASI-75 or PASI-90 responder for each treatment was estimated for the clinical trial period, and annually. RESULTS Compared with supportive care, the NNT to achieve PASI-75 was 1.18 for ixekizumab, 1.29 for secukinumab 300 mg, 1.37 for infliximab, 1.48 for adalimumab, 1.53 for secukinumab 150 mg, 1.58 for ustekinumab, 2.25 for etanercept, and 3.71 for apremilast. The one-year incremental cost per PASI-75 responder relative to supportive care was $59,830 for infliximab, $88,775 for secukinumab 300 mg, $91,837 for adalimumab, $95,898 for ixekizumab, $97,363 for ustekinumab, $105,131 for secukinumab 150 mg, $129,665 for apremilast, and $159,328 for etanercept. Results were similar for PASI-90. CONCLUSION The NNT and incremental cost per responder are meaningful ways to assess comparative effectiveness and cost effectiveness among psoriasis treatments.
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Affiliation(s)
- April W Armstrong
- a Keck School of Medicine , University of Southern California , Los Angeles , CA , USA
| | | | | | | | - Junlong Li
- b Analysis Group, Inc. , Boston , MA , USA
| | | | - Eric Q Wu
- b Analysis Group, Inc. , Boston , MA , USA
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Safety of Adalimumab Dosed Every Week and Every Other Week: Focus on Patients with Hidradenitis Suppurativa or Psoriasis. Am J Clin Dermatol 2018; 19:437-447. [PMID: 29380251 PMCID: PMC5945711 DOI: 10.1007/s40257-017-0341-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Adalimumab is approved for the treatment of hidradenitis suppurativa (HS), plaque psoriasis, and other inflammatory conditions. Objective Our objective was to examine the safety of adalimumab administered every other week (EOW) and every week (EW) in patients with HS and psoriasis and to investigate informative data from non-dermatologic indications. Methods The safety of adalimumab 40-mg EOW versus EW dosing was examined during placebo-controlled and open-label study periods in patients with HS (three studies), psoriasis (two studies), Crohn’s disease (six studies), ulcerative colitis (three studies), and rheumatoid arthritis (one study). Results No new safety risks or increased rates of particular adverse events (AEs) were identified with EW dosing. In patients with HS or psoriasis, the overall safety of adalimumab 40-mg EOW and EW was generally comparable. In studies of adalimumab for non-dermatologic indications, including Crohn’s disease, ulcerative colitis, and rheumatoid arthritis, the overall AE rates were similar for EW and EOW dosing. Conclusion In patients with HS or psoriasis, the safety of adalimumab EW and EOW was comparable and consistent with the expected adalimumab AE profile. The safety of adalimumab EW dosing in patients with dermatologic conditions is supported by data comparing adalimumab EW and EOW dosing for Crohn’s disease, ulcerative colitis, and rheumatoid arthritis. Trial registration ClinicalTrials.gov NCT00918255, NCT01468207, NCT01468233, NCT00645814, NCT00077779, NCT00055497, NCT01070303, NCT00195715, NCT00348283, NCT00385736, NCT00408629, and NCT00573794.
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18
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Costanzo A, Malara G, Pelucchi C, Fatiga F, Barbera G, Franchi A, Galeone C. Effectiveness End Points in Real-World Studies on Biological Therapies in Psoriasis: Systematic Review with Focus on Drug Survival. Dermatology 2018; 234:1-12. [DOI: 10.1159/000488586] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/17/2018] [Indexed: 12/26/2022] Open
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Bissonnette R, Luger T, Thaçi D, Toth D, Lacombe A, Xia S, Mazur R, Patekar M, Charef P, Milutinovic M, Leonardi C, Mrowietz U. Secukinumab demonstrates high sustained efficacy and a favourable safety profile in patients with moderate-to-severe psoriasis through 5 years of treatment (SCULPTURE Extension Study). J Eur Acad Dermatol Venereol 2018; 32:1507-1514. [PMID: 29444376 PMCID: PMC6175198 DOI: 10.1111/jdv.14878] [Citation(s) in RCA: 141] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 01/29/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Secukinumab, a fully human monoclonal antibody that selectively neutralizes IL-17A, has been shown to have significant efficacy and a favourable safety profile in the treatment of moderate-to-severe psoriasis and psoriatic arthritis. OBJECTIVE To assess the efficacy and safety of secukinumab through 5 years of treatment in moderate-to-severe psoriasis. METHODS In the core SCULPTURE study, Psoriasis Area and Severity Index (PASI) 75 responders at Week 12 continued receiving subcutaneous secukinumab until Year 1. Thereafter, patients entered the extension phase and continued treatment as per the core trial. Treatment was double-blinded until the end of Year 3 and open-label from Year 4. Here, we focus on the 300 mg fixed-interval (every 4 weeks) treatment, the recommended per label dose. Efficacy data are primarily reported as observed, but multiple imputation (MI) and last observation carried forward (LOCF) techniques were also undertaken as supportive analyses. RESULTS At Year 1, 168 patients entered the extension study and at the end of Year 5, 126 patients completed 300 mg (every 4 weeks) treatment. PASI 75/90/100 responses at Year 1 (88.9%, 68.5% and 43.8%, respectively) were sustained to Year 5 (88.5%, 66.4% and 41%). PASI responses were consistent regardless of the analysis undertaken (as observed, MI, or LOCF). The average improvement in mean PASI was approximately 90% through 5 years compared with core study baseline. DLQI (dermatology life quality index) 0/1 response also sustained through 5 years (72.7% at Year 1 and 65.5% at Year 5). The safety profile of secukinumab remained favourable, with no cumulative or unexpected safety concerns identified. CONCLUSION Secukinumab 300 mg treatment delivered high and sustained levels of skin clearance and improved quality of life through 5 years in patients with moderate-to-severe psoriasis. Favourable safety established in the secukinumab phase 2/3 programme was maintained through 5 years.
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Affiliation(s)
| | - T Luger
- Department of Dermatology, University of Münster, Münster, Germany
| | - D Thaçi
- Comprehensive Center for Inflammation Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - D Toth
- Department of Geriatric and Environmental Dermatology, Probity Medical Research Windsor and XLR8 Medical Research, Windsor, ON, Canada
| | - A Lacombe
- Novartis Pharma AG, Basel, Switzerland
| | - S Xia
- Beijing Novartis Pharma Co. Ltd., Shanghai, China
| | - R Mazur
- Novartis Pharma AG, Basel, Switzerland
| | - M Patekar
- Novartis Pharma AG, Basel, Switzerland
| | - P Charef
- Novartis Pharma AG, Basel, Switzerland
| | | | - C Leonardi
- Department of Dermatology, Saint Louis University Health Science Center, St Louis, MO, USA
| | - U Mrowietz
- Department of Dermatology, Psoriasis-Center, University Medical Center Schleswig-Holstein, Kiel, Germany
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Choosing First-Line Biologic Treatment for Moderate-to-Severe Psoriasis: What Does the Evidence Say? Am J Clin Dermatol 2018; 19:1-13. [PMID: 29080066 DOI: 10.1007/s40257-017-0328-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
An advanced understanding of the pathogenesis of psoriasis has led to the development of multiple therapeutic options for moderate-to-severe psoriasis. Tumor necrosis factor inhibitors, ustekinumab, interleukin-17 inhibitors, and guselkumab (an interleukin-23 inhibitor recently approved for psoriasis) are commercially available biologic agents for psoriasis. Evidence from clinical trials provides pertinent information regarding the safety and efficacy of biologic agents for psoriasis, which should be integrated into clinical decision making. However, disease presentations, disease severity, and comorbid conditions can complicate the choice of initial treatment, which underscores the importance of providing personalized therapy for patients with psoriasis. Furthermore, each biologic agent offers unique benefits and limitations for the treatment of patients with psoriasis. Here, evidence-based recommendations are presented and discussed regarding first-line biologic therapy options for patients with psoriasis and distinct comorbid conditions or patient-related factors. We discuss the comorbid conditions of psoriatic arthritis, multiple sclerosis, congestive heart failure, inflammatory bowel disease, hepatitis B, and latent tuberculosis. Moreover, we describe treatment recommendations for distinct patient populations with psoriasis, including pediatric patients with psoriasis and patients with psoriasis of childbearing potential and nursing.
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Mandy Chan W, Oon H, Chong WS. Clinical experience of adalimumab in the treatment of psoriasis - A 10-year journey in a tertiary dermatology centre. Indian J Dermatol Venereol Leprol 2018; 84:205-208. [DOI: 10.4103/ijdvl.ijdvl_163_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Choi CW, Yang S, Jo G, Kim BR, Youn SW. Economic Factors as Major Determinants of Ustekinumab Drug Survival of Patients with Chronic Plaque Psoriasis in Korea. Ann Dermatol 2018; 30:668-675. [PMID: 33911506 PMCID: PMC7992448 DOI: 10.5021/ad.2018.30.6.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 07/02/2018] [Accepted: 07/10/2018] [Indexed: 11/18/2022] Open
Abstract
Background Drug survival, defined as the time until discontinuation, is a parameter reflecting real-world therapeutic effectiveness. Few studies have examined the influence of economic factors on the drug survival of biologic agents for psoriasis, particularly in Asian countries. Objective To determine the drug survival for ustekinumab in real-life settings and investigate the factors affecting drug survival for psoriasis patients in Korea. Methods We evaluated 98 psoriasis patients who were treated with ustekinumab at a single center. We analyzed the efficacy and drug survival of ustekinumab. Cox proportional hazard analysis and competing risk regression analysis were performed to reveal the factors affecting the drug survival of ustekinumab. Results The overall mean drug survival was 1,596 days (95% confidence interval [CI], 904~2,288). Among the 39 cessations of ustekinumab treatment, 9 (23.1%) patients discontinued treatment after experiencing satisfactory results. Multivariate Cox proportional hazard analysis revealed that paying on patients' own expense was the major predictor for the discontinuation of ustekinumab (hazard ratio [HR], 9.696; 95% CI, 4.088~22.998). Competing risk regression analysis modeling of discontinuation because of factors other than satisfaction of an event also revealed that ustekinumab treatment at the patient's expense (HR, 4.138; 95% CI, 1.684~10.168) was a predictor of discontinuation rather than satisfaction. Conclusion The results of our study revealed that the cost of biologics treatment affects the drug survival of ustekinumab and suggested that economic factors affect the drug survival of ustekinumab treatment in Korea.
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Affiliation(s)
- Chong Won Choi
- Department of Dermatology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seungkeol Yang
- Department of Dermatology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Gwanghyun Jo
- Department of Dermatology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Bo Ri Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sang Woong Youn
- Department of Dermatology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Papp K, Bachelez H, Costanzo A, Foley P, Gooderham M, Kaur P, Philipp S, Spelman L, Zhang N, Strober B. Clinical similarity of the biosimilar ABP 501 compared with adalimumab after single transition: long-term results from a randomized controlled, double-blind, 52-week, phase III trial in patients with moderate-to-severe plaque psoriasis. Br J Dermatol 2017; 177:1562-1574. [DOI: 10.1111/bjd.15857] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2017] [Indexed: 02/06/2023]
Affiliation(s)
- K. Papp
- Clinical Research; Waterloo ON Canada
- Probity Medical Research; Waterloo ON Canada
| | - H. Bachelez
- Sorbonne Paris Cité Université Paris Diderot; Department of Dermatology; AP-HP HP Hôpital Saint-Louis; INSERM U1163; Institut Imagine; Paris France
| | - A. Costanzo
- Dermatology Unit; Department of Biomedical Sciences; Humanitas University; Rozzano - Milan Italy
| | - P. Foley
- Department of Medicine (Dermatology); The University of Melbourne; St Vincent's Hospital Melbourne; Australia
- Skin & Cancer Foundation Inc.; Carlton Australia
- Probity Medical Research; Carlton Australia
| | - M. Gooderham
- Probity Medical Research; Waterloo ON Canada
- SKiN Centre for Dermatology; ON Canada
| | - P. Kaur
- Amgen Inc.; Thousand Oaks CA U.S.A
| | - S. Philipp
- Psoriasis Research and Treatment Center; University Hospital Charité; Berlin Germany
| | - L. Spelman
- Veracity Clinical Research; Woolloongabba Queensland Australia
- Probity Medical Research; Woolloongabba Queensland Australia
| | - N. Zhang
- Amgen Inc.; Thousand Oaks CA U.S.A
| | - B. Strober
- University of Connecticut Health Center; Farmington CT U.S.A
- Probity Medical Research; Farmington CT U.S.A
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24
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Papp KA, Bachelez H, Blauvelt A, Winthrop KL, Romiti R, Ohtsuki M, Acharya N, Braun DK, Mallbris L, Zhao F, Xu W, Walls CD, Strober B. Infections from seven clinical trials of ixekizumab, an anti-interleukin-17A monoclonal antibody, in patients with moderate-to-severe psoriasis. Br J Dermatol 2017; 177:1537-1551. [PMID: 28600810 DOI: 10.1111/bjd.15723] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Infections are associated with biological therapies in psoriasis. OBJECTIVES To summarize the incidence of infections in patients with moderate-to-severe psoriasis treated with ixekizumab, an anti-interleukin-17A monoclonal antibody. METHODS Infections are summarized from an integrated database of seven controlled and uncontrolled ixekizumab psoriasis trials. Data are presented from placebo-controlled induction (weeks 0-12; UNCOVER-1, UNCOVER-2 and UNCOVER-3) and maintenance periods (weeks 12-60; UNCOVER-1 and UNCOVER-2), and all patients exposed to ixekizumab pooled from all seven trials. Comparisons with etanercept were made during the induction period of two trials (UNCOVER-2 and UNCOVER-3). Incidence and exposure-adjusted incidence rates (IRs) per 100 patient-years (PYs) are reported. RESULTS Overall, 4209 patients were treated with ixekizumab (6480 PY). During induction (weeks 0-12), overall infection rates were higher in patients treated with ixekizumab (27%) vs. placebo (23%, P < 0·05); however, specific infection rates were comparable overall across treatment groups. IRs of infections did not increase with longer-term exposure. For all patients treated with ixekizumab (all seven trials), the incidence of serious infections was low (2%, IR 1·3). Candida infections, including eight cases of oesophageal candidiasis, were adequately managed with antifungal therapy, were noninvasive and did not lead to discontinuation. CONCLUSIONS Overall, infections occurred in a higher percentage of patients treated with ixekizumab vs. placebo during the first 12 weeks of treatment; however, specific infection rates were comparable overall across treatment groups. Incidences of serious infections were low and similar across treatment groups.
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Affiliation(s)
- K A Papp
- K. Papp Clinical Research, Waterloo, ON, Canada.,Probity Medical Research, Waterloo, ON, Canada
| | - H Bachelez
- Service de Dermatologie, AP-HP Hôpital Saint Louis, Sorbonne Paris Cité Université Paris Diderot, Paris, France
| | - A Blauvelt
- Oregon Medical Research Center, Portland, OR, U.S.A
| | - K L Winthrop
- Oregon Health and Science University, Portland, OR, U.S.A
| | - R Romiti
- Departament of Dermatology, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil
| | - M Ohtsuki
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
| | - N Acharya
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | - D K Braun
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | - L Mallbris
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | - F Zhao
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | - W Xu
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | - C D Walls
- Eli Lilly and Company, Indianapolis, IN, U.S.A
| | - B Strober
- Probity Medical Research, Waterloo, ON, Canada.,Department of Dermatology, University of Connecticut Health Center, Farmington, CT, U.S.A
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Abstract
INTRODUCTION Childhood psoriasis is a special situation that is a management challenge for the treating dermatologist. As is the situation with traditional systemic agents, which are commonly used in managing severe psoriasis in children, the biologics are being increasingly used in the recalcitrant disease despite limited data on long term safety. AREAS COVERED We performed an extensive literature search to collect evidence-based data on the use of biologics in pediatric psoriasis. The relevant literature published from 2000 to September 2017 was obtained from PubMed, using the MeSH words 'biologics', 'biologic response modifiers' and 'treatment of pediatric/childhood psoriasis'. All clinical trials, randomized double-blind or single-blind controlled trials, open-label studies, retrospective studies, reviews, case reports and letters concerning the use of biologics in pediatric psoriasis were screened. Articles covering the use of biologics in pediatric psoriasis were screened and reference lists in the selected articles were scrutinized to identify other relevant articles that had not been found in the initial search. Articles without relevant information about biologics in general (e.g. its mechanism of action, pharmacokinetics and adverse effects) and its use in psoriasis in particular were excluded. We screened 427 articles and finally selected 41 relevant articles. EXPERT OPINION The available literature on the use of biologics such as anti-tumor necrosis factor (TNF)-α agents, and anti-IL-12/23 agents like ustekinumab suggests that these are effective and safe in managing severe pediatric psoriasis although there is an urgent need to generate more safety data. Dermatologists must be careful about the potential adverse effects of the biologics before administering them to children with psoriasis. It is likely that with rapidly evolving scenario of biologics in psoriasis, these will prove to be very useful molecules particularly in managing severe and recalcitrant psoriasis in pediatric age group.
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Affiliation(s)
- Sunil Dogra
- a Department of Dermatology, Venereology, and Leprology , Postgraduate Institute of Medical Education and Research , Chandigarh , India
| | - Rahul Mahajan
- a Department of Dermatology, Venereology, and Leprology , Postgraduate Institute of Medical Education and Research , Chandigarh , India
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Prussick R, Wu JJ, Armstrong AW, Siegel MP, Van Voorhees AS. Psoriasis in solid organ transplant patients: best practice recommendations from The Medical Board of the National Psoriasis Foundation. J DERMATOL TREAT 2017; 29:329-333. [DOI: 10.1080/09546634.2017.1373737] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ronald Prussick
- Department of Dermatology, George Washington University, Washington D.C., USA
| | - Jashin J. Wu
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA
| | - April W. Armstrong
- Department of Dermatology, University of Southern California, Los Angeles, CA, USA
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27
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Abstract
BACKGROUND Patient registries are databases comprised of standardized clinical data for a specific population of patients with a particular disease or medical condition. Information from patient registries allows clinicians to assess long-lasting outcomes in patients with a specific disease, such as psoriasis. OBJECTIVE Our primary objective was to identify available psoriasis registries in the United States (U.S.) and evaluate the application of patient registries compared to clinical trials. METHODS We searched Google, the Registry of Patient Registries, Orphanet and ClinicalTrials.gov to create a list of U.S. psoriasis registries. We also performed a literature review on the application of psoriasis registries using PubMed. RESULTS We identified 6 psoriasis patient registries in the United States. CONCLUSIONS Patient registries are frequently used for psoriasis in the U.S. and provide important information about the safety, efficacy and long-term effects of systemic therapies.
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Affiliation(s)
- Mina Amin
- a School of Medicine , University of California, Riverside , Riverside , CA , USA
| | - Daniel J No
- b School of Medicine , Loma Linda University , Loma Linda , CA , USA
| | - Jashin J Wu
- c Department of Dermatology , Kaiser Permanente Los Angeles Medical Center , Los Angeles , CA , USA
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Long-Term Safety and Effectiveness of Adalimumab for Moderate to Severe Psoriasis: Results from 7-Year Interim Analysis of the ESPRIT Registry. Dermatol Ther (Heidelb) 2017; 7:365-381. [PMID: 28815476 PMCID: PMC5574748 DOI: 10.1007/s13555-017-0198-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION ESPRIT (NCT00799877) is an ongoing 10-year international prospective observational registry evaluating the long-term safety and effectiveness of originator adalimumab in routine clinical practice for adult patients with chronic plaque psoriasis. Herein, we report the long-term safety, effectiveness, and patient-reported outcomes (PROs) following adalimumab treatment over the first 7 years of the ESPRIT registry. METHODS All treatment-emergent (All-TE) adverse events (AE) since the initial (first ever) dose of adalimumab were assessed. Physician Global Assessment (PGA) and PROs (PROs for US patients only) were evaluated during registry participation. RESULTS As of 30 November 2015, 6051 patients in the ESPRIT registry were analyzed, representing 23,660.1 patient-years (PY) of overall adalimumab exposure. The incidence rates for All-TE serious AEs, serious infections, and malignancies were 4.4, 1.0, and 1.0 events per 100 PY (E/100PY), respectively. The standardized mortality ratio for TE deaths in the registry was 0.27 (95% CI 0.18-0.38). During the registry's first 7 years, PGA "clear" or "minimal" was achieved by >50% of patients at each annual visit, and among US patients, the mean improvement from baseline in different PROs was maintained. CONCLUSION No new safety signals were identified during the first 7 years of the registry, and safety was consistent with the known safety profile of adalimumab. The number of TE deaths was below the expected rate. During the registry's first 7 years, most of the patients remained free of All-TE cardiovascular events, serious infections, and malignancy. As-observed effectiveness of adalimumab and improvements from baseline in PROs were maintained through 7 years of registry participation. FUNDING Abbvie. TRIAL REGISTRATION ClinicalTrials.gov identifier, NCT00799877.
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29
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Havmose M, Thomsen SF. Development of paradoxical inflammatory disorders during treatment of psoriasis with TNF inhibitors: a review of published cases. Int J Dermatol 2017; 56:1087-1102. [DOI: 10.1111/ijd.13691] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 03/18/2017] [Accepted: 05/22/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Martin Havmose
- Department of Dermatology; Bispebjerg Hospital; Copenhagen Denmark
| | - Simon Francis Thomsen
- Department of Dermatology; Bispebjerg Hospital; Copenhagen Denmark
- Department of Biomedical Sciences; University of Copenhagen; Copenhagen Denmark
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30
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Clinical similarity of biosimilar ABP 501 to adalimumab in the treatment of patients with moderate to severe plaque psoriasis: A randomized, double-blind, multicenter, phase III study. J Am Acad Dermatol 2017; 76:1093-1102. [DOI: 10.1016/j.jaad.2016.12.014] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 12/06/2016] [Accepted: 12/08/2016] [Indexed: 12/14/2022]
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31
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Blandizzi C, Meroni PL, Lapadula G. Comparing Originator Biologics and Biosimilars: A Review of the Relevant Issues. Clin Ther 2017; 39:1026-1039. [DOI: 10.1016/j.clinthera.2017.03.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 03/10/2017] [Accepted: 03/10/2017] [Indexed: 12/30/2022]
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32
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Zweegers J, Groenewoud J, van den Reek J, Otero M, van de Kerkhof P, Driessen R, van Lümig P, Njoo M, Ossenkoppele P, Mommers J, Koetsier M, Arnold W, Andriessen M, Kuijpers A, Berends M, Kievit W, de Jong E. Comparison of the 1- and 5-year effectiveness of adalimumab, etanercept and ustekinumab in patients with psoriasis in daily clinical practice: results from the prospective BioCAPTURE registry. Br J Dermatol 2017; 176:1001-1009. [DOI: 10.1111/bjd.15023] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2016] [Indexed: 01/24/2023]
Affiliation(s)
- J. Zweegers
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - J.M.M. Groenewoud
- Radboud University Medical Center; Radboud Institute for Health Sciences; Nijmegen the Netherlands
| | - J.M.P.A. van den Reek
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - M.E. Otero
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - P.C.M. van de Kerkhof
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - R.J.B. Driessen
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - P.P.M. van Lümig
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - M.D. Njoo
- Department of Dermatology; Ziekenhuisgroep Twente; Almelo/Hengelo the Netherlands
| | - P.M. Ossenkoppele
- Department of Dermatology; Ziekenhuisgroep Twente; Almelo/Hengelo the Netherlands
| | - J.M. Mommers
- Department of Dermatology; St Anna Ziekenhuis; Geldrop the Netherlands
| | - M.I.A. Koetsier
- Department of Dermatology; Gelre Ziekenhuizen; Apeldoorn the Netherlands
| | - W.P. Arnold
- Department of Dermatology; Ziekenhuis Gelderse Vallei; Ede the Netherlands
| | - M.P.M. Andriessen
- Department of Dermatology; Jeroen Bosch Ziekenhuis; Den Bosch the Netherlands
| | - A.L.A. Kuijpers
- Department of Dermatology; Maxima Medisch Centrum; Eindhoven/Veldhoven the Netherlands
| | - M.A.M. Berends
- Department of Dermatology; Slingeland Ziekenhuis; Doetinchem the Netherlands
| | - W. Kievit
- Radboud University Medical Center; Radboud Institute for Health Sciences; Nijmegen the Netherlands
| | - E.M.G.J. de Jong
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
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33
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Short- and long-term safety outcomes with ixekizumab from 7 clinical trials in psoriasis: Etanercept comparisons and integrated data. J Am Acad Dermatol 2017; 76:432-440.e17. [DOI: 10.1016/j.jaad.2016.09.026] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 09/22/2016] [Accepted: 09/23/2016] [Indexed: 01/05/2023]
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34
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Zweegers J, Roosenboom B, van de Kerkhof P, van den Reek J, Otero M, Atalay S, Kuijpers A, Koetsier M, Arnold W, Berends M, Weppner-Parren L, Bijen M, Njoo M, Mommers J, van Lümig P, Driessen R, Kievit W, de Jong E. Frequency and predictors of a high clinical response in patients with psoriasis on biological therapy in daily practice: results from the prospective, multicenter BioCAPTURE cohort. Br J Dermatol 2016; 176:786-793. [DOI: 10.1111/bjd.14888] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2016] [Indexed: 01/24/2023]
Affiliation(s)
- J. Zweegers
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - B. Roosenboom
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - P.C.M. van de Kerkhof
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - J.M.P.A. van den Reek
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - M.E. Otero
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - S. Atalay
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | | | | | - W.P. Arnold
- Ziekenhuis Gelderse Vallei; Ede the Netherlands
| | - M.A. Berends
- Slingeland Ziekenhuis; Doetinchem the Netherlands
| | | | - M. Bijen
- Ziekenhuisgroep Twente; Almelo/Hengelo the Netherlands
| | - M.D. Njoo
- Ziekenhuisgroep Twente; Almelo/Hengelo the Netherlands
| | | | - P.P.M. van Lümig
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - R.J.B. Driessen
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - W. Kievit
- Department of Epidemiology, Biostatistics and Health Technology Assessment; Radboud University Medical Center; Nijmegen the Netherlands
| | - E.M.G.J. de Jong
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
- Radboud University Nijmegen; Nijmegen the Netherlands
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Risk of serious infections, cutaneous bacterial infections, and granulomatous infections in patients with psoriasis treated with anti-tumor necrosis factor agents versus classic therapies: Prospective meta-analysis of Psonet registries. J Am Acad Dermatol 2016; 76:299-308.e16. [PMID: 27693008 DOI: 10.1016/j.jaad.2016.07.039] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 07/19/2016] [Accepted: 07/19/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND Anti-tumor necrosis factor (TNF) therapy in psoriasis has been associated with an increased risk of serious infections compared with nonbiologic systemic therapies. OBJECTIVE We sought to quantify the risk of: (1) serious infections (leading to hospitalization, sequelae, or death); and (2) "any infection," bacterial cutaneous infections, and granulomatous infections among patients receiving anti-TNF therapy compared with nonbiologics (acitretin, methotrexate, cyclosporine). METHODS We used prospective meta-analysis to combine data from the Psocare registry (Italy), Biobadaderm registry (Spain), and Clalit Health Services database (Israel), including 17,739 patients and 23,357.5 person-years of follow-up. RESULTS For serious infections, age, gender, and Charlson morbidity index adjusted hazard ratio of exposure to anti-TNFs compared with nonbiologics was 0.98 (95% confidence interval 0.80-1.19), for bacterial cutaneous infections it was 1.00 (95% confidence interval 0.62-1.61), and for granulomatous infections it was 1.23 (95% confidence interval 0.82-1.84). Using methotrexate as comparator and comparing first year of exposure with later exposure did not modify the results. For any infectious episode, risks and relative risks were heterogeneous among registries, probably because of different definitions of outcome. LIMITATIONS There was lack of power to describe risk of single drugs. CONCLUSION In current clinical practice, treatment with anti-TNF drugs was not associated with a higher risk of serious infections than treatment with nonbiologic systemic therapy.
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36
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Abstract
Many of the molecular pathways associated with psoriasis pathogenesis are also involved in host defense mechanisms that protect against common pathogens. Candida can stimulate the production of cytokines that trigger or exacerbate psoriasis, and many systemic psoriasis treatments may put patients at increased risk for developing oral, cutaneous, and genitourinary candidiasis. Therefore, dermatologists should regularly screen patients with psoriasis for signs of Candida infection, and take steps to effectively treat these infections to prevent worsening of psoriasis symptoms. This review provides an overview of candidiasis epidemiology in patients with psoriasis, followed by a primer on the diagnosis and treatment of superficial Candida infections, with specific guidance for patients with psoriasis. Candidiasis in patients with psoriasis typically responds to topical or oral antifungal therapy. While biologic agents used to treat moderate-to-severe psoriasis, such as tumor necrosis factor-α inhibitors and interleukin-17 inhibitors, are known to increase patients’ risk of developing localized candidiasis, the overall risk of infection is low, and candidiasis can be effectively managed in most patients while receiving systemic psoriasis therapies. Thus, the development of candidiasis does not usually necessitate changes to psoriasis treatment regimens.
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37
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Szántó S, Poór G, Opris D, Iaremenko O, Procházková L, Kuuse R, Nagy O, Chernyshov V, Géher P. Improved clinical, functional and work outcomes in spondyloarthritides during real-life adalimumab treatment in central-eastern Europe. J Comp Eff Res 2016; 5:475-85. [PMID: 27417564 DOI: 10.2217/cer-2016-0020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
AIM Adalimumab effectiveness on clinical, functional and work-related outcomes was evaluated in patients with active ankylosing spondylitis or psoriatic arthritis treated in routine clinical practice in central-eastern Europe. METHODS Patients (n = 555) were followed for 12 months. Primary end point was percentage of patients with a treatment response (≥50% decrease from baseline in Bath Ankylosing Spondylitis Disease Activity Index or ≥1.2 point decrease from baseline in Disease Activity Index-28 joint for axial or peripheral symptoms, respectively). Functional status was evaluated by the Bath Ankylosing Spondylitis Functional Index and Health Assessment Questionnaire Disability Index. Working ability was evaluated by the Work Productivity and Activity Impairment Questionnaire - Specific Health Problem. RESULTS 76.1% of patients with axial symptoms and 83.5% with peripheral symptoms achieved a treatment response. Frequency of extra-articular manifestations decreased. Improvements were observed in functional status and workability. No new safety signals were observed. CONCLUSION Adalimumab was effective and well tolerated during real-world use in central-eastern Europe.
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Affiliation(s)
- Sándor Szántó
- Department of Rheumatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gyula Poór
- National Institute of Rheumatology & Physiotherapy, Budapest, Hungary
| | | | | | - Leona Procházková
- Rheumatology Division, 2nd Department of Internal Medicine, St Anne's University Hospital Brno, Brno, Czech Republic
| | - Reet Kuuse
- Tartu University Hospital, Tartu, Estonia
| | | | | | - Pál Géher
- Hospitaller Brothers of St John of God Hospital, Budapest, Hungary
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38
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Cline A, Hill D, Lewallen R, Feldman SR. Current status and future prospects for biologic treatments of psoriasis. Expert Rev Clin Immunol 2016; 12:1273-1287. [DOI: 10.1080/1744666x.2016.1202115] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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39
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Zhu TH, Nakamura M, Abrouk M, Farahnik B, Koo J, Bhutani T. Demyelinating disorders secondary to TNF-inhibitor therapy for the treatment of psoriasis: A review. J DERMATOL TREAT 2016; 27:406-13. [DOI: 10.3109/09546634.2015.1136385] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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40
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41
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Galli-Novak E, Mook SC, Büning J, Schmidt E, Zillikens D, Thaci D, Ludwig RJ. Successful pregnancy outcome under prolonged ustekinumab treatment in a patient with Crohn's disease and paradoxical psoriasis. J Eur Acad Dermatol Venereol 2015; 30:e191-e192. [PMID: 26559393 DOI: 10.1111/jdv.13499] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- E Galli-Novak
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - S-C Mook
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany
| | - J Büning
- Gastroenterology, Medical Department I, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - D Thaci
- Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany
| | - R J Ludwig
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
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