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Manzo Margiotta F, Michelucci A, Capalbo E, Ricceri F, Rosi E, Rossari S, Magnano M, Savarese I, Milanesi N, Simoni B, Romanelli M, Rubegni P, DI Cesare A, Panduri S, Pescitelli L, Trovato E, Prignano F. Efficacy of risankizumab after intra-class switching between anti IL-23 antagonists: a multi-center, retrospective, real-life observation. Ital J Dermatol Venerol 2024; 159:64-65. [PMID: 37997317 DOI: 10.23736/s2784-8671.23.07648-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Affiliation(s)
| | | | - Eugenio Capalbo
- Section of Dermatology, Department of Medical, Surgical and Neurological Science, University of Siena, Siena, Italy
| | | | - Elia Rosi
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Susanna Rossari
- Unit of Dermatology, Versilia Hospital, Lido di Camaiore, Lucca, Italy
| | - Michela Magnano
- Unit of Dermatology, Versilia Hospital, Lido di Camaiore, Lucca, Italy
| | - Imma Savarese
- Department of Dermatology, San Jacopo Hospital, Pistoia, Italy
| | - Nicola Milanesi
- Department of Dermatology, San Jacopo Hospital, Pistoia, Italy
| | - Barbara Simoni
- Unit of Dermatology, Hospital of Campo di Marte, Lucca, Italy
| | | | - Pietro Rubegni
- Section of Dermatology, Department of Medical, Surgical and Neurological Science, University of Siena, Siena, Italy
| | - Antonella DI Cesare
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | | | | | - Emanuele Trovato
- Section of Dermatology, Department of Medical, Surgical and Neurological Science, University of Siena, Siena, Italy -
| | - Francesca Prignano
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
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Palmisano G, Di Stefani A, Cappilli S, Chiricozzi A, Peris K. Eruptive lentiginosis in resolving plaque psoriasis during treatment with risankizumab. Skin Res Technol 2023; 29:e13483. [PMID: 37881038 PMCID: PMC10518751 DOI: 10.1111/srt.13483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 09/17/2023] [Indexed: 10/27/2023]
Affiliation(s)
- Gerardo Palmisano
- UOC di DermatologiaDipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino MetabolicheFondazione Policlinico Universitario A. Gemelli – IRCCSRomeItaly
- DermatologiaUniversità Cattolica del Sacro CuoreRomeItaly
| | - Alessandro Di Stefani
- UOC di DermatologiaDipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino MetabolicheFondazione Policlinico Universitario A. Gemelli – IRCCSRomeItaly
- DermatologiaUniversità Cattolica del Sacro CuoreRomeItaly
| | - Simone Cappilli
- UOC di DermatologiaDipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino MetabolicheFondazione Policlinico Universitario A. Gemelli – IRCCSRomeItaly
- DermatologiaUniversità Cattolica del Sacro CuoreRomeItaly
| | - Andrea Chiricozzi
- UOC di DermatologiaDipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino MetabolicheFondazione Policlinico Universitario A. Gemelli – IRCCSRomeItaly
- DermatologiaUniversità Cattolica del Sacro CuoreRomeItaly
| | - Ketty Peris
- UOC di DermatologiaDipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino MetabolicheFondazione Policlinico Universitario A. Gemelli – IRCCSRomeItaly
- DermatologiaUniversità Cattolica del Sacro CuoreRomeItaly
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Martin G. Novel Therapies in Plaque Psoriasis: A Review of Tyrosine Kinase 2 Inhibitors. Dermatol Ther (Heidelb) 2023; 13:417-435. [PMID: 36592300 PMCID: PMC9884727 DOI: 10.1007/s13555-022-00878-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 12/14/2022] [Indexed: 01/03/2023] Open
Abstract
Plaque psoriasis is a systemic immune-mediated disease driven by interleukin-17 producing cells under the regulation of interleukin-23. Interleukin-23 signaling is mediated by the intracellular kinase tyrosine kinase 2, a Janus kinase family member. Tyrosine kinase 2 is a potential target for oral small-molecule therapies to treat psoriasis and psoriatic arthritis. A number of tyrosine kinase 2 inhibitors are in development or approved for the treatment of psoriasis or psoriatic arthritis. Deucravacitinib, an oral, selective, allosteric tyrosine kinase 2 inhibitor, is approved by the US Food and Drug Administration as a first-in-class treatment for adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy, and is approved by Pharmaceuticals and Medical Devices Agency (PDMA) in Japan for patients with plaque psoriasis, generalized pustular psoriasis, and erythrodermic psoriasis who have had an inadequate response to conventional therapies. Deucravacitinib selectively binds to the unique tyrosine kinase 2 regulatory pseudokinase domain in an allosteric fashion, preventing a conformational change in the catalytic domain required for ATP substrate binding, thus effectively locking tyrosine kinase 2 in an inactive state. Two other tyrosine kinase 2 inhibitors in later stage clinical development, brepocitinib (PF-06700841) and ropsacitinib (PF-06826647), are orthosteric inhibitors that target the highly conserved catalytic domain. This selective allosteric tyrosine kinase 2 inhibition may explain the improved safety profile of deucravacitinib versus orthosteric Janus kinase and tyrosine kinase 2 inhibitors. Two phase 3 psoriasis trials demonstrated deucravacitinib was efficacious and not associated with safety concerns characteristic of Janus kinase inhibitors, hence the new class designation (TYK2 inhibitor) by health authorities in the USA and Japan. Allosteric tyrosine kinase 2 inhibitors represent a promising new class of molecules for the treatment of psoriasis and psoriatic arthritis, and longer-term trials will establish their place in therapy.
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Affiliation(s)
- George Martin
- Dr. George Martin Dermatology Associates, 161 Wailea Ike Pl. A-104, Kihei, HI, 96753, USA.
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Michelucci A, Margiotta FM, Panduri S, Tonini A, Romanelli M, Morganti R, Janowska A, Dini V. A real-life experience as a proof of Guselkumab effectiveness and safety in patients with moderate to severe psoriasis. Dermatol Ther 2022; 35:e15339. [PMID: 35088508 DOI: 10.1111/dth.15339] [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] [Received: 10/01/2021] [Revised: 01/03/2022] [Accepted: 01/23/2022] [Indexed: 11/28/2022]
Abstract
Psoriasis is a skin disorder characterized by chronic inflammation driven by different immunologic pathways, among which the IL-23/Th17 axis plays a pivotal role. For this reason, the use of IL23p19 inhibitors in psoriasis treatment has been evaluated over the years. Guselkumab, a totally human IgG1 lambda monoclonal antibody, that selectively blocks the p 19 subunit of IL- 23 has demonstrated high efficacy and safety throughout several, randomized, double-blind phase III trials (VOYAGE 1 and 2, NAVIGATE and ECLIPSE). We designed a single-center retrospective cohort study in a population consisting of 46 patients followed from December 2018 to April 2021. After a diagnosis of moderate to severe psoriasis, all the patients were considered suitable to receive treatment with Guselkumab. In our population, among those who achieved clinical improvement in terms of Psoriasis Area Severity Index (PASI), PASI 75,90, and 100 were achieved on average on weeks 14,19,21 respectively. We then analyzed a subgroup of our population, consisting of 35 patients, who had an identical follow-up time of 28 weeks, thus observing the trend in mean PASI at subsequent assessments and the number of patients who had reached PASI 75, PASI 90, and PASI 100 at week 4 (10; 3;1), week 12 (12; 13; 11), week 20 (7;6;2) and week 28 (1;4;6), respectively. The results obtained are in line with those obtained from previous studies, thus confirming that Guselkumab is an excellent choice in terms of security, long-term efficacy and overall tolerance.
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Affiliation(s)
| | - Flavia Manzo Margiotta
- Department of Dermatology, University of Pisa, Pisa, Italy.,Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | | | | | - Riccardo Morganti
- Statistical Support to Clinical Trials Department, University of Pisa, Pisa, Italy
| | - Agata Janowska
- Department of Dermatology, University of Pisa, Pisa, Italy
| | - Valentina Dini
- Department of Dermatology, University of Pisa, Pisa, Italy
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Al-Janabi A, Warren RB. Update on risankizumab for the treatment of moderate to severe psoriasis. Expert Opin Biol Ther 2020; 20:1245-1251. [PMID: 32933320 DOI: 10.1080/14712598.2020.1822813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The therapeutic landscape for psoriasis is ever-changing. Risankizumab is the newest approved biologic and one of three currently licensed that targets the p19 subunit of interleukin-23 (IL-23). It is increasingly clear that different biologics vary in their efficacy, effectiveness, and safety profiles, highlighting that there is a need to understand for which patients and in which circumstances to use each drug. AREAS COVERED This article summarizes original clinical trial data, and reviews in more detail recent post-marketing studies and meta-analyses that differentiate risankizumab from other biologics. It also briefly explores the evidence for risankizumab in the treatment of other immune-mediated inflammatory diseases. EXPERT OPINION Risankizumab is a highly effective biologic for the treatment of moderate-to-severe plaque psoriasis. Recent open-label extension data for risankizumab shows sustained treatment responses to week 136. Indirect comparisons suggest IL-17 inhibitors have a faster onset, though head-to-head comparison with secukinumab shows non-inferiority at week 16 and superiority of risankizumab at week 52. Risankizumab is very well tolerated and data from the IMMhance trial suggests that risankizumab can be used in patients with latent tuberculosis without risk of reactivation.
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Affiliation(s)
- A Al-Janabi
- The Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, Manchester Academic Health Science Centre, The University of Manchester , Salford, UK
| | - R B Warren
- The Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, Manchester Academic Health Science Centre, The University of Manchester , Salford, UK
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A Nonsystematic Review on Risankizumab: a Novel Drug Recently Approved for Moderate to Severe Psoriasis. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/s42399-020-00356-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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