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Manoharan D, N. RV, Shreya S, Suzsmi L. S. Secukinumab: A Silver Lining in Dermatology. J Pharmacol Pharmacother 2022. [DOI: 10.1177/0976500x221105921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Secukinumab, a fully human monoclonal antibody, is a biological agent that targets interleukin-17A. Secukinumab is used in the management of the common dermatological entity - plaque-type psoriasis and its various types, namely psoriatic arthritis, hypertrophic palmoplantar psoriasis and generalized pustular psoriasis. Other less common indications of this popular interleukin -17A inhibitor, secukinumab include ankylosing spondylitis, rheumatoid arthritis, systemic lupus erythematosus, Familial Mediterranean fever, and tumor necrosis factor receptor-associated periodic syndrome (TRAPS). This review article was written by referring to various review articles, original articles, and some books related to highly regarded databases, such as the Web of Science, PubMed, and Scopus. The keywords explored during review of literature consisted of combinations of the following words: human monoclonal antibody, IL-17A, and biologicals. The authors with this in-depth review hope to explore the working of this versatile biological, Secukinumab, especially as a silver lining in dermatology.
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Affiliation(s)
- Dhanaraj Manoharan
- Department of Dermatology, Venereology and Leprosy, Sree Balaji Medical College and Hospitals, Bharath University, Chrompet, Chennai, Tamil Nadu, India
| | - Ravi Vignesh N.
- Department of Dermatology, Venereology and Leprosy, Sree Balaji Medical College and Hospitals, Bharath University, Chrompet, Chennai, Tamil Nadu, India
| | - Srinivasan Shreya
- Department of Dermatology, Venereology and Leprosy, Sree Balaji Medical College and Hospitals, Bharath University, Chrompet, Chennai, Tamil Nadu, India
| | - Saravanan Suzsmi L.
- Department of Dermatology, Venereology and Leprosy, Sree Balaji Medical College and Hospitals, Bharath University, Chrompet, Chennai, Tamil Nadu, India
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Enos CW, Ramos VL, McLean RR, Lin TC, Foster N, Dube B, Van Voorhees AS. Comorbid obesity and history of diabetes are independently associated with poorer treatment response to biologics at 6 months: A prospective analysis in Corrona Psoriasis Registry. J Am Acad Dermatol 2022; 86:68-76. [PMID: 34256035 DOI: 10.1016/j.jaad.2021.06.883] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/07/2021] [Accepted: 06/26/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Psoriasis is associated with comorbid systemic metabolic disease. OBJECTIVE To assess possible associations of comorbid obesity, history of diabetes, hypertension, and hyperlipidemia with response to biologic treatment at 6 months among patients in CorEvitas' Psoriasis Registry. METHODS Participants included 2924 patients initiating biologic therapy (tumour necrosis factor inhibitors [TNFi], interleukin [IL]-17i, IL-12/23i, or IL-23i) with baseline and 6-month follow-up visits available. Logistic regressions resulted in adjusted odd ratios (OR) and 95% confidence intervals (CI) for achievement of response in select outcomes for those with obesity and history of diabetes, hypertension, and hyperlipidemia relative to those without each. RESULTS Overall, obesity reduced by 25% to 30% odds of achieving PASI75 (OR, 0.75; 95% CI, 0.64-0.88) and PASI90 (OR, 0.70; 95% CI, 0.59-0.81). History of diabetes reduced odds of achieving PASI75 by 31% (OR, 0.69; 95% CI, 0.56-0.85) and PASI90 by 21% (OR, 0.79; 95% CI, 0.63-0.98). Obesity was associated with lower response to TNFi and IL-17i classes. Independent of obesity, diabetes was associated with poorer outcomes when on IL-17i therapy and hypertension, to a lesser extent, when on the TNFi class. No significant associations were found in the hyperlipidemia group. LIMITATIONS The study assessed only short-term effectiveness and small sample sizes limited the power to detect differences. CONCLUSION Assessment of comorbid disease burden is important for improved likelihoods of achieving treatment response with biologics.
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Affiliation(s)
- Clinton W Enos
- Eastern Virginia Medical School Department of Dermatology, Norfolk, Virginia
| | - Vanessa L Ramos
- Eastern Virginia Medical School Department of Dermatology, Norfolk, Virginia
| | | | | | | | | | - Abby S Van Voorhees
- Eastern Virginia Medical School Department of Dermatology, Norfolk, Virginia.
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Koguchi-Yoshioka H, Watanabe R, Matsumura Y, Ishitsuka Y, Inoue S, Furuta J, Nakamura Y, Okiyama N, Matsuzaka T, Shimano H, Fujisawa Y, Fujimoto M. Serum lactate dehydrogenase level as a possible predictor of treatment preference in psoriasis. J Dermatol Sci 2021; 103:109-115. [PMID: 34332850 DOI: 10.1016/j.jdermsci.2021.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND The efficacy of small molecule inhibitors for intracellular signal mediators varies among the individuals, and their mechanism of action is broad. A phosphodiesterase 4 inhibitor apremilast shows a dramatic effect on a certain proportion of psoriatic patients by modulating the cellular metabolism and regulating the production of pro-inflammatory molecules. However, it is unclear to which disease subtype this drug benefits. While psoriasis is a Th17-mediated disease, how immune cells are affected by the modulation of cellular metabolism is not fully evaluated, either. OBJECTIVE This study aims to identify the indices which predict the efficacy of apremilast in psoriasis, and to investigate the impact of metabolic activity in immune cells on the psoriatic pathogenesis. METHODS The association of treatment efficacy with clinical and laboratory data of the 58 psoriatic patients was evaluated. The reflector of the associated index was also sought among the indices of cellular metabolic pathways by use of an extracellular flux analyzer. RESULTS There was a correlation between clinical improvement and the serum lactate dehydrogenase (LDH) level in the patients treated with apremilast but not in those with biologics. Serum LDH level did not correlate with the cutaneous disease severity but correlated with the oxygen consumption rate of blood T cells. CONCLUSION Psoriatic patients with high serum LDH level can be benefitted by apremilast. The serum LDH level reflects the augmented respiratory activity of T cells in psoriasis. Our results would highlight the importance of regarding metabolic skew in immune cells as a treatment target in psoriasis.
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Affiliation(s)
- Hanako Koguchi-Yoshioka
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan; Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Rei Watanabe
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan; Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.
| | - Yutaka Matsumura
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan; Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yosuke Ishitsuka
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan; Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Sae Inoue
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Junichi Furuta
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Yoshiyuki Nakamura
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Naoko Okiyama
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Takashi Matsuzaka
- Department of Internal Medicine, Metabolism and Endocrinology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hitoshi Shimano
- Department of Internal Medicine, Metabolism and Endocrinology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Yasuhiro Fujisawa
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Manabu Fujimoto
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan; Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
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Alonso S, Villa I, Fernández S, Martín JL, Charca L, Pino M, Riancho L, Morante I, Santos M, Brandy A, Aurrecoechea E, Carmona L, Queiro R. Multicenter Study of Secukinumab Survival and Safety in Spondyloarthritis and Psoriatic Arthritis: SEcukinumab in Cantabria and ASTURias Study. Front Med (Lausanne) 2021; 8:679009. [PMID: 34124110 PMCID: PMC8187784 DOI: 10.3389/fmed.2021.679009] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/29/2021] [Indexed: 12/31/2022] Open
Abstract
Objectives: We aimed to evaluate the drug retention rate and safety of secukinumab (SEC) in patients with axial spondyloarthritis (AxSpA) and psoriatic arthritis (PsA) in a real clinical setting. Methods: This multicenter retrospective observational study included all AxSpA and PsA patients who received at least one dose of SEC. Adverse events (AE) and the drug retention rate were the main study outcomes. Drug survival was analyzed by Kaplan-Meier curves while predictive factors of discontinuation were evaluated using a Cox regression analysis. The weight of these associations was estimated by hazard ratio (HR) values. Results: We included 154 patients (59 PsA and 95 AxSpA). Mean disease duration was 6.5 years (IQR 2-8). Sixty-one percent of patients were treated with two or more biologics prior to SEC. The 1 and 2-year retention rates for SEC were 66 and 43%, respectively. The main causes of discontinuation were inefficacy (59%) and AE (36%). The factors associated with lower risk of discontinuation were male gender (HR 0.54, 95% CI 0.38-0.78 p = 0.001), obesity (HR 0.53, 95% CI 0.30-0.93 p = 0.027), hypertension (HR 0.55, 95% CI 0.30-0.93 p = 0.008), and diabetes (HR 0.42 95% CI 0.18-0.99 p = 0.047) while number of previous biologics and depression were predictors of discontinuation (HR 1.18, 95% CI 1.04-1.34 p = 0.011 and HR 2.53, 95% CI 1.61-3.96 p < 0.001). Conclusions: SEC showed a good retention rate in a population previously exposed to several biological therapies. As a novelty, cardiometabolic comorbidities were associated with better drug survival.
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Affiliation(s)
- Sara Alonso
- Rheumatology Division, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Ignacio Villa
- Rheumatology Division, Hospital Sierrallana, Torrelavega, Spain
| | - Sabela Fernández
- Rheumatology Division, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - José L Martín
- Rheumatology Division, Hospital Sierrallana, Torrelavega, Spain
| | - Lilyan Charca
- Rheumatology Division, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Marina Pino
- Rheumatology Division, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Leyre Riancho
- Rheumatology Division, Hospital Sierrallana, Torrelavega, Spain
| | - Isla Morante
- Rheumatology Division, Hospital Sierrallana, Torrelavega, Spain
| | | | - Anahy Brandy
- Rheumatology Division, Hospital Universitario de Cabueñes, Gijón, Spain
| | | | | | - Rubén Queiro
- Rheumatology Division, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA) Translational Immunology Division, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
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Porta S, Otero-Losada M, Kölliker Frers RA, Cosentino V, Kerzberg E, Capani F. Adipokines, Cardiovascular Risk, and Therapeutic Management in Obesity and Psoriatic Arthritis. Front Immunol 2021; 11:590749. [PMID: 33643281 PMCID: PMC7902722 DOI: 10.3389/fimmu.2020.590749] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 12/21/2020] [Indexed: 12/13/2022] Open
Abstract
Psoriatic arthritis is a chronic inflammatory disease with skin and joint pathology as the dominant characteristics. Scientific evidence supports its systemic nature and relevant relationship with obesity, metabolic syndrome, and associated conditions. Metabolic syndrome and obesity share common signaling pathways with joint inflammation, reinforcing the idea that adipose tissue is a major contributor to disease development and severity. The adipose tissue is not a mere energy store but also an endocrine organ participating in the immune response. In the search for the best therapeutic strategy for a patient, we should appraise the adipose tissue as an endocrine and immune organ responsible for mild chronic inflammation. Today, our challenge is not only to achieve disease remission but to control the associated comorbidities as well. In light of the high prevalence of obesity in psoriatic arthritis patients and the importance of the adipose tissue in the development of chronic inflammation, we aimed to identify the most relevant articles in this regard published in English until June 2020 using the PubMed database. Search terms included psoriatic arthritis, in combination with metabolic syndrome, obesity, adipokines, cardiovascular disease, and treatment. This review summarizes the current evidence regarding the role of adipose tissue as an adipokine-secreting endocrine organ, discussing its influence on disease development and severity, and ultimately in meeting successful disease management.
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Affiliation(s)
- Sabrina Porta
- Rheumatology Department, J. M. Ramos Mejía Hospital, Buenos Aires, Argentina
| | - Matilde Otero-Losada
- Biomedical Research Center, Interamerican Open University, National Research Council (CAECIHS-UAI. CONICET), Buenos Aires, Argentina
| | - Rodolfo A Kölliker Frers
- Rheumatology Department, J. M. Ramos Mejía Hospital, Buenos Aires, Argentina.,Biomedical Research Center, Interamerican Open University, National Research Council (CAECIHS-UAI. CONICET), Buenos Aires, Argentina
| | - Vanesa Cosentino
- Rheumatology Department, J. M. Ramos Mejía Hospital, Buenos Aires, Argentina
| | - Eduardo Kerzberg
- Rheumatology Department, J. M. Ramos Mejía Hospital, Buenos Aires, Argentina
| | - Francisco Capani
- Biomedical Research Center, Interamerican Open University, National Research Council (CAECIHS-UAI. CONICET), Buenos Aires, Argentina.,Department of Biology, University John F. Kennedy, Buenos Aires, Argentina.,Universidad Autónoma de Chile, Santiago, Chile
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The cutaneous and intestinal microbiome in psoriatic disease. Clin Immunol 2020; 218:108537. [PMID: 32679247 DOI: 10.1016/j.clim.2020.108537] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 07/04/2020] [Accepted: 07/08/2020] [Indexed: 12/11/2022]
Abstract
Psoriasis (PsO) and psoriatic arthritis (PsA) are chronic immune-mediated inflammatory diseases of multifactorial etiology. In addition to genetic and environmental factors, evidence supports involvement of a dysregulated human microbiome in the pathogenesis of psoriatic disease. In particular, alterations in the composition of the microbiome, termed dysbiosis, can result in downstream proinflammatory effects in the gut, skin, and joints. Both the cutaneous and intestinal microbial populations are implicated in the pathogenesis of psoriatic disease, although exact mechanisms are unclear. Herein, we review the relationship between the human microbiome and psoriatic disease. Further insight into the functions of the microbiome may allow for greater understanding of inflammatory disease processes and identification of additional therapeutic targets.
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Ibáñez Vodnizza S, van der Horst-Bruinsma I. Sex differences in disease activity and efficacy of treatment in spondyloarthritis: is body composition the cause? Curr Opin Rheumatol 2020; 32:337-342. [PMID: 32453036 DOI: 10.1097/bor.0000000000000717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE OF REVIEW The body composition and fat distribution is different between men and women, with different levels of circulating adipokines. These differences become more evident when suffering from an inflammatory disease, such as spondyloarthritris. In this review, we will explore the influence of obesity, body composition and adipokines on the differences in disease activity, progression and response to treatment, between men and women with spondyloarthritis. RECENT FINDINGS Obesity, mainly determined by the body fat content, which is higher in women, is related to worse disease activity scores. Men with higher disease activity lose more muscle mass than women. Leptin, which is usually found at higher levels in overweight women, seems to be associated with greater spinal radiographic progression when it rises during the course of the disease. Being a woman and obesity, mainly because of the body fat content, are related to a worse response to TNF-α blockers. SUMMARY Overlooking biological sex variation in body composition, circulating adipokines and hormonal levels, and the subsequent differences in clinical presentation, may ultimately hamper clinical treatment.
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Toussirot E. The Interrelations between Biological and Targeted Synthetic Agents Used in Inflammatory Joint Diseases, and Obesity or Body Composition. Metabolites 2020; 10:E107. [PMID: 32183053 PMCID: PMC7175105 DOI: 10.3390/metabo10030107] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/08/2020] [Accepted: 03/10/2020] [Indexed: 12/16/2022] Open
Abstract
Obesity is a comorbidity that plays a role in the development and severity of inflammatory joint diseases, including rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis. The relationships between obesity and adipose tissue and the treatments given for inflammatory joint diseases are bidirectional. In fact, biological agents (bDMARDs) and targeted synthetic agents (tsDMARDs) may influence body weight and body composition of treated patients, while obesity in turn may influence clinical response to these agents. Obesity is a prevalent comorbidity mainly affecting patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) with specific phenotypes. Tumour necrosis factor alpha (TNFα) inhibitors have been associated with changes in body composition by improving lean mass, but also by significantly increasing fat mass, which localized toward the abdominal/visceral region. The IL-6 inhibitor tocilizumab is associated with an increase in lean mass without change in fat mass. The clinical response to TNFα inhibitors is attenuated by obesity, an effect that is less pronounced with IL-6 inhibitors and the B-cell depletion agent rituximab. Conversely, body weight has no influence on the response to the costimulation inhibitor abatacept. These effects may be of help to the physician in personalized medicine, and may guide the therapeutic choice in obese/overweight patients.
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Affiliation(s)
- Eric Toussirot
- INSERM CIC-1431, CHU de Besançon, Centre d’Investigation Clinique Biothérapie, Pôle Recherche, 25000 Besançon, France; ; Tel.: +33-3-81-21-89-97
- Fédération Hospitalo-Universitaire INCREASE, CHU de Besançon, 25000 Besançon, France
- CHU de Besançon, Rhumatologie, Pôle PACTE (Pathologies Aiguës Chroniques Transplantation Éducation), 25000 Besançon, France
- Département Universitaire de Thérapeutique, Université de Bourgogne Franche-Comté, UFR des Sciences Médicales et Pharmaceutiques de Besançon, CS 71806, 25030 Besançon Cedex, France
- INSERM UMR1098, Relations Hôte Greffon Tumeurs, ingénierie cellulaire et génique, Université de Bourgogne Franche-Comté, 25000 Besançon, France
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Pande S, Chatterjee C. Secukinumab in psoriasis. INDIAN JOURNAL OF DRUGS IN DERMATOLOGY 2019. [DOI: 10.4103/ijdd.ijdd_62_19] [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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