1
|
Armstrong A, Fahrbach K, Leonardi C, Augustin M, Neupane B, Kazmierska P, Betts M, Freitag A, Kiri S, Taieb V, Slim M, Gomez NN, Warren RB. Efficacy of Bimekizumab and Other Biologics in Moderate to Severe Plaque Psoriasis: A Systematic Literature Review and a Network Meta-Analysis. Dermatol Ther (Heidelb) 2022; 12:1777-1792. [PMID: 35798920 PMCID: PMC9357587 DOI: 10.1007/s13555-022-00760-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/08/2022] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Biologic treatments are increasingly being used in the management of moderate to severe plaque psoriasis (PSO). Bimekizumab is a selective inhibitor of both interleukin (IL)-17A and IL-17F approved for the treatment of moderate to severe PSO. Although bimekizumab trials provide comparisons to secukinumab, adalimumab and ustekinumab, there are no further head-to-head comparisons of bimekizumab to other biologics. This network meta-analysis (NMA) aimed to compare the short-term efficacy of bimekizumab versus other biologic systemic therapies for moderate to severe PSO. METHODS A systematic literature review was conducted to identify randomised controlled trials (RCTs) in patients with moderate to severe PSO. MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and the Database of Systematic Reviews and PsycINFO were searched on July 1, 2020. An enhanced multinomial Bayesian NMA model was used to evaluate the comparative efficacy in 50%, 75%, 90% and 100% improvement from baseline Psoriasis Area and Severity Index (PASI 50/75/90/100) at 10-16 weeks. The model was also adjusted for baseline risk, given the variable placebo responses across the trials. RESULTS Eighty-six RCTs (including 34,476 patients) were included in the NMA. IL-17 and IL-23 inhibitors were the most effective treatments across all PASI levels. At 10-16 weeks, bimekizumab had the highest probability of achieving PASI 75 (92.3%), PASI 90 (84.0%) and PASI 100 (57.8%). Bimekizumab demonstrated statistical superiority over all biologics in achieving PASI 90 and PASI 100 thresholds. For PASI 75, the benefit of bimekizumab was statistically significant compared to all other treatments except risankizumab and ixekizumab. CONCLUSION This analysis demonstrated that IL-17 and IL-23 inhibitors were highly effective in achieving short-term improvement among patients with moderate to severe PSO. Patients receiving bimekizumab were significantly more likely to achieve PASI 90 or PASI 100 within 10-16 weeks of the first injection than all other biologics.
Collapse
Affiliation(s)
- April Armstrong
- Keck School of Medicine of USC, Dermatology, Los Angeles, CA, USA
| | - Kyle Fahrbach
- Evidera, Inc, 140 Kendrick St, 3rd Floor, Needham, MA, 02494, USA.
| | - Craig Leonardi
- Central Dermatology and Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | | | - Marissa Betts
- Evidera, Inc, 140 Kendrick St, 3rd Floor, Needham, MA, 02494, USA
| | | | | | | | - Mahmoud Slim
- Evidera (Evidence Synthesis), St-Laurent, Canada
| | | | - Richard B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, The University of Manchester, Manchester, UK
| |
Collapse
|
2
|
Fahrbach K, Sarri G, Phillippo DM, Neupane B, Martel SE, Kiri S, Reich K. Short-Term Efficacy of Biologic Therapies in Moderate-to-Severe Plaque Psoriasis: A Systematic Literature Review and an Enhanced Multinomial Network Meta-Analysis. Dermatol Ther (Heidelb) 2021; 11:1965-1998. [PMID: 34549383 PMCID: PMC8611163 DOI: 10.1007/s13555-021-00602-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 08/19/2021] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Many targeted, systemic therapies have been developed for treatment of moderate-to-severe psoriasis (PsO). A network meta-analysis (NMA) allows for comparison between treatments not directly compared in randomized controlled trials (RCT). This study's objective was to compare the short-term (10-16 weeks) clinical efficacy according to the Psoriasis Area and Severity Index (PASI) among approved biologic treatments for moderate-to-severe PsO using a novel (enhanced) NMA model. METHODS A systematic literature review (SLR) of RCTs for patients with moderate-to-severe PsO was conducted. English publications in MEDLINE, Embase, and The Cochrane Library up to March 2019 were searched. An enhanced multinomial Bayesian NMA was performed to simultaneously adjust for baseline risk and utilize the conditional nature of the PASI (50, 75, 90, and 100) levels. The model relaxes typical constraints that all treatments must have the same ranks across PASI levels. RESULTS The SLR resulted in 319 relevant publications, of which 72 publications from 73 RCTs reporting 10- to 16-week data for at least one PASI response level (30,314 total patients) were included. Interleukin (IL) inhibitors (risankizumab, ixekizumab, brodalumab, secukinumab, and guselkumab) were the best performing treatments for achieving all PASI levels. Etanercept was outperformed by the other subcutaneous tumor necrosis factor α inhibitors. Application of an enhanced NMA model that allowed treatment rankings to differ by PASI level tested the robustness of results of previous NMAs in PsO. CONCLUSION The results of this model confirmed that IL inhibitors are likely the best short-term treatment choices for improving all PASI levels.
Collapse
Affiliation(s)
- Kyle Fahrbach
- Evidera (Evidence Synthesis), 500 Totten Pond Road, Fifth Floor, Waltham, MA, 02451, USA.
| | - Grammati Sarri
- Evidera (Evidence Synthesis) The Ark, 201 Talgarth Rd., Hammersmith, London, W6 8BJ, UK
| | - David M Phillippo
- Bristol Medical School (Population Health Sciences), University of Bristol, Bristol, UK
| | - Binod Neupane
- Evidera (Evidence Synthesis), 500 Totten Pond Road, Fifth Floor, Waltham, MA, 02451, USA
| | - Samantha E Martel
- Evidera (Evidence Synthesis), 500 Totten Pond Road, Fifth Floor, Waltham, MA, 02451, USA
| | | | - Kristian Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf and Skinflammation® Center, Hamburg, Germany
| |
Collapse
|
3
|
Isom J, Braswell DS, Siroy A, Auerbach J, Motaparthi K. Clinical and histopathologic features differentiating acute generalized exanthematous pustulosis and pustular psoriasis: A retrospective series. J Am Acad Dermatol 2020; 83:265-267. [PMID: 32173359 DOI: 10.1016/j.jaad.2020.03.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/28/2020] [Accepted: 03/04/2020] [Indexed: 01/01/2023]
Affiliation(s)
- James Isom
- Department of Pathology, University of Florida Medicine, Gainesville, Florida
| | - Diana S Braswell
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida
| | - Alan Siroy
- Department of Pathology, University of Florida Medicine, Gainesville, Florida
| | - Jena Auerbach
- Department of Pathology, University of Florida Medicine, Gainesville, Florida
| | - Kiran Motaparthi
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida.
| |
Collapse
|
4
|
Antiga E, Bonciolini V, Volpi W, Del Bianco E, Caproni M. Oral Curcumin (Meriva) Is Effective as an Adjuvant Treatment and Is Able to Reduce IL-22 Serum Levels in Patients with Psoriasis Vulgaris. BIOMED RESEARCH INTERNATIONAL 2015; 2015:283634. [PMID: 26090395 PMCID: PMC4450233 DOI: 10.1155/2015/283634] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 05/05/2015] [Indexed: 12/11/2022]
Abstract
Curcumin is a complementary therapy that may be helpful for the treatment of psoriasis due to its anti-inflammatory, antiangiogenic, antioxidant, and antiproliferative effects. In the present study we performed a randomized, double-blind, placebo-controlled clinical trial to assess the effectiveness of a bioavailable oral curcumin in the treatment of psoriasis. Sixty-three patients with mild-to-moderate psoriasis vulgaris (PASI < 10) were randomly divided into two groups treated with topical steroids and Meriva, a commercially available lecithin based delivery system of curcumin, at 2 g per day (arm 1), or with topical steroids alone (arm 2), both for 12 weeks. At the beginning (T0) and at the end of the therapy (T12), clinical assessment and immunoenzymatic analysis of the serum levels of IL-17 and IL-22 were performed. At T12, both groups achieved a significant reduction of PASI values that, however, was higher in patients treated with both topical steroids and oral curcumin than in patients treated only with topical steroids. Moreover, IL-22 serum levels were significantly reduced in patients treated with oral curcumin. In conclusion, curcumin was demonstrated to be effective as an adjuvant therapy for the treatment of psoriasis vulgaris and to significantly reduce serum levels of IL-22.
Collapse
Affiliation(s)
- Emiliano Antiga
- Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Viale Michelangiolo 41, 50125 Florence, Italy
| | - Veronica Bonciolini
- Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Viale Michelangiolo 41, 50125 Florence, Italy
| | - Walter Volpi
- Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Viale Michelangiolo 41, 50125 Florence, Italy
| | - Elena Del Bianco
- Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Viale Michelangiolo 41, 50125 Florence, Italy
| | - Marzia Caproni
- Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Viale Michelangiolo 41, 50125 Florence, Italy
| |
Collapse
|
5
|
Orro K, Smirnova O, Arshavskaja J, Salk K, Meikas A, Pihelgas S, Rumvolt R, Kingo K, Kazarjan A, Neuman T, Spee P. Development of TAP, a non-invasive test for qualitative and quantitative measurements of biomarkers from the skin surface. Biomark Res 2014; 2:20. [PMID: 25785188 PMCID: PMC4362816 DOI: 10.1186/2050-7771-2-20] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 10/02/2014] [Indexed: 02/01/2023] Open
Abstract
Background The skin proteome contains valuable information on skin condition, but also on how skin may evolve in time and may respond to treatments. Despite the potential of measuring regulatory-, effector- and structural proteins in the skin for biomarker applications in clinical dermatology and skin care, convenient diagnostic tools are lacking. The aim of the present study was to develop a highly versatile and non-invasive diagnostic tool for multiplex measurements of protein biomarkers from the surface of skin. Results The Transdermal Analyses Patch (TAP) is a novel molecular diagnostic tool that has been developed to capture biomarkers directly from skin, which are quantitatively analyzed in spot-ELISA assays. Optimisation of protocols for TAP production and biomarker analyses makes TAP measurements highly specific and reproducible. In measurements of interleukin-1α (IL-1α), IL-1 receptor antagonist (IL-1RA) and human β-defensin (hBD-1) from healthy skin, TAP appears far more sensitive than skin lavage-based methods using ELISA. No side-effects were observed using TAP on human skin. Conclusion TAP is a practical and valuable new skin diagnostic tool for measuring protein-based biomarkers from skin, which is convenient to use for operators, with minimal burden for patients.
Collapse
Affiliation(s)
- Kadri Orro
- FibroTx LLC, Mäealuse 4, 12918 Tallinn, Estonia
| | | | | | | | - Anne Meikas
- FibroTx LLC, Mäealuse 4, 12918 Tallinn, Estonia
| | | | | | - Külli Kingo
- Dermatology Clinic, Tartu University Hospital, Raja 31, 50407 Tartu, Estonia
| | | | | | - Pieter Spee
- FibroTx LLC, Mäealuse 4, 12918 Tallinn, Estonia ; PS! Pharmaconsult, Møllemoseparken 44, 3450 Allerød, Denmark
| |
Collapse
|
6
|
Lembo S, Capasso R, Balato A, Cirillo T, Flora F, Zappia V, Balato N, Ingrosso D, Ayala F. MCP-1 in psoriatic patients: effect of biological therapy. J DERMATOL TREAT 2013; 25:83-6. [PMID: 23480385 DOI: 10.3109/09546634.2013.782091] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Monocyte chemoattractant protein-1 (MCP-1) is a chemokine locally and systemically augmented in psoriasis. A single nucleotide polymorphism in MCP-1 promoter region -2518A→G is associated with higher gene expression. OBJECTIVE The aim was to evaluate MCP-1 plasma level in psoriatic patients and to relate any association in plasmatic and cutaneous MCP-1 with clinical improvement due to biological drugs. METHODS Blood samples were obtained from: (i) 30 Caucasian patients with psoriasis and 10 controls, for determining MCP-1 plasma concentrations and -2518A→G polymorphism occurrence, (ii) 16 psoriatic patients treated by anti-tumor necrosis factor-α (TNF-α) adalimumab/etanercept or by anti-CD-11 efalizumab, before and after 2 months of treatment. Moreover, biopsies were performed on lesional skin of five patients treated with anti-TNF-α. MCP-1 plasma concentration and cutaneous expression were determined by ELISA and qRT-PCR. RESULTS MCP-1 plasma level was significantly increased in psoriatic patients. -2518A→G polymorphism was similarly distributed in patients and controls and unrelated to MCP-1 plasma level or to Psoriasis Area and Severity Index. All patients receiving biological drugs showed significant clinical improvement. Anti-TNF-α therapy moderately reduced MCP-1 plasma concentration and robustly decremented MCP-1 expression in lesional skin. CONCLUSION MCP-1 should be a potential local inflammatory marker in psoriatic patients to assess disease severity and anti-TNF-α treatment efficacy.
Collapse
Affiliation(s)
- Serena Lembo
- Department of Systematic Pathology, Section of Clinical, Allergological and Venereological Dermatology, University of Naples "Federico II" , Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Antiga E, Volpi W, Cardilicchia E, Maggi L, Filì L, Manuelli C, Parronchi P, Fabbri P, Caproni M. Etanercept Downregulates the Th17 Pathway and Decreases the IL-17+/IL-10+ Cell Ratio in Patients with Psoriasis Vulgaris. J Clin Immunol 2012; 32:1221-32. [DOI: 10.1007/s10875-012-9716-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 05/30/2012] [Indexed: 02/07/2023]
|
8
|
Jean J, Soucy J, Pouliot R. Effects of Retinoic Acid on Keratinocyte Proliferation and Differentiation in a Psoriatic Skin Model. Tissue Eng Part A 2011; 17:1859-68. [DOI: 10.1089/ten.tea.2010.0463] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jessica Jean
- Centre LOEX de l'Université Laval, Génie tissulaire et régénération: LOEX—Centre de recherche FRSQ du Centre hospitalier affilié universitaire de Québec, Québec, Canada
- Faculté de Pharmacie, Université Laval, Québec, Canada
| | - Jacques Soucy
- Département de Dermatologie, Hôpital de l'Enfant-Jésus, Québec, Canada
| | - Roxane Pouliot
- Centre LOEX de l'Université Laval, Génie tissulaire et régénération: LOEX—Centre de recherche FRSQ du Centre hospitalier affilié universitaire de Québec, Québec, Canada
- Faculté de Pharmacie, Université Laval, Québec, Canada
| |
Collapse
|