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Ruggiero A, Potestio L, Martora F, Villani A, Comune R, Megna M. Bimekizumab treatment in patients with moderate to severe plaque psoriasis: a drug safety evaluation. Expert Opin Drug Saf 2023; 22:355-362. [PMID: 37222656 DOI: 10.1080/14740338.2023.2218086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 05/22/2023] [Indexed: 05/25/2023]
Abstract
INTRODUCTION Biological treatments deeply changed the management of moderate-to-severe forms of psoriasis. Among the available biological therapies, interleukin (IL)-17 inhibitors, secukinumab, ixekizumab, brodalumab, and bimekizumab represent one of the most rapid and effective biologic classes available for psoriasis. Bimekizumab, the latest available IL-17 inhibitor, is a humanized monoclonal immunoglobulin (Ig)G1 antibody that acts by neutralizing both IL-17A and IL-17F, showing a unique mechanism of action differing from ixekizumab and secukinumab (selective IL17A inhibitor), as well as brodalumab (antagonist of IL17 receptor). AREAS COVERED This review aims to evaluate the safety profile of bimekizumab in the treatment of moderate-to-severe plaque psoriasis. EXPERT OPINION The efficacy and safety of bimekizumab have been reported by several phase II and III clinical trials, even in a longer-term period. Moreover, clinical trials also showed bimekizumab to have significantly higher efficacy compared to other biological classes, including anti-TNF, anti-IL-12/23, and even to another IL-17 inhibitor, secukinumab. Although numerous biologics are currently available for psoriasis, some patients may result resistant to other treatments and/or experience psoriatic flares during or after treatment withdrawal. In this scenario, bimekizumab may represent an additional valuable alternative for patients with moderate-to-severe forms of psoriasis.
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Affiliation(s)
- Angelo Ruggiero
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luca Potestio
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Fabrizio Martora
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Alessia Villani
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Rosita Comune
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Matteo Megna
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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2
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Zagni E, Bianchi L, Fabbrocini G, Corrao S, Offidani A, Stingeni L, Costanzo A, Pellacani G, Peris K, Bardazzi F, Argenziano G, Ruffolo S, Dapavo P, Carrera C, Fargnoli MC, Parodi A, Romanelli M, Malagoli P, Talamonti M, Megna M, Raspanti M, Paolinelli M, Hansel K, Narcisi A, Conti A, De Simone C, Chessa MA, De Rosa A, Provenzano E, Ortoncelli M, Moltrasio C, Fidanza R, Burlando M, Tonini A, Gaiani FM, Simoni L, Zullo A, Fiocchi M, Colombo D. A real-world economic analysis of biologic therapies for moderate-to-severe plaque psoriasis in Italy: results of the CANOVA observational longitudinal study. BMC Health Serv Res 2021; 21:924. [PMID: 34488749 PMCID: PMC8422702 DOI: 10.1186/s12913-021-06866-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 08/04/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Psoriasis is a chronic immune-mediated inflammatory skin disease which can also involve joints. It is often associated with burdensome comorbidities which negatively impact prognosis and quality of life (QoL). Biologic agents have been shown to be effective in controlling disease progression, but their use is associated with higher costs compared with traditional systemic treatments. The economic analysis of the CANOVA (EffeCtiveness of biologic treAtmeNts for plaque psOriasis in Italy: an obserVAtional longitudinal study of real-life clinical practice) study aims to assess the costs and cost-effectiveness of biologics in a real-world context in Italy. METHODS The annualised overall direct costs of moderate-to-severe plaque psoriasis management, the annualised cost of biologic drugs and the cost per responder in the Italian National Health System perspective were assessed. More specifically, the cost per response and cost per sustained response of the most prescribed biologic therapies for the treatment of moderate-to-severe plaque psoriasis within the CANOVA study were assessed using the Psoriasis Area Severity Index (PASI) at several score levels (75, 90 and 100%). RESULTS The most frequently used biologic therapies for plaque psoriasis were secukinumab, ustekinumab, adalimumab originator, and ixekizumab. Cost of biologics was the driver of expenditure, accounting for about 98% of total costs. Adalimumab originator was the biologic with the lowest cost per responder ratio (range: €7848 - €31,378), followed by secukinumab (range: €9015 - €33,419). Ustekinumab (range: €11,689 - €39,280) and ixekizumab (range: €11,092 - €34,289) ranked respectively third and fourth, in terms of cost-effectiveness ratio. As concerns the cost per sustained response analysis, secukinumab showed the lowest value observed (€21,375) over the other options, because of its high response rate (86% vs. 60-80%), which was achieved early in time. CONCLUSION Biologic therapy is a valuable asset for the treatment of moderate-to-severe plaque psoriasis. Concomitant assessment of treatment costs against the expected therapeutic response over time can provide physicians and payers additional insights which can complement the traditional risk-benefit profile assessment and drive treatment decisions.
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Affiliation(s)
- Emanuela Zagni
- Novartis Farma S.p.A, Largo Umberto Boccioni, 1, 21040, Origgio, Varese, Italy.
| | | | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | | | - Annamaria Offidani
- Dermatology Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Luca Stingeni
- Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | | | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy
| | - Ketty Peris
- Fondazione Policlinico Universitario A. Gemelli-IRCCS and Università Cattolica, Rome, Italy
| | - Federico Bardazzi
- Dermatology, IRCCS Policlinico di S Orsola Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Bologna, Italy
| | | | | | - Paolo Dapavo
- A.O.U. Città della Salute e della Scienza PO Molinette, Turin, Italy
| | - Carlo Carrera
- Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Concetta Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Aurora Parodi
- Clinica Dermatologica DiSSal Università di Genova/Ospedale-Policlinico San Martino IRCCS, Genoa, Italy
| | - Marco Romanelli
- U.O. Dermatologia Universitaria - Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | | | | | | | | | - Matteo Paolinelli
- Dermatology Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Katharina Hansel
- Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | | | | | - Clara De Simone
- Fondazione Policlinico Universitario A. Gemelli-IRCCS and Università Cattolica, Rome, Italy
| | - Marco Adriano Chessa
- Dermatology, IRCCS Policlinico di S Orsola Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Alina De Rosa
- Dermatology Unit, University of Campania, Naples, Italy
| | | | | | - Chiara Moltrasio
- Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Rosaria Fidanza
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Martina Burlando
- Clinica Dermatologica DiSSal Università di Genova/Ospedale-Policlinico San Martino IRCCS, Genoa, Italy
| | - Annalisa Tonini
- U.O. Dermatologia Universitaria - Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | | | | | | | - Martina Fiocchi
- Novartis Farma S.p.A, Largo Umberto Boccioni, 1, 21040, Origgio, Varese, Italy
| | - Delia Colombo
- Novartis Farma S.p.A, Largo Umberto Boccioni, 1, 21040, Origgio, Varese, Italy
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Romano C, Esposito S, Ferrara R, Cuomo G. Choosing the most appropriate biologic therapy for Crohn’s disease according to concomitant extra-intestinal manifestations, comorbidities, or physiologic conditions. Expert Opin Biol Ther 2019; 20:49-62. [DOI: 10.1080/14712598.2020.1689953] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Ciro Romano
- Division of Internal Medicine, Department of Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Sergio Esposito
- Division of Internal Medicine, Department of Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Roberta Ferrara
- Division of Internal Medicine, Department of Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giovanna Cuomo
- Division of Internal Medicine, Department of Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
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Larsen MH, Strumse YS, Andersen MH, Borge CR, Wahl AK. Associations between disease education, self-management support, and health literacy in psoriasis. J DERMATOL TREAT 2019; 32:603-609. [PMID: 31692398 DOI: 10.1080/09546634.2019.1688233] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Patients' ability to perform self-management may be compromised if they are unable to fully comprehend their diagnosis and treatments. Weaknesses in health literacy (HL) pose a considerable health concern and may negatively influence SM, as well as interactions with health care professionals (HCP) and peers. OBJECTIVES To investigate possible associations between comprehensive HL and psoriasis education from HCPs in a cohort of patients with psoriasis. Another aim was to examine essential sources for psoriasis information and how these are evaluated. METHODS Cross-sectional questionnaire data, including the comprehensive Health Literacy Questionnaire (HLQ) from 825 patients with psoriasis who had participated in Climate Helio Therapy (CHT). RESULTS Participants having received HCP education scored significantly better in all HLQ scales compared to participants who did not receive such education (Cohen's effect size: 0.24 to 0.44). The CHT program, peers, and dermatologists were the most important sources of psoriasis information. People having participated more than once in CHT presented better HL scores and also higher self-management (skill and technique acquisition) and more psoriasis knowledge (effect-size: 0.75). CONCLUSIONS Psoriasis education by HCP seems important for HL and psoriasis knowledge. Patients may need multiple approaches and repetitions over time to be health literate and effective self-managers.
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Affiliation(s)
- Marie Hamilton Larsen
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
| | | | - Marit Helen Andersen
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Christine Raaheim Borge
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway.,Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Astrid Klopstad Wahl
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway
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5
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Torres T. Selective Interleukin-23 p19 Inhibition: Another Game Changer in Psoriasis? Focus on Risankizumab. Drugs 2019; 77:1493-1503. [PMID: 28770513 DOI: 10.1007/s40265-017-0794-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The history of psoriasis treatment has been marked by several milestones. Corticosteroids, cyclosporine, tumor necrosis factor alpha (TNF-α) inhibitors and, more recently, interleukin (IL)-17A inhibitors have revolutionized the treatment of psoriasis, each in its own way and time. The IL-23/IL-17 axis is currently considered to be crucial in the pathogenesis of psoriasis and selective IL-23p19 inhibition may bring several advantages with respect to IL-12/23p40 inhibition, or distal blockade of IL-17A or its receptor. In fact, IL-12 axis inhibition does not appear to be essential in psoriasis and IL-12 inhibition may even have a negative effect in the treatment of psoriasis and have potential risks in tumor immune surveillance and in host defense against intracellular pathogens. On the other hand, contrary to IL-17 inhibition, IL-23p19 blockade does not increase the risk of candida infection, nor is it associated with inflammatory bowel disease worsening. Several IL-23p19 inhibitors are currently being developed for the treatment of psoriasis, such as tildrakizumab, guselkumab, and risankizumab. Although clinical data on risankizumab is still scarce, it has shown characteristics that signify a major advance in the treatment of this disease, offering comparable or higher efficacy than IL-17 inhibitors, without the safety concerns of this therapeutic class, combined with the excellent dosing regimen of ustekinumab. Currently, only phase II trial data is available; thus, the results of the large phase III trials will be essential to establish the efficacy and safety profile of risankizumab and its value in the biological armamentarium for the treatment of psoriatic patients.
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Affiliation(s)
- Tiago Torres
- Serviço de Dermatologia, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Rua D. Manuel II, s/n, ex-CICAP, 4099-001, Porto, Portugal. .,Department of Dermatology, Centro Hospitalar e Universitário do Porto, Porto, Portugal.
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Campbell JJ, Ebsworth K, Ertl LS, McMahon JP, Wang Y, Yau S, Mali VR, Chhina V, Kumamoto A, Liu S, Dang T, Newland D, Charo IF, Zhang P, Schall TJ, Singh R. Efficacy of Chemokine Receptor Inhibition in Treating IL-36α-Induced Psoriasiform Inflammation. THE JOURNAL OF IMMUNOLOGY 2019; 202:1687-1692. [PMID: 30718298 DOI: 10.4049/jimmunol.1801519] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 01/05/2019] [Indexed: 12/29/2022]
Abstract
Several types of psoriasiform dermatitis are associated with increased IL-36 cytokine activity in the skin. A rare, but severe, psoriasis-like disorder, generalized pustular psoriasis (GPP), is linked to loss-of-function mutations in the gene encoding IL-36RA, an important negative regulator of IL-36 signaling. To understand the effects of IL-36 dysregulation in a mouse model, we studied skin inflammation induced by intradermal injections of preactivated IL-36α. We found the immune cells infiltrating IL-36α-injected mouse skin to be of dramatically different composition than those infiltrating imiquimod-treated skin. The IL-36α-induced leukocyte population comprised nearly equal numbers of CD4+ αβ T cells, neutrophils, and inflammatory dendritic cells, whereas the imiquimod-induced population comprised γδ T cells and neutrophils. Ligands for chemokine receptors CCR6 and CXCR2 are increased in both GPP and IL-36α-treated skin, which led us to test an optimized small-molecule antagonist (CCX624) targeting CCR6 and CXCR2 in the IL-36α model. CCX624 significantly reduced the T cell, neutrophil, and inflammatory dendritic cell infiltrates and was more effective than saturating levels of an anti-IL-17RA mAb at reducing inflammatory symptoms. These findings put CCR6 and CXCR2 forward as novel targets for a mechanistically distinct therapeutic approach for inflammatory skin diseases involving dysregulated IL-36 signaling, such as GPP.
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Affiliation(s)
| | | | | | | | - Yu Wang
- ChemoCentryx, Inc., Mountain View, CA 94043
| | - Simon Yau
- ChemoCentryx, Inc., Mountain View, CA 94043
| | | | | | | | | | - Ton Dang
- ChemoCentryx, Inc., Mountain View, CA 94043
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7
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Sajja AP, Joshi AA, Teague HL, Dey AK, Mehta NN. Potential Immunological Links Between Psoriasis and Cardiovascular Disease. Front Immunol 2018; 9:1234. [PMID: 29910818 PMCID: PMC5992299 DOI: 10.3389/fimmu.2018.01234] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 05/16/2018] [Indexed: 12/12/2022] Open
Abstract
Preclinical and clinical research provide strong evidence that chronic, systemic inflammation plays a key role in development and progression of atherosclerosis. Indeed, chronic inflammatory diseases, such as psoriasis, are associated with accelerated atherosclerosis and increased risk of cardiovascular events. Contemporary research has demonstrated plausible mechanistic links between immune cell dysfunction and cardiometabolic disease in psoriasis. In this review, we describe the role of potential common immunological mechanisms underlying both psoriasis and atherogenesis. We primarily discuss innate and adaptive immune cell subsets and their contributions to psoriatic disease and cardiovascular morbidity. Emerging efforts should focus on understanding the interplay among immune cells, adipose tissue, and various biomarkers of immune dysfunction to provide direction for future targeted therapy.
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Affiliation(s)
| | | | | | | | - Nehal N. Mehta
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
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8
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Wu JJ, Joshi AA, Reddy SP, Batech M, Egeberg A, Ahlehoff O, Mehta NN. Anti-inflammatory therapy with tumour necrosis factor inhibitors is associated with reduced risk of major adverse cardiovascular events in psoriasis. J Eur Acad Dermatol Venereol 2018; 32:1320-1326. [PMID: 29573294 DOI: 10.1111/jdv.14951] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 02/09/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Psoriasis is a systemic chronic inflammatory condition associated with increased risk of cardiovascular disease. Data demonstrating that decreased skin inflammation reduces cardiovascular events in patients with psoriasis may be generalizable to other chronic inflammatory states with heightened cardiovascular risk. OBJECTIVE To determine whether tumour necrosis factor inhibitor (TNFi) therapy is associated with decreased major adverse cardiovascular events (MACE) in patients with psoriasis. METHODS In this retrospective cohort study using the KPSC health plan, patients had at least three ICD-9 codes for psoriasis and no antecedent MACE codes. Propensity score-adjusted multivariable Cox regression assessed hazard ratios (HR) of MACE associated with TNFi use. RESULTS After adjusting for cardiovascular risk factors, the TNFi cohort had significantly lower MACE HR compared with the topical cohort (HR, 0.80; 95% CI, 0.66-0.98). The oral/phototherapy cohort had similar MACE HR compared with the topical cohort (HR, 1.19 (95% CI, 0.99-1.42)). CONCLUSIONS We observed significantly lower MACE risk in patients with psoriasis receiving TNFi compared to topical or oral/phototherapy agents. TNFi therapy may have benefits beyond skin disease in mitigating cardiovascular event risk.
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Affiliation(s)
- J J Wu
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA
| | - A A Joshi
- National Heart, Lung, and Blood Institute, National Institutes of Health, Rockville, MD, USA
| | - S P Reddy
- University of Illinois at Chicago College of Medicine, Chicago, IL, USA
| | - M Batech
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - A Egeberg
- Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - O Ahlehoff
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - N N Mehta
- National Heart, Lung, and Blood Institute, National Institutes of Health, Rockville, MD, USA
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9
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Tang L, He S, Wang X, Liu H, Zhu Y, Feng B, Su Z, Zhu W, Liu B, Xu F, Li C, Zhao J, Zheng X, Lu C, Zheng G. Cryptotanshinonereduces psoriatic epidermal hyperplasia via inhibiting the activation of STAT3. Exp Dermatol 2018; 27:268-275. [PMID: 29427477 DOI: 10.1111/exd.13511] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Lipeng Tang
- Department of Pharmacology of Traditional Chinese Medicine; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine; Guangzhou China
- The Postdoctoral Research Station; Guangzhou University of Chinese Medicine; Guangzhou, Guangdong China
| | - Songmin He
- Department of Pharmacology of Traditional Chinese Medicine; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine; Guangzhou China
| | - Xieqi Wang
- The Second Clinical Medical College; Guangzhou University of Chinese Medicine; Guangzhou China
| | - Hongying Liu
- Department of Pathology; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine; Guangzhou China
| | - Ying Zhu
- Department of Pharmacology of Traditional Chinese Medicine; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine; Guangzhou China
| | - Bing Feng
- Department of Pharmacology of Traditional Chinese Medicine; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine; Guangzhou China
| | - Zuqing Su
- Department of Pharmacology of Traditional Chinese Medicine; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine; Guangzhou China
| | - Wei Zhu
- Traditional Chinese Medicine Material Basic Research Team; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine; Guangzhou China
| | - Bo Liu
- Department of Chemical Research and Structural Optimization based on Chinese Material Medicine; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine; Guangzhou China
| | - Fangfang Xu
- Department of Chemical Research and Structural Optimization based on Chinese Material Medicine; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine; Guangzhou China
| | - Chutian Li
- Department of Pathology; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine; Guangzhou China
| | - Jie Zhao
- Department of Pathology; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine; Guangzhou China
| | - Xirun Zheng
- Department of Pathology; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine; Guangzhou China
| | - Chuanjian Lu
- Department of Dermatology; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine; Guangzhou China
| | - Guangjuan Zheng
- Department of Pharmacology of Traditional Chinese Medicine; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine; Guangzhou China
- Department of Pathology; The Second Affiliated Hospital of Guangzhou University of Chinese Medicine; Guangzhou China
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10
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Gonzalez JM. Evaluating Risk Tolerance from a Systematic Review of Preferences: The Case of Patients with Psoriasis. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2018; 11:285-300. [DOI: 10.1007/s40271-017-0295-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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11
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Cohen AD, Wu JJ, Puig L, Chimenti S, Vender R, Rajagopalan M, Romiti R, de la Cruz C, Skov L, Zachariae C, Young HS, Foley P, van der Walt JM, Naldi L, Prens EP, Blauvelt A. Biosimilars for psoriasis: worldwide overview of regulatory guidelines, uptake and implications for dermatology clinical practice. Br J Dermatol 2017. [PMID: 28646580 DOI: 10.1111/bjd.15756] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The introduction of biological drugs for the treatment of patients with psoriasis has revolutionized treatment paradigms and enabled numerous patients to achieve disease control with an acceptable safety profile. However, the high cost of biologics limits access to these medications for the majority of patients worldwide. In recent years, the introduction of biosimilars for inflammatory diseases has become a fast evolving field. The future use of biosimilars offers the potential for decreased cost and increased access to biologics for patients with psoriasis. For approval of biosimilars, different regulatory agencies use highly variable methods for definition, production, approval, marketing and postmarketing surveillance. Due to potential interchangeability between biologics and biosimilars, traceability and pharmacovigilance are required to collect accurate data about adverse events in patients with psoriasis; spontaneous reporting, registries and use of 'big data' should facilitate this process on a global basis. The current article describes biosimilar regulatory guidelines and examples of biosimilar uptake in clinical practice in several countries around the world. As it is apparent that biological therapy treatment decisions may become more physician independent, the International Psoriasis Council recommends that dermatologists should take an active role in the development of biosimilar prescribing policies with their respective healthcare settings and government agencies.
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Affiliation(s)
- A D Cohen
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Quality Measurements and Research, Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel
| | - J J Wu
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, U.S.A
| | - L Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Chimenti
- University of Rome Tor Vergata, Rome, Italy
| | - R Vender
- Dermatrials Research Inc. & Venderm Innovations in Psoriasis, Hamilton, ON, Canada
| | - M Rajagopalan
- Department of Dermatology, Apollo Hospitals, Chennai, India
| | - R Romiti
- Department of Dermatology, University of São Paulo, São Paulo, Brazil
| | | | - L Skov
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - C Zachariae
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - H S Young
- The University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.,Department of Dermatology, Salford Royal NHS Foundation Trust, Manchester, U.K
| | - P Foley
- Skin & Cancer Foundation Inc., Carlton, Vic., Australia.,Department of Dermatology, The University of Melbourne, Melbourne, Vic., Australia.,St Vincent's Hospital, Melbourne, Vic., Australia
| | | | - L Naldi
- Department of Dermatology, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - E P Prens
- Deptartment of Dermatology, Erasmus MC, P.O. Box 5201, 3008, AE Rotterdam, the Netherlands
| | - A Blauvelt
- Oregon Medical Research Center, Portland, OR, U.S.A
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12
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Prinz JC. Autoimmune aspects of psoriasis: Heritability and autoantigens. Autoimmun Rev 2017; 16:970-979. [PMID: 28705779 DOI: 10.1016/j.autrev.2017.07.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 06/10/2017] [Indexed: 12/28/2022]
Abstract
Chronic immune-mediated disorders (IMDs) constitute a major health burden. Understanding IMD pathogenesis is facing two major constraints: Missing heritability explaining familial clustering, and missing autoantigens. Pinpointing IMD risk genes and autoimmune targets, however, is of fundamental importance for developing novel causal therapies. The strongest association of all IMDs is seen with human leukocyte antigen (HLA) alleles. Using psoriasis as an IMD model this article reviews the pathogenic role HLA molecules may have within the polygenic predisposition of IMDs. It concludes that disease-associated HLA alleles account for both missing heritability and autoimmune mechanisms by facilitating tissue-specific autoimmune responses through autoantigen presentation.
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Affiliation(s)
- Jörg Christoph Prinz
- Department of Dermatology, University Clinics, Ludwig-Maximilian-University of Munich, Munich, Germany.
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13
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Benjegerdes KE, Hyde K, Kivelevitch D, Mansouri B. Pustular psoriasis: pathophysiology and current treatment perspectives. PSORIASIS (AUCKLAND, N.Z.) 2016; 6:131-144. [PMID: 29387600 PMCID: PMC5683122 DOI: 10.2147/ptt.s98954] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Psoriasis vulgaris is a chronic inflammatory disease that classically affects skin and joints and is associated with numerous comorbidities. There are several clinical subtypes of psoriasis including the uncommon pustular variants, which are subdivided into generalized and localized forms. Generalized forms of pustular psoriasis include acute generalized pustular psoriasis, pustular psoriasis of pregnancy, and infantile and juvenile pustular psoriasis. Localized forms include acrodermatitis continua of Hallopeau and palmoplantar pustular psoriasis. These subtypes vary in their presentations, but all have similar histopathologic characteristics. The immunopathogenesis of each entity remains to be fully elucidated and some debate exists as to whether these inflammatory pustular dermatoses should be classified as entities distinct from psoriasis vulgaris. Due to the rarity of these conditions and the questionable link to the common, plaque-type psoriasis, numerous therapies have shown variable results and most entities remain difficult to treat. With increasing knowledge of the pathogenesis of these variants of pustular psoriasis, the development and use of biologic and other immunomodulatory therapies holds promise for the future of successfully treating pustular variants of psoriasis.
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Affiliation(s)
| | - Kimberly Hyde
- Texas A&M Health Science Center College of Medicine, Round Rock
| | | | - Bobbak Mansouri
- Texas A&M Health Science Center College of Medicine, Temple
- Department of Dermatology, Scott and White Hospital, Texas A&M Health Science Center College of Medicine, Temple, TX, USA
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14
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Micali G, Lacarrubba F, Santagati C, Egan CG, Nasca MR, Musumeci ML. Clinical, ultrasound, and videodermatoscopy monitoring of psoriatic patients following biological treatment. Skin Res Technol 2015; 22:341-8. [PMID: 26450445 DOI: 10.1111/srt.12271] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2015] [Indexed: 01/23/2023]
Abstract
BACKGROUND AND PURPOSE Effective non-invasive techniques to monitor plaque psoriasis progression and treatment are desirable. The aim of the study was to evaluate changes in vascular pattern using videodermatoscopy (VD) and in skin thickness by ultrasound (US), along with clinical observation, during treatment with biologicals. METHODS Forty-two patients with moderate-to-severe plaque psoriasis treated with adalimumab, etanercept, or ustekinumab were evaluated. Following the identification of a 'target' plaque at baseline, lesion changes were monitored at 15, 30 and 60 days by clinical observation using a Target Lesion Score (TLS), and by VD and US. RESULTS After 60 days, a significant improvement in all three parameters was observed. In adalimumab-treated patients mean values of TLS, VD, and US were reduced by 83.9%, 73.5%, and 90%, respectively; in etanercept-treated patients by 67.9%, 49.7%, and 79.3%; in ustekinumab-treated patients by 80.9%, 66.4%, and 80.1%. Skin thickness was the first parameter to improve. Vascular improvement was slower compared to clinical and US responses. CONCLUSION VD and US may be useful to monitor psoriasis treatment. Further investigations are warranted to assess if the persistence of an altered vascular pattern despite clinical and US normalization, as observed in 22% of patients, may influence disease progression and/or correlate with rate and severity degree of relapse.
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Affiliation(s)
- G Micali
- Dermatology Clinic, University of Catania, Catania, Italy
| | - F Lacarrubba
- Dermatology Clinic, University of Catania, Catania, Italy
| | - C Santagati
- Dermatology Clinic, University of Catania, Catania, Italy
| | - C G Egan
- Primula Multimedia SRL, Pisa, Italy
| | - M R Nasca
- Dermatology Clinic, University of Catania, Catania, Italy
| | - M L Musumeci
- Dermatology Clinic, University of Catania, Catania, Italy
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15
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Jiang S, Hinchliffe TE, Wu T. Biomarkers of An Autoimmune Skin Disease--Psoriasis. GENOMICS, PROTEOMICS & BIOINFORMATICS 2015; 13:224-33. [PMID: 26362816 PMCID: PMC4610974 DOI: 10.1016/j.gpb.2015.04.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 04/06/2015] [Accepted: 04/22/2015] [Indexed: 02/08/2023]
Abstract
Psoriasis is one of the most prevalent autoimmune skin diseases. However, its etiology and pathogenesis are still unclear. Over the last decade, omics-based technologies have been extensively utilized for biomarker discovery. As a result, some promising markers for psoriasis have been identified at the genome, transcriptome, proteome, and metabolome level. These discoveries have provided new insights into the underlying molecular mechanisms and signaling pathways in psoriasis pathogenesis. More importantly, some of these markers may prove useful in the diagnosis of psoriasis and in the prediction of disease progression once they have been validated. In this review, we summarize the most recent findings in psoriasis biomarker discovery. In addition, we will discuss several emerging technologies and their potential for novel biomarker discovery and diagnostics for psoriasis.
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Affiliation(s)
- Shan Jiang
- Department of Dermatology, Renmin Hospital of Wuhan University, Wuhan 430060, China; Department of Biomedical Engineering, University of Houston, Houston, TX 77204, USA
| | - Taylor E Hinchliffe
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204, USA
| | - Tianfu Wu
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204, USA.
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16
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Abstract
The umbrella term psoriasis is now understood to incorporate several distinct phenotypes or endotypes along the disease spectrum that in turn will dictate different therapies. A stratified medicine approach to psoriasis using this clinical information coupled with pharmacogenomic and immunologic data will become more widely acceptable in the future. Comorbidities associated with psoriasis, such as diabetes, depression, and Crohn disease, and the debate about the interdependence of psoriasis and cardiovascular disease will also dictate future research and holistic and management plans for this complex disease.
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Affiliation(s)
- M Alan Menter
- Division of Dermatology, Baylor University Medical Center at Dallas, Dallas, TX, USA
| | - Christopher E M Griffiths
- Dermatology Centre, Salford Royal Hospital, The University of Manchester, Manchester Academic Health Science Centre, Manchester M6 8HD, UK.
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17
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Ganzetti G, Campanati A, Offidani A. Non-alcoholic fatty liver disease and psoriasis: So far, so near. World J Hepatol 2015; 7:315-326. [PMID: 25848461 PMCID: PMC4381160 DOI: 10.4254/wjh.v7.i3.315] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 10/28/2014] [Accepted: 12/17/2014] [Indexed: 02/06/2023] Open
Abstract
Psoriasis is a chronic inflammatory immune-mediated skin diseases which is frequently associated to comorbidities. Non-alcoholic fatty liver disease (NAFLD) is defined as an excessive accumulation of triglycerides in hepatocytes and includes a wide spectrum of liver conditions ranging from relatively benign steatosis to non-alcoholic steatohepatitis with fatty infiltration and lobular inflammation and to cirrhosis and end-stage liver disease. Actually, psoriasis is considered a systemic diseases associated to comorbidities, as metabolic syndrome and NAFLD is seen the hepatic manifestation of the metabolic syndrome. The possible link between psoriasis, obesity and metabolic syndrome, which are known risk factors for NAFLD has been recently documented focusing in the crucial role of the adipose tissue in the development of the inflammatory background sharing by the above entities. According to recent data, patients with psoriasis show a greater prevalence of NAFLD and metabolic syndrome than the general population. Moreover, patients with NAFLD and psoriasis are at higher risk of severe liver fibrosis than those with NAFLD and without psoriasis. The link between these pathological conditions appears to be a chronic low-grade inflammatory status. The aim of this review is to focus on the multiple aspects linking NAFLD and psoriasis, only apparently far diseases.
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Guinea-Viniegra J, Jiménez M, Schonthaler HB, Navarro R, Delgado Y, Concha-Garzón MJ, Tschachler E, Obad S, Daudén E, Wagner EF. Targeting miR-21 to treat psoriasis. Sci Transl Med 2014; 6:225re1. [PMID: 24574341 DOI: 10.1126/scitranslmed.3008089] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Psoriasis is a common inflammatory skin disease with limited treatment options that is characterized by a complex interplay between keratinocytes, immune cells, and inflammatory mediators. MicroRNAs (miRNAs) are regulators of gene expression and play critical roles in many human diseases. A number of miRNAs have been described to be up-regulated in psoriasis, but their causal contribution to disease development has not been demonstrated. We confirm that miR-21 expression is increased in epidermal lesions of patients with psoriasis and that this leads to reduced epidermal TIMP-3 (tissue inhibitor of matrix metalloproteinase 3) expression and activation of TACE (tumor necrosis factor-α-converting enzyme)/ADAM17 (a disintegrin and metalloproteinase 17). Using patient-derived skin samples and mouse models of psoriasis, we demonstrate that increased miR-21 may be a consequence of impaired transcriptional activity of Jun/activating protein 1 (AP-1), leading to activation of the interleukin-6 (IL-6)/signal transducer and activator of transcription 3 (Stat3) pathway. Inhibition of miR-21 by locked nucleic acid (LNA)-modified anti-miR-21 compounds ameliorated disease pathology in patient-derived psoriatic skin xenotransplants in mice and in a psoriasis-like mouse model. Targeting miR-21 may represent a potential therapeutic option for the treatment of psoriasis.
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Affiliation(s)
- Juan Guinea-Viniegra
- F-BBVA-CNIO Cancer Cell Biology Program, Spanish National Cancer Research Centre (CNIO), Madrid 28029, Spain
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Zhao Y, Lai W. Patient considerations and targeted therapies in the management of psoriasis in Chinese patients: role of ustekinumab. Patient Prefer Adherence 2014; 8:865-72. [PMID: 24971001 PMCID: PMC4069134 DOI: 10.2147/ppa.s40638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Psoriasis is an immune-mediated disease affecting approximately 0.1% to 0.5% of the population in the People's Republic of China. Multiple therapeutic options are available for the treatment of moderate to severe psoriasis although they all have their respective disadvantages. The application of biological agents has brought significant efficacy in psoriasis treatment. Ustekinumab, a human monoclonal antibody targeting the interleukin-12/23 pathway, shows its superiority in efficacy, long duration of drug action, and good tolerance in patients. Phase III clinical trials of ustekinumab have been completed in Mainland China, and the drug is available in Taiwan and Hong Kong. Meanwhile, its long-term safety and efficacy merit further investigation.
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Affiliation(s)
- Yue Zhao
- Department of Dermatology and Venereology, the 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Wei Lai
- Department of Dermatology and Venereology, the 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China
- Correspondence: Wei Lai, Department of Dermatology and Venereology, the 3rd Affiliated Hospital of Sun Yat-sen University, No 600, Tianhe Road, Guangzhou, People’s Republic of China, Fax +86 20 8525 2425, Email
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