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Valenti M, Gargiulo L, Ibba L, Bertuzzi A, Manara S, Toso F, Costanzo A, Narcisi A. Apremilast for the treatment of pustular psoriasis induced by neoadjuvant ifosfamide + etoposide chemotherapy for Ewing Sarcoma: a case report. J DERMATOL TREAT 2024; 35:2319303. [PMID: 38378173 DOI: 10.1080/09546634.2024.2319303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Affiliation(s)
- Mario Valenti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, Humanitas Research Hospital IRCCS, Rozzano, Italy
| | - Luigi Gargiulo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, Humanitas Research Hospital IRCCS, Rozzano, Italy
| | - Luciano Ibba
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, Humanitas Research Hospital IRCCS, Rozzano, Italy
| | - Alexia Bertuzzi
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Sofia Manara
- Pathology Unit, Humanitas Research Hospital IRCCS, Rozzano, Italy
| | - Francesco Toso
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, Humanitas Research Hospital IRCCS, Rozzano, Italy
| | - Antonio Costanzo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, Humanitas Research Hospital IRCCS, Rozzano, Italy
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Avallone G, Mastorino L, Tavoletti G, Macagno N, Barei F, Schena D, Rossi M, Magnaterra E, Antonelli F, Babino G, Viola R, Gargiulo L, Conforti C, Rapparini L, Errichetti E, Patruno C, Ruggiero P, Roccuzzo G, Maronese CA, Girolomoni G, Gola M, Chiricozzi A, Balato A, Ambrogio F, Narcisi A, Zalaudek I, Gurioli C, Napolitano M, Marzano AV, Foti C, Costanzo A, Piraccini BM, Ferrucci SM, Ortoncelli M, Quaglino P, Ribero S. Clinical outcomes and management of JAK inhibitor-associated acne in patients with moderate-to-severe atopic dermatitis undergoing upadacitinib: A multicenter retrospective study. J Am Acad Dermatol 2024; 90:1031-1034. [PMID: 38199282 DOI: 10.1016/j.jaad.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/31/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Affiliation(s)
- Gianluca Avallone
- Department of Medical Sciences, University of Turin, Dermatology Clinic, Turin, Italy; Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
| | - Luca Mastorino
- Department of Medical Sciences, University of Turin, Dermatology Clinic, Turin, Italy
| | - Gianluca Tavoletti
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Nicole Macagno
- Department of Medical Sciences, University of Turin, Dermatology Clinic, Turin, Italy
| | - Francesca Barei
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Donatella Schena
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | | | - Elisabetta Magnaterra
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Flaminia Antonelli
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy; Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Graziella Babino
- Unit of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Riccardo Viola
- Department of Precision and Regenerative Medicine and Ionian Area, Unit of Dermatology, University of Bari Aldo Moro, Bari, Italy
| | - Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
| | - Claudio Conforti
- Dermatology Clinic, Maggiore Hospital of Trieste, Trieste, Italy; IDI-IRCCS, Dermatological Research Hospital, Rome, Italy
| | - Luca Rapparini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Enzo Errichetti
- Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), University of Udine, Udine, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Pasqualina Ruggiero
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriele Roccuzzo
- Department of Medical Sciences, University of Turin, Dermatology Clinic, Turin, Italy
| | - Carlo A Maronese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Giampiero Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Massimo Gola
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Andrea Chiricozzi
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy; Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Anna Balato
- Unit of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesca Ambrogio
- Department of Precision and Regenerative Medicine and Ionian Area, Unit of Dermatology, University of Bari Aldo Moro, Bari, Italy
| | - Alessandra Narcisi
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital of Trieste, Trieste, Italy
| | - Carlotta Gurioli
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Maddalena Napolitano
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Angelo V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Caterina Foti
- Department of Precision and Regenerative Medicine and Ionian Area, Unit of Dermatology, University of Bari Aldo Moro, Bari, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
| | - Bianca M Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Silvia M Ferrucci
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Michela Ortoncelli
- Department of Medical Sciences, University of Turin, Dermatology Clinic, Turin, Italy
| | - Pietro Quaglino
- Department of Medical Sciences, University of Turin, Dermatology Clinic, Turin, Italy
| | - Simone Ribero
- Department of Medical Sciences, University of Turin, Dermatology Clinic, Turin, Italy
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Orsini D, Malagoli P, Balato A, Bianchi L, Brianti P, Buononato D, Burlando M, Caldarola G, Campanati A, Campione E, Carrera CG, Carugno A, Cusano F, Dapavo P, Dattola A, De Simone C, Dini V, Esposito M, Fargnoli MC, Gaiani FM, Gargiulo L, Gisondi P, Giunta A, Ibba L, Lasagni C, Loconsole F, Maione V, Mortato E, Marzano AV, Maurelli M, Megna M, Mercuri SR, Narcisi A, Offidani A, Paolino G, Parodi A, Pellacani G, Potestio L, Quaglino P, Richetta AG, Romano F, Sena P, Venturini M, Assorgi C, Costanzo A. Bimekizumab for the Treatment of Plaque Psoriasis With Involvement of Genitalia: A 16-Week Multicenter Real-World Experience - IL PSO (Italian Landscape Psoriasis). Dermatol Pract Concept 2024:dpc.1402a52. [PMID: 38416060 DOI: 10.5826/dpc.1402a52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2024] [Indexed: 02/29/2024] Open
Abstract
INTRODUCTION Genital involvement is observed in approximately 60% of patients with psoriasis, presenting clinicians with formidable challenges in treatment. While new biologic drugs have emerged as safe and effective options for managing psoriasis, their efficacy in challenging-to-treat areas remains inadequately explored. Intriguingly, studies have shown that interleukin (IL)-17 inhibitors exhibit effectiveness in addressing genital psoriasis. OBJECTIVES We aimed to determine the effectiveness profile of bimekizumab in patients affected by moderate-to-severe plaque psoriasis with involvement of genitalia. METHODS Bimekizumab, a dual inhibitor of both IL-17A and IL-17F, was the focus of our 16-week study, demonstrating highly favorable outcomes for patients with genital psoriasis. The effectiveness of bimekizumab was evaluated in terms of improvement in Static Physician's Global Assessment of Genitalia (sPGA-G) and Psoriasis Area and Severity Index. RESULTS Sixty-five adult patients were enrolled. Remarkably, 98.4% of our participants achieved a clear sPGA-G score (s-PGA-g=0) within 16 weeks. Moreover, consistent improvements were observed in PASI scores, accompanied by a significant reduction in the mean Dermatology Life Quality Index (DLQI), signifying enhanced quality of life. Notably, none of the patients reported a severe impairment in their quality of life after 16 weeks of treatment. In our cohort of 65 patients, subgroup analyses unveiled that the effectiveness of bimekizumab remained unaffected by prior exposure to other biologics or by obesity. CONCLUSIONS Our initial findings suggest that bimekizumab may serve as a valuable treatment option for genital psoriasis. Nevertheless, further research with larger sample sizes and longer-term follow-up is imperative to conclusively validate these results.
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Affiliation(s)
- Diego Orsini
- Clinical Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Piergiorgio Malagoli
- Department of Dermatology, Dermatology Unit Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - Anna Balato
- Dermatology Unit, University of Campania L. Vanvitelli, Naples, Italy
| | - Luca Bianchi
- Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Pina Brianti
- Unit of Dermatology and Cosmetology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Dario Buononato
- Dermatology Unit, University of Campania L. Vanvitelli, Naples, Italy
| | - Martina Burlando
- Section of Dermatology, Department of Health Sciences (DISSAL), IRCCS San Martino University Hospital, Genoa, Italy
| | - Giacomo Caldarola
- Section of Dermatology, Department of Translational Medicine and Surgery, Catholic University of the Sacred Heart, Rome, Italy
- Dermatology Unit, Agostino Gemelli University Polyclinic Foundation, IRCCS, Rome, Italy
| | - Anna Campanati
- Department of Clinical and Molecular Sciences - Dermatological Clinic, Università Politecnica delle Marche, Ancona, Italy
| | - Elena Campione
- Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Carlo G Carrera
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Carugno
- Dermatology Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
- Molecular and Translational Medicine (DIMET), University of Milan-Bicocca, Milan, Italy
| | - Francesco Cusano
- Department of Dermatology, Gaetano Rummo Hospital, Benevento, Italy
| | - Paolo Dapavo
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - Annunziata Dattola
- Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, University of La Sapienza, Rome, Italy
| | - Clara De Simone
- Section of Dermatology, Department of Translational Medicine and Surgery, Catholic University of the Sacred Heart, Rome, Italy
- Dermatology Unit, Agostino Gemelli University Polyclinic Foundation, IRCCS, Rome, Italy
| | - Valentina Dini
- Dermatology Unit, Department of Clinical and Experimental Medicine, Ospedale Santa Chiara, Pisa, Italy
| | - Maria Esposito
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Maria C Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Francesca M Gaiani
- Department of Dermatology, Dermatology Unit Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Paolo Gisondi
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - Alessandro Giunta
- Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Claudia Lasagni
- Dermatological Clinic, Department of Specialized Medicine, University of Modena, Modena, Italy
| | | | - Vincenzo Maione
- Department of Dermatology, ASST Spedali Civili Hospital, Brescia, Italy
| | | | - Angelo V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Martina Maurelli
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Santo R Mercuri
- Università Vita-Salute San Raffaele, Milan, Italy
- Unit of Dermatology and Cosmetology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessandra Narcisi
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Annamaria Offidani
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Paolino
- Unit of Dermatology and Cosmetology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Aurora Parodi
- Section of Dermatology, Department of Health Sciences (DISSAL), IRCCS San Martino University Hospital, Genoa, Italy
| | - Giovanni Pellacani
- Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, University of La Sapienza, Rome, Italy
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Pietro Quaglino
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - Antonio G Richetta
- Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, University of La Sapienza, Rome, Italy
| | | | - Paolo Sena
- Dermatology Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Marina Venturini
- Department of Dermatology, ASST Spedali Civili Hospital, Brescia, Italy
| | - Chiara Assorgi
- Clinical Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
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Gargiulo L, Ibba L, Malagoli P, Burroni AG, Chiricozzi A, Dapavo P, Ferrucci SM, Gola M, Napolitano M, Ortoncelli M, Rossi MT, Sciarrone C, Costanzo A, Narcisi A. Management of Patients Affected by Moderate-to-Severe Atopic Dermatitis with JAK Inhibitors in Real-World Clinical Practice: An Italian Delphi Consensus. Dermatol Ther (Heidelb) 2024:10.1007/s13555-024-01135-x. [PMID: 38509380 DOI: 10.1007/s13555-024-01135-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 02/28/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION Several systemic therapies have been approved for the treatment of severe AD. In particular, Janus kinase inhibitors (JAKi), including abrocitinib, baricitinib, and upadacitinib, recently received approval for the treatment of patients with severe AD after being evaluated in several clinical trials. However, a few concerns have been raised regarding their long-term safety and the management of these drugs in real-world clinical practice. In this article we described the results of a Delphi consensus aimed at describing the knowledge on JAKi and focusing, in particular, on providing clinical recommendations for dermatologists in daily practice regarding the use of these drugs. METHODS Twelve Italian dermatologists reviewed the most recent literature regarding the efficacy and safety profiles of JAKi and proposed 24 statements. RESULTS Agreement was reached for statements focusing on three main topics: (1) place in therapy of JAKi in patients with moderate-to-severe AD; (2) effectiveness and safety of JAK inhibitors in different phenotypes; (3) different approaches to the management of patients treated with JAKi in clinical practice. The panel proposed several recommendations regarding all the statements. CONCLUSION Given the wide use of JAKi in clinical practice, it is crucial to establish a specific follow-up for each patient's phenotype in order to achieve the best possible clinical outcome and minimize potential adverse events.
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Affiliation(s)
- Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
| | - Piergiorgio Malagoli
- Department of Dermatology, Dermatology Unit Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - Anna G Burroni
- Section of Dermatology, Department of Health Sciences (Di.S.Sal), University of Genoa, IRCCS-San Martino Polyclinic Hospital, Genoa, Italy
| | - Andrea Chiricozzi
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy
- Dipartimento Scienze Mediche e Chirurgiche, UOC di Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Paolo Dapavo
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - Silvia M Ferrucci
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimo Gola
- Allergological and Pediatric Dermatology Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Maddalena Napolitano
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Michela Ortoncelli
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - Maria T Rossi
- Dermatology Department, University of Brescia, ASST Spedali Civili, Brescia, Italy
| | | | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Alessandra Narcisi
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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Maronese CA, Costanzo A, Gilliet M, Marzano AV. Paradoxical Psoriasis: From Its Many Faces to Possible Shared Therapeutic Targets. J Invest Dermatol 2024:S0022-202X(24)00195-7. [PMID: 38513820 DOI: 10.1016/j.jid.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 02/13/2024] [Accepted: 03/04/2024] [Indexed: 03/23/2024]
Affiliation(s)
- Carlo Alberto Maronese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Antonio Costanzo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Michel Gilliet
- Department of Dermatology, CHUV University Hospital and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
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Ibba L, Gargiulo L, Vignoli CA, Fiorillo G, Valenti M, Costanzo A, Narcisi A. Practical Use of Upadacitinib in Patients with Severe Atopic Dermatitis in a Real-World Setting: A Systematic Review. Clin Cosmet Investig Dermatol 2024; 17:593-604. [PMID: 38495913 PMCID: PMC10944248 DOI: 10.2147/ccid.s329442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 02/24/2024] [Indexed: 03/19/2024]
Abstract
Upadacitinib is a selective Janus kinase inhibitor approved for the treatment of severe atopic dermatitis (AD). This systematic review aims to summarize the most recent data in terms of effectiveness and safety of upadacitinib in the treatment of severe AD in a real-world setting. The review included a comprehensive search of databases, including PubMed, Google Scholar and Web of Science, according to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The literature search initially identified 242 studies. Of these, 214 were excluded after reviewing their titles and abstracts. We then conducted a full-text review of 25 studies, of which 17 met our inclusion criteria and were therefore included in our systematic review. The analysis of real-world studies showed high effectiveness of upadacitinib, in terms of both clinical signs and subjective symptoms, in different patient populations, including those resistant to other treatments. No new significant safety concerns have emerged as compared to randomized clinical trials.
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Affiliation(s)
- Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Carlo Alberto Vignoli
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Giovanni Fiorillo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Mario Valenti
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Ibba L, Gargiulo L, Pavia G, Narcisi A, Costanzo A, Valenti M. A severe psoriasis flare after COVID-19 treated with risankizumab: complete skin clearance after 16 weeks. Dermatol Reports 2024; 16:9722. [PMID: 38623366 PMCID: PMC11017708 DOI: 10.4081/dr.2023.9722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 04/03/2023] [Indexed: 04/17/2024] Open
Abstract
The development of flares or new-onset of immune-mediated dermatologic diseases, including psoriasis, has occurred with the worldwide spreading of the COVID-19 pandemic. We report the case of a 38-year-old woman who came to our department with a severe flare of plaque psoriasis four weeks after SARS-CoV-2 infection. Her Psoriasis Area Severity Index was 25, and her Dermatology Life Quality Index was 18. Our initial decision was to prescribe acitretin, but the patients reported adverse events. For this reason, we started risankizumab with complete skin clearance after 16 weeks. The patient is still on treatment, and no adverse events have been reported to date.
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Affiliation(s)
- Luciano Ibba
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Luigi Gargiulo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Giulia Pavia
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | | | - Antonio Costanzo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Mario Valenti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
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8
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Puig L, Costanzo A, de Jong EMGJ, Torres T, Warren RB, Wapenaar R, Wegner S, Gorecki P, Gramiccia T, Jazra M, Buyze J, Conrad C. Guselkumab-Treated Patients with Plaque Psoriasis Who Achieved Complete Skin Clearance for ≥ 156 Consecutive Weeks: A Post-Hoc Analysis From the VOYAGE 1 Clinical Trial. Am J Clin Dermatol 2024; 25:315-325. [PMID: 37804472 PMCID: PMC10866772 DOI: 10.1007/s40257-023-00816-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND Treatment of moderate-to-severe plaque psoriasis with biologics, such as guselkumab, has demonstrated greater efficacy over traditional non-biologic treatments. However, given patient diversity, greater understanding of the relationship between patient characteristics, positive clinical outcomes, and long-term response to biologics is crucial for optimizing treatment choices. MATERIALS AND METHODS This post-hoc analysis of the 5-year VOYAGE 1 clinical trial compares baseline characteristics of patients maintaining a Psoriasis Area and Severity Index (PASI) score of 0 at all visits for ≥ 156 consecutive weeks (PASI = 0 group) with those that never achieve PASI = 0 (comparator group), using descriptive statistics and a multiple logistic regression model. Guselkumab plasma trough concentrations in both response groups were assessed from Weeks 4-156. RESULTS Of patients who started guselkumab treatment at Week 0 or at Week 16 after switching from placebo, 22.7% (112/494) maintained PASI = 0 for ≥ 156 consecutive weeks. Numerical differences in baseline characteristics, including age, obesity, diabetes, PASI score, disease duration, smoking status, and psoriatic arthritis comorbidity, were identified between the PASI = 0 group and comparator group. Plasma guselkumab levels were consistently higher in the PASI = 0 group. Multiple logistic regression analysis revealed absence of diabetes, lower Dermatology Life Quality Index score at baseline, and higher Week 4 guselkumab plasma concentration as significantly (p < 0.05) associated with the PASI = 0 group. CONCLUSION A substantial (22.7%) number of guselkumab-treated patients in the VOYAGE 1 clinical trial maintained complete skin clearance for a consecutive period of ≥ 156 weeks. Factors associated with this outcome may suggest clinical benefits of holistic treatment approaches. TRIAL REGISTRATION NCT02207231.
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Affiliation(s)
- Luis Puig
- Department of Dermatology, IIB Sant Pau, Hospital de Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Antonio Costanzo
- Dermatology, Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Humanitas Clinical and Research Center IRCCS, Milan, Italy
| | - Elke M G J de Jong
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tiago Torres
- Centro Hospitalar Universitário do Porto, Porto, Portugal
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Richard B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, National Institute for Health Research Manchester Biomedical Research Centre, The University of Manchester, Manchester, UK
| | | | | | | | | | | | | | - Curdin Conrad
- Department of Dermatology, Lausanne University Hospital CHUV and University of Lausanne, Lausanne, Switzerland
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9
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Gargiulo L, Ibba L, Fiorillo G, Valenti M, Sierzputowska P, Costanzo A, Narcisi A. Pregnancy outcome of a patient treated with upadacitinib for severe atopic dermatitis. J Eur Acad Dermatol Venereol 2024; 38:e252-e253. [PMID: 37795665 DOI: 10.1111/jdv.19557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/27/2023] [Indexed: 10/06/2023]
Affiliation(s)
- L Gargiulo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - L Ibba
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - G Fiorillo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - M Valenti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | | | - A Costanzo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - A Narcisi
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
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10
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Orsini D, Frascione P, Assorgi C, Pacifico A, Sperduti I, Gargiulo L, Ibba L, Valenti M, Costanzo A, Narcisi A. Risankizumab for the treatment of genital psoriasis: A 1-year, real-world experience. J Eur Acad Dermatol Venereol 2024; 38:e256-e258. [PMID: 37795669 DOI: 10.1111/jdv.19562] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/27/2023] [Indexed: 10/06/2023]
Affiliation(s)
- D Orsini
- Clinical Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - P Frascione
- Dermatology Oncology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - C Assorgi
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - A Pacifico
- Clinical Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - I Sperduti
- Biostatistical Unit, IRCCS 'Regina Elena' National Cancer Institute, Rome, Italy
| | - L Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
- Department of Biomedical Sciences, Humanitas University, Italy
| | - L Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
- Department of Biomedical Sciences, Humanitas University, Italy
| | - M Valenti
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
- Department of Biomedical Sciences, Humanitas University, Italy
| | - A Costanzo
- Biostatistical Unit, IRCCS 'Regina Elena' National Cancer Institute, Rome, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - A Narcisi
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
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11
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Gargiulo L, Ibba L, Piscazzi F, Amoruso F, Balato A, Barei F, Bertello M, Burroni AG, Caccavale S, Ferrucci SM, Foti C, Gaiani FM, Girolomoni G, Malagoli P, Marzano AV, Maurelli M, Napolitano M, Nettis E, Ortoncelli M, Patruno C, Pezzolo E, Ribero S, Romita P, Rossi MT, Zaza I, Costanzo A, Narcisi A. Upadacitinib improves symptoms of concomitant allergic rhinitis or allergic asthma in patients with severe atopic dermatitis: A 16-week multicentre retrospective study. J Eur Acad Dermatol Venereol 2024. [PMID: 38329235 DOI: 10.1111/jdv.19862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024]
Affiliation(s)
- L Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - L Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - F Piscazzi
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - F Amoruso
- Dermatology Unit, Azienda Ospedaliera di Cosenza, Cosenza, Italy
| | - A Balato
- Dermatology Unit, University of Campania L, Naples, Italy
| | - F Barei
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M Bertello
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - A G Burroni
- Section of Dermatology, Department of Health Sciences (Di.S.Sal), IRCCS - San Martino Polyclinic Hospital, University of Genoa, Genoa, Italy
| | - S Caccavale
- Dermatology Unit, University of Campania L, Naples, Italy
| | - S M Ferrucci
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - C Foti
- Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - F M Gaiani
- Department of Dermatology, Dermatology Unit Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - G Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - P Malagoli
- Department of Dermatology, Dermatology Unit Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - A V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M Maurelli
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - M Napolitano
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - E Nettis
- Department of Emergency and Organ Transplantation, School of Allergology and Clinical Immunology, University of Bari Aldo Moro, Bari, Italy
| | - M Ortoncelli
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - C Patruno
- Section of Dermatology, Health Sciences Department, Magna Graecia University, Catanzaro, Italy
| | - E Pezzolo
- Department of Dermatology, San Bortolo Hospital, Vicenza, Italy
- A Study Centre of the Italian Group for the Epidemiologic Research in Dermatology (GISED), Bergamo, Italy
| | - S Ribero
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - P Romita
- Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - M T Rossi
- Dermatology Department, University of Brescia, Brescia, Italy
| | - I Zaza
- Department of Emergency and Organ Transplantation, School of Allergology and Clinical Immunology, University of Bari Aldo Moro, Bari, Italy
| | - A Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - A Narcisi
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
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12
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Fiorillo G, Ibba L, Gargiulo L, Narcisi A, Costanzo A, Valenti M. Effectiveness and Safety of Biological Therapies in Very Severe Plaque Psoriasis: A Real-Life Retrospective Study. J Pers Med 2024; 14:186. [PMID: 38392619 PMCID: PMC10890562 DOI: 10.3390/jpm14020186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
Psoriasis can have a significant impact on quality of life and productivity, especially with increased severity. However, there is limited evidence on biologics' efficacy in highly severe cases compared to moderate-to-severe ones. This study aimed to evaluate the effectiveness and safety of novel biological therapies in very severe psoriasis. We conducted a retrospective analysis on patients ≥ 18 years old affected by very severe psoriasis who had received a biological agent for at least 16 weeks. We used PASI to assess disease severity and effectiveness at weeks 16, 52, 104, and 156. Safety was evaluated by tracking treatment discontinuation rates and adverse events. This study included 29 males and 11 females, with a mean age of 55.80 years (SD 13.82). Cardiometabolic diseases were the most common comorbidities (25.00%). Twenty-eight (70.00%) patients had psoriasis involvement in at least one difficult-to-treat area. All patients completed 16 weeks of treatment. The mean PASI was 31.60 (SD 2.57) at baseline, 3.48 (SD 4.13) at week 16, 0.58 (SD 1.70) at week 52, 0.77 (SD 1.66) at week 104, and 1.29 (SD 2.12) at week 156. PASI90 and 100 were achieved by 52.50% and 30.00% of patients at week 16, by 96.15% and 80.77% at week 52, by 93.33% and 66.67% at week 104, and by 85.71% and 42.86% at week 156. PASIs ≤ 2 were achieved by 50.00% of patients at week 16, 88.46% at week 52, 86.67% at week 104, and 85.71% at week 156. Only two patients discontinued biologics due to complete remission, and mild AEs were reported by four patients. Our findings show that biologics are effective and well tolerated for treating very severe psoriasis, maintaining long-term effectiveness.
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Affiliation(s)
- Giovanni Fiorillo
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Luciano Ibba
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Luigi Gargiulo
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Alessandra Narcisi
- Dermatology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Antonio Costanzo
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Mario Valenti
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
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13
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Paolino G, Carugno A, Rongioletti F, Ponzoni M, Russo V, Sena P, Ardigò M, Costanzo A, Mercuri SR, Valenti M. Bone marrow metastases: a systematic review of a neglected involvement in malignant melanoma. Melanoma Res 2024; 34:31-37. [PMID: 37939076 DOI: 10.1097/cmr.0000000000000942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
The occurrence of bone marrow metastases (BMM) in melanoma patients is often underestimated, with only 7% detected during in-vivo staging procedures but rising to 45% in autopsy cases. This systematic review aims to shed light on the clinical and laboratory features of BMM in melanoma by analyzing 73 studies selected from 2 482 initially retrieved from PubMed, Embase , and Cochrane CENTRAL databases. Our findings reveal a slight male predominance, with a median age at BMM diagnosis of 56 years. Primary melanoma sites included the skin (52%), mucosa (8.8%), uvea (20.5%) and unidentified (19%). BMM was preceded by lymph node involvement in 36.5% of cases, whereas 63% showed no nodal metastases, with direct BMM occurring in 22.5% and metastases to other sites in 41%. Common BMM symptoms included pain (60.7%), anemia (80%), thrombocytopenia, leukoerythroblastosis, pancytopenia and leukopenia, while disseminated intravascular coagulation was detected in 11% of cases. In 23.6% of cases, BMM was amelanotic. The prognosis for BMM is grim, with a median survival of only 2 months. Conventional therapies for BMM remain largely ineffective, emphasizing the importance of considering bone marrow as a potential metastatic site in melanoma patients.
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Affiliation(s)
- Giovanni Paolino
- Unit of Dermatology, IRCCS Ospedale San Raffaele
- Unit of Dermatologic Clinic, Università Vita-Salute, San Raffaele, Milan
| | - Andrea Carugno
- Dermatology Unit, ASST Papa Giovanni XXIII, Bergamo
- Ph.D. Program in Molecular and Translational Medicine (DIMET), University of Milan-Bicocca
| | - Franco Rongioletti
- Unit of Dermatology, IRCCS Ospedale San Raffaele
- Unit of Dermatologic Clinic, Università Vita-Salute, San Raffaele, Milan
| | - Maurilio Ponzoni
- Vita-Salute San Raffaele University
- Pathology Unit, IRCCS Ospedale San Raffaele
| | - Vincenzo Russo
- Unit of Immuno-Biotherapy of Melanoma and Solid Tumors, IRCCS Ospedale San Raffaele
| | - Paolo Sena
- Dermatology Unit, ASST Papa Giovanni XXIII, Bergamo
| | - Marco Ardigò
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Santo Raffaele Mercuri
- Unit of Dermatology, IRCCS Ospedale San Raffaele
- Unit of Dermatologic Clinic, Università Vita-Salute, San Raffaele, Milan
| | - Mario Valenti
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
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14
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Gargiulo L, Ibba L, Piscazzi F, Alfano A, Cascio Ingurgio R, Valenti M, Costanzo A, Narcisi A. Effectiveness and safety of upadacitinib for moderate-to-severe atopic dermatitis in a real-world setting: A 52-week retrospective study. J Eur Acad Dermatol Venereol 2024; 38:e152-e154. [PMID: 37714196 DOI: 10.1111/jdv.19507] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/08/2023] [Indexed: 09/17/2023]
Affiliation(s)
- L Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - L Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - F Piscazzi
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - A Alfano
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - R Cascio Ingurgio
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - M Valenti
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - A Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - A Narcisi
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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15
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Valenti M, Gargiulo L, Ibba L, Cortese A, Toso F, Orsini D, Lora V, Frascione P, Sena P, Carugno A, Assorgi C, Costanzo A, Narcisi A. Effectiveness of ixekizumab for the treatment of moderate-to-severe plaque psoriasis with involvement of difficult-to-treat areas: A 52-week multicenter retrospective study. J Dermatol 2024. [PMID: 38292002 DOI: 10.1111/1346-8138.17115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/28/2023] [Accepted: 12/28/2023] [Indexed: 02/01/2024]
Abstract
Biological drugs have dramatically changed the approach to treating moderate-to-severe plaque psoriasis, achieving excellent skin clearance and safety outcomes. However, the management of difficult-to-treat areas (e.g., scalp, palms/soles, nails, and genitalia) still represents a challenge in psoriasis treatment. Data in the literature on difficult-to-treat sites are limited and, frequently, no specific analysis is performed during clinical trials. We conducted a 52-week, retrospective study to evaluate the effectiveness of ixekizumab in 120 patients with moderate-to-severe plaque psoriasis of at least one difficult-to-treat area (scalp, palmoplantar surfaces, nails, and genitalia). Ninety-nine patients had scalp psoriasis, 35 had involvement of the palms or soles, 27 were affected by genital psoriasis, and 22 patients reported involvement of the nails. After 1 year of treatment, 96% of patients with scalp involvement, 95.6% of patients with palmoplantar psoriasis, 95.2% of patients with genital psoriasis, and 85% of patients with nail involvement achieved a site-specific Physician's Global Assessment of 0 or 1 (clear or almost clear). No serious adverse events were observed during the study. Our study supports the effectiveness of ixekizumab in plaque psoriasis involving difficult-to-treat sites.
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Affiliation(s)
- Mario Valenti
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Andrea Cortese
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Francesco Toso
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Diego Orsini
- Clinical Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Viviana Lora
- Clinical Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Pasquale Frascione
- Dermatology Oncology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Paolo Sena
- Dermatology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Andrea Carugno
- Dermatology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
- Ph.D. Program in Molecular and Translational Medicine (DIMET), University of Milan-Bicocca, Milan, Italy
| | - Chiara Assorgi
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
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16
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Avallone G, Cavallo F, Tancredi A, Maronese CA, Bertello M, Fraghì A, Conforti C, Calabrese G, Di Nicola MR, Oddenino GA, Gargiulo L, Gori N, Loi C, Romita P, Piras V, Bonzano L, Tolino E, Paolino G, Napolitano M, Patruno C, Nettis E, Ferreli C, Roccuzzo G, Marozio L, Silvio M, Russo F, Bettolini L, Gallo R, Mercuri SR, Mastorino L, Rossi M, Zalaudek I, Argenziano G, Trave I, Costanzo A, Chiricozzi A, Gurioli C, Foti C, Potenza C, Ferrucci SM, Balato A, Parodi A, Marzano AV, Ortoncelli M, Ribero S, Quaglino P. Association between maternal dupilumab exposure and pregnancy outcomes in patients with moderate-to-severe atopic dermatitis: A nationwide retrospective cohort study. J Eur Acad Dermatol Venereol 2024. [PMID: 38284131 DOI: 10.1111/jdv.19794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 12/07/2023] [Indexed: 01/30/2024]
Abstract
BACKGROUND There is limited epidemiological evidence on outcomes associated with dupilumab exposure during pregnancy; monitoring pregnancy outcomes in large populations is required. OBJECTIVE To investigate the potential association between exposure to dupilumab in pregnant women with atopic dermatitis and any adverse pregnancy, neonatal, congenital and post-partum outcomes. METHODS We performed a multicentre retrospective cohort study across 19 Italian tertiary referral hospital. Childbearing women were eligible if aged 18-49 years and carried out the pregnancy between 1 October 2018 and 1 September 2022. RESULTS We retrospectively screened records of 5062 patients receiving dupilumab regardless of age and gender, identifying 951 female atopic dermatitis patients of childbearing age, 29 of whom had been exposed to the drug during pregnancy (3%). The median duration of dupilumab treatment prior to conception was 22.5 weeks (range: 3-118). The median time of exposure to the drug during pregnancy was 6 weeks (range: 2-24). All the documented pregnancies were unplanned, and the drug was discontinued in all cases once pregnancy status was reported. The comparison of the study cohort and the control group found no significant drug-associated risk for adverse pregnancy, congenital, neonatal or post-partum outcomes. The absence of a statistically significant effect of exposure on the event was confirmed by bivariate analysis and multivariate analysis adjusted for other confounding factors. CONCLUSIONS This cohort of pregnant patients exposed to dupilumab adds to the existing evidence concerning the safety of biologic agents in pregnancy. No safety issues were identified regarding the primary outcome assessed. In clinical practice, these data provide reassurance in case of dupilumab exposure during the first trimester. However, the continuous use of dupilumab throughout pregnancy warrants further research.
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Affiliation(s)
- Gianluca Avallone
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Francesco Cavallo
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Annalisa Tancredi
- Obstetrics and Gynecology 1U, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, Sant Anna Hospital, University of Torino, Turin, Italy
| | - Carlo A Maronese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Martina Bertello
- Dermatology Section, Department of Medical, Surgical, and Neurological Sciences, Santa Maria Alle Scotte Hospital, University of Siena, Siena, Italy
| | | | - Claudio Conforti
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
- IDI-IRCCS, Dermatological Research Hospital, Rome, Italy
| | - Giulia Calabrese
- Unit of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | - Giorgio A Oddenino
- Section of Dermatology - Department of Health Sciences, University of Genoa, IRCCS - Ospedale Policlinico San Martino, Genoa, Italy
| | - Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Niccolò Gori
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Camilla Loi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Paolo Romita
- Unit of Dermatology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari Aldo Moro, Bari, Italy
| | - Viviana Piras
- Unit of Dermatology, Department of Medical Sciences and Public Health, Azienda Ospedaliero-Universitaria Cagliari, Cagliari, Italy
| | - Laura Bonzano
- Dermatology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Ersilia Tolino
- Department of Medico-surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Italy
| | - Giovanni Paolino
- Unit of Dermatology, IRCCS Ospedale San Raffaele, Milan, Italy
- Unit of Clinical Dermatology, Università Vita-Salute San Raffaele, Milan, Italy
| | - Maddalena Napolitano
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Eustachio Nettis
- Department of Emergency and Organ Transplantation, School of Allergology and Clinical Immunology, University of Bari Aldo Moro, Bari, Italy
| | - Caterina Ferreli
- Unit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Gabriele Roccuzzo
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Luca Marozio
- Obstetrics and Gynecology 1U, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, Sant Anna Hospital, University of Torino, Turin, Italy
| | - Martina Silvio
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Filomena Russo
- Dermatology Section, Department of Medical, Surgical, and Neurological Sciences, Santa Maria Alle Scotte Hospital, University of Siena, Siena, Italy
| | - Luca Bettolini
- Dermatology Department, University of Brescia, Brescia, Italy
| | - Rosella Gallo
- Section of Dermatology - Department of Health Sciences, University of Genoa, IRCCS - Ospedale Policlinico San Martino, Genoa, Italy
| | - Santo R Mercuri
- Unit of Dermatology, IRCCS Ospedale San Raffaele, Milan, Italy
- Unit of Clinical Dermatology, Università Vita-Salute San Raffaele, Milan, Italy
| | - Luca Mastorino
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | | | - Ilaria Trave
- Section of Dermatology - Department of Health Sciences, University of Genoa, IRCCS - Ospedale Policlinico San Martino, Genoa, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Andrea Chiricozzi
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Carlotta Gurioli
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Caterina Foti
- Unit of Dermatology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari Aldo Moro, Bari, Italy
| | - Concetta Potenza
- Department of Medico-surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Italy
| | - Silvia M Ferrucci
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Balato
- Unit of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Aurora Parodi
- Section of Dermatology - Department of Health Sciences, University of Genoa, IRCCS - Ospedale Policlinico San Martino, Genoa, Italy
| | - Angelo V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Michela Ortoncelli
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Simone Ribero
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Pietro Quaglino
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
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Gargiulo L, Ibba L, Malagoli P, Amoruso F, Argenziano G, Balato A, Bardazzi F, Burlando M, Carrera CG, Damiani G, Dapavo P, Dini V, Franchi C, Gaiani FM, Girolomoni G, Guarneri C, Lasagni C, Loconsole F, Marzano AV, Maurelli M, Megna M, Orsini D, Sampogna F, Travaglini M, Valenti M, Costanzo A, Narcisi A. Effectiveness, Tolerability, and Drug Survival of Risankizumab in a Real-World Setting: A Three-Year Retrospective Multicenter Study-IL PSO (ITALIAN LANDSCAPE PSORIASIS). J Clin Med 2024; 13:495. [PMID: 38256629 PMCID: PMC10816779 DOI: 10.3390/jcm13020495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Risankizumab is a humanized monoclonal antibody that selectively inhibits interleukin-23. It has been approved for moderate-to-severe plaque psoriasis and has shown efficacy and safety in clinical trials and real-world experiences. This study aimed to evaluate the long-term effectiveness, safety, and drug survival of risankizumab in a real-life setting. MATERIALS AND METHODS We included patients treated with risankizumab from January 2019 to February 2023. A Psoriasis Area and Severity Index score (PASI) was collected at weeks 0, 16, 28, 52, 104, and 156, when available. The occurrence of any adverse events was recorded at each visit. RESULTS We enrolled 1047 patients. At week 52, a ≥90% improvement in PASI was observed in 81.44% of patients, with a continuous improvement throughout the study (88.99% and 99.07% at weeks 104 and 156, respectively). After three years of treatment, all patients involving the scalp, palms/soles, and genitalia and 95% of patients with nail psoriasis achieved a complete or almost complete skin clearance. No significant safety findings were observed, and 90.73% of the patients were still on treatment after 36 months. CONCLUSIONS This study supports the long-term effectiveness and safety of risankizumab in a real-world setting, even in patients involving difficult-to-treat areas.
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Affiliation(s)
- Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (L.I.); (M.V.); (A.C.); (A.N.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy
| | - Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (L.I.); (M.V.); (A.C.); (A.N.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy
| | - Piergiorgio Malagoli
- Department of Dermatology, Dermatology Unit Azienda Ospedaliera San Donato Milanese, 20097 Milan, Italy; (P.M.); (F.M.G.)
| | - Fabrizio Amoruso
- Dermatology Unit, Azienda Ospedaliera di Cosenza, 87100 Cosenza, Italy;
| | - Giuseppe Argenziano
- Dermatology Unit, University of Campania L. Vanvitelli, 80138 Naples, Italy; (G.A.); (A.B.)
| | - Anna Balato
- Dermatology Unit, University of Campania L. Vanvitelli, 80138 Naples, Italy; (G.A.); (A.B.)
| | - Federico Bardazzi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola Malpighi, 40138 Bologna, Italy;
| | - Martina Burlando
- Department of Dermatology, Dipartimento di Scienze della Salute (DISSAL), University of Genoa, IRCCS Ospedale Policlinico San Martino, 16100 Genoa, Italy;
| | - Carlo Giovanni Carrera
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (C.G.C.); (A.V.M.)
| | - Giovanni Damiani
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20133 Milan, Italy;
- Clinical Dermatology, IRCCS Ospedale Galeazzi-Sant’Ambrogio, 20157 Milan, Italy;
| | - Paolo Dapavo
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, 10124 Turin, Italy;
| | - Valentina Dini
- Dermatology Unit, Department of Clinical and Experimental Medicine Ospedale Santa Chiara, 11 Via Roma 67, 56126 Pisa, Italy;
| | - Chiara Franchi
- Clinical Dermatology, IRCCS Ospedale Galeazzi-Sant’Ambrogio, 20157 Milan, Italy;
| | - Francesca Maria Gaiani
- Department of Dermatology, Dermatology Unit Azienda Ospedaliera San Donato Milanese, 20097 Milan, Italy; (P.M.); (F.M.G.)
| | - Giampiero Girolomoni
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Piazzale A. Stefani 1, 37126 Verona, Italy; (G.G.); (M.M.)
| | - Claudio Guarneri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Dermatology, University of Messina, AOU Policlinico G. Martino, Via Consolare Valeria 1, 98125 Messina, Italy;
| | - Claudia Lasagni
- Dermatological Clinic, Department of Specialized Medicine, University of Modena, Via del Pozzo 71, 41121 Modena, Italy;
| | - Francesco Loconsole
- Department of Dermatology, University of Bari, Piazza Umberto I, 1, 70121 Bari, Italy;
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (C.G.C.); (A.V.M.)
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milan, Italy
| | - Martina Maurelli
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Piazzale A. Stefani 1, 37126 Verona, Italy; (G.G.); (M.M.)
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy;
| | - Diego Orsini
- UOC Clinical Dermatology—Dermatological Institute S. Gallicano, IRCCS, 00167 Rome, Italy;
| | - Francesca Sampogna
- Clinical Epidemiology Unit, Istituto Dermopatico dell’Immacolata (IDI), IRCCS, 00167 Rome, Italy;
| | - Massimo Travaglini
- U.O.S.D. Dermatologica—Centro per la Cura Della Psoriasi, Ospedale Perrino, 72100 Brindisi, Italy;
| | - Mario Valenti
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (L.I.); (M.V.); (A.C.); (A.N.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (L.I.); (M.V.); (A.C.); (A.N.)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy
| | - Alessandra Narcisi
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy; (L.I.); (M.V.); (A.C.); (A.N.)
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Gargiulo L, Ibba L, Malagoli P, Balato A, Bardazzi F, Burlando M, Carrera CG, Damiani G, Dapavo P, Dini V, Gaiani FM, Girolomoni G, Guarneri C, Lasagni C, Loconsole F, Marzano AV, Megna M, Mercuri SR, Travaglini M, Costanzo A, Narcisi A. Drug survival of IL-12/23, IL-17 and IL-23 inhibitors for moderate-to-severe plaque psoriasis: a retrospective multicenter real-world experience on 5932 treatment courses - IL PSO (Italian landscape psoriasis). Front Immunol 2024; 14:1341708. [PMID: 38274801 PMCID: PMC10808601 DOI: 10.3389/fimmu.2023.1341708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/22/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction The development of several effective biological drugs for moderate-to-severe plaque psoriasis has dramatically changed the lives of patients. Despite the wide use of interleukin (IL) inhibitors, limited data are available to date regarding long-term treatment persistence. Method This multicenter retrospective real-world study evaluated 5932 treatment courses across 5300 patients, all treated with interleukin inhibitors. Drug survival was expressed by using the Kaplan-Meier estimator for each biological drug at 6, 12, 24, 36 and 48 months. We also stratified by discontinuation associated with primary or secondary ineffectiveness. Results In our study, the most prescribed drugs were secukinumab (1412), ixekizumab (1183), and risankizumab (977). After four years of follow-up, risankizumab emerged as the treatment with the highest drug survival overall, as 91.6% of patients were still on treatment. The overall probability of drug survival at four years was comparable for tildrakizumab (83.5%), ixekizumab (82.6%), guselkumab (82.4%) and brodalumab (81.8%). When evaluating only patients who discontinued the treatment because of ineffectiveness, once again risankizumab was the molecule with the highest drug survival at 4 years (93.4%), this time followed by ixekizumab (87%). Our study, in which all IL inhibitors were adequately represented, confirmed a slightly better treatment persistence for IL-23 inhibitors, consistent with other real-world studies. Conclusion Our experience showed that IL-23 inhibitors, and risankizumab in particular, had a higher probability of drug survival overall during a 4-year follow-up. Risankizumab and ixekizumab were less likely to be discontinued because of ineffectiveness after four years.
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Affiliation(s)
- Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Piergiorgio Malagoli
- Department of Dermatology, Dermatology Unit, Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - Anna Balato
- Dermatology Unit, University of Campania L. Vanvitelli, Naples, Italy
| | - Federico Bardazzi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Martina Burlando
- Section of Dermatology, Department of Health Sciences (DISSAL), IRCCS San Martino University Hospital, Genoa, Italy
| | - Carlo G. Carrera
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Damiani
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Dermatology and Cosmetology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Paolo Dapavo
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - Valentina Dini
- Dermatology Unit, Department of Clinical and Experimental Medicine, Ospedale Santa Chiara, Pisa, Italy
| | - Francesca M. Gaiani
- Department of Dermatology, Dermatology Unit, Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - Giampiero Girolomoni
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - Claudio Guarneri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Claudia Lasagni
- Dermatological Clinic, Department of Specialized Medicine, University of Modena, Modena, Italy
| | | | - Angelo V. Marzano
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Santo R. Mercuri
- Dermatology and Cosmetology Unit, IRCCS San Raffaele Hospital, Milan, Italy
- Dermatology Unit, Università Vita-Salute San Raffaele, Milan, Italy
| | - Massimo Travaglini
- U.O.S.D. Dermatologica - Centro per la Cura della Psoriasi, Ospedale Perrino, Brindisi, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Orsini D, Maramao FS, Gargiulo L, Ibba L, Piscazzi F, Pacifico A, Latini A, Gianserra L, Cristaudo A, Costanzo A, Narcisi A. Effectiveness and safety of risankizumab in HIV patients with psoriasis: A case series. Int J STD AIDS 2024; 35:67-70. [PMID: 37691387 PMCID: PMC10751968 DOI: 10.1177/09564624231199510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/21/2023] [Indexed: 09/12/2023]
Abstract
Biological therapies represent the gold-standard treatment of severe forms of plaque psoriasis. However, people living with HIV are often under-treated for psoriasis because very limited data are available on the use of biologics in this population. We report four cases of patients affected by HIV and moderate-to-severe plaque psoriasis, all treated with risankizumab, a monoclonal antibody that selectively targets interleukin-23. After 16 weeks, all patients experienced complete or almost complete skin clearance without any adverse events. Data on the effectiveness and safety of biological therapies in people living with HIV are limited to case reports or small case series, especially for the most recently approved inhibitors of interleukin-23. Our experienced, although limited, supports the role of risankizumab as a safe and effective therapy for psoriasis amongst patients living with HIV.
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Affiliation(s)
- Diego Orsini
- Clinical Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Fabio S. Maramao
- UOSD di Dermatologia, Fondazione Policlinico Tor Vergata, Università degli studi di Roma Tor Vergata, Roma, Italy
| | - Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Francesco Piscazzi
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Alessia Pacifico
- Clinical Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Alessandra Latini
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Roma, Italy
| | - Laura Gianserra
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Roma, Italy
| | - Antonio Cristaudo
- Clinical Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
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Chiricozzi A, Costanzo A, Levi A, Parretta F, Ravasio R. Costo per NNT di upadacitinib nel trattamento dei pazienti con dermatite atopica da moderata a severa in Italia. Glob Reg Health Technol Assess 2024; 11:38-50. [PMID: 38380163 PMCID: PMC10877702 DOI: 10.33393/grhta.2024.2728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/21/2024] [Indexed: 02/22/2024] Open
Abstract
Background: Targeted systemic therapies, including abrocitinib, baricitinib, dupilumab, tralokinumab and upadacitinib, are new treatments for moderate to severe atopic dermatitis (AD). We evaluated the efficacy and the costs of these targeted systemic therapies in the treatment of adult patients with moderate to severe AD. Methods: The clinical efficacy was assessed considering the results of a previous network meta-analysis (NMA). The analysis involved five therapies approved in Italy for the treatment of moderate to severe AD: abrocitinib (ABR), baricitinib (BAR), dupilumab (DUP), tralokinumab (TRA) and upadacitinib (UPA). According to the NMA, the cost of the treatment was based on the number of administrations dispensed at 16 weeks and the clinical efficacy was measured by the number needed to treat (NNT) compared to placebo using the improvement ≥ 75% (EASI-75) or ≥ 90 (EASI-90) from baseline of the eczema area and severity index (EASI). Only the ex-factory price of the targeted systemic therapies was considered. The cost per NNT was adopted as a cost-effectiveness indicator. Results: At 16 weeks, the cost per NNT based on EASI-75 was lower for UPA 15 mg (€ 6,384.00) compared to BAR 4 mg (€ 11,619.73) and 2 mg (€ 14,524.66), ABR 100 mg (€ 16,265.22), DUP 300 mg (€ 16,115.04) and TRA 300 mg (€ 31,710.24). UPA 15 (€ 8,512.00) also showed the lower cost per NNT based on EASI-90 at 16 weeks compared to BAR 4 mg (€ 14,788.75) and 2 mg (€ 20,862.70), ABR 100 mg (€ 25,922.69), DUP 300 mg (€ 25,992.00) and TRA 300 mg (€ 41,067.36). Conclusions: The findings show that upadacitinib is the most cost-effective option (cost per NNT) for the treatment of moderate to severe atopic dermatitis.
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Affiliation(s)
- Andrea Chiricozzi
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma - Italy
| | - Antonio Costanzo
- Department of Biomedical Sciences, Humanitas University, Dermatology Unit, Humanitas Research Hospital, Rozzano, Milano - Italy
| | | | | | - Roberto Ravasio
- HEOR and RWE Lead, PharmaLex Italy S.p.A. formerly MA Provider, Milano - Italy
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Gargiulo L, Ibba L, Malagoli P, Amoruso F, Argenziano G, Balato A, Bardazzi F, Burlando M, Carrera CG, Damiani G, Dapavo P, Dini V, Fabbrocini G, Franchi C, Gaiani FM, Girolomoni G, Guarneri C, Lasagni C, Loconsole F, Marzano AV, Maurelli M, Megna M, Orsini D, Sampogna F, Travaglini M, Valenti M, Costanzo A, Narcisi A. A risankizumab super responder profile identified by long-term real-life observation-IL PSO (ITALIAN LANDSCAPE PSORIASIS). J Eur Acad Dermatol Venereol 2024; 38:e113-e116. [PMID: 37611277 DOI: 10.1111/jdv.19464] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/18/2023] [Indexed: 08/25/2023]
Affiliation(s)
- L Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - L Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - P Malagoli
- Department of Dermatology, Dermatology Unit, Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - F Amoruso
- Dermatology Unit, Azienda Ospedaliera di Cosenza, Cosenza, Italy
| | - G Argenziano
- Dermatology Unit, University of Campania L. Vanvitelli, Naples, Italy
| | - A Balato
- Dermatology Unit, University of Campania L. Vanvitelli, Naples, Italy
| | - F Bardazzi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola Malpighi, Bologna, Italy
| | - M Burlando
- Department of Dermatology, Dipartimento di Scienze della Salute (DISSAL), University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - C G Carrera
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G Damiani
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
- Clinical Dermatology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
| | - P Dapavo
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - V Dini
- Dermatology Unit, Department of Clinical and Experimental Medicine Ospedale Santa Chiara, Pisa, Italy
| | - G Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - C Franchi
- Clinical Dermatology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
| | - F M Gaiani
- Department of Dermatology, Dermatology Unit, Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - G Girolomoni
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - C Guarneri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Dermatology, University of Messina, AOU Policlinico G. Martino, Messina, Italy
| | - C Lasagni
- Dermatological Clinic, Department of Specialized Medicine, University of Modena, Modena, Italy
| | - F Loconsole
- Department of Dermatology, University of Bari, Bari, Italy
| | - A V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - M Maurelli
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - M Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - D Orsini
- UOC Clinical Dermatology - Dermatological Institute S. Gallicano, IRCCS, Rome, Italy
| | - F Sampogna
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata (IDI) IRCCS, Rome, Italy
| | - M Travaglini
- U.O.S.D. Dermatologica - Centro per la Cura Della Psoriasi, Brindisi, Italy
| | - M Valenti
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - A Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - A Narcisi
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
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22
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Solitano V, Facheris P, Petersen M, D'Amico F, Ortoncelli M, Aletaha D, Olivera PA, Bieber T, Ramiro S, Ghosh S, D'Agostino MA, Siegmund B, Chary-Valckenaere I, Hart A, Dagna L, Magro F, Felten R, Kotze PG, Jairath V, Costanzo A, Kristensen LE, Biroulet LP, Danese S. Implementation of regulatory guidance for JAK inhibitors use in patients with immune-mediated inflammatory diseases: An international appropriateness study. Autoimmun Rev 2023; 23:103504. [PMID: 38128748 DOI: 10.1016/j.autrev.2023.103504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 12/17/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND AND AIMS The Pharmacovigilance Risk Assessment Committee (PRAC) proposed measures to address severe side effects linked to Janus kinase inhibitors (JAKi) in immune-mediated inflammatory diseases (IMID). Use of these medications in individuals aged 65 and older, those at high cardiovascular risk, active or former long-term smokers, and those with increased cancer risk should be considered only if no alternatives exist. Caution is advised when administering JAKi to patients at risk of venous thromboembolism. We aim to implement recommendations from regulatory guidelines based on areas of uncertainty identified. METHODS A two-round modified Research and Development/University of California Los Angeles appropriateness methodology study was conducted. A panel of 21 gastroenterologists, dermatologists and rheumatologists used a 9-point Likert scale to rate the appropriateness of administering a JAKi for each proposed clinical scenario. Scores for appropriateness were categorized as appropriate, uncertain, or inappropriate. Two rounds were performed, each with online surveys and a virtual meeting to enable discussion and rating of each best practice. RESULTS Round 1 involved participants rating JAKi appropriateness and suggesting descriptors to reduce uncertainty. Survey results were discussed in a virtual meeting, identifying areas of disagreement. In round 2, participants rated their agreement with descriptors from round 1, and the level of uncertainty and disagreement reduced. Age flexibility is recommended in the absence of other risk factors. Active counseling on modifiable risks (e.g., overweight, mild hyperlipidemia and hypertension) and smoking cessation is advised. Uncertainty persists regarding cancer risk due to various factors. CONCLUSIONS We outlined regulatory guidance without a personalized evaluation of the patient's risk profile might lead to uncertainty and become an arid technicality. Therefore, we identified gaps and implemented PRAC recommendations to help health professionals in clinical practice.
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Affiliation(s)
- Virginia Solitano
- Division of Gastroenterology and Gastrointestinal Endoscopy, IRCCS Ospedale San Raffaele, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - Paola Facheris
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Magnus Petersen
- The Parker Institute, University of Copenhagen & Bispebjerg University Hospital, Copenhagen, Denmark
| | - Ferdinando D'Amico
- Division of Gastroenterology and Gastrointestinal Endoscopy, IRCCS Ospedale San Raffaele, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
| | - Michela Ortoncelli
- Medical Sciences Department, Dermatologic Clinic, University of Turin, Turin, Italy
| | - Daniel Aletaha
- Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Pablo A Olivera
- Gastroenterology Department, CEMIC, Buenos Aires C1425ASS, Argentina; Zane Cohen Centre for Digestive Diseases-Lunenfeld-Tanenbaum Research Institute-Sinai Health System-Gastroenterology, Toronto, ON M5T 3L9, Canada
| | - Thomas Bieber
- Department of Dermatology and Allergy, University Hospital of Bonn, Bonn, Germany
| | - Sofia Ramiro
- Rheumatology, Leiden University Medical Center, Leiden, the Netherlands; Zuyderland Medical Center, Heerlen, the Netherlands
| | - Subrata Ghosh
- APC Microbiome Ireland, College of Medicine and Health, University College Cork, T12 E138 Cork, Ireland
| | - Maria Antonietta D'Agostino
- Rheumatology Fondazione Policlinico Universitario A. Gemelli,IRCSS and Università Cattolica del Sacro Cuore, Rome, Italy
| | - Britta Siegmund
- Department of Gastroenterology, Infectious Diseases and Rheumatology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | | | | | - Lorenzo Dagna
- IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Fernando Magro
- CINTESIS@RISE, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Renaud Felten
- Centre d'Investigation Clinique, INSERM CIC-1434, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Service de Rhumatologie, Centre National de Référence des Maladies Autoimmunes (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Département Universitaire de Pharmacologie-Addictologie, Toxicologie et Thérapeutique, Université de Strasbourg, Strasbourg, France
| | - Paulo Gustavo Kotze
- Health Sciences Postgraduate Program, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba 80215-901, Brazil
| | - Vipul Jairath
- Division of Gastroenterology, Department of Medicine, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences Humanitas University, Pieve Emanuele, Italy
| | - Lars Erik Kristensen
- The Parker Institute, University of Copenhagen & Bispebjerg University Hospital, Copenhagen, Denmark
| | - Laurent Peyrin Biroulet
- Department of Gastroenterology, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France; Inserm, NGERE, University of Lorraine, F-54000 Vandœuvre-lès-Nancy, France; INFINY Institute, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France; FHU-CURE, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France; Groupe Hospitalier Privé Ambroise Paré-Hartmann, Paris IBD Center, F-92200 Neuilly sur Seine, France; Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Silvio Danese
- Division of Gastroenterology and Gastrointestinal Endoscopy, IRCCS Ospedale San Raffaele, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy.
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23
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Pinter A, Costanzo A, Khattri S, Smith SD, Carrascosa JM, Tada Y, Riedl E, Reich A, Brnabic A, Haustrup N, Lampropoulou A, Lipkovich I, Kadziola Z, Paul C, Schuster C. Comparative Effectiveness and Durability of Biologics in Clinical Practice: Month 12 Outcomes from the International, Observational Psoriasis Study of Health Outcomes (PSoHO). Dermatol Ther (Heidelb) 2023:10.1007/s13555-023-01086-9. [PMID: 38113010 DOI: 10.1007/s13555-023-01086-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/08/2023] [Indexed: 12/21/2023] Open
Abstract
INTRODUCTION Given the chronic nature of psoriasis (PsO), more studies are needed that directly compare the effectiveness of different biologics over long observation periods. This study compares the effectiveness and durability through 12 months of anti-interleukin (IL)-17A biologics relative to other approved biologics in patients with moderate-to-severe psoriasis in a real-world setting. METHODS The Psoriasis Study of Health Outcomes (PSoHO) is an ongoing 3-year, prospective, non-interventional cohort study of 1981 adults with chronic moderate-to-severe plaque psoriasis initiating or switching to a new biologic. The study compares the effectiveness of anti-IL-17A biologics with other approved biologics and provides pairwise comparisons of seven individual biologics versus ixekizumab. The primary outcome was defined as the proportion of patients who had at least a 90% improvement in Psoriasis Area and Severity Index score (PASI90) and/or a score of 0 or 1 in static Physician Global Assessment (sPGA). Secondary objective comparisons included the proportion of patients who achieved PASI90, PASI100, a Dermatology Life Quality Index (DLQI) score of 0 or 1, and three different actions of durability of treatment response. Unadjusted response rates are presented alongside the primary analysis, which uses frequentist model averaging (FMA) to evaluate the adjusted comparative effectiveness. RESULTS Compared to the other biologics cohort, the anti-IL-17A cohort had a higher response rate (68.0% vs. 65.1%) and significantly higher odds of achieving the primary outcome at month 12. The two cohorts had similar response rates for PASI100 (40.5% and 37.1%) and PASI90 (53.9% and 51.7%) at month 12, with no significant differences between the cohorts in the adjusted analyses. At month 12, the response rates across the individual biologics were 53.5-72.6% for the primary outcome, 27.6-48.3% for PASI100, and 41.7-61.4% for PASI90. CONCLUSIONS These results show the comparative effectiveness of biologics at 6 and 12 months in the real-world setting. TRIAL REGISTRATION ClinicalTrials.gov identifier EUPAS24207.
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Affiliation(s)
- A Pinter
- University Hospital Frankfurt, Frankfurt am Main, Germany.
| | - A Costanzo
- Division of Dermatology, Humanitas Research Hospital, Pieve Emanuele, Milan, Italy
- Dermatology IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - S Khattri
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - S D Smith
- ANU Medical School, ANU College of Health and Medicine, The Australian National University, Canberra, Australia
| | - J M Carrascosa
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma of Barcelona, IGTP, Carretera de Canyet, S/N, 08916, Badalona, Barcelona, Spain
| | - Y Tada
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - E Riedl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - A Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | - A Brnabic
- Eli Lilly and Company, Indianapolis, USA
| | - N Haustrup
- Eli Lilly and Company, Indianapolis, USA
| | | | | | - Z Kadziola
- Eli Lilly and Company, Indianapolis, USA
| | - C Paul
- Université Paul Sabatier Toulouse III, Toulouse, France
| | - C Schuster
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
- Eli Lilly and Company, Indianapolis, USA
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24
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Gargiulo L, Ibba L, Pavia G, Avagliano J, Cortese A, Costanzo A, Narcisi A. Upadacitinib for the treatment of concomitant psoriasis and atopic dermatitis: a case series. J DERMATOL TREAT 2023; 34:2183729. [PMID: 36809172 DOI: 10.1080/09546634.2023.2183729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Purpose: The overlap of psoriasis and atopic dermatitis (AD) is rare and treating moderate-to-severe cases can be challenging. Conventional immune-suppressive drugs cannot be used long-term, and no biological drugs are currently approved for treating both conditions.Method: We report the cases of four patients with overlapping features of both psoriasis and AD.Result: After being treated with several systemic drugs, including gold-standard treatments for both psoriasis and AD, they received upadacitinib 15 or 30 mg, achieving complete remission. Upadacitinib is an inhibitor of Janus Kinase 1, currently approved for treating moderate-to-severe AD.Conclusion: To date, very limited data are available regarding the efficacy of upadacitinib in psoriasis. In a phase-3 trial on the efficacy of upadacitinib 15 mg in patients affected by psoriatic arthritis, 52.3% of patients achieved a 75% improvement in Psoriasis Area and Severity Index (PASI75) after one year. Currently, no clinical trials are evaluating the efficacy of upadacitinib in plaque psoriasis.
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Affiliation(s)
- Luigi Gargiulo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.,Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
| | - Luciano Ibba
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.,Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
| | - Giulia Pavia
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.,Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
| | - Jessica Avagliano
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
| | - Andrea Cortese
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.,Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
| | - Antonio Costanzo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.,Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
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25
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Gargiulo L, Ibba L, Vignoli CA, Facheris P, Valenti M, Costanzo A, Narcisi A. Tralokinumab rapidly improves subjective symptoms and quality of life in patients with moderate-to-severe atopic dermatitis: a real-life 16-week experience. J DERMATOL TREAT 2023; 34:2216815. [PMID: 37246920 DOI: 10.1080/09546634.2023.2216815] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Carlo Alberto Vignoli
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Paola Facheris
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Mario Valenti
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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26
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Vignoli CA, Gargiulo L, Sanna F, Narcisi A, Costanzo A. Adalimumab-induced paradoxical pustular psoriasis and alopecia successfully treated with ixekizumab in a patient affected by hidradenitis suppurativa. J DERMATOL TREAT 2023; 34:2256905. [PMID: 37705359 DOI: 10.1080/09546634.2023.2256905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 09/04/2023] [Indexed: 09/15/2023]
Affiliation(s)
- Carlo Alberto Vignoli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Luigi Gargiulo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Federica Sanna
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | | | - Antonio Costanzo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
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27
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Piscazzi F, Gargiulo L, Ibba L, Valenti M, Facheris P, Costanzo A, Narcisi A. Upadacitinib for the treatment of atopic dermatitis in the elderly: an Italian case series of seven patients. J DERMATOL TREAT 2023; 34:2245510. [PMID: 37558218 DOI: 10.1080/09546634.2023.2245510] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 12/31/2023] [Indexed: 08/11/2023]
Affiliation(s)
- Francesco Piscazzi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Luigi Gargiulo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Luciano Ibba
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Mario Valenti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Paola Facheris
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Antonio Costanzo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
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28
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Orsini D, Gargiulo L, Ibba L, Cascio Ingurgio R, Valenti M, Perugini C, Pacifico A, Maramao FS, Frascione P, Costanzo A, Narcisi A. Effectiveness of risankizumab in plaque psoriasis with involvement of difficult-to-treat areas: a real-world experience from two referral centers. J DERMATOL TREAT 2023; 34:2220849. [PMID: 37288760 DOI: 10.1080/09546634.2023.2220849] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The management of plaque psoriasis that affects difficult-to-treat areas can be challenging. Biologics have become the treatment of choice for moderate-to-severe plaque psoriasis. However, there are limited data on their efficacy in difficult-to-treat sites (including scalp, palms/soles, nails and genitalia). We conducted a 52-week retrospective study to evaluate the effectiveness of risankizumab in 202 patients with moderate-to-severe involvement of at least one difficult-to-treat area. One hundred and sixty-five patients had scalp psoriasis, 21 had involvement of palms or soles, 72 were affected by genital psoriasis, and 50 patients reported the involvement of the fingernails. After one year of treatment, 97.58% of patients with scalp involvement, 95.28% of patients with palmoplantar psoriasis, 100% of patients with genital psoriasis and 82% of patients with nail involvement achieved a site-specific Physician's Global Assessment of 0 or 1 (clear or almost clear). No serious adverse events were observed during the study. Our study supports the effectiveness of risankizumab in plaque psoriasis involving difficult-to-treat sites.
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Affiliation(s)
- Diego Orsini
- Clinical Dermatology Unit - San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Ruggero Cascio Ingurgio
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Mario Valenti
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Chiara Perugini
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
| | - Alessia Pacifico
- Clinical Dermatology Unit - San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Fabio S Maramao
- UOSD di Dermatologia, Fondazione Policlinico Tor Vergata, Università degli studi di Roma Tor Vergata
| | - Pasquale Frascione
- Dermatology Oncology Unit- San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
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29
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Gargiulo L, Ibba L, Vignoli CA, Ferrucci SM, Mercuri SR, Malagoli P, Marzano AV, Barbareschi M, Bianchi VG, Valenti M, Costanzo A, Narcisi A. Effectiveness and safety of baricitinib in patients with severe alopecia areata: a 36-week multicenter real-world experience. J DERMATOL TREAT 2023; 34:2268764. [PMID: 37818648 DOI: 10.1080/09546634.2023.2268764] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/04/2023] [Indexed: 10/12/2023]
Affiliation(s)
- Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Carlo A Vignoli
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Silvia M Ferrucci
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Santo R Mercuri
- Dermatology and Cosmetology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Piergiorgio Malagoli
- Department of Dermatology, Dermatology Unit Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - Angelo V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Mauro Barbareschi
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Vittoria G Bianchi
- Dermatology and Cosmetology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Mario Valenti
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Ibba L, Gargiulo L, Vignoli CA, Fiorillo G, Valenti M, Costanzo A, Narcisi A. Safety of anti-IL-23 drugs in patients with moderate-to-severe plaque psoriasis and previous tuberculosis infection: a monocentric retrospective study. J DERMATOL TREAT 2023; 34:2241585. [PMID: 37501617 DOI: 10.1080/09546634.2023.2241585] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Affiliation(s)
- Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Carlo Alberto Vignoli
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Giovanni Fiorillo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Mario Valenti
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Fiorillo G, Ibba L, Gargiulo L, Vignoli CA, Alfano A, Cortese A, Toso F, Orsini D, Iacovelli P, Frascione P, Narcisi A, Costanzo A, Valenti M. Effectiveness and safety of anti-IL-23 and anti-IL-17 biological therapies for psoriasis in elderly patients: Real-world experience from two Italian hospitals. J Eur Acad Dermatol Venereol 2023; 37:e1444-e1446. [PMID: 37458684 DOI: 10.1111/jdv.19355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/12/2023] [Indexed: 07/25/2023]
Affiliation(s)
- G Fiorillo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - L Ibba
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - L Gargiulo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - C A Vignoli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - A Alfano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - A Cortese
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - F Toso
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - D Orsini
- Clinical Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - P Iacovelli
- Clinical Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - P Frascione
- Dermatology Oncology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - A Narcisi
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - A Costanzo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - M Valenti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
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Merola JF, Chiou AS, During E, Costanzo A, Foley P, Alfalasi A, Gogate S, Pinter A, Dodiuk-Gad R, Simon D, Tauber M, Weller R, Pereyra-Rodriguez JJ, Ardeleanu M, Wu J, Ozturk ZE. Dupilumab significantly improves sleep in adults with atopic dermatitis: results from the 12-week placebo-controlled period of the 24-week phase IV randomized double-blinded placebo-controlled DUPISTAD study. Br J Dermatol 2023; 189:685-694. [PMID: 37562034 DOI: 10.1093/bjd/ljad284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Sleep disturbance is a prominent symptom of atopic dermatitis (AD) and can result in insomnia, daytime fatigue, drowsiness, reduced productivity and impaired quality of life (QoL). OBJECTIVES The Dupilumab Effect on Sleep in AD Patients (DUPISTAD) phase IV randomized double-blinded placebo-controlled study evaluated the impact of dupilumab treatment on sleep and other patient- and physician-reported outcomes. METHODS Adults with moderate-to-severe AD were randomized 2 : 1 to dupilumab 300 mg once every 2 weeks (q2w) or placebo for 12 weeks; concomitant topical corticosteroids were permitted. Patients subsequently entered an open-label phase and received dupilumab 300 mg q2w for a further 12 weeks. The primary endpoint was the percentage change in sleep quality from baseline to week 12, assessed using a novel numeric rating scale (NRS). Secondary and exploratory endpoints included percentage change in peak pruritus NRS (PP NRS), change in SCORing Atopic Dermatitis (SCORAD), SCORAD sleep visual analogue scale (VAS), Eczema Area and Severity Index, Patient-Reported Outcomes Measurement Information System (PROMIS) sleep-related impairment T-score and the Epworth Sleepiness Scale. Sleep diary and wrist actigraphy measurements were recorded throughout the study. RESULTS In total, 127 patients received dupilumab and 61 patients received placebo. Demographic and baseline disease characteristics were balanced between groups. Sleep quality NRS significantly improved in patients treated with dupilumab by week 12 vs. placebo [least squares mean of the difference (LSMD) -15.5%, P < 0.001]. PP NRS (LSMD -27.9%, P < 0.001), SCORAD (LSMD -15.1, P < 0.001), SCORAD sleep VAS (LSMD -2.1, P < 0.001) and PROMIS T-score (LSMD -3.6, P < 0.001) were also significantly improved at week 12 with dupilumab vs. placebo. The overall percentage of patients reporting treatment-emergent adverse events was lower in the dupilumab group (56.7%) than in the placebo group (67.2%). CONCLUSIONS Dupilumab significantly improved sleep quality and perception of sleep continuity, itch, metrics of AD severity and QoL in adults with moderate-to-severe AD, with an acceptable safety profile compared with placebo.
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Affiliation(s)
- Joseph F Merola
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Albert S Chiou
- Department of Dermatology, Stanford University, Palo Alto, CA, USA
| | - Emmanuel During
- Department of Neurology & Neurological Sciences, Stanford University, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, Division of Sleep Medicine, Stanford University, Palo Alto, CA, USA
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Peter Foley
- Skin Health Institute, Carlton, VIC, Australia
- Department of Dermatology, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
- Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia
| | | | | | - Andreas Pinter
- Department of Dermatology, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
| | - Roni Dodiuk-Gad
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Dermatology Department, Emek Medical Center, Afula, Israel
| | - Dagmar Simon
- Department of Dermatology, Universitätsspital Bern, Bern, Switzerland
| | - Marie Tauber
- Department of Allergology and Clinical Immunology, CIRI Inserm U1111, Lyon Sud Hospital, Lyon, France
| | - Richard Weller
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK
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Favaro R, Formai A, Pavia G, Gargiulo L, Avagliano J, Valenti M, Facheris P, Salsano B, Latorre RV, Bellinato F, Gisondi P, Narcisi A, Costanzo A. The impact of biologic therapy for moderate-to-severe psoriasis on the immune responses to SARS-CoV-2 infection and vaccination. Br J Dermatol 2023; 189:635-637. [PMID: 37463513 DOI: 10.1093/bjd/ljad242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/05/2023] [Accepted: 08/05/2023] [Indexed: 07/20/2023]
Abstract
Biologic therapy for moderate-to-severe psoriasis with anti-IL-23 and anti-IL-17 does not reduce the humoral and T-cell-mediated immune responses after COVID infection or vaccination; on the contrary, anti-IL-23 treatment was associated with a higher level of specific IgG following vaccination. In contrast, conventional therapies and TNF-α blockade reduce the production of specific antibodies.
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Affiliation(s)
- Rebecca Favaro
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Alessandra Formai
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Giulia Pavia
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Luigi Gargiulo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Jessica Avagliano
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Mario Valenti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Paola Facheris
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Beatrice Salsano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Roberta V Latorre
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Department of Medicine, Division of General Pathology, University of Verona, Verona, Italy
| | - Francesco Bellinato
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - Paolo Gisondi
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - Alessandra Narcisi
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Antonio Costanzo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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Ciolfi C, Balestri R, Bardazzi F, Burlando M, Chersi K, Costanzo A, Dapavo P, Gisondi P, Malagoli P, Pizzolato M, Rech G, Russo FP, Battistella S, Piaserico S. Safety profile of risankizumab in the treatment of psoriasis patients with concomitant hepatitis B or C infection: A multicentric retrospective cohort study of 49 patients. J Eur Acad Dermatol Venereol 2023; 37:e1203-e1207. [PMID: 37170951 DOI: 10.1111/jdv.19186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/05/2023] [Indexed: 05/13/2023]
Affiliation(s)
- Christian Ciolfi
- Dermatology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | | | - Federico Bardazzi
- Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Sant'Orsola Polyclinic, University of Bologna, Bologna, Italy
| | - Martina Burlando
- Department of Dermatology, Dipartimento di Scienze della Salute-DISSAL, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Karin Chersi
- ASUGI-Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Antonio Costanzo
- Unit of Dermatology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Paolo Dapavo
- Department of Medical Sciences, Section of Dermatology, University of Turin, Torino, Italy
| | - Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | | | - Miriam Pizzolato
- Division of Dermatology, Santa Maria della Misericordia Hospital, Rovigo, Italy
| | - Giulia Rech
- Division of Dermatology, Santa Chiara Hospital, Trento, Italy
| | - Francesco Paolo Russo
- Gastroenterology and Multivisceral Transplant Unit, Azienda Ospedale - Università di Padova, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Sara Battistella
- Gastroenterology and Multivisceral Transplant Unit, Azienda Ospedale - Università di Padova, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Stefano Piaserico
- Dermatology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
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Gargiulo L, Ibba L, Valenti M, Orsini D, Cristaudo A, Frascione P, Costanzo A, Narcisi A. Safety of Interleukin Inhibitors in Patients with Plaque Psoriasis and Neoplasm: A Retrospective Study from Two Referral Centers. Clin Drug Investig 2023; 43:807-812. [PMID: 37715898 DOI: 10.1007/s40261-023-01306-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 09/18/2023]
Affiliation(s)
- Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy.
| | - Mario Valenti
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Diego Orsini
- UOC Dermatologia Clinica, Istituto Dermatologico San Gallicano (IRCCS), Rome, Italy
| | - Antonio Cristaudo
- UOC Dermatologia Clinica, Istituto Dermatologico San Gallicano (IRCCS), Rome, Italy
| | - Pasquale Frascione
- UOSD Dermatologia Oncologica, Istituto Dermatologico San Gallicano (IRCCS), Rome, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Alessandra Narcisi
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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Costanzo A, Llamas-Velasco M, Fabbrocini G, Cuccia A, Rivera-Diaz R, Gaarn Du Jardin K, Kasujee I, Puig L, Carrascosa JM. Tildrakizumab improves high burden skin symptoms, impaired sleep and quality of life of moderate-to-severe plaque psoriasis patients in conditions close to clinical practice. J Eur Acad Dermatol Venereol 2023; 37:2004-2015. [PMID: 37246505 DOI: 10.1111/jdv.19229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 04/20/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Tildrakizumab (TIL) is an interleukin (IL)-23p19 inhibitor for the treatment of moderate-to-severe plaque psoriasis with long-term efficacy and safety demonstrated in Phase III trials. Studies conducted in conditions closer to clinical practice are needed. OBJECTIVES The TRIBUTE study (open-label, Phase IV) assessed the efficacy and impact on health-related quality of life (HRQoL) of TIL 100 mg in adult moderate-to-severe psoriasis patients (naïve to IL-23/Th17 pathway inhibitors) in conditions similar to clinical practice. METHODS Key efficacy measure was Psoriasis Area Severity Index (PASI). HRQoL was evaluated using the Dermatology Life Quality Index (DLQI) and Skindex-16. Additional patient-reported outcomes included Pain-, Pruritus- and Scaling-Numerical Rating Scale (NRS), Medical Outcome Study (MOS)-Sleep, Work Productivity and Activity Impairment (WPAI), Patient Benefit Index (PBI) and Treatment Satisfaction Questionnaire for Medication (TSQM). RESULTS One hundred and seventy-seven patients were enrolled (six patients did not complete the study). After 24 weeks, the proportion of patients achieving PASI scores ≤ 3, PASI 75, PASI 90 and DLQI 0/1 was 88.4%, 92.5%, 74.0% and 70.4%, respectively. Skindex-16 overall score improved (mean absolute change from baseline, MACB [95%CI]: -53.3 [-58.1, -48.5]). Significant benefits (MACB [95%CI]) were found on pruritus-, pain- and scaling-NRS scores (-5.7 [-6.1, -5.2], -3.5 [-4.1, -3.0] and -5.7 [-6.2, -5.2], respectively), MOS-Sleep (-10.4 [-13.3, -7.4] Sleep problems Index II) and WPAI (-36.4 [-42.6, -30.2] activity impairment, -28.2 [-34.7, -21.7] productivity loss, -27.0 [-32.9, -21.1] presenteeism and -6.8 [-12.1, -1.5] absenteeism). 82.7% of patients reported PBI ≥ 3 and the mean (SD) global TSQM score was high (80.5 [18.5]). Only one serious treatment-emergent adverse event was reported (not-related to TIL). CONCLUSIONS TIL 100 mg treatment after 24 weeks in conditions close to real clinical practice showed a quick and high improvement in psoriasis signs and HRQoL. Patient reported improvements in sleep outcomes and work productivity, relevant benefits and high treatment satisfaction. The safety profile was favourable and consistent with Phase III trials.
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Affiliation(s)
- Antonio Costanzo
- Section of Dermatology, Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Mar Llamas-Velasco
- Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Aldo Cuccia
- Unit of Dermatology, San Donato Hospital, Arezzo, Italy
| | - Raquel Rivera-Diaz
- Department of Dermatology, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain
| | | | | | - Lluís Puig
- Department of Dermatology, IIB SANTPAU, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Cortese A, Gargiulo L, Ibba L, Fiorillo G, Toso F, Vignoli CA, Narcisi A, Costanzo A, Valenti M. Anti-interleukin-17 and anti-interleukin-23 biologic drugs for genital psoriasis: a single-center retrospective comparative study. Dermatol Reports 2023; 15:9692. [PMID: 37790655 PMCID: PMC10543193 DOI: 10.4081/dr.2023.9692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 02/24/2023] [Indexed: 10/05/2023] Open
Abstract
Genital psoriasis affects 3-33% of patients with psoriasis during the course of the disease, usually leading to a severe reduction in the patient's quality of life. This study aims to retrospectively assess the effectiveness of interleukin (IL)-23 and IL-17 inhibitors in a real-life population affected by moderate-to-severe plaque psoriasis with genital involvement coming from our dermatology department. A total of 86 patients with a diagnosis of moderate-tosevere plaque psoriasis with severe genital involvement were enrolled. Patient characteristics, psoriasis area and severity index (PASI), and static physician global assessment of genitalia (sPGAG) at each visit were recorded. During the treatment, the mean PASI decreased from 12.8 to 0.63 at week 52; a PGA of 0/1 was reached by 97.40% at week 52 and by 100% of patients (37/37) at week 104. No significant differences between IL-23 and IL-17 inhibitors were observed; indeed, the bio-naïve group of patients demonstrated a superior response compared to the group of bioexperienced patients.Our findings confirmed that IL-23 and IL-17 inhibitors are safe and effective therapeutic options for the treatment of genital psoriasis.
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Affiliation(s)
- Andrea Cortese
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele
- Dermatology Unit, Humanitas IRCCS Research Hospital, Rozzano, Italy
| | - Luigi Gargiulo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele
- Dermatology Unit, Humanitas IRCCS Research Hospital, Rozzano, Italy
| | - Luciano Ibba
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele
- Dermatology Unit, Humanitas IRCCS Research Hospital, Rozzano, Italy
| | - Giovanni Fiorillo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele
- Dermatology Unit, Humanitas IRCCS Research Hospital, Rozzano, Italy
| | - Francesco Toso
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele
- Dermatology Unit, Humanitas IRCCS Research Hospital, Rozzano, Italy
| | - Carlo Alberto Vignoli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele
- Dermatology Unit, Humanitas IRCCS Research Hospital, Rozzano, Italy
| | | | - Antonio Costanzo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele
- Dermatology Unit, Humanitas IRCCS Research Hospital, Rozzano, Italy
| | - Mario Valenti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele
- Dermatology Unit, Humanitas IRCCS Research Hospital, Rozzano, Italy
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Gargiulo L, Narcisi A, Ibba L, Balato A, Bianchi L, Brianti P, Buononato D, Burlando M, Caldarola G, Campanati A, Campione E, Carrera CG, Carugno A, Cristaudo A, Cusano F, Dapavo P, Dattola A, De Simone C, Gaiani FM, Gisondi P, Giunta A, Loconsole F, Maione V, Mortato E, Marzano AV, Maurelli M, Megna M, Mercuri SR, Offidani A, Orsini D, Parodi A, Pellacani G, Potestio L, Quaglino P, Richetta AG, Romano F, Sena P, Venturini M, Malagoli P, Costanzo A. Effectiveness and safety of bimekizumab for the treatment of plaque psoriasis: a real-life multicenter study-IL PSO (Italian landscape psoriasis). Front Med (Lausanne) 2023; 10:1243843. [PMID: 37614958 PMCID: PMC10442506 DOI: 10.3389/fmed.2023.1243843] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 07/27/2023] [Indexed: 08/25/2023] Open
Abstract
Introduction Bimekizumab is a monoclonal antibody that targets Interleukin-17 A and F, approved for the treatment of moderate-to-severe plaque psoriasis. While bimekizumab has been evaluated in several phase-III clinical trials, real-world evidence is still very limited. Method This multicenter retrospective study included patients affected by plaque psoriasis treated with bimekizumab from May 1, 2022 to April 30, 2023, at 19 Italian referral hospitals. Patients affected by moderate-to-severe plaque psoriasis eligible for systemic treatments were included. The effectiveness of bimekizumab was evaluated in terms of reduction in psoriasis area and severity index (PASI) compared with baseline at weeks 4 and 16. The main outcomes were the percentages of patients achieving an improvement of at least 75% (PASI75), 90% (PASI90) and 100% (PASI100) in PASI score. Results The study included 237 patients who received at least one injection of bimekizumab. One hundred and seventy-one patients and 114 reached four and 16 weeks of follow-up, respectively. Complete skin clearance was achieved by 43.3% and 75.4% of patients at weeks 4 and 16, respectively. At week 16, 86.8% of patients reported no impact on their quality of life. At week 16, there were no significant differences between bio-naïve and bio-experienced patients in terms of PASI75, PASI90 and PASI100. The most commonly reported adverse events (AEs) were oral candidiasis (10.1%). No severe AEs or AEs leading to discontinuation were observed throughout the study. Conclusion Our experience supports the effectiveness and tolerability of bimekizumab in a real-world setting with similar results compared with phase-III clinical trials.
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Affiliation(s)
- Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | - Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Anna Balato
- Dermatology Unit, University of Campania L. Vanvitelli, Naples, Italy
| | - Luca Bianchi
- Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Pina Brianti
- Unit of Dermatology and Cosmetology, Vita-Salute San Raffaele University and Institute for Research and Care, Milan, Italy
| | - Dario Buononato
- Dermatology Unit, University of Campania L. Vanvitelli, Naples, Italy
| | - Martina Burlando
- Section of Dermatology, Department of Health Sciences (DISSAL), IRCCS San Martino University Hospital, Genoa, Italy
| | - Giacomo Caldarola
- Section of Dermatology, Department of Translational Medicine and Surgery, Catholic University of the Sacred Heart, Rome, Italy
- Dermatology Unit, Agostino Gemelli University Hospital, Rome, Italy
| | - Anna Campanati
- Department of Clinical and Molecular Sciences—Dermatological Clinic, Università Politecnica delle Marche, Ancona, Italy
| | - Elena Campione
- Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Carlo G. Carrera
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Carugno
- Dermatology Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
- PhD Program in Molecular and Translational Medicine (DIMET), University of Milan-Bicocca, Milan, Italy
| | - Antonio Cristaudo
- Clinical Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Francesco Cusano
- Department of Dermatology, Gaetano Rummo Hospital, Benevento, Italy
| | - Paolo Dapavo
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - Annunziata Dattola
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | - Clara De Simone
- Section of Dermatology, Department of Translational Medicine and Surgery, Catholic University of the Sacred Heart, Rome, Italy
- Dermatology Unit, Agostino Gemelli University Hospital, Rome, Italy
| | - Francesca M. Gaiani
- Department of Dermatology, Dermatology Unit Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - Paolo Gisondi
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - Alessandro Giunta
- Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Vincenzo Maione
- Department of Dermatology, ASST Spedali Civili Hospital, Brescia, Italy
| | | | - Angelo V. Marzano
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Martina Maurelli
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Santo R. Mercuri
- Unit of Dermatology and Cosmetology, Vita-Salute San Raffaele University and Institute for Research and Care, Milan, Italy
| | - Annamaria Offidani
- Department of Clinical and Molecular Sciences—Dermatological Clinic, Università Politecnica delle Marche, Ancona, Italy
| | - Diego Orsini
- Clinical Dermatology Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Aurora Parodi
- Section of Dermatology, Department of Health Sciences (DISSAL), IRCCS San Martino University Hospital, Genoa, Italy
| | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Pietro Quaglino
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - Antonio G. Richetta
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | - Francesca Romano
- Department of Precision Medicine, Dermatology Unit, Università degli Studi della Campania L. Vanvitelli, Naples, Italy
| | - Paolo Sena
- Dermatology Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Marina Venturini
- Department of Dermatology, ASST Spedali Civili Hospital, Brescia, Italy
| | - Piergiorgio Malagoli
- Department of Dermatology, Dermatology Unit Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Thyssen JP, de Bruin-Weller M, Costanzo A, Grond S, Schuster C, Liu C, Rueda MJ, Chen YF, Pinter A, Bieber T. Baseline Body Surface Area and Itch Severity Define Response to Baricitinib in Patients with Moderate-to-Severe Atopic Dermatitis at Week 16. Adv Ther 2023; 40:3574-3587. [PMID: 37332021 PMCID: PMC10329959 DOI: 10.1007/s12325-023-02528-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/19/2023] [Indexed: 06/20/2023]
Abstract
INTRODUCTION Atopic dermatitis (AD) is a chronic, inflammatory skin disease characterized by heterogeneous clinical phenotypes and high symptom burden, especially through itch. Baricitinib (BARI), an oral Janus Kinase 1/2 inhibitor, is approved in Europe, Japan, and other countries, for treatment of adults with moderate-to-severe AD who are candidates for systemic therapy. This post hoc analysis of a Phase 3 topical corticosteroid (TCS) combination therapy trial (BREEZE-AD7) aims to characterize patients who might benefit most from BARI. METHOD Classification and regression tree (CART) analysis was used to identify baseline predictors for patients treated with BARI 4-mg, who achieved ≥ 75% improvement in Eczema Area and Severity Index (EASI75), or EASI75 or Itch Numerical Rating Scale (NRS) ≥ 4-point improvement at week 16 (responders), versus non-responders. Subgroup efficacy analyses were performed based on identified predictor variables, combined with Itch NRS < 7/ ≥ 7. Missing data were imputed as non-responder. RESULTS Baseline body surface area (BSA) was identified by CART as strongest variable predicting response to BARI at week 16, with a cut-off around 40% (BSA ≤ 40%). When combining BSA with itch severity, highest response rates were achieved by BARI patients with BSA ≤ 40%/Itch NRS ≥ 7 at baseline. In this subgroup, 69% and 58% of patients treated with BARI 4-mg achieved EASI75 and Itch NRS ≥ 4-point response at week 16, respectively. While these response rates were 65% and 50% for BARI 4-mg patients with baseline BSA ≤ 40%/Itch NRS < 7, they were 33% and 11% in BSA > 40%/Itch NRS < 7, and 32% and 49% in BSA > 40%/Itch NRS ≥ 7 subgroups, respectively. CONCLUSION Using a machine learning approach, patients with moderate-to-severe AD and a BSA affecting 10-40% and Itch NRS ≥ 7 were characterized as likely to benefit most from BARI 4-mg TCS combination therapy. This was confirmed by subgroup analyses, which showed that these patients are most likely to show favorable response rates in improving AD signs and symptoms, specifically itch, after 16 weeks of treatment.
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Affiliation(s)
- Jacob P Thyssen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
| | - Marjolein de Bruin-Weller
- Department of Dermatology and Allergology, National Expertise Center of Atopic Dermatitis, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Antonio Costanzo
- Dermatology, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Dermatology, Humanitas Research Hospital, Rozzano, Milan, Italy
| | | | - Christopher Schuster
- Eli Lilly and Company, Indianapolis, IN, USA
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | | | | | | | - Andreas Pinter
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Thomas Bieber
- Department of Dermatology and Allergy, University Hospital, Bonn, Germany
- Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
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Gargiulo L, Ibba L, Malagoli P, Amoruso F, Argenziano G, Balato A, Bardazzi F, Burlando M, Carrera CG, Damiani G, Dapavo P, Dini V, Fabbrocini G, Franchi C, Gaiani FM, Girolomoni G, Guarneri C, Lasagni C, Loconsole F, Marzano AV, Megna M, Sampogna F, Travaglini M, Costanzo A, Narcisi A. Brodalumab for the treatment of plaque psoriasis in a real-life setting: a 3 years multicenter retrospective study-IL PSO (Italian landscape psoriasis). Front Med (Lausanne) 2023; 10:1196966. [PMID: 37469659 PMCID: PMC10352451 DOI: 10.3389/fmed.2023.1196966] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/16/2023] [Indexed: 07/21/2023] Open
Abstract
Introduction Brodalumab is a monoclonal antibody that targets the subunit A of the interleukin-17A receptor (IL17RA), inhibiting the signaling of various isoforms of the IL-17 family. It has been approved for the treatment of moderate-to-severe plaque psoriasis after being evaluated in three Phase-3 trials. However, long-term data on brodalumab in a real-life setting are still limited. Methods The aim of this study was to evaluate the long-term effectiveness and safety of brodalumab in psoriasis. We also assessed the drug survival of brodalumab in a 3 years timespan. We conducted a retrospective multicenter study on 606 patients followed up at 14 Italian dermatology units, all treated with brodalumab according to Italian guidelines. Patients' demographics and disease characteristics were retrieved from electronic databases. At baseline and weeks 12, 24, 52, 104 and 156, we evaluated the psoriasis area and severity index (PASI) score and investigated for adverse events. The proportions of patients reaching 75, 90 and 100% (PASI 75, PASI 90 and PASI 100, respectively) improvement in PASI, compared with baseline, were also recorded. Results At week 12, 63.53% of the patients reached PASI 90 and 49.17% PASI 100. After 3 years of treatment, 65.22% of patients maintained a complete skin clearance, and 91.30% had an absolute PASI of 2 or less. Patients naïve to biological therapies had better clinical responses at weeks 12, 24 and 52. However, after 2 years of treatment, no significant differences were observed. Body mass index did not interfere with the effectiveness of brodalumab throughout the study. No new safety findings were recorded. After 36 months, 85.64% of our patients were still on treatment with brodalumab. Conclusion Our data confirm the effectiveness and the safety of brodalumab in the largest real-life cohort to date, up to 156 weeks.
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Affiliation(s)
- Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Piergiorgio Malagoli
- Dermatology Unit, Department of Dermatology, Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - Fabrizio Amoruso
- Dermatology Unit, Azienda Ospedaliera di Cosenza, Cosenza, Italy
| | | | - Anna Balato
- Dermatology Unit, University of Campania L. Vanvitelli, Naples, Italy
| | - Federico Bardazzi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola Malpighi, Bologna, Italy
| | - Martina Burlando
- Department of Dermatology, Dipartimento di Scienze della Salute (DISSAL), University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Carlo Giovanni Carrera
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Damiani
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
| | - Paolo Dapavo
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - Valentina Dini
- Dermatology Unit, Department of Clinical and Experimental Medicine, Ospedale Santa Chiara, Pisa, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Chiara Franchi
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
| | - Francesca Maria Gaiani
- Dermatology Unit, Department of Dermatology, Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - Giampiero Girolomoni
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - Claudio Guarneri
- Unit of Dermatology, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, AOU Policlinico G. Martino, Messina, Italy
| | - Claudia Lasagni
- Department of Specialized Medicine, Dermatological Clinic, University of Modena, Modena, Italy
| | | | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Francesca Sampogna
- Clinical Epidemiology Unit, Istituto Dermopatico dell’Immacolata (IDI) IRCCS, Rome, Italy
| | - Massimo Travaglini
- U.O.S.D. dermatologica—centro per la cura della psoriasi, Ospedale Perrino, Brindisi, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Gargiulo L, Vignoli CA, Cortese A, Ibba L, Costanzo A, Narcisi A. Real-Life Safety and Effectiveness of Dupilumab in Patients with Concomitant Malignancies: a Case Series. Dermatol Pract Concept 2023; 13:e2023143. [PMID: 37557123 PMCID: PMC10412017 DOI: 10.5826/dpc.1303a143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 08/11/2023] Open
Affiliation(s)
- Luigi Gargiulo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Carlo Alberto Vignoli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Andrea Cortese
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Luciano Ibba
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Antonio Costanzo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Alessandra Narcisi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
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Motta F, Morandini P, Maffia F, Vecellio M, Tonutti A, De Santis M, Costanzo A, Puggioni F, Savevski V, Selmi C. Connecting the use of innovative treatments and glucocorticoids with the multidisciplinary evaluation through rule-based natural-language processing: a real-world study on patients with rheumatoid arthritis, psoriatic arthritis, and psoriasis. Front Med (Lausanne) 2023; 10:1179240. [PMID: 37387783 PMCID: PMC10301822 DOI: 10.3389/fmed.2023.1179240] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/15/2023] [Indexed: 07/01/2023] Open
Abstract
Background The impact of a multidisciplinary management of rheumatoid arthritis (RA), psoriatic arthritis (PsA), and psoriasis on systemic glucocorticoids or innovative treatments remains unknown. Rule-based natural language processing and text extraction help to manage large datasets of unstructured information and provide insights into the profile of treatment choices. Methods We obtained structured information from text data of outpatient visits between 2017 and 2022 using regular expressions (RegEx) to define elastic search patterns and to consider only affirmative citation of diseases or prescribed therapy by detecting negations. Care processes were described by binary flags which express the presence of RA, PsA and psoriasis and the prescription of glucocorticoids and biologics or small molecules in each cases. Logistic regression analyses were used to train the classifier to predict outcomes using the number of visits and the other specialist visits as the main variables. Results We identified 1743 patients with RA, 1359 with PsA and 2,287 with psoriasis, accounting for 5,677, 4,468 and 7,770 outpatient visits, respectively. Among these, 25% of RA, 32% of PsA and 25% of psoriasis cases received biologics or small molecules, while 49% of RA, 28% of PsA, and 40% of psoriasis cases received glucocorticoids. Patients evaluated also by other specialists were treated more frequently with glucocorticoids (70% vs. 49% for RA, 60% vs. 28% for PsA, 51% vs. 40% for psoriasis; p < 0.001) as well as with biologics/small molecules (49% vs. 25% for RA, 64% vs. 32% in PsA; 51% vs. 25% for psoriasis; p < 0.001) compared to cases seen only by the main specialist. Conclusion Patients with RA, PsA, or psoriasis undergoing multiple evaluations are more likely to receive innovative treatments or glucocorticoids, possibly reflecting more complex cases.
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Affiliation(s)
- Francesca Motta
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Pierandrea Morandini
- Artificial Intelligence Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Fiore Maffia
- Artificial Intelligence Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Matteo Vecellio
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Centro Ricerche Fondazione Italiana Ricerca Sull'Artrite (FIRA), Fondazione Pisana per la Scienza ONLUS, San Giuliano Terme (Pisa), Milan, Italy
| | - Antonio Tonutti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Maria De Santis
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Antonio Costanzo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Division of Dermatology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Francesca Puggioni
- Division of Asthma, Allergy and Personalized Medicine, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Victor Savevski
- Artificial Intelligence Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Carlo Selmi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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Gargiulo L, Ibba L, Cortese A, Alfano A, Valenti M, Costanzo A, Narcisi A. Intra-Class Switch Among IL-23 Inhibitors for Plaque Psoriasis: Is It Worth It? Clin Drug Investig 2023; 43:365-367. [PMID: 37155117 DOI: 10.1007/s40261-023-01271-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2023] [Indexed: 05/10/2023]
Affiliation(s)
- Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, 20090, Pieve Emanuele, MI, Italy
| | - Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy.
- Department of Biomedical Sciences, Humanitas University, 20090, Pieve Emanuele, MI, Italy.
| | - Andrea Cortese
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, 20090, Pieve Emanuele, MI, Italy
| | - Angela Alfano
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, 20090, Pieve Emanuele, MI, Italy
| | - Mario Valenti
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, 20090, Pieve Emanuele, MI, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
- Department of Biomedical Sciences, Humanitas University, 20090, Pieve Emanuele, MI, Italy
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Borroni RG, Piscazzi F, Valenti M, Rimoldi V, Barile M, Bianchi P, Favaro R, Formai A, Selicorni A, Manara S, Vinci V, Lania AG, Costanzo A. Multiple facial angiofibromas: A manifestation of Frank-ter Haar syndrome? Am J Med Genet A 2023. [PMID: 37141407 DOI: 10.1002/ajmg.a.63231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/17/2023] [Accepted: 04/24/2023] [Indexed: 05/06/2023]
Affiliation(s)
- Riccardo G Borroni
- Dermatology Unit, Humanitas Research Hospital, IRCCS, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Francesco Piscazzi
- Dermatology Unit, Humanitas Research Hospital, IRCCS, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Mario Valenti
- Dermatology Unit, Humanitas Research Hospital, IRCCS, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Valeria Rimoldi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Monica Barile
- U.O. Laboratorio Analisi, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy
| | - Paolo Bianchi
- U.O. Laboratorio Analisi, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy
| | - Rebecca Favaro
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Skin Pathology Lab, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Alessandra Formai
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Skin Pathology Lab, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Angelo Selicorni
- Pediatrics Unit, Mariani Foundation Center for Fragile Child ASST-Lariana, Sant'Anna Hospital, San Fermo della Battaglia, Como, Italy
| | - Sofia Manara
- Pathology, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy
| | - Valeriano Vinci
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Plastic and Reconstructive Surgery Unit, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy
| | - Andrea G Lania
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Endocrinology, Humanitas Research Hospital-IRCCS, Rozzano, Milan, Italy
| | - Antonio Costanzo
- Dermatology Unit, Humanitas Research Hospital, IRCCS, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
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Gargiulo L, Vignoli CA, Ibba L, Cortese A, Valenti M, Costanzo A, Narcisi A. Real-life effectiveness and safety of dupilumab in adolescents with atopic dermatitis: a 52-week single-center retrospective study. J DERMATOL TREAT 2023; 34:2200867. [PMID: 37026618 DOI: 10.1080/09546634.2023.2200867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Dupilumab is a monoclonal antibody that selectively targets the alpha subunit of the interleukin-4-Receptor and it is approved for the treatment of atopic dermatitis in adults, children and adolescents. Real life data on effectiveness and safety of dupilumab in adolescents are limited.In this study, 30 patients who started dupilumab between the ages of 12 and 18 were evaluated. All patients completed at least 16 weeks of therapy, with 25 reaching week 52. In our experience, the mean Eczema Area and Severity Index decreased from 23.25 ± 4.15 at baseline to 2.06 ± 1.99 at week 52.
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Affiliation(s)
- Luigi Gargiulo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - Carlo Alberto Vignoli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - Luciano Ibba
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - Andrea Cortese
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - Mario Valenti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - Antonio Costanzo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - Alessandra Narcisi
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
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Ibba L, Gargiulo L, Alfano A, Cascio Ingurgio R, Narcisi A, Costanzo A, Valenti M. Anti-IL-23 and anti-IL-17 drugs for the treatment of non-pustular palmoplantar psoriasis: a real-life retrospective study. J DERMATOL TREAT 2023; 34:2199108. [PMID: 37010456 DOI: 10.1080/09546634.2023.2199108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
Palmoplantar psoriasis is a subtype of psoriasis that occurs in 12-26% of patients during the natural history of the disease. Limited data are available regarding the use of biologics in psoriasis with the involvement of palms or soles. We conducted a retrospective study to assess the effectiveness of anti-Interleukin (IL)-23 and anti-IL-17 in palmoplantar psoriasis over 104 weeks. No statistically significant differences were observed between the two subgroups throughout the study period. After 52 weeks, 80.95% of patients treated with anti-IL-23 and 64.86% receiving an anti-IL-17 achieved a ppPGA of 0 or 1. No serious AEs or AEs leading to discontinuation were observed. Our findings support the effectiveness of IL inhibitors in this difficult-to-treat area.
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Affiliation(s)
- Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Angela Alfano
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Ruggero Cascio Ingurgio
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | | | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Mario Valenti
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano (MI)
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
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Gargiulo L, Vignoli CA, Pavia G, Narcisi A, Costanzo A, Perugini C. Risankizumab for the Treatment of Palmoplantar Pustular Psoriasis: a Report of Two Cases. Dermatol Pract Concept 2023; 13:dpc.1302a97. [PMID: 37196292 DOI: 10.5826/dpc.1302a97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 05/19/2023] Open
Affiliation(s)
- Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
| | - Carlo Alberto Vignoli
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
| | - Giulia Pavia
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
| | - Alessandra Narcisi
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
| | - Chiara Perugini
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
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Cortese A, Pancetti S, Pressiani T, Toso F, Fiorillo G, Costanzo A, Borroni RG. Sorafenib-Induced Acute Generalized Exanthematous Pustulosis. Dermatol Pract Concept 2023; 13:dpc.1302a130. [PMID: 37196299 DOI: 10.5826/dpc.1302a130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2022] [Indexed: 05/19/2023] Open
Affiliation(s)
- Andrea Cortese
- Dermatology, Humanitas Research Hospital - IRCCS, Rozzano (MI), Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - Saverio Pancetti
- Pathology, Humanitas Research Hospital - IRCCS, Rozzano (MI), Italy
| | | | - Francesco Toso
- Dermatology, Humanitas Research Hospital - IRCCS, Rozzano (MI), Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - Giovanni Fiorillo
- Dermatology, Humanitas Research Hospital - IRCCS, Rozzano (MI), Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - Antonio Costanzo
- Dermatology, Humanitas Research Hospital - IRCCS, Rozzano (MI), Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - Riccardo Giovanni Borroni
- Dermatology, Humanitas Research Hospital - IRCCS, Rozzano (MI), Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
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Talamonti M, Russo F, Malara G, Hansel K, Papini M, Cattaneo A, Parodi A, Chiricozzi A, Malagoli P, Bardazzi F, Brazzelli V, Dapavo P, Gisondi P, Zane C, Potenza C, Cantoresi F, Fargnoli MC, Trevisini S, Brianti P, Pescitelli L, Gigante G, Bartezaghi M, Caputo L, Aloisi E, Costanzo A. Efficacy and Safety of Secukinumab in Elderly Patients with Moderate to Severe Plaque-Type Psoriasis: Post-Hoc Analysis of the SUPREME Study. Clin Cosmet Investig Dermatol 2023; 16:847-852. [PMID: 37033782 PMCID: PMC10075320 DOI: 10.2147/ccid.s400520] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/21/2023] [Indexed: 04/04/2023]
Abstract
Purpose Secukinumab is a fully human monoclonal antibody that inhibits interleukin (IL)-17A approved for the treatment of moderate to severe plaque psoriasis in adults and children. We compared the efficacy and safety of secukinumab in patients aged < 65 years (adult patients) versus patients aged ≥ 65 years (elderly patients) in a post-hoc analysis of the SUPREME study. Patients and Methods Patients with moderate to severe plaque psoriasis received subcutaneous secukinumab 300 mg per week for the first 5 weeks, then 300 mg per month. We compared the following outcomes in patients aged ≥ 65 years vs < 65 years: baseline characteristics; PASI50/75/90/100 response rates (improvements ≥ 50%/75%/90%/100% in Psoriasis Area and Severity Index (PASI) from baseline); changes in Dermatology Life Quality Index (DLQI); Hospital Anxiety and Depression Scale (HAD-A, HAD-D) score changes; treatment-emergent adverse events (TEAEs). Results Secukinumab was slightly less effective in elderly patients than in adult patients (response rates at week 16: PASI90, 69.4% vs 80.9%, p = 0.4528; PASI100, 44.4% vs 56.7%, p = 0.8973). Elderly and adult patients showed a similar time course of changes in absolute PASI scores. Patients aged ≥ 65 years had a statistically significantly lower improvement in quality of life (mean DLQI reduction) than patients aged < 65 years at week 16 [-5.4 (±4.3) vs -8.8 (±6.9), p = 0.0065] and at week 24 [-5.3 (±4.4) vs -9.2 (±7.1), p = 0.0038]. Secukinumab treatment resulted in comparable mean reductions in anxiety and depression scores in both cohorts at 24 weeks [HAD-A, -1.3 (±3.3) vs -2.1 (±3.8), p = 0.9004; HAD-D, -1.0 (±3.3) vs -1.5 (±3.1), p = 0.4598]. The frequency of TEAEs in the two cohorts was similar (16.7% vs 14.6%, p = 0.7391). Conclusion Secukinumab is a valid option for the management of moderate to severe psoriasis in elderly patients.
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Affiliation(s)
- Marina Talamonti
- Dermatology, University of Rome Tor Vergata, Rome, Italy
- Correspondence: Marina Talamonti, Dermatology-Department of Systems Medicine, University of Rome Tor Vergata, PTV – Policlinico Tor Vergata, V.le Oxford 81, Rome, 00133, Italy, Tel +39 0620902743, Fax +39 0620902742, Email
| | - Filomena Russo
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - Giovanna Malara
- Dermatology Unit, Hospital “Bianchi Melacrino Morelli”, Reggio, Calabria, Italy
- Department of Dermatology, Papardo Hospital, Messina, Italy
| | - Katharina Hansel
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Manuela Papini
- Dermatologic Clinic of Terni, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Angelo Cattaneo
- U.O. Dermatologia, Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Milano, Italy
| | - Aurora Parodi
- Di.S.Sal. Section of Dermatology, Ospedale Policlinico San Martino, University of Genova, Genova GE, 16132, Italy
| | - Andrea Chiricozzi
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Federico Bardazzi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Valeria Brazzelli
- Dermatology, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - Paolo Dapavo
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Torino, Torino, Italy
| | - Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Cristina Zane
- Dermatology Department, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Concetta Potenza
- Dermatology Unit “Daniele Innocenzi”, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome – Polo Pontino, Latina, Italy
| | - Franca Cantoresi
- Dermatology Unit, Department of Medicine, University of Roma, Roma, Italy
| | - Maria Concetta Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Sara Trevisini
- Department of Dermatology, University of Trieste, Trieste, Italy
| | - Pina Brianti
- Dermatology and Cosmetology Unit - San Raffaele Hospital, Milan, Italy
| | - Leonardo Pescitelli
- Department of Health Sciences, Dermatology Clinic, University of Firenze, Firenze, Italy
| | | | | | | | | | - Antonio Costanzo
- Unit of Dermatology, IRCCS Humanitas Research Hospital, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Milano, Italy
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Gargiulo L, Toso F, Ibba L, Valenti M, Costanzo A, Narcisi A. Biologics for the Treatment of Severe Acrodermatitis Continua of Hallopeau: Report of Two Cases Successfully Treated with Ixekizumab and Ustekinumab. Dermatol Pract Concept 2023; 13:dpc.1302a103. [PMID: 37196286 DOI: 10.5826/dpc.1302a103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 05/19/2023] Open
Affiliation(s)
- Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
| | - Francesco Toso
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
| | - Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
| | - Mario Valenti
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
| | - Alessandra Narcisi
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
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