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Gkalpakiotis S, Kojanová M, Fialová J, Cetkovská P, Vašků V, Vantuchová Y, Machovcová A, Gkalpakioti P, Hrdá P, Arenberger P. Management of Moderate to Severe Plaque Psoriasis with Brodalumab in Daily Practice: Real-World Evidence from the LIBERO Study in the Czech Republic. Dermatol Ther (Heidelb) 2024; 14:115-130. [PMID: 38032433 PMCID: PMC10828329 DOI: 10.1007/s13555-023-01066-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Psoriasis is a chronic, immune-mediated inflammatory skin disease. Despite the availability of several therapies, many patients affected by this disease remain untreated, do not have adequate response, or suffer from treatment-related toxic effects. It has been shown that the interleukin (IL)-17 pathway plays a key role in the immunopathogenesis of psoriasis. Brodalumab, the first human monoclonal IgG2 antibody that selectively binds to subunit A of the human IL-17 receptor, blocking interactions with a number of cytokines of the IL-17 family, has confirmed fast onset of action, high complete clearance rates, and sustained efficacy. Nevertheless, there is only a limited amount of published real-world evidence (RWE) data. METHODS This was an open-label, multicenter, real-world, prospective, non-interventional, non-controlled (single-arm) observational study (LIBERO-CZ) assessing the management of moderate to severe psoriasis with brodalumab in daily practice for up to 52 weeks of treatment. RESULTS Fifty-four patients (70.4% male, mean age 46.9 ± 13.4 years, weight 95.6 ± 22.7 kg, disease duration 18.6 ± 12.7 years) were enrolled and included in the final analysis. Forty-nine of the patients completed the study and five discontinued prematurely; 51.8% of all the enrolled patients were biologic-naïve. At baseline, 28% patients were classified as severe (psoriasis area severity index (PASI) ≥ 20). Overall, the mean PASI decreased by 15.6 from 16.1 (± 5.0) at baseline to 0.5 (± 1.2) at the last visit. The primary endpoint of an absolute PASI ≤ 3 at week 12 (as observed analysis) was achieved by 95.9% of patients. The static Physician's Global Assessment (sPGA) success (defined as clear = 0 and almost clear = 1) at week 52 was achieved by 92.1% of patients. PASI 75, PASI 90, and PASI 100 were achieved by 98.0%, 87.8%, and 75.5% of patients, respectively, after approximately 52 weeks of treatment. The study also recorded very positive results concerning patient-reported outcomes. CONCLUSIONS LIBERO-CZ confirms the fast onset and high clearance rates of brodalumab in real life in both biologic-naïve and biologic-experienced patients.
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Affiliation(s)
- Spyridon Gkalpakiotis
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Královské Vinohrady University Hospital, Prague, Czech Republic.
| | - Martina Kojanová
- Department of Dermatovenereology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Jorga Fialová
- Department of Dermatovenereology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Petra Cetkovská
- Department of Dermatovenereology, Faculty of Medicine and University Hospital, Charles University, Pilsen, Czech Republic
| | - Vladimír Vašků
- Department of Dermatovenereology, St. Anne's University Hospital, Faculty of Medicine, Masaryk University Brno, Brno, Czech Republic
| | - Yvetta Vantuchová
- Department of Dermatology, Faculty of Medicine, University Hospital Ostrava, Ostrava, Czech Republic
| | - Alena Machovcová
- Department of Dermatovenereology, Motol University Hospital, Prague, Czech Republic
| | - Petra Gkalpakioti
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Královské Vinohrady University Hospital, Prague, Czech Republic
| | | | - Petr Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Královské Vinohrady University Hospital, Prague, Czech Republic
- Sanatorium of Professor Arenberger, Prague, Czech Republic
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Tichy M, Kojanova M, Velackova B, Dolezal T, Gkalpatiotis S, Cetkovska P, Antal Z, Arenberger P, Bartonova J, Blahova L, Brodska P, Petr B, Buckova H, Cetkovsky M, Diamantova D, Duchkova H, Fialova J, Filipovska O, Gkalpakioti P, Grycova M, Horazdovsky J, Horka E, Hrazdirova K, Hrncir E, Hugo J, Janku J, Kopova R, Kovandova D, Lomicova I, Machackova R, Machovcova A, Malikova H, Matzenauer M, Necas M, Nemcova H, Neumannova R, Michaela N, Osmerova J, Pallova V, Pinkova B, Plzakova Z, Policarova M, Pospisil T, Filip R, Salavec M, Slonkova V, Smetanova A, Strouhalova I, Stuchlik D, Stumpfova A, Sevcik J, Sternbersky J, Stork J, Svarcova K, Tepla K, Tomkova H, Vantuchova Y, Vasku V, Vejrova I, Zampachova I. Efficacy of switches within the class of IL‐17 inhibitors: An analysis of data from the Czech nationwide registry of psoriatic patients receiving biological/targeted therapy (BIOREP). Dermatol Ther 2022; 35:e15772. [DOI: 10.1111/dth.15772] [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: 05/16/2022] [Revised: 07/13/2022] [Accepted: 08/15/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Martin Tichy
- Department of Dermatology and Venereology, Faculty of Medicine and Dentistry Palacky University and University Hospital Olomouc Czech Republic
| | - Martina Kojanova
- Department of Dermatovenereology, First Faculty of Medicine and General University Hospital Charles University Prague Czech Republic
| | | | | | - Spyridon Gkalpatiotis
- Department of Dermatovenereology, Third Faculty of Medicine Charles University and Kralovske Vinohrady University Hospital Prague Czech Republic
| | - Petra Cetkovska
- Department of Dermatovenereology, Faculty of Medicine in Pilsen Charles University Czech Republic
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Hugo J, Gkalpakioti P, Arenbergerova M, Arenberger P, Gkalpakiotis S. Acrodermatitis continua Hallopeau successfully treated by risankizumab. Int J Dermatol 2020; 60:e144-e145. [PMID: 33368238 DOI: 10.1111/ijd.15391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 12/01/2020] [Accepted: 12/03/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Jan Hugo
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University in Prague and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Petra Gkalpakioti
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University in Prague and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Monika Arenbergerova
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University in Prague and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Petr Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University in Prague and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Spyridon Gkalpakiotis
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University in Prague and University Hospital Kralovske Vinohrady, Prague, Czech Republic
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Gkalpakiotis S, Arenbergerova M, Gkalpakioti P, Potockova J, Arenberger P, Kraml P. Long-term impact of adalimumab therapy on biomarkers of systemic inflammation in psoriasis: Results of a 2 year study. Dermatol Ther 2020; 33:e14110. [PMID: 32734665 DOI: 10.1111/dth.14110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 06/29/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 12/28/2022]
Abstract
Psoriasis patients are at increased risk of atherosclerosis, characterized by endothelial dysfunction, linked through systemic inflammation. Anti-TNF-a therapy seems to decrease this risk. The purpose of this study was to measure the levels of serum markers associated with systemic inflammation in psoriasis patients, compared to healthy individuals and to investigate the change in their levels after 3 months and 2 years of adalimumab therapy. We investigated four biomarkers: high-sensitivity C-reactive protein (hsCRP), oxidized low-density lipoproteins (OxLDL), E-selectin, and Interleukin 22 (IL-22). These markers were measured in healthy volunteers and in 28 patients with moderate/severe psoriasis before and after 3 and 24 months of treatment with adalimumab. Psoriasis patients had increased levels of markers in comparison to the control group. After 3 months of therapy, E-selectin decreased significantly (P < .001), as well as IL-22 (P < .001). hsCRP also decreased but did not show a statistical significance, OxLDL were slightly higher than initially. After 24 months, 17 patients were still being treated with adalimumab. In these patients, hsCRP (P < .05), E-selectin (P < .001) and IL-22 (P < .001) were significantly decreased. OxLDL remained at a higher level. The stable decrease of E-selectin, hsCRP, and IL-22 after 24 months confirms that adalimumab suppresses systemic inflammation.
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Affiliation(s)
- Spyridon Gkalpakiotis
- Third Faculty of Medicine, Department of Dermatology and Venereology, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic
| | - Monika Arenbergerova
- Third Faculty of Medicine, Department of Dermatology and Venereology, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic
| | - Petra Gkalpakioti
- Third Faculty of Medicine, Department of Dermatology and Venereology, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic
| | - Jana Potockova
- Third Faculty of Medicine, Second Department of Internal Medicine, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic
| | - Petr Arenberger
- Third Faculty of Medicine, Department of Dermatology and Venereology, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic
| | - Pavel Kraml
- Third Faculty of Medicine, Second Department of Internal Medicine, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic
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Adenubiova E, Arenberger P, Gkalpakioti P, Arenbergerova M, Jircikova J, Dolezal T, Gkalpakiotis S. Psoriasis treatment with adalimumab in clinical practice: long-term experience in a center for biological therapy in the Czech Republic. J DERMATOL TREAT 2018; 29:579-582. [PMID: 29307245 DOI: 10.1080/09546634.2018.1425358] [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: 10/18/2022]
Abstract
BACKGROUND Adalimumab therapy has an established record of high efficacy in psoriasis treatment. However, only a limited number of studies have investigated long-term results in clinical practice. OBJECTIVES To evaluate the effectiveness and safety of adalimumab in a center for biological therapy in the Czech Republic. METHODS Retrospectively, we analyzed 90 patients with moderate to severe psoriasis who were treated with adalimumab between 2008 and 2016. The proportion of patients achieving PASI75, 90, and 100 after 3, 6, 12, 18, 24, 30, and 36 months was determined. RESULTS The mean period of treatment was 4.4 years (maximum duration reached was 8.6 years). PASI75 was observed in 85.6% of patients after 3 months, PASI90 in 50%, and PASI100 in 23.3%. Throughout the 3-year analysis, PASI90 was persistent in 91.4% and PASI100 in 51.7%. The majority of patients who reached PASI100 showed a trend to maintain the response in the long-term follow-up. No safety issues were identified. CONCLUSIONS Adalimumab is effective and safe in the long-term treatment of psoriatic patients in daily clinical practice. Once patients achieved PASI100, they tended to remain stable in treatment.
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Affiliation(s)
- Elizabeth Adenubiova
- a Department of Dermatovenereology, Third Faculty of Medicine , Charles University and Faculty Hospital of Kralovske Vinohrady , Prague , Czech Republic
| | - Petr Arenberger
- a Department of Dermatovenereology, Third Faculty of Medicine , Charles University and Faculty Hospital of Kralovske Vinohrady , Prague , Czech Republic
| | - Petra Gkalpakioti
- a Department of Dermatovenereology, Third Faculty of Medicine , Charles University and Faculty Hospital of Kralovske Vinohrady , Prague , Czech Republic
| | - Monika Arenbergerova
- a Department of Dermatovenereology, Third Faculty of Medicine , Charles University and Faculty Hospital of Kralovske Vinohrady , Prague , Czech Republic
| | | | | | - Spyridon Gkalpakiotis
- a Department of Dermatovenereology, Third Faculty of Medicine , Charles University and Faculty Hospital of Kralovske Vinohrady , Prague , Czech Republic
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Gkalpakiotis S, Arenbergerova M, Gkalpakioti P, Potockova J, Arenberger P, Kraml P. Impact of adalimumab treatment on cardiovascular risk biomarkers in psoriasis: Results of a pilot study. J Dermatol 2017; 44:363-369. [PMID: 27774694 DOI: 10.1111/1346-8138.13661] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 06/23/2016] [Accepted: 09/14/2016] [Indexed: 12/11/2022]
Abstract
Psoriasis is a chronic systemic immune-mediated inflammatory dermatosis associated with several comorbidities. Psoriasis patients are at increased risk of developing cardiovascular diseases (CVD), namely, coronary heart disease, stroke or peripheral vascular disease, and psoriasis seems to be an independent cardiovascular risk factor. Antipsoriatic systemic therapy, especially anti-tumor necrosis factor (TNF)-α, seems to exert a beneficial effect on these comorbidities. The purpose of this study was: (i) to measure the level of cardiovascular serum markers in psoriasis patients in comparison with healthy volunteers; and (ii) to compare the serum level of the same markers in patients before and 3 months after adalimumab therapy. We investigated six biomarkers connected to CVD: C-reactive protein (measured high sensitively, hsCRP), oxidized low-density lipoproteins (oxLDL), oxLDL/β-glycoprotein I complex (oxLDL/β2GPI), vascular endothelial adhesion molecule 1 (VCAM-1), E-selectin and interleukin (IL)-22. These biomarkers were measured in 21 patients with moderate/severe psoriasis before and after treatment with adalimumab and in healthy volunteers. hsCRP (P < 0.05), oxLDL-β2GPI complex (P < 0.05), E-selectin (P < 0.001) and IL-22 (P < 0.001) were significantly increased in comparison with healthy controls, whereas oxLDL and VCAM-1 were also higher in psoriasis patients but the difference did not reach statistical significance. A decrease of E-selectin (P < 0.001) and IL-22 (P < 0.001) was observed after 3 months of adalimumab therapy. Inhibition of TNF-α seems to not only improve psoriasis but also decreases serum cardiovascular biomarkers. E-selectin and IL-22 could serve for monitoring of the efficacy of antipsoriatic systemic therapy on cardiovascular risk.
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Affiliation(s)
- Spyridon Gkalpakiotis
- Department of Dermatology and Venereology, Third Faculty of Medicine, Charles University in Prague and Faculty Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - Monika Arenbergerova
- Department of Dermatology and Venereology, Third Faculty of Medicine, Charles University in Prague and Faculty Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - Petra Gkalpakioti
- Department of Dermatology and Venereology, Third Faculty of Medicine, Charles University in Prague and Faculty Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - Jana Potockova
- 2nd Department of Internal Medicine, Third Faculty of Medicine, Charles University in Prague and Faculty Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - Petr Arenberger
- Department of Dermatology and Venereology, Third Faculty of Medicine, Charles University in Prague and Faculty Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - Pavel Kraml
- 2nd Department of Internal Medicine, Third Faculty of Medicine, Charles University in Prague and Faculty Hospital of Kralovske Vinohrady, Prague, Czech Republic
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Gkalpakiotis S, Arenberger P, Gkalpakioti P, Hugo J, Sticova E, Tesinsky P, Arenbergerová M. A case of acute generalized pustular psoriasis of von Zumbusch treated with adalimumab. J Eur Acad Dermatol Venereol 2014; 29:2063-4. [PMID: 24981161 DOI: 10.1111/jdv.12597] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S Gkalpakiotis
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University in Prague and Faculty Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - P Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University in Prague and Faculty Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - P Gkalpakioti
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University in Prague and Faculty Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - J Hugo
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University in Prague and Faculty Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - E Sticova
- Department of Pathology, Third Faculty of Medicine, Charles University in Prague and Faculty Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - P Tesinsky
- 2nd Department of Internal Medicine, Third Faculty of Medicine, Charles University in Prague and Faculty Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - M Arenbergerová
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University in Prague and Faculty Hospital of Kralovske Vinohrady, Prague, Czech Republic
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Gkalpakiotis S, Arenberger P, Gkalpakioti P, Meluzinova E, Chandran D, Arenbergerova M. Management of psoriasis vulgaris and multiple sclerosis with fumaric acid. J Am Acad Dermatol 2014; 70:e60-1. [DOI: 10.1016/j.jaad.2013.10.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 10/14/2013] [Accepted: 10/15/2013] [Indexed: 11/24/2022]
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