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Stölzl D, Sander N, Siegels D, Harder I, Kind B, Fonfara M, Heinrich L, Abraham S, Neustädter I, Kleinheinz A, Gerdes S, Wollenberg A, Lau S, Nemat K, Heratizadeh A, Gellhaus I, Werfel T, Schmitt J, Weidinger S. Clinical and molecular response to dupilumab treatment in pediatric atopic dermatitis: Results of the German TREATkids registry. Allergy 2024. [PMID: 38712730 DOI: 10.1111/all.16147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/26/2024] [Accepted: 04/14/2024] [Indexed: 05/08/2024]
Affiliation(s)
- D Stölzl
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - N Sander
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - D Siegels
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - I Harder
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - B Kind
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - M Fonfara
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - L Heinrich
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - S Abraham
- Department of Dermatology, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - I Neustädter
- Cnopfsche Children's Hospital/Neonatology, Pediatrics, DIAKONEO KdöR, Nuremberg, Germany
| | - A Kleinheinz
- Clinics for Dermatology, Elbe Klinikum Buxtehude, Buxtehude, Germany
| | - S Gerdes
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - A Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, Munich, Germany
- Department of Dermatology and Allergy, University Hospital Augsburg, Augsburg, Germany
| | - S Lau
- Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - K Nemat
- Praxis für Kinderpneumologie/Allergologie, Kinderzentrum Dresden-Friedrichstadt, Dresden, Germany
| | - A Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | | | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - J Schmitt
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - S Weidinger
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Germany
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Gerdes S, Ostendorf R, Süß A, Schadeck T, Taut F, Makuc J, Scharfenberger L, Jacobsen S, Trenkler N, Behrens J, Joks G, Tabori S, Mortazawi D. Effectiveness, safety and impact of guselkumab on sexuality and perceived stigmatization in patients with psoriasis in routine clinical practice: Week 28 results from the prospective German multicentre G-EPOSS study. J Eur Acad Dermatol Venereol 2024. [PMID: 38602225 DOI: 10.1111/jdv.19927] [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: 10/03/2023] [Accepted: 02/16/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND G-EPOSS is a prospective, non-interventional, German multicentre study of patients with moderate-to-severe plaque psoriasis receiving guselkumab, a therapeutic monoclonal antibody targeting interleukin-23, in a real-world setting. OBJECTIVES The objective of the study was to evaluate the effectiveness and safety of guselkumab, including its impact on skin, health-related quality of life (HRQoL), sexuality, and perceived stigmatization. METHODS Patients (≥18 years old) received guselkumab per routine clinical practice. The primary endpoint was the proportion of patients achieving absolute Psoriasis Area and Severity Index (PASI) ≤ 3 at Week (W)28. Secondary endpoint assessments over 28 weeks included the Nail Psoriasis Severity Index (NAPSI), anogenital Physician's Global Assessment (aPGA), and Dermatology Life Quality Index (DLQI). Sexuality and perceived stigmatization were assessed by patients using the Relationship and Sexuality Scale (RSS) and Perceived Stigmatization Questionnaire (PSQ), respectively. RESULTS Overall, 293 patients were included in the evaluable set population. Mean age and disease duration were 45.6 and 17.6 years, respectively. At baseline, mean PASI, aPGA and DLQI scores were 15.3, 2.7 and 11.3, respectively. In total, 25.9% of patients had received a prior biologic. Overall, 83.0% of patients achieved PASI ≤ 3, and 56.2%/35.1% achieved PASI ≤ 1/PASI = 0, respectively, at W28. Among those with NAPSI ≥ 1 and aPGA ≥ 1 at baseline, NAPSI = 0 and aPGA = 0 were achieved by 39.2% and 61.1% of patients, respectively, and 61.4% of patients achieved DLQI 0-1 at W28. Improvements were observed over 28 weeks across individual items of the DLQI, RSS and PSQ, indicating improved HRQoL and sex life, and decreased perceived stigmatization. Based on DLQI Question (Q)9, 53.6% of patients experienced sexual difficulties at baseline, which decreased to 12.1% at W28. DLQI Q9 responses were consistent with RSS item responses, highlighting DLQI Q9 as a sentinel for sexual impairment. CONCLUSIONS Guselkumab improved overall skin symptoms and HRQoL in patients with psoriasis and decreased sexual impairment and perceived stigmatization. No new safety signals were observed. STUDY CODE CNTO1959PSO4008.
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Affiliation(s)
- S Gerdes
- Psoriasis Center Kiel, Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | | | - A Süß
- Dermatology Practice Dr. med. Anke Süß, Wittlich, Germany
| | - T Schadeck
- Dermatology Practice Tobias Schadeck, Bogen, Germany
| | - F Taut
- Taut Science and Service GmbH, Konstanz, Germany
| | - J Makuc
- Janssen-Cilag GmbH, Neuss, Germany
| | | | | | | | | | - G Joks
- Janssen-Cilag Pty Ltd, Sydney, New South Wales, Australia
| | - S Tabori
- Janssen-Cilag GmbH, Neuss, Germany
| | - D Mortazawi
- Dermatology Practice Dariusch Mortazawi, Remscheid, Germany
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3
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Mrowietz U, Sümbül M, Gerdes S. Depression, a major comorbidity of psoriatic disease, is caused by metabolic inflammation. J Eur Acad Dermatol Venereol 2023; 37:1731-1738. [PMID: 37184282 DOI: 10.1111/jdv.19192] [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] [Received: 01/31/2023] [Accepted: 04/26/2023] [Indexed: 05/16/2023]
Abstract
Psoriatic disease is a chronic, systemic immune-mediated inflammatory disorder comprising three major domains, skin, vascular and bone/joint inflammation. It is known for a long time that psoriatic disease is associated with a number of conditions such as hypertension, dyslipidemia, diabetes (metabolic syndrome) and depression. Up to one out of five people with psoriasis show concomitant depression. In the past, this was attributed to psychological stress of suffering from a chronic condition that is often visible and itchy, leading to stigmatization and adding to a significant burden of disease. Recent data provide evidence that depression associated with psoriatic disease is linked to the specific inflammatory pattern with IL-23, IL-17 family cytokines, TNF, IL-6 and IL-8 causing neuroinflammation and subsequently depression or depressive behaviour and/or anxiety. Psoriatic disease shows a distinct pattern of immune cells (e.g. dendritic cells, Th17 cells, neutrophils), mediators (e.g. IL-17A/F, IL-23, TNF) and tissue-related factors in all major domains that is different from other inflammatory dermatoses. There is a striking similarity between the inflammatory pattern in psoriatic disease and neuroinflammation that leads to depression. A number of risk factors have been identified in psoriatic disease, the most important of which are obesity and tobacco smoking. Obesity is known as a major risk factor for depression and anxiety due to its inflammatory signature. Apart from psychotherapy and anti-depressive medication, targeted treatments for psoriasis, including TNF, IL-17 and IL-23 inhibitors, can improve depression/depressive symptoms. The review summarizes the current knowledge about depression as a comorbidity in psoriatic disease.
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Affiliation(s)
- U Mrowietz
- Psoriasis Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - M Sümbül
- Psoriasis Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - S Gerdes
- Psoriasis Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
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Gerdes S, Hoffmann M, Asadullah K, Korge B, Mortazawi D, Krüger N, Personke Y, Tabori S, Gomez M, Wegner S, Kreimendahl F, Taut F, Sticherling M. Effectiveness, safety and quality-of-life effects of guselkumab and ustekinumab in patients with psoriasis: Week 104 results from the non-interventional, prospective, German multicentre PERSIST study. J Eur Acad Dermatol Venereol 2023. [PMID: 37462295 DOI: 10.1111/jdv.19296] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 11/23/2022] [Accepted: 05/03/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND PERSIST was a prospective, non-interventional, real-world study of guselkumab and ustekinumab in adult patients with moderate-to-severe plaque psoriasis in Germany. OBJECTIVES To examine effectiveness, safety and quality-of-life (QoL) outcomes to Week (W) 104 of treatment with guselkumab and ustekinumab in patients with moderate-to-severe plaque psoriasis. METHODS Patients (≥18 years of age) received guselkumab or ustekinumab as per routine clinical practice. Outcomes to W104 were examined separately in guselkumab and ustekinumab recipients. An ad hoc exploratory analysis of outcomes with guselkumab versus ustekinumab was also performed following propensity score matching. RESULTS Overall, 302 and 313 patients received guselkumab and ustekinumab, respectively. Patients in both cohorts experienced improvements in disease activity and QoL that were maintained to W104, with 64.7% and 63.6% of guselkumab- and 54.6% and 64.4% of ustekinumab-treated patients achieving a Psoriasis Area and Severity Index (PASI) 90 response and a Dermatology Life Quality Index (DLQI) 0/1 score, respectively. Propensity score matching yielded well-balanced baseline characteristics except for prior biologic use, which was higher in guselkumab versus ustekinumab recipients (51.7% vs. 32.0%). Achievement of PASI ≤1 at W104 was more common in guselkumab versus ustekinumab recipients (58.7% vs. 49.7%). The W104 PASI90 response rate was 65.6% with guselkumab and 56.0% with ustekinumab; corresponding rates for PASI100 were 44.3% and 28.5%. In guselkumab recipients, response rates were higher in biologic-naïve versus biologic-experienced patients (PASI90, 77.1% vs. 53.4%; PASI100, 55.0% vs. 33.0%). A high level of response for QoL outcomes was observed for both treatments. CONCLUSIONS Ustekinumab and guselkumab led to improvements in physician-assessed and patient-reported outcomes that were sustained for up to 2 years, with no new safety signals identified. Following propensity score matching, greater improvements in PASI outcomes were observed with guselkumab versus ustekinumab. Improvements with guselkumab were highest in biologic-naïve patients, highlighting the value of early treatment.
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Affiliation(s)
- S Gerdes
- Psoriasis-Center Kiel, Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - M Hoffmann
- Dermatology Practice Dr. Matthias Hoffmann, Witten, Germany
| | - K Asadullah
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Prof. Dr. med. Asadullah, Dermatology Practice, Potsdam, Germany
| | - B Korge
- Dermatology Practice Dr. Bernhard Korge, Düren, Germany
| | - D Mortazawi
- Dermatology Practice Dr. Dariusch Mortazawi, Remscheid, Germany
| | - N Krüger
- Janssen-Cilag GmbH, MAF, Neuss, Germany
| | | | - S Tabori
- Janssen-Cilag GmbH, MAF, Neuss, Germany
| | - M Gomez
- Janssen Global Services LLC, Raritan, New Jersey, USA
| | - S Wegner
- Janssen-Cilag GmbH, MAF, Neuss, Germany
| | | | - F Taut
- Taut Science and Service GmbH, Konstanz, Germany
| | - M Sticherling
- Department of Dermatology, University Hospital of Erlangen, Deutsches Zentrum für Immuntherapie, Erlangen, Germany
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Seidl U, Bohne AS, Kaeding M, Bauer L, Weichenthal M, Wehkamp U, Hutloff A, Schwarz T, Gerdes S, Heine G. Angiolymphoid hyperplasia with eosinophilia infiltrated by GATA3+ Th2 cells responding to dupilumab. J Eur Acad Dermatol Venereol 2023. [PMID: 37060261 DOI: 10.1111/jdv.19116] [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: 01/13/2023] [Accepted: 04/07/2023] [Indexed: 04/16/2023]
Affiliation(s)
- U Seidl
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - A S Bohne
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - M Kaeding
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - L Bauer
- Institute of Immunology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - M Weichenthal
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - U Wehkamp
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - A Hutloff
- Institute of Immunology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - T Schwarz
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - S Gerdes
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - G Heine
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
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Gerdes S, Asadullah K, Hoffmann M, Korge B, Mortazawi D, Wegner S, Personke Y, Gomez M, Sticherling M. Real-world evidence from the non-interventional, prospective, German multicentre PERSIST study of patients with psoriasis after 1 year of treatment with guselkumab. J Eur Acad Dermatol Venereol 2022; 36:1568-1577. [PMID: 35569014 DOI: 10.1111/jdv.18218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/21/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND PERSIST was a prospective, non-interventional, long-term, German multicentre study of patients with moderate-to-severe psoriasis receiving guselkumab, an approved monoclonal antibody that binds to the p19 subunit of interleukin (IL)-23, in a real-world setting. OBJECTIVES Evaluation of the efficacy and safety of guselkumab, and its effect on health-related quality of life (HRQoL), in patients with moderate-to-severe psoriasis who have received 52 weeks of treatment. METHODS Patients (≥18 years old) were prescribed guselkumab as per routine clinical practice. End points assessed include Psoriasis Area and Severity Index (PASI), Physician's Global Assessment (PGA), target Nail Psoriasis Severity Index (NAPSI), and the Dermatology Life Quality Index (DLQI). RESULTS Overall, 303 patients were enrolled and treated with guselkumab. Mean disease duration was 21.0 years, and 77.2% and 51.2% of patients had received ≥1 prior conventional systemic or ≥1 prior biologic therapy, respectively. Mean PASI score decreased from 16.4 at baseline to 3.0 by Week (W) 28, and further decreased to 2.4 by W52, while the proportion of patients achieving an absolute PASI score of ≤1 increased from 1.3% at baseline, to 50.8% at W28 and to 58.4% by W52. PASI90 and PASI100 responses also showed marked improvements between W28 and W52, regardless of biologic treatment history. Clearance of psoriatic skin was observed in difficult-to-treat areas, with the percentage of patients achieving a PGA score ≤1 increasing between W28 and W52. Guselkumab improved HRQoL; mean DLQI score decreased from 13.7 at baseline to 2.8 by W28, and further decreased to 2.4 by W52. At W52, 64.6% of patients achieved a DLQI score ≤1. The cumulative probability of drug survival was 92.4% at W52. CONCLUSIONS Guselkumab is efficacious and well tolerated regardless of previous biologic therapies, comorbidities or psoriasis manifestation in difficult-to-treat areas. No new safety signals were observed.
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Affiliation(s)
- S Gerdes
- Psoriasis Center Kiel, Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - K Asadullah
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Prof. Dr. med. Asadullah, Hautarztpraxis, Potsdam, Germany
| | - M Hoffmann
- Dermatology Practice Dr. Matthias Hoffmann, Witten, Germany
| | - B Korge
- Dermatology Practice Dr. Bernhard Korge, Düren, Germany
| | - D Mortazawi
- Dermatology Practice Dr. Dariusch Mortazawi, Remscheid, Germany
| | - S Wegner
- Janssen-Cilag GmbH, MAF, Neuss, Germany
| | | | - M Gomez
- Janssen-Cilag GmbH, MAF, Neuss, Germany
| | - M Sticherling
- Department of Dermatology, University Hospital of Erlangen, Deutsches Zentrum für Immuntherapie, Erlangen, Germany
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Sommer R, Westphal L, Mrowietz U, Gerdes S, Augustin M. Measuring well-being in psoriasis: Psychometric properties of the WHO-5 questionnaire. J Eur Acad Dermatol Venereol 2022; 36:e986-e987. [PMID: 35788987 DOI: 10.1111/jdv.18396] [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] [Indexed: 11/26/2022]
Affiliation(s)
- R Sommer
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - L Westphal
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - U Mrowietz
- Psoriasis-Center Kiel, Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - S Gerdes
- Psoriasis-Center Kiel, Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Fernandez AP, Dauden E, Gerdes S, Lebwohl MG, Menter MA, Leonardi C, Gooderham M, Gebauer K, Tada Y, Lacour JP, Bianchi L, Egeberg A, Pau-Charles I, Mendelsohn AM, Rozzo SJ, Mehta NN. Tildrakizumab efficacy and safety in patients with psoriasis and concomitant metabolic syndrome: post hoc analysis of 5-year data from reSURFACE 1 and reSURFACE 2. J Eur Acad Dermatol Venereol 2022; 36:1774-1783. [PMID: 35460287 PMCID: PMC9545614 DOI: 10.1111/jdv.18167] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/15/2021] [Accepted: 01/18/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Limited data are available on long-term efficacy and safety of biologics in patients with psoriasis and metabolic syndrome (MetS), a common comorbidity. OBJECTIVES This analysis updates tildrakizumab efficacy and safety for up to 5 years in patients with and without MetS. METHODS This was a post hoc analysis of the double-blind, randomized, placebo-controlled, phase 3 reSURFACE 1 (NCT01722331) and reSURFACE 2 (NCT01729754) trials in adult patients with moderate to severe chronic plaque psoriasis. Analyses included data through Week 244 from patients who continuously received tildrakizumab 100 (TIL100) or 200 mg (TIL200) and entered the extension studies, stratified by baseline MetS status. Efficacy was assessed via Psoriasis Area and Severity Index (PASI) scores. Safety was evaluated from exposure-adjusted incidence rates (EAIRs) of treatment-emergent adverse events (TEAEs). RESULTS reSURFACE 1 and reSURFACE 2 analyses included 26 and 44 TIL100-treated patients with MetS, 98 and 167 TIL100-treated patients without MetS, 34 and 30 TIL200-treated patients with MetS, and 111 and 130 TIL200-treated patients without MetS, respectively. There were no clinically relevant differences in PASI 75/90/100 response rates at Week 244 between patients with vs without MetS. The proportion of patients with vs without MetS achieving absolute PASI score <3 at Week 244 was 53.8% vs 69.4% and 77.3% vs 80.8% in reSURFACE 1 and 2, respectively, for TIL100-treated patients and 58.8% vs 72.1% and 63.3% vs 72.3%, respectively, for TIL200-treated patients. In both studies, median reduction from baseline PASI score at all time points in patients with vs without MetS was >83% vs >89% for TIL100 and >85% vs >90% for TIL200. Pooled EAIRs of TEAEs, serious TEAEs, and TEAEs of special interest were similar in patients with and without MetS. CONCLUSIONS Tildrakizumab maintains efficacy and a favorable safety profile over 5 years in patients with psoriasis regardless of MetS status.
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Affiliation(s)
- A P Fernandez
- Departments of Dermatology and Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - E Dauden
- Dermatology Department, Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain
| | - S Gerdes
- Department of Dermatology, Psoriasis-Center, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - M G Lebwohl
- Department of Dermatology, Mount Sinai Hospital, New York, NY, USA
| | - M A Menter
- Division of Dermatology, Baylor Scott & White, and Texas A&M College of Medicine, Dallas, TX, USA
| | - C Leonardi
- Central Dermatology and Saint Louis University School of Medicine, St. Louis, MO, USA
| | - M Gooderham
- Probity Medical Research, Peterborough, ON, Canada.,SKiN Centre for Dermatology, Peterborough, ON, Canada.,Queen's University, Kingston, ON, Canada
| | - K Gebauer
- Fremantle Dermatology, Fremantle, Western Australia, Australia
| | - Y Tada
- Teikyo University, Tokyo, Japan
| | - J P Lacour
- Department of Dermatology, University of Nice Sophia Antipolis, Nice, France
| | - L Bianchi
- Dermatology Unit, Tor Vergata University Hospital, Rome, Italy
| | - A Egeberg
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | | | - S J Rozzo
- Sun Pharmaceutical Industries, Inc., Princeton, NJ, USA
| | - N N Mehta
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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9
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Geisen UM, Sümbül M, Tran F, Berner DK, Reid HM, Vullriede L, Ciripoi M, Longardt AC, Hoff P, Morrison PJ, Schneider VE, Zeuner R, Schirmer JH, Steinbach A, Nikolaus S, Gerdes S, Schreiber S, Bacher P, Hoyer BF. Humoral protection to SARS-CoV2 declines faster in patients on TNF alpha blocking therapies. RMD Open 2021; 7:rmdopen-2021-002008. [PMID: 34880128 PMCID: PMC8655347 DOI: 10.1136/rmdopen-2021-002008] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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: 10/05/2021] [Accepted: 11/03/2021] [Indexed: 02/02/2023] Open
Abstract
Background The persistence of the SARS-CoV2 pandemic, partly due to the appearance of highly infectious variants, has made booster vaccinations necessary for vulnerable groups. Questions remain as to which cohorts require SARS-CoV2 boosters. However, there is a critical lack of data on the dynamics of vaccine responses in patients with chronic inflammatory diseases (CID) undergoing immunosuppressive/disease modifying anti-rheumatic (DMARD) treatment. Here, we present the first data regarding the decline of the vaccine-induced humoral immune responses in patients with CID. Methods 23 patients with CID were monitored clinically and for anti-spike IgG and IgA levels, neutralization efficacy and antigen-specific CD4+ T cell responses over the first 6 months after SARS-CoV2 vaccination. 24 healthy individuals were included as controls. Results While anti-spike IgG-levels declined in CID patients and healthy controls, patients receiving anti-TNF treatment showed significantly greater declines at 6 months post second vaccination in IgG and especially neutralizing antibodies. IgA levels were generally lower in CID patients, particularly during anti-TNF therapy. No differences in SARS-CoV2 spike-specific CD4+ T-cell frequencies were detected. Conclusion Although the long-term efficacy of SARS-CoV2 vaccination in CID patients undergoing disease-modifying therapy is still not known, the pronounced declines in humoral responses towards SARS-CoV2 6 months after mRNA vaccination in the context of TNF blockade should be considered when formulating booster regimens. These patients should be considered for early booster vaccinations.
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Affiliation(s)
- Ulf M Geisen
- Medical Department 1, Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Melike Sümbül
- Department for Dermatology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Florian Tran
- Department for Internal Medicine I, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany.,Institute of Clinical Molecular Medicine, Christian-Albrechts-Universitat zu Kiel, Kiel, Germany
| | - Dennis K Berner
- Medical Department 1, Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Hayley M Reid
- Medical Department 1, Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Lena Vullriede
- Medical Department 1, Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Maria Ciripoi
- Medical Department 1, Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Ann C Longardt
- Department for Pediatrics, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Paula Hoff
- Department of Rheumatology, Endokrinologikum-Gruppe, Berlin, Germany
| | - Peter J Morrison
- Department for Dermatology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Verena E Schneider
- Medical Department 1, Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Rainald Zeuner
- Medical Department 1, Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Jan H Schirmer
- Medical Department 1, Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Andrea Steinbach
- Medical Department 1, Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Susanna Nikolaus
- Department for Internal Medicine I, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - S Gerdes
- Department for Dermatology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Stefan Schreiber
- Department for Internal Medicine I, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany.,Institute of Clinical Molecular Medicine, Christian-Albrechts-Universitat zu Kiel, Kiel, Germany
| | - Petra Bacher
- Institute of Clinical Molecular Medicine, Christian-Albrechts-Universitat zu Kiel, Kiel, Germany.,Institute for Immunology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Bimba F Hoyer
- Medical Department 1, Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
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10
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Gerdes S, Albrecht J. Long-term efficacy: the new gold standard? Br J Dermatol 2021; 185:1086-1087. [PMID: 34632571 DOI: 10.1111/bjd.20715] [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: 08/14/2021] [Accepted: 08/16/2021] [Indexed: 11/27/2022]
Affiliation(s)
- S Gerdes
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - J Albrecht
- Division of Dermatology, Department of Medicine, Cook County Health, Chicago, IL, USA.,Department of Otolaryngology, Division of Dermatology, Rush Medical College, Chicago, IL, USA
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11
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Emmert H, Rademacher F, Norsgaard H, Gerdes S, Weidinger S, Harder J. 191 Hair follicle-derived keratinocytes as a useful tool to study atopic dermatitis-related TH2 cytokine responses. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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12
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Mrowietz U, Dieckmann T, Gerdes S, Szymczak S, von Spreckelsen R, Körber A. ActiPso: definition of activity types for psoriatic disease: A novel marker for an advanced disease classification. J Eur Acad Dermatol Venereol 2021; 35:2027-2033. [PMID: 34076926 DOI: 10.1111/jdv.17434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 04/29/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Assessment of psoriasis is exclusively done measuring severity using somatic scores such as the psoriasis area and severity index or patient-reported outcomes such as the dermatology life quality index. There is no established tool to measure a patient's individual psoriasis activity over time. OBJECTIVES Development of a new tool to classify psoriasis activity types. METHODS Open patient interviews were performed and adapted in several steps and by using different groups of patients. Wording of the tool's axis and description how to use it was optimized with the input of patients. The final ActiPso tool was used in a prospective study in psoriasis patients. RESULTS Four activity types could be identified describing psoriasis intensity (e.g. severity, itch, pain) over one typical year and an event/trigger type describing flares. In the study in 586 psoriasis patients of the 536 patients eligible for analysis 40.9% self-classified as type 1 ('stable'), 22.6% as type 2 ('unstable'), 30.6% as type 3 ('winter type') and 6.0% as type 4 ('summer type'), respectively. Flares of psoriasis as identified by the event/trigger type were reported in 36.1% of patients with activity type 1, 67.8% with type 2, 73.8% of type 3 and 59.4% of type 4, respectively. CONCLUSIONS Interviewed patients were able to describe their course of psoriatic disease and to name potential triggering factors. By doing so, activity types of psoriasis were defined for the first time and the importance of events/triggers for flares described and integrated into ActiPso types as a basis for advanced patient-centric management. A limitation of ActiPso is that in regions with no seasonal variations types 3 and 4 may not apply.
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Affiliation(s)
- U Mrowietz
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - T Dieckmann
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - S Gerdes
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - S Szymczak
- Institute of Medical Informatics and Statistics, Kiel University and University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - R von Spreckelsen
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - A Körber
- Dermatology Practice RÜ 143, Essen, Germany
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13
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Wilsmann-Theis D, Kromer C, Gerdes S, Linker C, Magnolo N, Sabat R, Reich K, Mössner R. A multicentre open-label study of apremilast in palmoplantar pustulosis (APLANTUS). J Eur Acad Dermatol Venereol 2021; 35:2045-2050. [PMID: 34077577 DOI: 10.1111/jdv.17441] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Palmoplantar pustulosis (PPP) is a chronic skin disease with painful erythematous scaly or crusty lesions and pustules on the palms and soles. Apremilast is a phosphodiesterase 4 inhibitor that has proven effective in the therapy of psoriasis, psoriatic arthritis and in oral ulcers associated with Behcet's disease. OBJECTIVE To explore the efficacy of apremilast in PPP. METHODS APLANTUS was a phase 2 single-arm multicentre study of apremilast in 21 subjects with moderate-to-severe PPP. Primary endpoint was the per cent change of the Palmoplantar Pustulosis Psoriasis Area and Severity Index (PPPASI) at week 20 compared to baseline. RESULTS 20 weeks of oral treatment with apremilast in patients with moderate-to-severe PPP resulted in a significant decrease of the PPPASI with a median reduction of 57.1% (p < 0.001), and 61.9% of patients achieved at least a 50% improvement of the PPPASI relative to baseline. The total number of pustules per patient decreased significantly relative to baseline with 76.2% of patients achieving at least a 50% reduction in total pustules count at week 20. Improvement of PPP was also apparent in a significant decrease of the dermatologic life quality index (DLQI). The median DLQI score dropped from 8.5 at baseline to 2.0 at week 20 (p = 0.030). Apremilast was generally well tolerated, and no serious adverse events occurred. CONCLUSIONS Patients with PPP treated with apremilast showed benefit both in objective and subjective disease parameters. Apremilast should be investigated further in this difficult-to-treat skin condition. EudraCT number: 2016-005122-11.
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Affiliation(s)
- D Wilsmann-Theis
- Department of Dermatology and Allergy, University of Bonn, Bonn, Germany
| | - C Kromer
- Department of Dermatology, University Medical Center Göttingen, Göttingen, Germany
| | - S Gerdes
- Center for Inflammatory Skin Diseases, Department of Dermatology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - C Linker
- TFS Clinic, TFS Trial Form Support GmbH, Hamburg, Germany
| | - N Magnolo
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - R Sabat
- Psoriasis Research and Treatment Centre, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - R Mössner
- Department of Dermatology, University Medical Center Göttingen, Göttingen, Germany
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14
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Armstrong A, Gerdes S. Calcipotriol/betamethasone dipropionate foam demonstrates comparable efficacy to clinical trial data in the real world, improves patient satisfaction and is cost-effective. J Eur Acad Dermatol Venereol 2021; 35 Suppl 1:28-34. [PMID: 33619780 DOI: 10.1111/jdv.17084] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/01/2020] [Indexed: 12/30/2022]
Abstract
Real-world evidence studies are becoming increasingly important in providing insight into clinical effectiveness and safety, economic outcomes, patient-reported outcomes and health-related quality of life of treatments in the clinical setting. These studies also help to complement data reported in clinical studies. Fixed-dose combination calcipotriol 50 µg/g plus betamethasone dipropionate 0.5 mg/g cutaneous foam (Cal/BD foam) is a topical agent used for the treatment of psoriasis vulgaris. In clinical studies, Cal/BD foam has demonstrated a significantly greater efficacy and rapid onset of action compared with both single and combination formulations such as ointments and gels. To date, three observational studies have examined the real-world efficacy and safety of Cal/BD foam in clinical practice in the United States, Germany and Spain. Data gathered from these studies reinforce the positive findings reported in clinical studies assessing Cal/BD foam for the treatment of psoriasis and demonstrate improved patient satisfaction with Cal/BD foam. Using Cal/BD foam has been shown to be cost-effective based on results from randomised clinical trials and cost-effective analysis. As such, Cal/BD foam has the potential to lower treatment costs by reducing the need for some patients to progress to more expensive treatments, such as phototherapy and biologics. Cal/BD foam is therefore a cost-effective solution for the treatment of psoriasis vulgaris that should be considered when prescribing topicals.
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Affiliation(s)
- A Armstrong
- University of Southern California, Los Angeles, CA, USA
| | - S Gerdes
- Center for Inflammatory Skin Diseases, Department of Dermatology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
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15
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Spreckelsen R, Wittbecker L, Gerdes S, Mrowietz U, Emmert H, Gläser R. Vermittlung des biopsychosozialen Modells in der universitären Lehre: Konzeption und Durchführung eines Seminars mit Betroffenen und Experten aus Dermatologie und Psychosomatik. Aktuelle Dermatologie 2021. [DOI: 10.1055/a-1329-2561] [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] [Indexed: 10/22/2022]
Abstract
Zusammenfassung
Ziel der Studie Zahlreiche Studien zeigen, dass chronisch entzündliche Hauterkrankungen mit starken Einbußen in nahezu allen Dimensionen der gesundheitsbezogenen Lebensqualität einhergehen. Ziel war es daher, in der universitären dermatologischen Lehre ein extracurriculares Seminar anzubieten, um Medizinstudierenden bereits während ihrer Ausbildung praxisnah das erweiterte biopsychosoziale Modell zu vermitteln und sie frühzeitig für das psychosomatische Grundverständnis zu sensibilisieren.
Methodik Den Studierenden der Dermatologie (i. a. 7. Semester) wurde seit dem Wintersemester 2018/2019 ein zusätzliches Format auf freiwilliger Basis als einmaliges Seminar angeboten, durchgeführt und evaluiert. Insgesamt nahmen 25 Studierende teil, und 22 Fragebögen wurden anschließend deskriptiv und inhaltsanalytisch ausgewertet.
Ergebnisse Die Ergebnisse zeigen, dass großes Interesse und Offenheit für das psychosomatische Grundverständnis seitens der Studierenden besteht. Dabei wurde deutlich, dass die konkrete Option auf ein gemeinsames Zusammentreffen von interessierten Studierenden, Betroffenen und Fachärzten aus Dermatologie und Psychosomatik eine besondere Rolle einnimmt. Studierende nehmen die übliche Fokussierung auf das rein Biologische als unipolar und unvollständig in ihrer derzeitigen universitären Ausbildung wahr.
Schlussfolgerung Fächerübergreifende Seminare unter Anwesenheit von Betroffenen und im gemeinsamen fächerübergreifenden Diskurs tragen zur frühzeitigen Sensibilisierung auf das gleichzeitige Vorliegen von psychologischen und physiologischen Prozessen innerhalb ein und desselben Ereignisvorgangs bei. Die holistische Betrachtung scheint einen günstigen Einfluss für die eigene innere Haltung eines zukünftigen Arztes oder einer zukünftigen Ärztin zu haben.
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Affiliation(s)
- R. Spreckelsen
- Klinik für Dermatologie, Venerologie und Allergologie am UKSH, Campus Kiel
- Zentrum für Integrative Psychiatrie ZIP gGmbH Kiel
| | - L. Wittbecker
- Klinik für Dermatologie, Venerologie und Allergologie am UKSH, Campus Kiel
| | - S. Gerdes
- Klinik für Dermatologie, Venerologie und Allergologie am UKSH, Campus Kiel
| | - U. Mrowietz
- Klinik für Dermatologie, Venerologie und Allergologie am UKSH, Campus Kiel
| | - H. Emmert
- Klinik für Dermatologie, Venerologie und Allergologie am UKSH, Campus Kiel
| | - R. Gläser
- Klinik für Dermatologie, Venerologie und Allergologie am UKSH, Campus Kiel
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16
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Morrison PJ, Suhrkamp I, Gerdes S, Mrowietz U. Oral dimethyl fumarate induces changes within the peripheral neutrophil compartment of patients with psoriasis that are linked with skin improvement. Br J Dermatol 2021; 185:605-615. [PMID: 33657656 DOI: 10.1111/bjd.19899] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Dimethyl fumarate (DMF) is a treatment for moderate-to-severe psoriasis and multiple sclerosis. DMF therapy typically improves skin inflammation within the first 3 months of treatment. DMF is a prodrug that generates the hydroxycarboxylic acid receptor 2 (HCA2) agonist, monomethyl fumarate (MMF). Despite widespread clinical use, DMF's mechanism of action is not fully understood. OBJECTIVES We wished to characterize the changes induced by DMF in peripheral neutrophils within the first 3 months of treatment to better understand its early antipsoriatic effects. METHODS Flow cytometry was used to assess T-cell and neutrophil frequencies, apoptosis and activation phenotype. In vitro culture of neutrophils with DMF and MMF was used to evaluate apoptosis and HCA2 internalization. Serum levels of neutrophil degranulation products were measured by enzyme-linked immunosorbent assay. RESULTS Patients with psoriasis had significantly higher leucocyte counts at baseline compared with controls, with a large population of pro-inflammatory CD62Llo CD11bbright neutrophils. Analysis revealed that DMF treatment reduced the frequency of CD62Llo CD11bbright neutrophils and serum levels of neutrophil activation markers. This reduction was not linked to increased apoptosis. CONCLUSIONS Our results reveal a novel in vivo effect of DMF therapy on pro-inflammatory neutrophils that likely contributes to this treatment's antipsoriatic efficacy.
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Affiliation(s)
- P J Morrison
- Psoriasis Center, Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, 24105, Germany
| | - I Suhrkamp
- Psoriasis Center, Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, 24105, Germany
| | - S Gerdes
- Psoriasis Center, Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, 24105, Germany
| | - U Mrowietz
- Psoriasis Center, Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, 24105, Germany
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17
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Augustin M, Dauden E, Mrowietz U, Konstantinou M, Gerdes S, Kingo K, Szepietowski J, Perrot J, Cuccia A, Rissler M, Gathmann S, Sieder C, Orsenigo R, Jagiello P, Bachhuber T. Secukinumab treatment leads to normalization of quality of life and disease symptoms in psoriasis patients with or without prior systemic psoriasis therapy: the PROSE study results. J Eur Acad Dermatol Venereol 2020; 35:431-440. [DOI: 10.1111/jdv.16632] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 05/05/2020] [Indexed: 12/19/2022]
Affiliation(s)
- M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Centre Hamburg‐Eppendorf Hamburg Germany
| | - E. Dauden
- Department of Dermatology Hospital Universitario de la Princesa Madrid Spain
| | - U. Mrowietz
- Psoriasis‐Center Department of Dermatology University Medical Center Schleswig‐Holstein, Campus Kiel Kiel Germany
| | | | - S. Gerdes
- Psoriasis‐Center Department of Dermatology University Medical Center Schleswig‐Holstein, Campus Kiel Kiel Germany
| | - K. Kingo
- Dermatology Clinic, Tartu University Hospital Department of Dermatology, University of Tartu Tartu Estonia
| | - J.C. Szepietowski
- Department of Dermatology, Venereology and Allergology Wroclaw Medical University Wroclaw Poland
| | - J.L. Perrot
- Department of Dermatology Venereology and Allergology Jacques Lisfranc University Saint‐Etienne France
| | - A. Cuccia
- Unit of Dermatology San Donato Hospital Arezzo Italy
| | | | | | - C. Sieder
- Novartis Pharma GmbH Nuernberg Germany
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18
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Ehrenthal JC, Woeste S, Mrowietz U, Gerdes S, Graetz C. Profiles of psychosocial variables and dental status in patients with psoriasis. J Eur Acad Dermatol Venereol 2020; 34:e586-e587. [PMID: 32277503 DOI: 10.1111/jdv.16452] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J C Ehrenthal
- Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
| | - S Woeste
- Clinic of Conservative Dentistry and Periodontology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - U Mrowietz
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - S Gerdes
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - C Graetz
- Clinic of Conservative Dentistry and Periodontology, University Medical Center Schleswig-Holstein, Kiel, Germany
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19
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Augustin M, Dauden E, Mrowietz U, Konstantinou M, Gerdes S, Rissler M, Gathmann S, Sieder C, Baeumer D, Orsenigo R. Baseline characteristics of patients with moderate‐to‐severe psoriasis according to previous systemic treatment exposure: the PROSE study population. J Eur Acad Dermatol Venereol 2020; 34:2548-2556. [DOI: 10.1111/jdv.16400] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 03/10/2020] [Indexed: 12/18/2022]
Affiliation(s)
- M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - E. Dauden
- Department of Dermatology Instituto de Investigación Sanitaria la Princesa (IIS‐IP)Hospital Universitario la Princesa Madrid Spain
| | - U. Mrowietz
- Department of Dermatology Psoriasis‐Center University Medical Center Schleswig‐Holstein Kiel Germany
| | | | - S. Gerdes
- Department of Dermatology Psoriasis‐Center University Medical Center Schleswig‐Holstein Kiel Germany
| | | | | | - C. Sieder
- Novartis Pharma AG Basel Switzerland
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20
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Kromer C, Wilsmann-Theis D, Gerdes S, Krebs S, Pinter A, Philipp S, Mössner R. Changing within the same class: efficacy of brodalumab in plaque psoriasis after treatment with an IL-17A blocker – a retrospective multicenter study. J DERMATOL TREAT 2020; 32:878-882. [DOI: 10.1080/09546634.2020.1716932] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- C. Kromer
- Department of Dermatology, University Medical Center Göttingen, Göttingen, Germany
| | | | - S. Gerdes
- Psoriasis-Center, Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - S. Krebs
- Psoriasis-Center, Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - A. Pinter
- Department of Dermatology, Venereology, and Allergology, University Hospital, Frankfurt, Frankfurt/Main, Germany
| | - S. Philipp
- Department of Dermatology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - R. Mössner
- Department of Dermatology, University Medical Center Göttingen, Göttingen, Germany
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21
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Amschler K, Phillip S, Mohr J, Wilsmann-Theis D, Poortinga S, Gerdes S, Mössner R. Long-term follow-up of 22 psoriatic patients treated with ixekizumab after failure of secukinumab. Dermatol Online J 2020; 26:13030/qt11d602x5. [PMID: 32239902] [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] [Received: 03/26/2020] [Accepted: 03/26/2020] [Indexed: 06/11/2023] Open
Abstract
The original article was published on February 15, 2020 and corrected on March 26, 2020. The revised version of the article amends the table and figure, while leaving the text largely unchanged. The changes appear in the revised online PDF copy of this article.
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Affiliation(s)
- K Amschler
- Department of Dermatology, University Medical Center Göttingen, Göttingen, Germany.
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22
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Thaçi D, Pinter A, Sebastian M, Termeer C, Sticherling M, Gerdes S, Wegner S, Krampe S, Bartz H, Rausch C, Mensch A, Eyerich K. Guselkumab is superior to fumaric acid esters in patients with moderate‐to‐severe plaque psoriasis who are naive to systemic treatment: results from a randomized, active‐comparator‐controlled phase IIIb trial (POLARIS). Br J Dermatol 2020; 183:265-275. [DOI: 10.1111/bjd.18696] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2019] [Indexed: 02/06/2023]
Affiliation(s)
- D. Thaçi
- Institute and Comprehensive Centre for Inflammation Medicine University of Lübeck Lübeck Germany
| | - A. Pinter
- Department of Dermatology, Venereology and Allergology University Hospital of Frankfurt am Main Frankfurt am Main Germany
| | - M. Sebastian
- Dermatological Practice Dr. med. Michael Sebastian Mahlow Germany
| | - C. Termeer
- Dermatological Practice Prof. Dr. med. Christian Termeer Stuttgart Germany
- Department of Dermatology University of Freiburg Freiburg Germany
| | - M. Sticherling
- Department of Dermatology University Hospital of Erlangen Erlangen Germany
| | - S. Gerdes
- Psoriasis‐Center Department of Dermatology, Venerology and Allergology University Hospital Schleswig‐Holstein Campus Kiel Kiel Germany
| | | | | | - H. Bartz
- Janssen‐Cilag GmbH Neuss Germany
| | | | | | - K. Eyerich
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
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23
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Amschler K, Phillip S, Mohr J, Wilsmann-Theis D, Poortinga S, Gerdes S, Mössner R. Long-term follow-up of 22 psoriatic patients treated with ixekizumab after failure of secukinumab. Dermatol Online J 2020; 26:13030/qt235408bf. [PMID: 32155021] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 03/02/2020] [Indexed: 06/10/2023] Open
Abstract
Switching of biologic agents in treatment of plaque psoriasis is a common strategy. Only a few studies are available on switching between IL17A-blockers. In a retrospective study, we identified 22 psoriasis patients who, after failing secukinumab as a first IL17A-blocker received ixekizumab with an observation period of at least 24 weeks. At last observation 10/22 patients had a good response (PASI75 or PASI<3) using ixekizumab therapy. None of five patients with primary non-response to secukinumab reached a good, durable response to ixekizumab. In conclusion, ixekizumab appears to be a therapeutic option as a second IL17A-blocker in psoriasis patients who did not show a primary non-response to secukinumab.
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Affiliation(s)
- K Amschler
- Department of Dermatology, University Medical Center Göttingen, Göttingen.
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24
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Amschler K, Phillip S, Mohr J, Wilsmann-Theis D, Poortinga S, Gerdes S, Mössner R. Long-term follow-up of 22 psoriatic patients treated with ixekizumab after failure of secukinumab. Dermatol Online J 2020. [DOI: 10.5070/d3262047415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Augustin M, Thaci D, Eyerich K, Pinter A, Radtke M, Lauffer F, Mrowietz U, Gerdes S, Pariser D, Lebwohl M, Sieder C, Melzer N, Reich K. 苏金单抗持续用于治疗银屑病的疗效. Br J Dermatol 2020. [DOI: 10.1111/bjd.18670] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Augustin M, Thaci D, Eyerich K, Pinter A, Radtke M, Lauffer F, Mrowietz U, Gerdes S, Pariser D, Lebwohl M, Sieder C, Melzer N, Reich K. The efficacy of secukinumab with continued use in the treatment of psoriasis. Br J Dermatol 2020. [DOI: 10.1111/bjd.18653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Amschler K, Phillip S, Mohr J, Wilsmann-Theis D, Poortinga S, Gerdes S, Mössner R. Long-term follow-up of 22 psoriatic patients treated with ixekizumab after failure of secukinumab. Dermatol Online J 2020. [DOI: 10.5070/d3261047182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Gerdes S, Pinter A, Papavassilis C, Reinhardt M. Effects of secukinumab on metabolic and liver parameters in plaque psoriasis patients. J Eur Acad Dermatol Venereol 2019; 34:533-541. [PMID: 31599476 PMCID: PMC7065121 DOI: 10.1111/jdv.16004] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 09/13/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Psoriasis is associated with metabolic, liver and cardiovascular comorbidity. Secukinumab, a fully human monoclonal antibody that selectively neutralizes interleukin-17A, has shown significant and sustained efficacy in the treatment of moderate to severe psoriasis. OBJECTIVES This was an exploratory post hoc analysis of pooled data from three phase 3 studies in plaque psoriasis patient populations. The objective was to show the course of metabolic and liver parameters under secukinumab, etanercept or placebo treatment over time. A further objective was to assess the impact of selected comorbidities and metabolic characteristics on high-sensitivity C-reactive protein (hs-CRP), as a surrogate marker of systemic inflammation. METHODS Data from the phase 3 randomized controlled trials [FIXTURE (NCT01358578), ERASURE (NCT01365455) and SCULPTURE (NCT01406938); n = 3010] were included in this analysis. Patients were treated with secukinumab 150 mg or 300 mg, placebo or etanercept 50 mg (FIXTURE only) as active comparator. A set of metabolic and liver parameters was longitudinally assessed over 52 weeks. Multivariate regression analyses assessed the impact of selected comorbidities and metabolic characteristics on hs-CRP levels at baseline and under treatment. RESULTS Secukinumab treatment reduced hs-CRP levels. Body weight and uric acid levels tended to decrease over 52 weeks with secukinumab. Secukinumab showed a neutral effect on fasting plasma glucose, lipid parameters and liver enzymes. Psoriatic arthritis, metabolic syndrome, obesity, impaired glucose metabolism, and hyperuricemia were each associated with increased hs-CRP levels at baseline. Concomitant obesity attenuated the decline in hs-CRP under treatment. CONCLUSIONS These analyses suggest neutral to favourable long-term trends in metabolic and liver parameters under secukinumab treatment. Metabolic comorbidities were associated with increased hs-CRP levels, reflecting the role of systemic inflammatory processes in their pathophysiology.
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Affiliation(s)
- S Gerdes
- Psoriasis-Center, Department of Dermatology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - A Pinter
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | | | - M Reinhardt
- Novartis Pharma AG, Basel, Switzerland.,Novartis Pharma GmbH, Nürnberg, Germany
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Struck F, Farid Y, Rademacher F, Gerdes S, Weidinger S, Harder J. 368 The microbiota of atopic dermatitis lesions induces TSLP expression in a 3D skin equivalent. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
Background: Adiponectin is an adipocyte-secreted protein potentially relevant in the context of cardiometabolic comorbidity of psoriasis patients.Objective: This post-hoc analysis aimed to assess the impact of obesity, metabolic syndrome, psoriasis severity and treatment with secukinumab/etanercept on adiponectin.Methods: Three phase III trials in moderate to severe plaque psoriasis were included. Correlations of Psoriasis Area and Severity Index (PASI), body mass index (BMI), and associated comorbidity with adiponectin levels as well as the impact of secukinumab, etanercept, and placebo were analyzed.Results: Data of 3010 patients were included of whom 71.2% had a BMI >25. Adiponectin levels were significantly higher in patients with lower BMI (r = -0.23; p < .0001) and in patients without metabolic syndrome compared to patients with higher BMI and with metabolic syndrome. PASI score was negatively associated with adiponectin levels (r = -0.065; p = .0004). However, the correlation was extremely weak and thus clinically irrelevant. During treatment with secukinumab or etanercept over 52 weeks adiponectin levels remained stable.Conclusion: Metabolic syndrome and BMI are key determinants of adiponectin levels in psoriasis patients. Psoriasis severity and anti-psoriatic treatment had no relevant impact on adiponectin levels.
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Affiliation(s)
- S Gerdes
- Psoriasis-Center, Department of Dermatology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - A Pinter
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - M Biermann
- Novartis Pharma GmbH, Nuernberg, Germany
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Augustin M, Thaci D, Eyerich K, Pinter A, Radtke M, Lauffer F, Mrowietz U, Gerdes S, Pariser D, Lebwohl M, Sieder C, Melzer N, Reich K. Continued treatment with secukinumab is associated with high retention or regain of response. Br J Dermatol 2019; 182:67-75. [PMID: 30972746 DOI: 10.1111/bjd.17991] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Conventional analyses present aggregate data, masking late responders and efficacy reductions. Secukinumab, a fully human monoclonal antibody that selectively neutralizes interleukin (IL)-17A, shows sustained efficacy in moderate-to-severe psoriasis. OBJECTIVES To determine stability of response to secukinumab, changes in efficacy were assessed in individual patients. METHODS This is a post hoc analysis of two phase III randomized controlled trials, FIXTURE (trial registration: NCT01358578) and CLEAR (trial registration: NCT02074982). Patients received secukinumab 300 mg (FIXTURE and CLEAR), etanercept 50 mg (FIXTURE) or ustekinumab 45 or 90 mg (CLEAR) over 52 weeks. Mutually exclusive response categories were defined: ≥ 90% improvement in the Psoriasis Area and Severity Index (PASI 90) ('excellent'), ≥ 75% improvement in PASI (PASI 75) and < PASI 90 ('good') and < PASI 75 ('insufficient'). Reductions in efficacy were defined as shifts from higher to lower response categories between two consecutive visits maintained for a third consecutive visit. Loss of efficacy was defined as a reduction of efficacy resulting in 'insufficient' response. All comparisons are descriptive. RESULTS At 52 weeks, in CLEAR, 90·2% (303/336) of patients on secukinumab achieved stable efficacy without loss and 77·7% (261/336) showed stable efficacy without any reduction of response [74·3% (252/339) and 59·9% (203/339) of patients for ustekinumab]. In FIXTURE, 83·5% (273/327) and 66·4% (217/327) of patients on secukinumab had stable efficacy without loss or reduction of response [58·3% (190/326) and 42·6% (139/326) for etanercept]. Response was regained by continuing secukinumab treatment in 50% (8/16) of patients in CLEAR and 26% (9/34) in FIXTURE. Similar patterns were observed for other response definitions. CONCLUSIONS Efficacy with secukinumab was stable over 52 weeks of treatment in most patients. Continued treatment with secukinumab resulted in regain of efficacy in some patients. Persistent loss of response was uncommon. What's already known about this topic? Secukinumab, a fully human monoclonal antibody that selectively neutralizes interleukin (IL)-17A, shows significant and sustained efficacy in the treatment of moderate-to-severe psoriasis. Secondary loss of response may be experienced by a minority of patients treated with secukinumab, as with other biologics, but the extent of this and the potential for regain of efficacy with continued treatment is not well understood. What does this study add? To determine stability of response to secukinumab and inform clinical practice, changes in efficacy were assessed at individual patient level using response categories. Efficacy with secukinumab was stable over 52 weeks of treatment in most patients, and continued treatment with secukinumab resulted in efficacy regain after loss in some patients. Persistent loss of response was uncommon. Patient factors such as body weight may affect the likelihood of loss of efficacy.
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Affiliation(s)
- M Augustin
- Institute of Health Services Research in Dermatology and Nursing, University Medical Center of Hamburg Eppendorf, Germany
| | - D Thaci
- Comprehensive Centre of Inflammation Medicine, University of Lübeck, Lübeck, Germany
| | - K Eyerich
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - A Pinter
- University Hospital Frankfurt, Frankfurt am Main, Germany
| | - M Radtke
- Institute of Health Services Research in Dermatology and Nursing, University Medical Center of Hamburg Eppendorf, Germany
| | - F Lauffer
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - U Mrowietz
- Psoriasis-Center, Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - S Gerdes
- Psoriasis-Center, Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - D Pariser
- Eastern Virginia Medical School and Virginia Clinical Research, Inc., Norfolk, VA, U.S.A
| | - M Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, U.S.A
| | - C Sieder
- Novartis Pharma GmbH, Nürnberg, Germany
| | - N Melzer
- Novartis Pharma GmbH, Nürnberg, Germany
| | - K Reich
- Dermatologikum Berlin and SCIderm Research Institute, Hamburg, Germany
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Schulte DM, Paulsen K, Türk K, Brandt B, Freitag-Wolf S, Hagen I, Zeuner R, Schröder JO, Lieb W, Franke A, Nikolaus S, Mrowietz U, Gerdes S, Schreiber S, Laudes M. Small dense LDL cholesterol in human subjects with different chronic inflammatory diseases. Nutr Metab Cardiovasc Dis 2018; 28:1100-1105. [PMID: 30143407 DOI: 10.1016/j.numecd.2018.06.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 06/06/2018] [Accepted: 06/27/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND AIMS Chronic inflammatory diseases (CID) are associated with a profound increase in cardiovascular (CV) risk resulting in reduced life expectancy. However, LDL-cholesterol is reported to be low in CID patients which is referred to as the "LDL paradoxon". The aim of the present study was to investigate whether LDL-particles in CID exhibit an increased content of the highly atherogenic small-dense LDL subfraction (sdLDL). METHODS AND RESULTS In this prospective, single center, observational study we enrolled 141 patients with CID (RA n = 59, inflammatory bowel disease (IBD) n = 35, ankylosing spondylitis (SpA) n = 25, Psoriasis n = 22) in 2011 through 2013 to evaluate sdLDL levels before as well as 6 and 26 weeks after initiation of different anti-cytokine therapies (anti-TNFα, anti-IL-6R antibodies). sdLDL levels were compared to 141 healthy individuals in a case control design. Compared to healthy controls, all CID patients displayed a significantly higher sdLDL content within the LDL cholesterol fraction: RA 35.0 ± 9.2% (p < 0.001), SpA 42.5 ± 10.5% (p < 0.001), IBD 37.5 ± 7.1% (p < 0.001), Psoriasis 33.6 ± 4.6% (p < 0.01). Furthermore, the sdLDL/LDL ratio was significantly higher in male compared to female RA subjects (p < 0.05). Neither anti-TNFα nor anti-IL6R medication altered sdLDL levels despite a significant improvement of disease activity. CONCLUSION In several different chronic inflammatory disease entities, LDL-cholesterol is shifted toward a pro-atherogenic phenotype due to an increased sdLDL content which might in part explain the LDL paradoxon. Since premature CV disease is a major burden of affected patients, specifically targeting lipid metabolism should be considered routinely in clinical patient care. CLINICAL TRIALS Registration at German Clinical Trial Register (DRKS): DRKS00005285.
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Affiliation(s)
- D M Schulte
- Department of Internal Medicine I, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany; Cluster of Excellence Inflammation at Interfaces, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany
| | - K Paulsen
- Department of Internal Medicine I, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany
| | - K Türk
- Department of Internal Medicine I, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany
| | - B Brandt
- Institute of Clinical Chemistry, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany
| | - S Freitag-Wolf
- Institute of Medical Informatics and Statistics, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany
| | - I Hagen
- Department of Internal Medicine I, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany
| | - R Zeuner
- Department of Internal Medicine I, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany
| | - J O Schröder
- Department of Internal Medicine I, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany; Cluster of Excellence Inflammation at Interfaces, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany
| | - W Lieb
- Institute of Epidemiology, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany
| | - A Franke
- Cluster of Excellence Inflammation at Interfaces, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany; Institute of Clinical Molecular Biology, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany
| | - S Nikolaus
- Department of Internal Medicine I, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany; Cluster of Excellence Inflammation at Interfaces, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany
| | - U Mrowietz
- Cluster of Excellence Inflammation at Interfaces, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany; Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany
| | - S Gerdes
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany
| | - S Schreiber
- Department of Internal Medicine I, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany; Cluster of Excellence Inflammation at Interfaces, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany
| | - M Laudes
- Department of Internal Medicine I, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany; Cluster of Excellence Inflammation at Interfaces, University of Kiel, Arnold-Heller-Strasse 3, D-24105, Kiel, Germany.
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Gerdes S, Hanke-Lensing A, Baxmann M, Bliemeister M, Beckert P, Yilmaz M. 15 Jahre Fingerprinting in der Region Hannover. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1639262] [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] [Indexed: 10/28/2022]
Affiliation(s)
- S Gerdes
- Region Hannover, Fachbereich Gesundheit, Hannover, Germany
| | | | - M Baxmann
- Region Hannover, Team Tuberkulose, Hannover, Germany
| | - M Bliemeister
- Region Hannover, Team Tuberkulose, Hannover, Germany
| | - P Beckert
- Forschungszentrum Borstel, Molekulare und experimentelle Mykobakteriologie, Borstel, Germany
| | - M Yilmaz
- Region Hannover, Fachbereich Gesundheit, Hannover, Germany
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Mössner R, Wilsmann-Theis D, Oji V, Gkogkolou P, Löhr S, Schulz P, Körber A, Prinz JC, Renner R, Schäkel K, Vogelsang L, Peters KP, Philipp S, Reich K, Ständer H, Jacobi A, Weyergraf A, Kingo K, Kõks S, Gerdes S, Steinz K, Schill T, Griewank KG, Müller M, Frey S, Ebertsch L, Uebe S, Sticherling M, Sticht H, Hüffmeier U. The genetic basis for most patients with pustular skin disease remains elusive. Br J Dermatol 2018; 178:740-748. [PMID: 28887889 DOI: 10.1111/bjd.15867] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Rare variants in the genes IL36RN, CARD14 and AP1S3 have been identified to cause or contribute to pustular skin diseases, primarily generalized pustular psoriasis (GPP). OBJECTIVES To better understand the disease relevance of these genes, we screened our cohorts of patients with pustular skin diseases [primarily GPP and palmoplantar pustular psoriasis (PPP)] for coding changes in these three genes. Carriers of single heterozygous IL36RN mutations were screened for a second mutation in IL36RN. METHODS Coding exons of IL36RN, CARD14 and AP1S3 were sequenced in 67 patients - 61 with GPP, two with acute generalized exanthematous pustulosis and four with acrodermatitis continua of Hallopeau. We screened IL36RN and AP1S3 for intragenic copy-number variants and 258 patients with PPP for coding changes in AP1S3. Eleven heterozygous IL36RN mutations carriers were analysed for a second noncoding IL36RN mutation. Genotype-phenotype correlations in carriers/noncarriers of IL36RN mutations were assessed within the GPP cohort. RESULTS The majority of patients (GPP, 64%) did not carry rare variants in any of the three genes. Biallelic and monoallelic IL36RN mutations were identified in 15 and five patients with GPP, respectively. Noncoding rare IL36RN variants were not identified in heterozygous carriers. The only significant genotype-phenotype correlation observed for IL36RN mutation carriers was early age at disease onset. Additional rare CARD14 or AP1S3 variants were identified in 15% of IL36RN mutation carriers. CONCLUSIONS The identification of IL36RN mutation carriers harbouring additional rare variants in CARD14 or AP1S3 indicates a more complex mode of inheritance of pustular psoriasis. Our results suggest that, in heterozygous IL36RN mutation carriers, there are additional disease-causing genetic factors outside IL36RN.
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Affiliation(s)
- R Mössner
- Department of Dermatology, Georg-August-University Göttingen, Göttingen, Germany
| | - D Wilsmann-Theis
- Department of Dermatology and Allergy, University Bonn, Bonn, Germany
| | - V Oji
- Department of Dermatology, University Münster, Münster, Germany
| | - P Gkogkolou
- Department of Dermatology, University Münster, Münster, Germany
| | - S Löhr
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - P Schulz
- Department of Dermatology, Fachklinik Bad Bentheim, Bad Bentheim, Germany
| | - A Körber
- Department of Dermatology, University of Essen, Essen, Germany
| | - J C Prinz
- Department of Dermatology and Allergology, Ludwig-Maximilian University Munich, Munich, Germany
| | - R Renner
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
| | - K Schäkel
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - L Vogelsang
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - K-P Peters
- Department of Dermatology and Allergology, Hospital Bayreuth, Bayreuth, Germany
| | - S Philipp
- Department of Dermatology and Allergy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - K Reich
- Dermatologikum Hamburg, Hamburg, Germany
| | - H Ständer
- Department of Dermatology, Klinikum Dortmund, Dortmund, Germany
| | - A Jacobi
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Weyergraf
- Department of Dermatology, Fachklinik Bad Bentheim, Bad Bentheim, Germany
| | - K Kingo
- Department of Dermatology, Dermatology Clinic, University of Tartu, Tartu, Estonia
| | - S Kõks
- Department of Pathophysiology, University of Tartu, Tartu, Estonia
| | - S Gerdes
- Department of Dermatology, University of Kiel, Kiel, Germany
| | - K Steinz
- Department of Dermatology, University of Kiel, Kiel, Germany
| | - T Schill
- Department of Dermatology and Allergy, University Bonn, Bonn, Germany
| | - K G Griewank
- Department of Dermatology, University of Essen, Essen, Germany
| | - M Müller
- Institute of Occcupational, Social and Environmental Medicine, Georg-August-University Göttingen, Göttingen, Germany
| | - S Frey
- Department of Internal Medicine 3 - Rheumatology and Immunology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - L Ebertsch
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - S Uebe
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - M Sticherling
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
| | - H Sticht
- Bioinformatics, Institute of Biochemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - U Hüffmeier
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Albrecht J, Gerdes S. When to switch biologics: some answers, but lots of questions too. Br J Dermatol 2018; 178:20. [DOI: 10.1111/bjd.16118] [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] [Indexed: 11/28/2022]
Affiliation(s)
- J. Albrecht
- Division of Dermatology Department of Medicine J.H. Stroger Hospital of Cook County Chicago IL U.S.A
- Department of Dermatology Rush Medical College Chicago IL U.S.A
| | - S. Gerdes
- Psoriasis Center at the Department of Dermatology University Medical Center Schleswig‐Holstein Campus Kiel Kiel Germany
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Gerdes S, Thaçi D, Griffiths CEM, Arenberger P, Poetzl J, Wuerth G, Afonso M, Woehling H. Multiple switches between GP2015, an etanercept biosimilar, with originator product do not impact efficacy, safety and immunogenicity in patients with chronic plaque-type psoriasis: 30-week results from the phase 3, confirmatory EGALITY study. J Eur Acad Dermatol Venereol 2017; 32:420-427. [PMID: 28960486 PMCID: PMC5887937 DOI: 10.1111/jdv.14605] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/20/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND EGALITY was a phase III confirmatory efficacy and safety study conducted in patients with plaque-type psoriasis as a part of totality of evidence gathered during the development of GP2015, an etanercept biosimilar. OBJECTIVE To demonstrate equivalent efficacy and comparable safety and immunogenicity of GP2015 and the etanercept originator product (ETN, Enbrel® ) and evaluate effects of repeated switching between GP2015 and ETN. Results for efficacy, safety and immunogenicity during treatment period (TP) 2 (TP2) are presented pooling the two continued treatment arms (pooled continued) versus the two treatment arms with repeated switches (pooled switched). METHODS Patients (n = 531) were randomized 1:1 to self-administer GP2015 or ETN twice-weekly subcutaneously during TP1. Patients with a ≥50% improvement in Psoriasis Area and Severity Index (PASI 50) at week 12 were re-randomized for TP2 to continue the same treatment at once-weekly dosing or to undergo three consecutive treatment switches between GP2015 and ETN until week 30. Patients continued the last-assigned treatment during TP2, until week 52. RESULTS Mean (standard deviation [SD]) PASI scores at baseline were similar in patients who underwent multiple switches compared to those with continued treatments during TP2. During TP2, PASI 50, PASI 75 and PASI 90 response rates, percent change from baseline in PASI scores and all other efficacy parameters were similar between the pooled switched and pooled continued treatment groups at all time points. The incidence of treatment-emergent adverse events including injection site reactions was comparable between the pooled switched (36.7%) and pooled continued (34.9%) groups. None of the patients in either treatment group were positive for binding anti-drug antibodies in TP2. CONCLUSION Treatment efficacy, safety and immunogenicity were similar between the pooled continued and pooled switched treatments during TP2, indicating that there are no effects in the short term on clinical data of multiple switches between GP2015 and ETN.
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Affiliation(s)
- S Gerdes
- Psoriasis-Center at the Department of Dermatology, Universitaetsklinikum Schleswig-Holstein, Kiel, Germany
| | - D Thaçi
- Comprehensive Center for Inflammation Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - C E M Griffiths
- Dermatology Centre, Salford Royal Hospital, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - P Arenberger
- Department of Dermatology, Charles University, Third Medical Faculty and Faculty Hospital Kralovske Vinohrady, Prague 10, Czech Republic
| | - J Poetzl
- Global Clinical Development, Biopharmaceuticals, Hexal AG, Holzkirchen, Germany
| | - G Wuerth
- Global Clinical Development, Biopharmaceuticals, Hexal AG, Holzkirchen, Germany
| | - M Afonso
- Global Clinical Development, Biopharmaceuticals, Hexal AG, Holzkirchen, Germany
| | - H Woehling
- Global Clinical Development, Biopharmaceuticals, Hexal AG, Holzkirchen, Germany
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Griffiths C, Reich K, Thaçi D, Gerdes S, Arenberger P, Kingo K, Weglowska J, Woehling H. 002 Switching treatments of etanercept biosimilar GP2015 with originator product does not impact efficacy, safety and immunogenicity in patients with chronic plaque-type psoriasis. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gerdes S, Mrowietz U, Wagner U. Differenzialdiagnostisches Spektrum der Psoriasis versus Psoriasisarthritis an Haut und Gelenken. Z Rheumatol 2017; 76:484-494. [DOI: 10.1007/s00393-017-0340-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Albrecht J, Gerdes S. Switching expensive drugs with frequently diminishing value. Br J Dermatol 2017; 177:338-339. [DOI: 10.1111/bjd.15678] [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] [Indexed: 11/28/2022]
Affiliation(s)
- J. Albrecht
- Division of Dermatology; Department of Medicine; J.H. Stroger Hospital of Cook County; Chicago IL U.S.A
- Department of Dermatology; Rush Medical College; Chicago IL U.S.A
| | - S. Gerdes
- Psoriasis-Center at the Department of Dermatology; University Medical Center Schleswig-Holstein; Campus Kiel, Kiel Germany
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Gerdes S, Nagott B, Wasmus C, Yilmaz M. Gesundheitsberichterstattung mit Gimmick. Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1602025] [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] [Indexed: 10/19/2022]
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Gerdes S, Nagott B, Wasmus C, Yilmaz M. 7 Jahre Gesundheitsberichterstattung in der Region Hannover. Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1602068] [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] [Indexed: 10/19/2022]
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Abstract
Psoriasis is a systemic chronic inflammatory disease associated with comorbidity. Many epidemiological studies have shown that psoriasis is associated with psoriatic arthritis as well as cardiovascular and metabolic diseases. Furthermore, obesity and psychological diseases such as depression and anxiety disorders are linked with psoriasis and play a central role in its management. The association of psoriasis and its comorbidity can be partly explained by genetic and pathophysiological mechanisms. Approximately 40 psoriasis susceptibility loci have been described with the majority linked to the innate and adaptive immune system. In some associated diseases, such as psoriatic arthritis, an overlap of their genetic susceptibility exists. Pathophysiologically the "psoriatic march" is a model that describes the development of metabolic and cardiovascular diseases due to the presence of underlying systemic inflammation. Dermatologists are the gatekeepers to treatment for patients with psoriasis. The early detection and the management of comorbidity is part of their responsibility. Concepts for the management of psoriasis and tools to screen for psoriatic comorbidity have been developed in order to support dermatologists in daily practice.
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Affiliation(s)
- S Gerdes
- Psoriasis-Zentrum, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Schittenhelmstr. 7, 24105, Kiel, Deutschland.
| | - U Mrowietz
- Psoriasis-Zentrum, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Schittenhelmstr. 7, 24105, Kiel, Deutschland
| | - W-H Boehncke
- Service de Dermatologie et Vénéréologie, Hôpitaux Universitaires de Genève und Département de Pathologie et Immunologie, Université de Genève, Genf, Schweiz
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Griffiths C, Thaçi D, Gerdes S, Arenberger P, Pulka G, Kingo K, Weglowska J, Hattebuhr N, Poetzl J, Woehling H, Wuerth G, Afonso M. The EGALITY study: a confirmatory, randomized, double-blind study comparing the efficacy, safety and immunogenicity of GP2015, a proposed etanercept biosimilar, vs. the originator product in patients with moderate-to-severe chronic plaque-type psoriasis. Br J Dermatol 2017; 176:928-938. [DOI: 10.1111/bjd.15152] [Citation(s) in RCA: 134] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2016] [Indexed: 12/30/2022]
Affiliation(s)
- C.E.M. Griffiths
- Dermatology Centre; Salford Royal Hospital; University of Manchester; Manchester Academic Health Science Centre; Manchester U.K
| | - D. Thaçi
- Comprehensive Center for Inflammation Medicine; University Hospital Schleswig-Holstein; Campus Lübeck Lübeck Germany
| | - S. Gerdes
- Psoriasis-Center at the Department of Dermatology; Universitaetsklinikum; Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Haus 19 24105 Kiel Germany
| | - P. Arenberger
- Department of Dermatology; Charles University Third Medical Faculty and Faculty Hospital Kralovske Vinohrady; Srobarova 50 Prague 10 10034 Czech Republic
| | - G. Pulka
- Grazyna Pulka Specjalistyczny Osrodek ‘ALL-MED’ ul. Sw. Marka 31/IU; ul. Sw. Krzyza 16/14 Krakow 31-023 Poland
| | - K. Kingo
- Dermatology Clinic; Tartu University Hospital; Raja 31 Tartu 50417 Estonia
| | - J. Weglowska
- Department of Dermatology; Wojewodzki Szpital Specjalistyczny we Wroclawiu; ul. Kamienskiego 73a Wroclaw 51-124 Poland
| | - N. Hattebuhr
- Global Clinical Development, Biopharmaceuticals; Hexal AG; Industriestraße 25 D 83607 Holzkirchen Germany
| | - J. Poetzl
- Global Clinical Development, Biopharmaceuticals; Hexal AG; Industriestraße 25 D 83607 Holzkirchen Germany
| | - H. Woehling
- Global Clinical Development, Biopharmaceuticals; Hexal AG; Industriestraße 25 D 83607 Holzkirchen Germany
| | - G. Wuerth
- Global Clinical Development, Biopharmaceuticals; Hexal AG; Industriestraße 25 D 83607 Holzkirchen Germany
| | - M. Afonso
- Global Clinical Development, Biopharmaceuticals; Hexal AG; Industriestraße 25 D 83607 Holzkirchen Germany
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Gerdes S, Korman N, Wilhelm S, Casillas M, Zhao F, Schacht A, Dutronc Y, Augendre-Ferrante B. Ixékizumab : efficacité chez des patients atteints de psoriasis avec ou sans traitement biologique préalable ; résultats d’UNCOVER-1 semaines 12 et 60. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gottlieb AB, Lacour JP, Korman N, Wilhelm S, Dutronc Y, Schacht A, Erickson J, Zhang L, Mallbris L, Gerdes S. Treatment outcomes with ixekizumab in patients with moderate-to-severe psoriasis who have or have not received prior biological therapies: an integrated analysis of two Phase III randomized studies. J Eur Acad Dermatol Venereol 2016; 31:679-685. [PMID: 27696577 PMCID: PMC5412924 DOI: 10.1111/jdv.13990] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 09/16/2016] [Indexed: 01/17/2023]
Abstract
Background Biologics are effective for the treatment of psoriasis. However, treatment outcomes may differ among biologic‐naive patients and those switched from previous biological therapies. Objectives The study's objective was to investigate efficacy and safety of ixekizumab, a high‐affinity anti‐interleukin‐17A antibody, in patients with psoriasis with and without previous exposure to biologics. Methods Data were integrated from the 12‐week induction phase of two etanercept‐controlled Phase III trials. Patients received 80 mg ixekizumab every 2 weeks (IXE Q2W; N = 736) or every 4 weeks (IXE Q4W; N = 733) following a 160‐mg starting dose, or placebo (N = 361). Etanercept (50 mg twice weekly; N = 740) was administered as active control. Psoriasis Area and Severity Index (PASI) 75, PASI 90 and PASI 100 response rates at week 12 were evaluated in patients with or without previous exposure to biologics. Treatment effects were analysed with the Cochran–Mantel–Haenszel test stratified by study; missing values were imputed as non‐response. Results Overall, 497 (19.3%) patients had prior exposure to biologics and 2073 (80.7%) were naive to biologic therapy. PASI 75 was achieved by 91.5% of biologic‐experienced patients and 87.7% of biologic‐naive patients for IXE Q2W, 76.2% and 82.2% for IXE Q4W, respectively, and 34.6% and 50.7%, respectively, for etanercept. Higher response rates favouring each ixekizumab dose over etanercept within subgroups were also seen regarding PASI 90 and PASI 100. Conclusions Contrary to etanercept, the efficacy of ixekizumab was similarly high in patients with and without previous exposure to biologics when administered 80 mg every 2 weeks.
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Affiliation(s)
- A B Gottlieb
- Department of Dermatology, New York Medical College, Valhalla, NY, USA
| | - J-P Lacour
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - N Korman
- Murdough Family Center for Psoriasis, University Hospitals Case Medical Center, Cleveland, OH, USA
| | - S Wilhelm
- Global Medical Affairs, Lilly Deutschland GmbH, Bad Homburg, Germany
| | - Y Dutronc
- Regional Medical Affairs, Lilly France, Neuilly-sur-Seine, France
| | - A Schacht
- Global Medical Affairs, Lilly Deutschland GmbH, Bad Homburg, Germany
| | - J Erickson
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - L Zhang
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - L Mallbris
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - S Gerdes
- Department of Dermatology, Psoriasis-Center, University Medical Center Schleswig-Holstein, Kiel, Germany
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Gottlieb A, Gerdes S, Lacour J, Korman N, Papp K, Dutronic Y, Mallbris L, Erickson J, Schacht A, Bachelez H. 052 Efficacy of ixekizumab in moderate-to-severe psoriasis patients who have or have not received prior biologic therapies: An integrated analysis of 3 phase 3 studies. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Schuler MK, Gerdes S, West A, Richter S, Busemann C, Hentschel L, Lenz F, Kopp HG, Ehninger G, Reichardt P, Pink D. Efficacy and safety of Dexrazoxane (DRZ) in sarcoma patients receiving high cumulative doses of anthracycline therapy - a retrospective study including 32 patients. BMC Cancer 2016; 16:619. [PMID: 27507014 PMCID: PMC4977890 DOI: 10.1186/s12885-016-2654-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 02/10/2015] [Accepted: 07/29/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Anthracyclines, as the most effective therapy, are the cornerstone of advanced stage sarcoma treatment. However, anthracyclines can also contribute to myocardial dysfunction and congestive heart failure, ultimately limiting the therapeutic potential of the drug. Coadministration of Dexrazoxane has been shown to effectively reduce cardiotoxicity, however primarily in patients suffering in diseases other than sarcoma. METHODS The aim of this retrospective analysis was to evaluate safety and efficacy of chemotherapy with high cumulative doses of anthracyclines in combination with Dexrazoxane. The medical charts of 32 patients treated in four institutions were analyzed. Reasons for coadministration were rechallenge, reaching the cumulative anthracycline dose and preexisting heart failure. RESULTS The median age was 54 years [18-68 years]. The median cumulative anthracycline dose before adding DRZ was 450 mg/m(2) and after administration of last anthracycline containing therapy 750 mg/m(2). Either during treatment or follow up, 2/27 patients (7 %) without preexisting major cardiac findings developed anthracycline-induced cardiotoxicity. The median overall survival (OS) from start of the first anthracycline containing chemotherapy was 46 months and 17 months from the initial coadministration of DRZ. At rechallenge, the median progression free survival (PFS) with DRZ was 7 months. In continuous therapy, the median PFS was 13 months from beginning of chemotherapy and 9 months from the addition of DRZ. CONCLUSION Chemotherapy with high cumulative doses of anthracyclines in addition with DRZ demonstrated a remarkable OS in these advanced disease patients. Cardiac side-effects due to high cumulative doses of anthracyclines requiring discontinuation of anthracycline treatment were rare. A PFS of 9 months from the beginning of the coadministration of DRZ indicates that continuing anthracycline therapy beyond established cumulative doses is a promising therapeutic option.
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Affiliation(s)
- Markus K Schuler
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, Technical University Dresden, Fetscherstraße 74, 01307, Dresden, Germany. .,Department of Internal Medicine II, HELIOS Clinic Emil von Behring, Walterhöferstr. 11, 14165, Berlin, Germany.
| | - Sebastian Gerdes
- Institute of Medical Informatics and Biometry, University Hospital Carl Gustav Carus, Technical University Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Antje West
- Department of Hematology and Oncology, HELIOS Clinic Bad Saarow, Pieskower Straße 33, 15526, Bad Saarow, Germany
| | - Stephan Richter
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, Technical University Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Christoph Busemann
- Department of Internal Medicine C, University Hospital Greifswald, Sauerbruchstraße, 17475, Greifswald, Germany
| | - Leopold Hentschel
- University Cancer Center, University Hospital Carl Gustav Carus, Technical University Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Felicitas Lenz
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, Technical University Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Hans-Georg Kopp
- Department of Internal Medicine II, University Hospital Tübingen, Eberhard Karls University Tübingen, Geissweg 3, 72076, Tübingen, Germany
| | - Gerhard Ehninger
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, Technical University Dresden, Fetscherstraße 74, 01307, Dresden, Germany.,University Cancer Center, University Hospital Carl Gustav Carus, Technical University Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Peter Reichardt
- Department of Interdisciplinary Oncology, HELIOS Clinic Berlin-Buch, Berlin, Germany
| | - Daniel Pink
- Department of Hematology and Oncology, HELIOS Clinic Bad Saarow, Pieskower Straße 33, 15526, Bad Saarow, Germany.,Department of Internal Medicine C, University Hospital Greifswald, Sauerbruchstraße, 17475, Greifswald, Germany
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Albrecht J, Gerdes S. A new option on the horizon for the treatment of psoriasis: it is needed, but not at any price. Br J Dermatol 2016; 174:1183-4. [PMID: 27317278 DOI: 10.1111/bjd.14712] [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] [Indexed: 11/30/2022]
Affiliation(s)
- J Albrecht
- Division of Dermatology, Department of Medicine, J. H. Stroger Hospital of Cook County, 5th Floor Administration Building, 1900 West Polk Street, Chicago, IL, 60612, U.S.A
| | - S Gerdes
- Division of Dermatology, Department of Medicine, J. H. Stroger Hospital of Cook County, 5th Floor Administration Building, 1900 West Polk Street, Chicago, IL, 60612, U.S.A
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Paulsen K, Schulte D, Türck K, Freitag-Wolf S, Hagen I, Zeuner R, Schröder JO, Lieb W, Franke A, Nikolaus S, Mrowietz U, Gerdes S, Schreiber S, Laudes M. Small dense LDL cholesterol is a cardiovascular risk factor in several chronic inflammatory diseases. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gerdes S, Dethlefs B, Personke Y, Storim J, Mrowietz U. Online weight-loss coaching for patients with psoriasis: results of a pilot study. Br J Dermatol 2016; 174:674-6. [PMID: 26399576 DOI: 10.1111/bjd.14187] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S Gerdes
- Psoriasis Center at the Department of Dermatology, University Medical Center, Schleswig-Holstein, Campus Kiel, Schittenhelmstraße 7, 24105, Kiel, Germany.
| | - B Dethlefs
- Psoriasis Center at the Department of Dermatology, University Medical Center, Schleswig-Holstein, Campus Kiel, Schittenhelmstraße 7, 24105, Kiel, Germany
| | - Y Personke
- Janssen-Cilag GmbH, Johnson & Johnson Platz 1, 41470, Neuss, Germany
| | - J Storim
- Janssen-Cilag GmbH, Johnson & Johnson Platz 1, 41470, Neuss, Germany
| | - U Mrowietz
- Psoriasis Center at the Department of Dermatology, University Medical Center, Schleswig-Holstein, Campus Kiel, Schittenhelmstraße 7, 24105, Kiel, Germany
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