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Knobler R, Geroldinger-Simić M, Kreuter A, Hunzelmann N, Moinzadeh P, Rongioletti F, Denton CP, Mouthon L, Cutolo M, Smith V, Gabrielli A, Bagot M, Olesen AB, Foeldvari I, Jalili A, Kähäri V, Kárpáti S, Kofoed K, Olszewska M, Panelius J, Quaglino P, Seneschal J, Sticherling M, Sunderkötter C, Tanew A, Wolf P, Worm M, Skrok A, Rudnicka L, Krieg T. Consensus statement on the diagnosis and treatment of sclerosing diseases of the skin, Part 1: Localized scleroderma, systemic sclerosis and overlap syndromes. J Eur Acad Dermatol Venereol 2024. [PMID: 38456584 DOI: 10.1111/jdv.19912] [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: 09/07/2023] [Accepted: 01/26/2024] [Indexed: 03/09/2024]
Abstract
The term 'sclerosing diseases of the skin' comprises specific dermatological entities, which have fibrotic changes of the skin in common. These diseases mostly manifest in different clinical subtypes according to cutaneous and extracutaneous involvement and can sometimes be difficult to distinguish from each other. The present consensus provides an update to the 2017 European Dermatology Forum Guidelines, focusing on characteristic clinical and histopathological features, diagnostic scores and the serum autoantibodies most useful for differential diagnosis. In addition, updated strategies for the first- and advanced-line therapy of sclerosing skin diseases are addressed in detail. Part 1 of this consensus provides clinicians with an overview of the diagnosis and treatment of localized scleroderma (morphea), and systemic sclerosis including overlap syndromes.
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Affiliation(s)
- R Knobler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - M Geroldinger-Simić
- Department of Dermatology, Ordensklinikum Linz Elisabethinen, Linz, Austria
- Faculty of Medicine, Johannes Kepler University, Linz, Austria
| | - A Kreuter
- Department of Dermatology, Venereology and Allergology, HELIOS St. Elisabeth Klinik Oberhausen, University Witten-Herdecke, Oberhausen, Germany
| | - N Hunzelmann
- Department of Dermatology and Venereology, University of Cologne, Cologne, Germany
| | - P Moinzadeh
- Department of Dermatology and Venereology, University of Cologne, Cologne, Germany
| | - F Rongioletti
- Vita Salute University IRCSS San Raffaele Hospital, Milan, Italy
| | - C P Denton
- Center for Rheumatology, Royal Free and University College Medical School, London, UK
| | - L Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Auto-Immunes et Systémiques Rares d'Ile de France, APHP-CUP, Hôpital Cochin, Paris, France
- Institut Cochin, Université de Paris Cité, Paris, France
| | - M Cutolo
- Laboratories for Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine DiMI, University Medical School of Genoa, IRCCS San Martino Genoa, Genoa, Italy
| | - V Smith
- Department of Internal Medicine, Ghent University, Ghent, Belgium
- Department of Rheumatology, Ghent University Hospital, Ghent, Belgium
- Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Center (IRC), Ghent, Belgium
| | - A Gabrielli
- Fondazione di Medicina Molecolare e Terapia Cellulare, Università Politecnica delle Marche, Ancona, Italy
| | - M Bagot
- Department of Dermatology, Hôpital Saint-Louis, Université Paris Cité, Paris, France
| | - A B Olesen
- Department of Dermatology, University Hospital of Aarhus, Aarhus, Denmark
| | - I Foeldvari
- Hamburg Centre for Pediatric and Adolescent Rheumatology, Schön Klinik Hamburg Eilbek, Hamburg, Germany
| | - A Jalili
- Dermatology & Skin Care Clinic, Buochs, Switzerland
| | - V Kähäri
- Department of Dermatology and Venereology, University of Turku and Turku University Hospital, Turku, Finland
| | - S Kárpáti
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - K Kofoed
- The Skin Clinic, Copenhagen, Denmark
| | - M Olszewska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - J Panelius
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - P Quaglino
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, Turin, Italy
| | - J Seneschal
- Department of Dermatology and Pediatric Dermatology, National Centre for Rare Skin Disorders, Hôpital Saint-Andre, University of Bordeaux, CNRS, Immuno CencEpT, UMR 5164, Bordeaux, France
| | - M Sticherling
- Department of Dermatology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - C Sunderkötter
- Department of Dermatology and Venereology, University Hospital Halle, Halle (Saale), Germany
| | - A Tanew
- Private Practice, Vienna, Austria
| | - P Wolf
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - M Worm
- Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergology, University Hospital Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A Skrok
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - L Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - T Krieg
- Department of Dermatology and Venereology, and Translational Matrix Biology, University of Cologne, Cologne, 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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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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Tascilar K, Simon D, Kleyer A, Fagni F, Krönke G, Meder C, Dietrich P, Orlemann T, Kliem T, Mößner J, Liphardt AM, Schönau V, Bohr D, Schuster L, Hartmann F, Taubmann J, Leppkes M, Ramming A, Pachowsky M, Schuch F, Ronneberger M, Kleinert S, Hueber A, Manger K, Manger B, Atreya R, Berking C, Sticherling M, Neurath MF, Schett G. POS0260 LONG-TERM HUMORAL RESPONSE TO SARS-CoV-2 VACCINATION IN PATIENTS WITH IMMUNE-MEDIATED INFLAMMATORY DISEASE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe first vaccine against SARS-CoV-2 was approved in December 2020. Immunogenicity of SARS-CoV2 vaccines in patients with immune-mediated inflammatory disease (IMID) have so far been evaluated in the 2-6 weeks following complete vaccination and risk groups for poor early vaccine response have been identified leading to specific vaccination recommendations. However, data on the long-term course and persistence of vaccine response in IMID patients, as well as the outcomes of the specific recommendations are lacking.ObjectivesTo evaluate the long-term course of humoral response to SARS-CoV-2 vaccination in a large prospective cohort of IMID patients and non-IMID controls with a follow-up duration of up-to to 10 months after the first vaccine dose.MethodsWe have initiated a prospective dynamic cohort of IMID patients and healthy controls in February 2020 to monitor immune response to SARS-CoV-2 and respiratory infections including COVID-19 (1). Participants who contributed data starting from the 4 weeks before their first vaccination onwards were included in this analysis. Antibodies against SARS-CoV-2 spike protein were quantified with an ELISA from Euroimmun (Lübeck, Germany) with an optical density cutoff of 0.8. We fitted linear mixed-effect models for log-transformed antibody levels using time splines with adjustment for age and sex. Marginal mean antibody levels with 95% confidence intervals (CI) were estimated at selected time points for IMID patients and controls with double vaccination. We descriptively analyzed the observed antibody levels over time in cohort participants receiving two vaccinations vs. three vaccinations.ResultsAmong 5076 cohort participants, 3147 IMID patients and healthy controls (mean (SD) age 49 (16)) provided 4756 samples for this analysis between December 2020 and 2021, with a median (IQR) 28 (14-31) weeks of follow-up after the first vaccination (Table 1). 2965 (94%) participants had received at least 2 and 223 (7%) participants had received three vaccine doses by the date of their latest sampling. In IMID patients, age and sex-adjusted estimated marginal mean antibody levels waned after week 16 and were substantially reduced at all time points compared to the controls, finally dropping to the borderline range (1.01, 95%CI 0.86 to 1.19) at week 40 (Figure 1A, Table 1). A third dose was given to 128 (7%) of IMID patients with a poor response to 2 vaccine doses after a median 20 weeks of the second dose (IQR 10 to 26 weeks). After the third dose, antibody levels in IMID patients were comparable to those of healthy controls at 40 weeks who had three vaccine doses. These were also higher than that of IMID patients and controls who did not receive a third dose (Figure 1B).Table 1.Participant characteristics and antibody levelsHealthy controlsIMID N11991948 Age, mean (SD)40.8 (13.5)54.3 (14.8) Follow-up, weeks, median (IQR)31.1 (23.8-36.6)19.6 (12.3-26.6) Follow-up range, weeks,1.6-46.11.7-46.3Sex, n(%) Female554 (46.2)1136 (58.3)Vaccine intervals, ´median (IQR) 1st to 2nd dose4.6 (3.0-6.0)6.0 (5.0-6.1) 2nd to 3rd dose29.6 (26.9-36.4)19.9 (10.0-26.1)Diagnosis, n (%) Spondyloarthritis-713 (36.6) Rheumatoid arthritis-489 (25.1) Autoimmune disease, systemic+-420 (21.5) Inflammatory bowel disease-219 (11.2) Psoriasis-107 (5.5)Mean* antibody levels after 1st dose Week-84.16 (3.89 to 4.45)2.97 (2.83 to 3.12) Week-168.39 (7.81 to 9.02)5.04 (4.81 to 5.28) Week-325.02 (4.73 to 5.33)2.52 (2.32 to 2.74) Week-402.14 (1.95 to 2.35)1.01 (0.86 to 1.19)+ Systemic lupus, systemic sclerosis, Sjögren’s syndrome, vasculitis* Estimated marginal means adjusted for age and sex.Figure 1.ConclusionHumoral response to vaccination against SARS-CoV-2 was weaker in IMID patients compared to controls at all time points after the first vaccine dose and practically disappeared after 1 year. IMID patients can still achieve a good antibody response with a third dose even after a weak response with two doses.References[1]Simon D et al Nat Commun 2020Disclosure of InterestsNone declared
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Haschka J, Simon D, Bayat S, Messner Z, Kampylafka E, Fagni F, Skalicky S, Hackl M, Resch H, Zwerina J, Kleyer A, Sticherling M, Schett G, Kocijan R, Rech J. POS0314 IDENTIFICATION OF CIRCULATING microRNA SIGNATURES IN PATIENTS WITH PSORIASIS WITH SUBCLINICAL JOINT DISEASE AND PATIENTS WITH PSORIATIC ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundMicroRNAs (miRNAs) are small non-coding RNAs that control gene expression. Specific miRNA signatures have been identified in numerous diseases and may serve as potential biomarkers or new drug targets. Whether certain miRNA signatures are associated with psoriatic joint disease is currently unknown.ObjectivesTo search for circulating miRNA signatures in psoriasis patients with subclinical joint disease and in patients with psoriatic arthritis (PsA).MethodsAnalyses of serum miRNA were done in three groups: (1) PsA patients fulfilling CASPAR criteria (PsA), (2) healthy controls without past or present signs of musculoskeletal disease (HC) and (3) psoriasis patients with musculoskeletal pain but no signs of clinical PsA (PsO). PsO and PsA patients received a hand MRI, which was scored according to PsAMRIS method. miRNA analysis of serum samples was performed stepwise using RT-qPCR (TAmiRNA Vienna). In the discovery phase 192 miRNA assays were analyzed in 48 samples (N=16 each group). In the validation phase 17 miRNAs (Table 1) were selected and analyzed in 94 samples (N=35 PsA, N=24 PsO, N=35 HC) based on results of discovery phase and previous reports in literature. Results presented as mean±SD/median (IQR), p-values are adjusted for multiple testing.Table 1.miRNAsPsA vs HCPsO vs HCPsA vs PsODiscovery PhaseValidation PhaseDiscovery PhaseValidation PhaseDiscovery PhaseValidation Phasep-adj.p-adj.p-adj.p-adj.p-adj.p-adj.miR-93-5p0.0001<0.0010.0080.0050.0390.947miR-29b-3p0.0001<0.00010.0040.00020.1910.522miR-19b-3p0.0070.7080.00020.0200.1380.147miR-320d0.0010.619<0.00010.1350.9410.247miR-144-5p0.0030.0060.00010.1690.3500.444miR-188-5p0.0140.9900.9750.6470.0530.839let-7b-5p0.0250.00030.8890.0260.00030.472miR-92a-3p0.0430.0010.0050.773<0.00010.0005miR-324-3p0.1381.0000.2570.3920.8140.518miR-126-3p0.0140.1690.0130.5980.9220.654miR-223-3p0.1690.8720.6170.7460.5191.000miR-130a-3p0.0390.0350.5560.0090.0060.724miR-140-3p0.3500.0530.0020.0060.1180.683miR-155-5p0.1590.9950.1690.5490.9220.604miR-21-5p0.2970.9900.0030.1160.080.014miR-146a-5p0.7060.0040.8360.0380.9050.941miR-122-5p0.9600.7340.6950.7990.9050.444Results51 PsA patients (age: 51.3±11.4 years; 56.9% females), 40 PsO patients (51.4±11.0; 37.5%) and 50 HC (51.0±10.5; 52.9%) were assessed. Duration of psoriasis was 12(25) years in PsA and 15(22.8) years in PsO. Duration of joint disease in PsA was 1.0(4.8) year. 51% of PsA and 5% of PsO patients were on biological disease modifying drugs (bDMARDs), 49% vs. 10% on conventional DMARDs. The most frequent findings in the MRI were erosions (PsA 59.6%; PsO 40%) and synovitis (PsA 48.9%; PsO 42.5%). PsA patients had higher number of tenosynovitis compared to PsO (p=0.04). In discovery phase 51 miRNAs in PsO and 64 miRNAs in PsA were down- or upregulated compared to HC, with an overlap of 33 miRNAs changed in PsA and PsO (p<0.05). Results of the selected 17 miRNAs are presented in Table 1. The top candidates to differentiate PsA and HC were miR-29b-3p (AUC=0.87), miR-93-5p (AUC=0.83) and let-7b-5p (AUC=0.79). For differentiating PsO and HC, they were miR-29b-3p (AUC=0.82), miR-140-3p (AUC=0.81) and miR-19b-3p (AUC=0.80) and for PsO vs. PsA miR-92a-3p (AUC=0.87), let-7b-5p (AUC=0.72) and miR-21-5p (AUC=0.70). miR-93-5p was lower in patients with erosions (p=0.01). miR-92a-3p, let-7b-5p and miR-21-5p were lower in patients with tenosynovitis, bone proliferations or erosions.ConclusionPsA and PsO patients show miRNA signatures different from HC. Top candidate miRNAs differentially regulated in PsA and PsO have been previously reported in alteration of bone metabolism and osteoarthritis indicating the intimate association of psoriatic inflammation with bone and cartilage changes.References[1]Faustini F et al. Ann Rheum Dis 2016 Dec;75(12):2068-2074[2]Hackl, M et al. Molecular and Cellular Endocrinology Elsevier Ireland Ltd 432, pp 83–95[3]Feichtinger X et al. Sci Rep 2018 Mar 20;8(1):4867Disclosure of InterestsNone declared
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Folle L, Bayat S, Kleyer A, Fagni F, Kapsner L, Schlereth M, Meinderink T, Breininger K, Tascilar K, Krönke G, Uder M, Sticherling M, Bickelhaupt S, Schett G, Maier A, Roemer F, Simon D. OP0292 CLASSIFICATION OF PSORIATIC ARTHRITIS, SERONEGATIVE RHEUMATOID ARTHRITIS, AND SEROPOSITIVE RHEUMATOID ARTHRITIS USING DEEP LEARNING ON MAGNETIC RESONANCE IMAGING. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundWhile MRI evaluation of joints has been primarily used to quantify inflammation at a cross-sectional and longitudinal level, less is known about the potential of MRI in distinguishing different patterns of inflammation in the various forms of arthritis.ObjectivesTo evaluate (i) whether deep learning using neural networks can be trained to distinguish between seropositive rheumatoid arthritis (RA+), seronegative RA (RA-), and psoriatic arthritis (PsA) based on structural inflammatory patterns on hand magnetic resonance imaging and (ii) to assess if psoriasis patients with subclinical inflammation fit into such patterns.MethodsResNet 3D [1] neural networks were trained to distinguish (i) RA+ vs. PsA, (ii) RA- vs. PsA and (iii) RA+ vs. RA- with respect to hand MRI data. Diagnosis of patients was determined using the following guidelines: ACR/EULAR 2010 [2] for RA and CASPAR [3] for PsA. Results from T1 coronal, T2 coronal, T1 coronal and axial fat suppressed contrast-enhanced (CE) and T2 fat suppressed axial sequences were used. The performance of such trained networks was analyzed by the area-under-the-receiver-operating-characteristic curve (AUROC) with and without imputation of demographic and clinical parameters (Figure 1A). Additionally, the trained networks were applied to psoriasis patients without clinical signs of PsA.Figure 1.(A) Neural network combining MR sequences with optional additional clinical data. The prediction for a single case is formed by averaging the prediction of all sequences and the clinical data. (B) Plot of the AUROC for increasing percentages (0.6 – 60%) of training data for the differentiation between RA+ and PsA by the neural network. The light blue area around the dark blue mean indicates the uncertainty measured using a 5-fold cross-validation.ResultsMRI scans from 649 patients (135 RA-, 190 RA+, 177 PsA, 147 psoriasis) were included (Table 1). The AUROC for differentiation between disease entities was 75% (SD 3%) for RA+ vs. PsA, 74% (SD 8%) for RA- vs. PsA, and 67% (6%) for RA+ vs. RA-. All MRI sequences were relevant for classification, however, when deleting CE sequences, the loss of performance was only marginal. The addition of patient-specific data to the networks did not provide significant improvements. Increasing amounts of training data demonstrated improved performance of the networks (Figure 1B). Psoriasis patients were mostly assigned to PsA by the neural networks, suggesting that PsA-like MRI pattern may be present early in the course of psoriatic disease.Table 1.Overview of demographic and clinical information.RA+RA-PsAPsoriasisTotal Number (N)649Number (N)190135177147Age (years), mean±SD56.9±12.660.5±10.356.3±12.049.6±13.8Sex (female/male)126/6493/4292/8571/76BMI (kg/m2), mean±SD26.6±10.527.6 ±9.329.1±11.326.7±6.9Disease duration (years), mean±SD2.6±4.91.3±2.30.8±2.34.2±5.1DAS28, mean±SD3.3±1.33.4±1.23.2±1.3-CRP (mg/L), mean±SD0.9±2.50.7±1.20.5±0.80.5±1.3HAQ, mean±SD0.8±0.60.9±0.80.6±0.60.3±0.4MedicationbDMARD88.46%83.87%81.32%35.01%csDMARD89.52%88.89%80.54%12.28%ConclusionDeep learning can be successfully applied to differentiate MRI inflammatory patterns related to RA+, RA-, and PsA. Early changes in psoriasis patients can be recognized by neural networks and are characterized by a pattern that allowed the networks to classify them as PsA.References[1]Kensho Hara, Hirokatsu Kataoka, and Yutaka Satoh 2018. Can Spatiotemporal 3D CNNs Retrace the History of 2D CNNs and ImageNet? In Proceedings of the IEEE Conference on Computer Vision and Pattern Recognition (CVPR) (pp. 6546–6555).[2]Aletaha D, Neogi T et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010 Sep;62(9):2569-81.[3]Helliwell PS, Taylor WJ. Classification and diagnostic criteria for psoriatic arthritis. Annals of the Rheumatic Diseases 2005;64:ii3-ii8.AcknowledgementsThe study was supported by the Deutsche Forschungsgemeinschaft (DFG-FOR2886 PANDORA and the CRC1181 Checkpoints for Resolution of Inflammation). Additional funding was received by the Bundesministerium für Bildung und Forschung (BMBF; project MASCARA), the ERC Synergy grant 4D Nanoscope, the IMI funded projects HIPPOCRATES and RTCure, the Emerging Fields Initiative MIRACLE of the Friedrich-Alexander-Universität Erlangen-Nürnberg and the Else Kröner-Memorial Scholarship (DS, no. 2019_EKMS.27). Furthermore, infrastructural and hardware support was provided by the d.hip Digital Health Innovation Platform.Disclosure of InterestsNone declared
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Raimondo MG, Rauber S, Xu C, Mohammadian H, Vogg M, Anchang CG, Rius Rigau A, Luber M, Labinsky H, Soare A, Distler JHW, Fearon U, Veale D, Sticherling M, Cañete JDD, Schett G, Ramming A. POS0450 TEMPORAL MIGRATION OF IMMUNE CELLS FROM PSORIATIC SKIN TO JOINTS INITIATING SYNOVIAL INFLAMMATION IN PSORIATIC ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundSpreading of inflammation from skin to joint is a key question behind the pathogenesis of psoriatic arthritis (PsA). Psoriasis (PsO), being one of the most prevalent skin diseases, usually anticipates joint manifestations, suggesting spreading of skin to joint disease, which happens in about 30% of the patients with psoriasis.1 To date, it is still obscure why the inflammatory process in some patients with PsO remains restrained to the skin, whereas in other patients it extents to tendons and joints.ObjectivesUsing a pre-clinical model of PsA, we aimed to unveil the skin-joint axis, i.e. the spreading of psoriatic inflammation from the skin to the joints.MethodsKAEDE transgenic mice expressing a photo-convertible fluorescent reporter were used to assess cell trafficking from inflamed skin to other organs in the mouse model of IL-23 overexpression (IL-23OE) induced PsA. Psoriatic skin lesions were irradiated with UV light to trigger the photoswitch from KAEDEGREEN to KAEDERED. Migration to different organs was determined by flow cytometry. Imaging flow cytometry was used to characterize the type of cells migrating from the skin to the joints. Migrating cells were further characterized by single-cell RNA-sequencing (scRNAseq) and functional analyses.ResultsMRI imaging and histological evaluation of IL-23OE mice revealed skin inflammation preceding joint inflammation in both wild-type and KAEDE-transgenic mice. Specific leukocyte migration from the skin to the joints started shortly after the onset of skin inflammation and before onset of inflammation within the joints of KAEDE transgenic mice. No migration was observed in healthy control animals. Other organs such as spleen or lymph nodes showed no model-dependent migration. Imaging flow cytometry revealed that the cells migrating to the joints were predominantly CD45+ CD11b+ cells. ScRNAseq analysis of sorted KAEDERED cells from inflamed joints confirmed that approximately 80% of the migrating cells were macrophages. Differential gene expression and pathway analysis revealed an imbalance between pro- and anti-inflammatory macrophages in the joints of experimental psoriatic arthritis.ConclusionWe describe IL-23-mediated migration of skin-derived macrophages from the skin to the joints during the onset of experimental psoriatic arthritis. This process may explain the spreading from psoriatic skin to joint disease as these cells foster the development by local cytokine production once arrived in the joints.References[1]Veale, D.J. & Fearon, U. The pathogenesis of psoriatic arthritis. Lancet391, 2273-2284 (2018).Disclosure of InterestsNone declared.
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Liphardt AM, Tascilar K, Coppers B, Manger E, Liehr S, Bieniek L, Bayat S, Simon D, Sticherling M, Rech J, Hueber A, Schett G, Kleyer A. POS0009 SUBJECTIVE ASSESSMENT OF PHYSICAL FUNCTION DOES NOT SUFFICIENTLY EXPLAIN VARIANCE OF MEASURED HAND FUNCTION AND GRIP STRENGTH IN ARTHRITIS PATIENTS AND NON-ARTHRITIS CONTROLS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundMonitoring disease activity in patients with inflammatory arthritis is essential for effective treatment. While the health assessment questionnaire (HAQ) is commonly used to assess physical function, additional functional tests, such as isometric grip strength and the Moberg Pick-Up-Test (MPUT), provide objective measures for hand function and allow assessing hand function across different diseases (1). It remains unclear to date, if measured hand function is already reflected by the HAQ, as the most widely used patient reported outcome measure of physical function in arthritis.ObjectivesTo estimate the proportion of hand function and grip strength variability explained by HAQ, patient-reported hand function, and between-person variation in patients with inflammatory arthritis and non-arthritic controls.MethodsPatients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), psoriasis without PsA (PsO) and healthy controls (HC) were investigated. Subject characteristics (age, sex, disease) and HAQ were recorded. Hand function was assessed by vigorimetric grip strength, MPUT, and a patient-reported tool (Michigan Hand Questionnaire, MHQ). Mixed pure-random-effect linear regression models were used to estimate the proportion of variance in measured hand function or grip strength explained by subject characteristics (age, hand dominance, sex, reported hand function, disease group).Results299 subjects were tested, 101 with RA (Age: 59.1±13.3 years, BMI: 27.2±5 kg/m2, HAQ-DI score: 0.9±06), 92 with PsA (Age: 58.8±11.6 years, BMI: 29±6.1kg/m2, HAQ-DI score: 0.6±0.7) and 106 non-arthritic controls (51 with Pso (Age: 47.3±14.1 years, BMI: 29.8±7.3 kg/m2, HAQ-DI score: 0.4±06) and 55 HC (Age: 54.6±16.5 years, BMI: 25.2±3.3 kg/m2, HAQ-DI score: 0.1±0.2). Overall variation of MPUT is mostly accounted for by between-person variation (43.1%), followed by HAQ (20.3%) and MHQ (20.2%) (Figure 1A). Overall variation in grip strength is mostly accounted for by sex (59.8%), between-person variation (21.1%) and HAQ (11.3%) (Figure 1B). Overall variation in MHQ is mostly accounted for by HAQ (59.2%) and residual variation (28.3%). Study group specific result are summarized in Table 1.Table 1.Variance proportions for each of the four study groups.Variance proportions (%)Hand function (MPUT)Grip strengthGroupControlPsAPsORAControlPsAPsORAMHQ3.439.00.00.00.02.10.00.0ID34.836.251.652.816.112.921.327.9Age0.013.80.00.78.48.40.00.0HAQ35.810.834.316.43.83.110.312.0Dominant hand0.60.20.00.03.50.61.30.2Sex12.10.00.04.364.268.963.755.0Residual13.30.014.125.83.94.03.45.0ConclusionWhile the variance variation in grip strength is mainly explained by sex and between-person variation for all subject groups, the proportions of explained variance for measured hand function is not similar between diseases. In all groups > 50% of the variation in measured hand function remains unexplained by the variables used. Especially in arthritis patients, HAQ explained less than 25% of the variance in measured hand function. Grip-strength can be considered a poor surrogate for hand function in this context due to its large gender dependence. The explainability of MHQ variation largely by HAQ indicates that it has limited potential to provide further information beyond overall functional impairment. In contrast, the large between-person variation in MPUT likely indicates unexplored movement patterns of hand motion that may be further dissected using sensor-based analyses (2) and can help identify movement components a potential for an in-depth assessment of subtle hand-function alterations in inflammatory arthritis.References[1]Liphardt AM et al. ACR Open Rheumatol 2020, 2, 734-740. 2. Phutane U et al. Sensors (Basel) 2021, 21.AcknowledgementsThis study was supported by the German Research Council (SFB 1483 – Project-ID 442419336, INST 90 / 985-1 FUGG, FOR2438/2886; SFB1181), the German Ministry of Science and Education (project MASCARA), the European Union (H2020 GA 810316 - 4D-Nanoscope European Research Council Synergy Project) and Novartis Germany GmbH.Disclosure of InterestsNone declared
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Heinrich L, Haufe E, Abraham S, Heratizadeh A, Harder I, Kleinheinz A, Wollenberg A, Weisshaar E, Wiemers F, Ertner K, Schäkel K, Augustin M, Wildberger J, von Kiedrowski R, Zink A, Pawlak M, Worm M, Sticherling M, Effendy I, Hilgers M, Quist S, Asmussen A, Handrick C, Bell M, Staubauch-Renz P, Schwarz B, Hong-Weldemann SH, Homey B, Werfel T, Weidinger S, Schmitt J. Einschätzung der Erkrankungsschwere der Neurodermitis durch Ärzte und Patienten in Abhängigkeit vom Geschlecht: Ergebnisse aus dem Deutschen Neurodermitisregister TREATgermany+. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732223] [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: 10/20/2022]
Affiliation(s)
- L Heinrich
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, TU Dresden
| | - E Haufe
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, TU Dresden
| | - S Abraham
- Universitäts AllergieCentrum Dresden, Klinik für Dermatologie, Universitätsklinikum Carl Gustav Carus
| | - A Heratizadeh
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - I Harder
- Zentrum für Entzündliche Hauterkrankungen, Klinik für Dermatologie und Allergologie, Universitäts-klinikum Schleswig-Holstein, Campus Kiel
| | | | - A Wollenberg
- Klinik und Poliklinik für Dermatologie und Allergologie, LMU München
| | - E Weisshaar
- Berufsdermatologie, Klinik für Dermatologie, Universität Heidelberg
| | - F Wiemers
- Praxis Dr. Ulrike Wiemers/Dr. Franca Wiemers
| | | | - K Schäkel
- Klinik für Dermatologie, Universität Heidelberg
| | - M Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf
| | | | | | - A Zink
- Klinik für Dermatologie und Allergologie, TU München & Zentrum für Umweltmedizin GmbH
| | - M Pawlak
- Praxis Dr. Anika Hünermund, Mario Pawlak
| | - M Worm
- Klinik für Dermatologie, Venerologie und Allergologie, Charité Berlin
| | - M Sticherling
- Klinik für Dermatologie, Universität Erlangen-Nürnberg
| | - I Effendy
- Klinik für Dermatologie, Klinikum Rosenhöhe
| | - M Hilgers
- Universitätsklinikum Aachen, Uniklinik RWTH Aachen
| | | | - A Asmussen
- Praxis Dr. Andrea Asmussen, Dermatologie an der Lesum
| | | | - M Bell
- Praxis Dr. Magnus Bell, Thomas Kaiser
| | - P Staubauch-Renz
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Mainz
| | | | | | - B Homey
- Klinik für Dermatologie, Universität Düsseldorf
| | - T Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - S Weidinger
- Zentrum für Entzündliche Hauterkrankungen, Klinik für Dermatologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - J Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, TU Dresden
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Helmert C, Haufe E, Abraham S, Heratizadeh A, Harder I, Kleinheinz A, Wollenberg A, Wiemers F, Weisshaar E, Augustin M, von Kiedrowski R, Wildberg J, Pawlak M, Hilgers M, Worm M, Schäkel K, Sticherling M, Effendy I, Staubach-Renz P, Handrick C, Bell M, Asmussen A, Schwarz B, Werfel T, Weidinger S, Schmitt J. Fatigue und Neurodermitis: Ergebnisse aus dem deutschen Neurodermitisregister TREATgermany. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732225] [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: 10/20/2022]
Affiliation(s)
- C Helmert
- Zentrum für evidenzbasierte Gesundheitsversorgung, Medizinische Fakultät Carl Gustav Carus, TU Dresden
| | - E Haufe
- Zentrum für evidenzbasierte Gesundheitsversorgung, Medizinische Fakultät Carl Gustav Carus, TU Dresden
| | - S Abraham
- UniversitätsAllergieZentrum, Klinik für Dermatologie, Universitätsklinikum Carl Gustav Carus
| | - A Heratizadeh
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - I Harder
- Zentrum für entzündliche Hauterkrankungen an der Klinik für Dermatologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | | | - A Wollenberg
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München
| | | | - E Weisshaar
- Berufsdermatologie, Universitätsklinikum Heidelberg
| | - M Augustin
- Institut für Versorgugnsforschung in der Dermatologie und Pflegeberufe, Universitätsklinikum Hamburg-Eppendorf
| | - R von Kiedrowski
- CMSS - Company for Medical Study and Service Selters, Dermatologische Spezialpraxis
| | | | | | - M Hilgers
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Aachen
| | - M Worm
- Klinik für Dermatologie, Venerologie und Allergologie, Charité Universitätsmedizin Berlin
| | | | | | - I Effendy
- Hautklinik, Klinikum Bielefeld Rosenhöhe
| | - P Staubach-Renz
- Universitätshautklinik und poliklinik, Universitätsmedizin Mainz
| | - C Handrick
- Praxis, für Haut- und Geschlechtskrankheiten
| | | | | | - B Schwarz
- Praxis, Dermatologie und Allergologie
| | - T Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - S Weidinger
- Zentrum für entzündliche Hauterkrankungen an der Klinik für Dermatologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - J Schmitt
- Zentrum für evidenzbasierte Gesundheitsversorgung, Medizinische Fakultät Carl Gustav Carus, TU Dresden
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Tascilar K, Simon D, Krönke G, Kleyer A, Ramming A, Atreya R, Tenbusch M, Überla K, Berking C, Sticherling M, Neurath MF, Schett G. POS1426 PATIENTS WITH IMMUNE MEDIATED INFLAMMATORY DISEASES ARE OVERREPRESENTED IN LOW- FREQUENCY VIRAL SYMPTOM CLUSTERS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Viral respiratory infections are common in the general population and result in a spectrum of outcomes ranging from effective viral clearance with no symptoms, to a maladaptive immune response that can result in severe symptomatic disease and death. Although patients with immune-mediated inflammatory diseases (IMID) are considered susceptible to poor outcomes from infectious syndromes, it is not known whether IMID patients are overall more prone to manifest common viral infection symptoms.Objectives:To explore frequency patterns of common viral infection symptoms in IMID patients.Methods:We previously recruited patients with IMIDs and individuals with no IMIDs for a seroprevalence study between February 1st and April 30th 2020 (1). Participants were questioned for the presence of eleven common viral disease symptoms. We clustered these data using an unsupervised binary data clustering algorithm (2) into 6 symptom clusters based on symptom frequency. Three major clusters (broadly symptomatic, intermediately symptomatic and oligo-/asymptomatic) and 2 sub-clusters (higher and lower frequency) for each major cluster. In addition, qualitative symptom clustering was done. We estimated standardized residuals to quantify the over/underrepresentation of IMID diagnosis frequencies in each subject cluster. We used Poisson regression to compare symptom counts by diagnosis.Results:We analyzed 1909 participants (757 with IMIDs; 1152 non-IMID controls; Table 1). Within each major subject cluster (Figure 1A), IMID patients showed the highest positive deviation from the expected frequencies in lower frequency sub-clusters while non IMID controls showed the highest positive deviations in the higher frequency sub-clusters (Figure 1B). Inflammatory bowel disease and psoriasis were remarkably overrepresented in the lower frequency sub-cluster of the broadly-symptomatic cluster while RA was overrepresented in the lower frequency sub-clusters of intermediate and oligo-/asymptomatic clusters. X axis of Figure 1A presents qualitative symptom clusters. Regression analysis shows that RA patients among other IMIDs reported overall less symptoms (RR= 0.69, 95%CI, 0.58 - 0.80) compared to non-IMID controls.Figure 1.A) distribution of common viral respiratory disease symptoms across patient and symptom clusters. B) Standardized residuals indicating deviation from expected frequencies of IMID diagnoses across patient clusters. sob: shortness of breath, mskpain: musculoskeletal painConclusion:This analysis shows that symptoms of common respiratory viral infections are less frequent in RA patients and to a lesser extent in other IMID patient. As major clusters in this analysis can also be considered to represent exposure categories, these data suggest that IMIDs or their treatments may mitigate common respiratory viral infection symptoms.References:[1]Simon D. et al. Nat Commun (2020) 11, 3774[2]Bhatia P. et al. J. Stat. Softw (2017) 76(9)Table 1.Participant characteristics and distribution of IMID diagnoses across subject clusters.ClustersBroad SymptomaticIntermediate SymptomaticOligo-AsymptomaticOverallHigherLowerHigherLowerHigherLowerN190910185412259283769Age, years, mean (SD)45.4(15.2)42.4(13.3)47.3 (15.2)42.4(12.9)50.4(15.5)41.8(14.9)46.8(15.9)Male1080 (56.6)42 (41.6)38 (44.7)196 (47.6)137 (52.9)178 (62.9)489 (63.6)Diagnosis, n(%)No-IMID1152 (60.3)72 (71.3)44 (51.8)280 (68.0)112 (43.2)207 (73.1)437 (56.8)RA226 (11.8)7 (6.9)5 (5.9)29 (7.0)56 (21.6)17 (6.0)112 (14.6)IBD178 (9.3)5 (5.0)15 (17.6)46 (11.2)29 (11.2)19 (6.7)64 (8.3)SpA142 (7.4)7 (6.9)5 (5.9)23 (5.6)25 (9.7)14 (4.9)68 (8.8)Psoriasis89 (4.7)4 (4.0)9 (10.6)14 (3.4)8 (3.1)13 (4.6)41 (5.3)Other122 (6.4)6 (5.9)7 (8.2)20 (4.9)29 (11.2)13 (4.6)47 (6.1)Symptom count/patient, mean (SD)1.2 (1.7)6.0 (1.3)3.9 (1.1)2.2 (1.0)1.5 (0.6)0.5 (0.5)0.0 (0.0)IBD, inflammatory bowel disease.Acknowledgements:This study was supported by the Deutsche Forschungsgemeinschaft (DFG- FOR2886 PANDORA and the CRC1181), the Bundesministerium für Bildung und Forschung (BMBF; project MASCARA), the H2020 GA 810316 - 4D-Nanoscope ERC Synergy Project, the IMI funded project RTCure, the Emerging Fields Initiative MIRACLE of the Friedrich-Alexander-Universität Erlangen-Nürnberg as well as the Schreiber Stiftung gemeinnützige Gesellschaft mbH.Disclosure of Interests:None declared
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Abstract
Vaccinations are among the most successful prophylactic measures in medicine. As they are applied to healthy subjects, regulatory steps before licensing of any vaccination are strictly based on clinically controlled studies as well as on registry data in the further course. The probability and relevance of adverse reactions to vaccinations have to be weighed against any harm through the respective natural infection as well as the vaccination-induced protection against infections. Intolerance reactions to vaccinations are far more suspected than proven and altogether rare. Among these, specific dermatoses like psoriasis, atopic dermatitis and lichen planus are found as well as allergic reactions and a number of more nonspecific skin symptoms. Apart from provocation or exacerbation of an underlying dermatological disease, various intolerance reactions may be encountered which are classically allergologic or anaphylactoid. People with chronic dermatoses, especially those on immunosuppressive and immunomodulatory therapy, should have all recommended standard vaccinations. Vaccinations should not be administered during acute skin manifestations and relevant comedication-especially if immunomodulatory or immunosuppressive-has be taken into account in the decision to vaccinate and to define the time point of any vaccination. Inactivated vaccines may be administered even during ongoing immunosuppressive therapy, but may result in decreased immunological reactions and protection to infection. Live vaccines should be avoided.
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Affiliation(s)
- M Sticherling
- Psoriasiszentrum, Deutsches Zentrum Immuntherapie, Hautklinik Universitätsklinikum Erlangen, Ulmenweg 18, 91045, Erlangen, Deutschland.
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Reich K, Körber A, Mrowietz U, Sticherling M, Sieder C, Früh J, Bachhuber T. Secukinumab 2-weekly vs. 4-weekly dosing in patients with plaque-type psoriasis: results from the randomized GAIN study. Br J Dermatol 2020; 184:849-856. [PMID: 32652528 DOI: 10.1111/bjd.19398] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Secukinumab is a fully human monoclonal antibody that selectively neutralizes interleukin-17A and shows long-lasting efficacy and safety in plaque psoriasis. More evidence is required to optimize secukinumab dosing according to clinical response. OBJECTIVES GAIN compared the efficacy and safety of secukinumab 300 mg every 2 weeks (q2w) with 300 mg every 4 weeks (q4w) in patients achieving ≥ 75% improvement in Psoriasis Area and Severity Index (PASI 75) but not PASI 90 after 16 weeks. METHODS In total, 772 patients with moderate-to-severe plaque psoriasis received secukinumab 300 mg subcutaneously at baseline and weeks 1, 2, 3 and 4, then q4w until week 16. At week 16, patients with PASI ≥ 75 to PASI < 90 were randomized 1: 1 to continue q4w dosing (n = 162) or switch to q2w (n = 163) to week 32. The primary endpoint was superiority of q2w to q4w dosing for PASI 90 response at week 32. RESULTS PASI 90 response at week 32 was numerically greater with secukinumab 300 mg q2w than with secukinumab 300 mg q4w in suboptimal responders, but this did not reach statistical significance (64·4% vs. 57·4%; odds ratio 0·64, 95% confidence interval 0·39-1·07; P = 0·087). Although the primary endpoint was not met, absolute PASI was significantly lower at week 32 in q2w vs. q4w patients (2·11 vs. 2·84, P = 0·024). Significantly more patients with q2w vs. q4w dosing showed minimal disease activity (Investigator's Global Assessment score 0 or 1: 73·0% vs. 64·1%, P < 0·05) and improved quality of life (Dermatology Life Quality Index score 0 or 1: 58·9% vs. 50·6%, P < 0·05) at week 32. No new or unexpected safety signals arose. CONCLUSIONS Most patients achieved PASI 90 response with secukinumab q4w. There was potential benefit of q2w dosing in some suboptimal responders. Continued q4w treatment can improve response even after 16 weeks.
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Affiliation(s)
- K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, and Skinflammation® Center, Hamburg, Germany
| | - A Körber
- Department of Dermatology, University Hospital Essen, Essen, Germany
| | - U Mrowietz
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - M Sticherling
- Department of Dermatology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - C Sieder
- Novartis Pharma GmbH, Nürnberg, Germany
| | - J Früh
- Novartis Pharma AG, Basel, Switzerland
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Simon D, Tascilar K, Kleyer A, Bayat S, Kampylafka E, Hueber A, Rech J, Schuster L, Engel K, Sticherling M, Schett G. OP0051 STRUCTURAL ENTHESEAL LESIONS IN PSORIASIS PATIENTS ARE ASSOCIATED WITH AN INCREASED RISK OF PROGRESSION TO PSORIATIC ARTHRITIS - A PROSPECTIVE COHORT STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1524] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:We have previously reported that the presence of musculoskeletal pain in psoriasis patients is associated with a higher risk of developing psoriatic arthritis (PsA) (1). Furthermore, a subset of psoriasis patients shows evidence for structural entheseal lesions (SEL) in their hand joints (2), sometimes also referred as “Deep Koebner Phenomenon”, which are highly specific for psoriatic disease and virtually absent in healthy controls, rheumatoid arthritis and hand osteoarthritis patients (2-4). However, it remains unclear whether SEL alone or in combination with musculoskeletal pain are associated with the development of PsA.Objectives:To test whether the presence of SEL in psoriasis patients increases the risk for progression to PsA and how this is related to the presence of musculoskeletal pain.Methods:Psoriasis patients without evidence of PsA were enrolled in a prospective cohort study between 2011 and 2018. All patients underwent baseline assessment of SEL in their 2ndand 3rdMCP joints by high-resolution peripheral quantitative computed tomography (HR-pQCT). The risk of PsA development associated with SEL and arthralgia was explored using survival analyses and multivariable Cox regression models.Results:114 psoriasis patients (72 men/42 women) with a mean (SD) follow-up duration of 28.2 (17.7) months were included, 24 of whom developed PsA (9.7 /100 patient-years, 95%CI 6.2 to 14.5) during the observation period. Patients with SEL (N=41) were at higher risk of developing PsA compared to patients without such lesions (21.4/100 patient-years, 95%CI 12.5 to 34.3, HR 5.10, 95%CI 1.53 to 16.99, p=0.008) (Kaplan Meier plot A). Furthermore, while patients without arthralgia and without SEL had a very low progression rate to PsA (1/29; 3.4%), patients with arthralgia but no SEL showed higher progression (5/33; 15.2%), which was in line with previous observations (1) (Kaplan Meier plot B). Presence of SEL further enhanced the risk for progression to PsA both in the absence (6/16; 37.5%) and presence (6/14; 42.8%) of arthralgia with the highest progression rate in those subjects with both arthralgia and SEL (p<0.001 by log rank test for trend) (Kaplan Meier plot B).Conclusion:Presence of SEL is associated with an increased risk of developing PsA in patients with psoriasis. If used together with pain, SEL allow defining subsets of psoriasis patients with very low and very high risk to develop PsA.References:[1]Faustini F et al. Ann Rheum Dis. 2016;75:2068-2074[2]Simon D et al. Ann Rheum Dis. 2016;75:660-6[3]Finzel S et al. Ann Rheum Dis. 2011;70:122-7[4]Finzel S et al. Arthritis Rheum. 2011;63:1231-6Disclosure of Interests:David Simon Grant/research support from: Else Kröner-Memorial Scholarship, Novartis, Consultant of: Novartis, Lilly, Koray Tascilar: None declared, Arnd Kleyer Consultant of: Lilly, Gilead, Novartis,Abbvie, Speakers bureau: Novartis, Lilly, Sara Bayat Speakers bureau: Novartis, Eleni Kampylafka Speakers bureau: Novartis, BMS, Janssen, Axel Hueber Grant/research support from: Novartis, Lilly, Pfizer, Consultant of: Abbvie, BMS, Celgene, Gilead, GSK, Lilly, Novartis, Speakers bureau: GSK, Lilly, Novartis, Jürgen Rech Consultant of: BMS, Celgene, Novartis, Roche, Chugai, Speakers bureau: AbbVie, Biogen, BMS, Celgene, MSD, Novartis, Roche, Chugai, Pfizer, Lilly, Louis Schuster: None declared, Klaus Engel: None declared, Michael Sticherling Grant/research support from: Novartis, Consultant of: Advisory boards Abbvie, Celgene, Janssen Cilag, Lilly, Pfizer, MSD, Novartis, Amgen, Leo, Sanofi, UCB, Speakers bureau: Abbvie, Celgene, Janssen Cilag, Leo, MSD, Novartis, Pfizer, Georg Schett Speakers bureau: AbbVie, BMS, Celgene, Janssen, Eli Lilly, Novartis, Roche and UCB
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Raimondo MG, Rauber S, Luber M, Rius Rigau A, Weber S, Anchang CG, Agarwal R, Soare A, Sticherling M, Rech J, Kleyer A, Distler J, Schett G, Ramming A. SAT0354 TYPE 3 INNATE LYMPHOID CELLS ARE KEY DRIVERS OF PSORIATIC ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Psoriasis (PsO) and psoriatic arthritis (PsA) are two types of chronic inflammatory diseases that share a similar cytokines profile. About 30% of PsO patients also develop a joint involvement, but the underlying mechanism is still unclear. Innate lymphoid cells (ILC) and specifically the type 3 ILCs (ILC3s) have raised increasing interest as possible player in the pathogenesis of both diseases, as they produce the pathological key cytokine IL-17A.Objectives:We addressed the contribution of ILC3s to the pathogenesis of PsO and PsA in patients as well as murinein vivomodels.Methods:130 patients satisfying the Classification Criteria for Psoriatic Arthritis (CASPAR), 40 patients with PsO and 35 healthy volunteers were enrolled in the study. Information regarding clinical features, laboratory parameters were collected and psoriasis area severity index (PASI), disease activity score 28 (DAS28), disease activity in psoriatic arthritis (DAPSA), minimal disease activity score (MDA) were calculated. Magnetic resonance imaging (MRI) and high-resolution peripheral CT (HR-pQCT) were taken and PsA MRI score (PsAMRIS) was assessed. Flow cytometric analysis was performed and IFNγ-producing ILC1s, IL-4/IL-5-producing ILC2s and IL-17/IL-22-producing ILC3s were identified among ILCs. Multivariate linear regression and Receiver-Operating Characteristic (ROC) Curve analysis was performed using the IBM SPSS Statistics software. Different in vivo models were used to assess functional implications of ILCs at different time points of the disease. Joint inflammation was assessed through MRI and H&E staining of ankle areas. Peripheral blood was obtained from mice of each group and flow cytometry analysis was performed. High dimensional analyses including RNA-seq was performed to identify phenotypic characteristics of ILCs implemented into the pathogenesis of the disease.Results:Total number of circulating ILCs were increased in PsA patients compared to PsO and healthy controls (p<0,001). Linear regression analyses of the relationship between disease activity and circulating ILCs counts showed strongest correlation between ILC3s counts and DAPSA score. ILC3s counts also correlated with imaging signs of inflammation such as enthesitis, synovitis, erosions and/or ostoeproliferation as assessed by MRI and HR-pQCT. Musculoskeletal inflammation in mice was predominantly associated with p19 expression and IL-23R-signaling as assessed by RNA-seq. These effects were also accompanied by a strong upregulation of IL-17-producing lymphocytes within the inflamed joint niche with a dominant presence of ILC3s. Multi-channel immunofluorescence and confocal laser scanning microscopy revealed not only upregulation of ILC3 induced IL-17 production within the synovial membrane but also in peri-articular areas of the inflamed joints.Conclusion:ILC3s not only correlate with various facets of PsA manifestations but also functionally contribute to synovitis and enthesitis suggesting them as interesting target for upcoming treatment strategies in the near future.Disclosure of Interests:Maria Gabriella Raimondo Grant/research support from: Celgene, Partner Fellowship, Simon Rauber: None declared, Markus Luber: None declared, Aleix Rius Rigau: None declared, Stefanie Weber: None declared, Charles Gwellem Anchang: None declared, Rahul Agarwal: None declared, Alina Soare: None declared, Michael Sticherling Grant/research support from: Novartis, Consultant of: Advisory boards Abbvie, Celgene, Janssen Cilag, Lilly, Pfizer, MSD, Novartis, Amgen, Leo, Sanofi, UCB, Speakers bureau: Abbvie, Celgene, Janssen Cilag, Leo, MSD, Novartis, Pfizer, Jürgen Rech Consultant of: BMS, Celgene, Novartis, Roche, Chugai, Speakers bureau: AbbVie, Biogen, BMS, Celgene, MSD, Novartis, Roche, Chugai, Pfizer, Lilly, Arnd Kleyer Consultant of: Lilly, Gilead, Novartis,Abbvie, Speakers bureau: Novartis, Lilly, Jörg Distler Grant/research support from: Boehringer Ingelheim, Consultant of: Boehringer Ingelheim, Paid instructor for: Boehringer Ingelheim, Speakers bureau: Boehringer Ingelheim, Georg Schett Speakers bureau: AbbVie, BMS, Celgene, Janssen, Eli Lilly, Novartis, Roche and UCB, Andreas Ramming Grant/research support from: Pfizer, Novartis, Consultant of: Boehringer Ingelheim, Novartis, Gilead, Pfizer, Speakers bureau: Boehringer Ingelheim, Roche, Janssen
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Heratizadeh A, Haufe E, Stölzl D, Abraham S, Heinrich L, Kleinheinz A, Wollenberg A, Weisshaar E, Augustin M, Wiemers F, Zink A, von Kiedrowski R, Hilgers M, Worm M, Pawlak M, Sticherling M, Fell I, Handrick C, Schäkel K, Staubach-Renz P, Asmussen A, Schwarz B, Bell M, Effendy I, Bieber T, Homey B, Gerlach B, Tchitcherina E, Stahl M, Schwichtenberg U, Rossbacher J, Buck P, Mempel M, Beissert S, Biedermann T, Weidinger S, Schmitt J, Werfel T. Baseline characteristics, disease severity and treatment history of patients with atopic dermatitis included in the German AD Registry TREATgermany. J Eur Acad Dermatol Venereol 2020; 34:1263-1272. [PMID: 31721316 DOI: 10.1111/jdv.16078] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 10/17/2019] [Indexed: 01/26/2023]
Abstract
BACKGROUND The Atopic Dermatitis (AD) TREATgermany registry was initiated by the German Society for Dermatology (DDG) in 2011 to evaluate the 'real-life' situation of health care for patients with AD. OBJECTIVES Interim data analysis on baseline characteristics as well as current and prescribed systemic treatments of the TREATgermany registry patients. METHODS Patients (≥18 years) with moderate-to-severe AD [objective (o)SCORAD > 20], or with current or previous anti-inflammatory systemic treatment for AD within 24 months, were included and are followed up over at least 24 months. To assess clinical signs, the eczema area severity index (EASI, 0-72), the oSCORAD (0-83) and the Investigator Global Assessment (IGA; 6-point scale) were used. The disease severity was globally scored by the patients [Patient Global Assessment (PGA); six-step Likert scale]. Disease symptoms were assessed by the patient-oriented eczema measure (POEM, 0-28) and numeric rating scales (NRS, 0-10). Health-related quality of life was measured using the dermatological life quality index (DLQI, 0-30). RESULTS A total of 612 patients were recruited across 32 sites between 06/2016 and 01/2019 (mean age: 42.6 ± 14.2 years; mean oSCORAD: 40.8 ± 16.3). The mean POEM score was 16.3 ± 7.5. Pruritus was rated highest among subjective symptoms (NRS: 5.4 ± 2.7). The mean DLQI value was 11.3 ± 7.5. The frequency of arterial hypertension was lower (20.8%) compared with the general population, whilst this was higher for depression (10%). More than 60% of the patients had received systemic glucocorticosteroids, and 36.8% had received cyclosporine A prior to inclusion. Dupilumab was the leading substance documented as either 'current' (12.1%) or 'prescribed' (31.4%) at baseline. CONCLUSIONS These 'real-life' data clearly demonstrate the substantial disease burden. Most of TREATgermany patients were already treated with or prescribed dupilumab at baseline. Moreover, current findings indicate the urgent need for further alternative agents in order to achieve a perceptible improvement of quality of life of patients with moderate-to-severe AD.
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Affiliation(s)
- A Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - E Haufe
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - D Stölzl
- Department of Dermatology and Allergy, Center for Inflammatory Skin Diseases, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - S Abraham
- Department of Dermatology, University Allergy Center, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - L Heinrich
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - A Kleinheinz
- Clinics for Dermatology, Elbe Klinikum Buxtehude, Buxtehude, Germany
| | - A Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, Munich, Germany
| | - E Weisshaar
- Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - M Augustin
- Insitute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - F Wiemers
- Practice Dr. med. Franca Wiemers, Leipzig, Germany
| | - A Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Clinical Unit Allergology, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, Munich, Germany
| | - R von Kiedrowski
- CMSS - Company for Medical Study and Service, Selters/Westerwald, Germany
| | - M Hilgers
- Clinics for Dermatology and Allergy, University Hospital Aachen, Aachen, Germany
| | - M Worm
- Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - M Pawlak
- Practice Dr. med. Anika Hünermund and Mario Pawlak, Heilbad Heiligenstadt, Germany
| | - M Sticherling
- Department of Dermatology, University Hospital, Friedrich Alexander University Erlangen-Nurnberg, Erlangen, Germany
| | - I Fell
- Hautmedizin Bad Soden, Bad Soden, Germany
| | - C Handrick
- Practice Dr. med. Christiane Handrick, Berlin, Germany
| | - K Schäkel
- Department of Dermatology, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - P Staubach-Renz
- Department of Dermatology and Allergy, University Medical Center Mainz, Mainz, Germany
| | - A Asmussen
- Practice Dermatologie an der Lesum, Bremen, Germany
| | - B Schwarz
- Practice Dr. med. Beate Schwarz, Langenau, Germany
| | - M Bell
- Practice Dr. Magnus Bell, Thomas Kaiser, Andernach, Germany
| | - I Effendy
- Department of Dermatology, Hospital Rosenhoehe, Bielefeld, Germany
| | - T Bieber
- Department of Dermatology and Allergy, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - B Homey
- Department of Dermatology, Heinrich-Heine-University Duesseldorf, Düsseldorf, Germany
| | - B Gerlach
- Practice Dr. med. Beatrice Gerlach, Dresden, Germany
| | - E Tchitcherina
- Practice Dr. med. Ekaterina Tchitcherina, Friedberg/Hessen, Germany
| | - M Stahl
- Practice Dr. med. Maren Stahl, Osterode, Germany
| | | | | | - P Buck
- Goldbek Medical, Hamburg, Germany
| | - M Mempel
- Practice Prof. Dr. med. Martin Mempel, Elmshorn, Germany
| | - S Beissert
- Department of Dermatology, University Allergy Center, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - T Biedermann
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Clinical Unit Allergology, Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, Munich, Germany
| | - S Weidinger
- Department of Dermatology and Allergy, Center for Inflammatory Skin Diseases, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - J Schmitt
- Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
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Simon D, Haschka J, Muschitz C, Kocijan A, Baierl A, Kleyer A, Schett G, Kapiotis S, Resch H, Sticherling M, Rech J, Kocijan R. Bone microstructure and volumetric bone mineral density in patients with hyperuricemia with and without psoriasis. Osteoporos Int 2020; 31:931-939. [PMID: 31925472 DOI: 10.1007/s00198-019-05160-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 12/02/2018] [Accepted: 09/09/2019] [Indexed: 12/15/2022]
Abstract
UNLABELLED We analyzed volumetric bone mineral density (vBMD) and bone microstructure using HR-pQCT in subjects with normouricemia (NU) and subjects with hyperuricemia (HU) with and without psoriasis (PSO). HU was associated with higher cortical vBMD and thickness. Differences in average and trabecular vBMD were found between patients with PSO + HU and NU. INTRODUCTION Hyperuricemia (HU) and gout are co-conditions of psoriasis and psoriatic arthritis. Current data suggest a positive association between HU and areal bone mineral density (BMD) and a negative influence of psoriasis on local bone, even in the absence of arthritis. However, the influence of the combination of HU and psoriasis on bone is still unclear. The aim of this study was to assess the impact of HU with and without psoriasis on bone microstructure and volumetric BMD (vBMD). METHODS Healthy individuals with uric acid levels within the normal range (NU), with hyperuricemia (HU), patients with hyperuricemia and psoriasis (PSO + HU), and patients with uric acid within the normal range and psoriasis (PSO + NU) were included in our study. Psoriasis patients had no current or past symptoms of arthritis. Average, trabecular, and cortical vBMD (mgHA/cm3); trabecular number (Tb.N, 1/mm) and thickness (Tb.Th, mm); inhomogeneity of the network (1/N.SD, mm); and cortical thickness (Ct.Th., mm) were carried out at the ultradistal radius using high-resolution peripheral quantitative computed tomography. In addition, bone turnover markers such as DKK-1, sclerostin, and P1NP were analyzed. RESULTS In total, 130 individuals were included (44 NU participants (34% female), 50 HU (24%), 16 PSO + HU (6%), 20 PSO + NU (60%)). Subjects were aged: NU 54.5 (42.8, 62.1), HU 57.5 (18.6, 65.1), PSO + HU 52.0 (42.3, 57.8), and PSO + NU 42.5 (34.8, 56.8), respectively. After adjusting for age, sex, BMI, and diabetes, patients in the HU group revealed significantly higher values of cortical vBMD (p < 0.001) as well as cortical thickness (p = 0.04) compared to the NU group. PSO + NU showed no differences to NU, but PSO + HU demonstrated both lower average (p = 0.03) and trabecular vBMD (p = 0.02). P1NP was associated with average, cortical, and trabecular vBMD as well as cortical thickness while sclerostin levels were related to trabecular vBMD. CONCLUSION Hyperuricemia in otherwise healthy subjects was associated with a better cortical vBMD and higher cortical thickness. However, patients with both psoriasis and hyperuricemia revealed a lower vBMD.
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Affiliation(s)
- D Simon
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054, Erlangen, Germany
| | - J Haschka
- St. Vincent Hospital Vienna, Medical Department II, Academic Teaching Hospital of the Medical University Vienna, Stumpergasse 13, 1060, Vienna, Austria
- Karl Landsteiner Institute for Rheumatology and Gastroenterology, 1060, Vienna, Austria
| | - C Muschitz
- St. Vincent Hospital Vienna, Medical Department II, Academic Teaching Hospital of the Medical University Vienna, Stumpergasse 13, 1060, Vienna, Austria
| | | | - A Baierl
- Department of Statistics and Operations Research, University of Vienna, Oskar Morgenstern-Platz 1, 1090, Vienna, Austria
| | - A Kleyer
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054, Erlangen, Germany
| | - G Schett
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054, Erlangen, Germany
| | - S Kapiotis
- Central Laboratory, St. Vincent Group, 1060, Vienna, Austria
| | - H Resch
- St. Vincent Hospital Vienna, Medical Department II, Academic Teaching Hospital of the Medical University Vienna, Stumpergasse 13, 1060, Vienna, Austria
- Karl Landsteiner Institute for Rheumatology and Gastroenterology, 1060, Vienna, Austria
- Medical Faculty of Bone Diseases, Sigmund Freud University Vienna, Sigmund Freud Platz 1, Vienna, Austria
| | - M Sticherling
- Department of Dermatology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054, Erlangen, Germany
| | - J Rech
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054, Erlangen, Germany
| | - R Kocijan
- St. Vincent Hospital Vienna, Medical Department II, Academic Teaching Hospital of the Medical University Vienna, Stumpergasse 13, 1060, Vienna, Austria.
- Karl Landsteiner Institute for Rheumatology and Gastroenterology, 1060, Vienna, Austria.
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Abraham S, Haufe E, Harder I, Heratizadeh A, Kleinheinz A, Wollenberg A, Weisshaar E, Augustin M, Wiemers F, Zink A, Biedermann T, von Kiedrowski R, Hilgers M, Worm M, Pawlak M, Sticherling M, Fell I, Handrick C, Schäkel K, Staubach P, Asmussen A, Schwarz B, Bell M, Neubert K, Effendy I, Bieber T, Homey B, Gerlach B, Tchitcherina E, Stahl M, Schwichtenberg U, Rossbacher J, Buck P, Mempel M, Beissert S, Werfel T, Weidinger S, Schmitt J. Implementation of dupilumab in routine care of atopic eczema: results from the German national registry TREATgermany. Br J Dermatol 2020; 183:382-384. [PMID: 32068242 DOI: 10.1111/bjd.18958] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- S Abraham
- Department of Dermatology, University Allergy Center, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - E Haufe
- Center of Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - I Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - A Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - S Beissert
- Department of Dermatology, University Allergy Center, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - S Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - J Schmitt
- Center of Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
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Erfurt‐Berge C, Sticherling M. Successful treatment of ulcerative necrobiosis lipoidica with janus kinase inhibitor. J Eur Acad Dermatol Venereol 2020; 34:e331-e333. [DOI: 10.1111/jdv.16297] [Citation(s) in RCA: 2] [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: 12/17/2022]
Affiliation(s)
- C. Erfurt‐Berge
- Department of Dermatology University Hospital Erlangen Erlangen Germany
| | - M. Sticherling
- Department of Dermatology University Hospital Erlangen Erlangen Germany
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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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Holtsche MM, Goletz S, van Beek N, Zillikens D, Benoit S, Harman K, Walton S, English J, Sticherling M, Chapman A, Levell NJ, Groves R, Williams HC, König IR, Schmidt E. Prospective study in bullous pemphigoid: association of high serum anti-BP180 IgG levels with increased mortality and reduced Karnofsky score. Br J Dermatol 2018; 179:918-924. [PMID: 29607480 DOI: 10.1111/bjd.16553] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Bullous pemphigoid (BP) is a subepidermal blistering disease characterized by autoantibodies against the two hemidesmosomal proteins, BP180 (type XVII collagen) and BP230. The multicentre prospective BLISTER (Bullous Pemphigoid Steroids and Tetracyclines) trial randomized 253 patients with BP to compare the benefits and harms between initial treatment with doxycycline or prednisolone. OBJECTIVES To analyse distinct autoantibody profiles for the prediction of the disease course in a well-characterized cohort of BP sera. METHODS One hundred and forty-three patients of the BLISTER trial consented to participate in this serological study. Sera taken at baseline were analysed by (i) indirect immunofluorescence, (ii) anti-BP180 NC16A (16th noncollagenous domain) and anti-BP230 enzyme-linked immunosorbent assay and (iii) immunoblotting with various substrates. Results were then linked with clinical parameters including age, Karnofsky score, number of blisters, related adverse events and mortality. RESULTS Disease activity correlated with immunoglobulin (Ig)G anti-BP180 levels but not with levels of anti-BP230 IgG and anti-BP180 IgE. High levels of both anti-BP180 IgG and anti-BP230 IgG were associated with a low Karnofsky score. The presence of anti-BP230 IgG was more frequent in older patients. Those with higher total IgE serum levels suffered from fewer adverse events. Higher IgG anti-BP180 levels were associated with an increased 1-year mortality rate. CONCLUSIONS Analysis of the autoantibody profile is not only of diagnostic relevance but may also be helpful in predicting the course of the disease.
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Affiliation(s)
- M M Holtsche
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - S Goletz
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - N van Beek
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - S Benoit
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - K Harman
- Department of Dermatology, University Hospitals Leicester, Leicester Royal Infirmary, Leicester, U.K
| | - S Walton
- Castle Hill Hospital, Cottingham, U.K
| | - J English
- Queen's Medical Centre, University Hospital, Nottingham, U.K
| | - M Sticherling
- Department of Dermatology, University of Erlangen, Erlangen, Germany
| | - A Chapman
- Queen Elizabeth Hospital, Greenwich, London, U.K
| | - N J Levell
- Norfolk and Norwich University Hospital, Norwich, U.K
| | - R Groves
- Department of Immunodermatology, St John's Institute of Dermatology, St Thomas' Hospital, London, U.K
| | - H C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - I R König
- Institute of Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
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Holtsche M, Goletz S, van Beek N, Zillikens D, Benoit S, Harman K, Walton S, English J, Sticherling M, Chapman A, Levell N, Groves R, Williams H, K€onig I, Schmidt E. BP:血清抗 BP180 IgG 水平、死亡率和卡式评分. Br J Dermatol 2018. [DOI: 10.1111/bjd.17174] [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: 11/26/2022]
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23
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Holtsche M, Goletz S, van Beek N, Zillikens D, Benoit S, Harman K, Walton S, English J, Sticherling M, Chapman A, Levell N, Groves R, Williams H, König I, Schmidt E. BP: serum anti-BP180 IgG levels, mortality and Karnofsky score. Br J Dermatol 2018. [DOI: 10.1111/bjd.17163] [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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24
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Sticherling M. Ulcerative colitis: yet another paradoxical effect of tumour necrosis factor blockers? Br J Dermatol 2018; 178:333-334. [DOI: 10.1111/bjd.16066] [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: 11/27/2022]
Affiliation(s)
- M. Sticherling
- Department of Dermatology; University of Erlangen; Erlangen 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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Sticherling M, Franke A, Aberer E, Gläser R, Hertl M, Pfeiffer C, Rzany B, Schneider S, Shimanovich I, Werfel T, Wilczek A, Zillikens D, Schmidt E. An open, multicentre, randomized clinical study in patients with bullous pemphigoid comparing methylprednisolone and azathioprine with methylprednisolone and dapsone. Br J Dermatol 2017; 177:1299-1305. [PMID: 28494097 DOI: 10.1111/bjd.15649] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Current treatment of bullous pemphigoid (BP) is based on the long-term use of topical and/or systemic corticosteroids, which are associated with a high rate of adverse events and increased mortality. OBJECTIVES To study the corticosteroid-sparing potential of azathioprine and dapsone. METHODS This was a prospective, multicentre, randomized, nonblinded clinical trial that compared the efficacy and safety of two parallel groups of patients with BP treated with oral methylprednisolone 0·5 mg kg-1 per day in combination with either azathioprine 1·5-2·5 mg kg-1 per day or dapsone 1·5 mg kg-1 per day. Nine German and Austrian departments of dermatology included 54 patients based on clinical lesions, positive direct immunofluorescence (IF) microscopy and detection of serum autoantibodies by indirect IF microscopy, immunoblotting or enzyme-linked immunosorbent assay. The primary end point was the time until complete tapering of methylprednisolone, and the most important secondary end point was the cumulative corticosteroid dose. RESULTS In eight patients (five azathioprine, three dapsone), methylprednisolone could be discontinued after a median time of 251 days in the azathioprine group and 81 days in the dapsone group. The median cumulative corticosteroid dose was 2·65 g for azathioprine compared with 1·92 g for dapsone (P = 0·06). The median numbers of days when corticosteroids were applied were 148 and 51, respectively (P = 0·24). No significant difference in the number of adverse events was seen between the treatment arms. Four patients (8%) died within the observation period of 12 months. CONCLUSIONS Due to the lower than intended number of patients, the results of the primary and secondary end points were not or only barely significant. Dapsone appeared to have a moderately higher corticosteroid-sparing potential than azathioprine. The combination regimen of either drug with oral methylprednisolone is associated with a relatively low 1-year mortality in this vulnerable patient population.
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Affiliation(s)
- M Sticherling
- Department of Dermatology, University of Leipzig, Leipzig, Germany.,Department of Dermatology, University of Erlangen, Ulmenweg 18, D-91054, Erlangen, Germany
| | - A Franke
- Center for Clinical Trials, University of Leipzig, Leipzig, Germany
| | - E Aberer
- Department of Dermatology, University of Graz, Graz, Austria
| | - R Gläser
- Department of Dermatology, University of Kiel, Kiel, Germany
| | - M Hertl
- Department of Dermatology, University of Erlangen, Ulmenweg 18, D-91054, Erlangen, Germany.,Department of Dermatology, University of Marburg, Marburg, Germany
| | - C Pfeiffer
- Department of Dermatology, University of Dresden, Dresden, Germany.,Department of Dermatology, University of Ulm, Ulm, Germany
| | - B Rzany
- Department of Dermatology, Charité-Medical University Berlin, Berlin, Germany
| | - S Schneider
- Department of Dermatology, University Münster, Münster, Germany.,Department of Dermatology, University of Mannheim, Mannheim, Germany
| | - I Shimanovich
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - T Werfel
- Department of Dermatology, Medical University, Hannover, Germany
| | - A Wilczek
- Department of Dermatology, University of Leipzig, Leipzig, Germany
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Department of Dermatology, University of Würzburg, Würzburg, Germany
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Department of Dermatology, University of Würzburg, Würzburg, Germany
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27
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Reich K, Sieder C, Bachhuber T, Melzer N, Sticherling M. 009 PASI ≤ 2 corresponds to PASI 90, irrespective of baseline severity: A post-hoc analysis of the PRIME-study. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.105] [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: 11/29/2022]
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28
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Sticherling M, Mrowietz U, Augustin M, Thaçi D, Melzer N, Hentschke C, Kneidl J, Sieder C, Reich K. Secukinumab is superior to fumaric acid esters in treating patients with moderate-to-severe plaque psoriasis who are naive to systemic treatments: results from the randomized controlled PRIME trial. Br J Dermatol 2017; 177:1024-1032. [DOI: 10.1111/bjd.15707] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2017] [Indexed: 02/06/2023]
Affiliation(s)
- M. Sticherling
- Universitätsklinikum Erlangen; Hautklinik, Ulmenweg 18 Erlangen D-91054 Germany
| | - U. Mrowietz
- Department of Dermatology; Psoriasis-Center; University Medical Center Schleswig-Holstein; Campus Kiel Schittenhelmstraße 7 Kiel 24105 Germany
| | - M. Augustin
- Institute for Health Services Research in Dermatology & Nursing; Medical Centre Hamburg-Eppendorf; Martinistraße 52 Hamburg 20246 Germany
| | - D. Thaçi
- Department of Dermatology; Institut für Entzündungsmedizin; University Hospitals Schleswig-Holstein; Ratzeburger Str. 160 Lübeck 23538 Germany
| | - N. Melzer
- Novartis Pharma GmbH; Roonstrasse 25 Nürnberg 90429 Germany
| | - C. Hentschke
- Novartis Pharma GmbH; Roonstrasse 25 Nürnberg 90429 Germany
| | - J. Kneidl
- Novartis Pharma GmbH; Roonstrasse 25 Nürnberg 90429 Germany
| | - C. Sieder
- Novartis Pharma GmbH; Roonstrasse 25 Nürnberg 90429 Germany
| | - K. Reich
- Dermatologikum Hamburg and SCIderm Research Institute; Stephansplatz 5 Hamburg 20354 Germany
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29
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Affiliation(s)
- U Uslu
- Department of Dermatology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - F Heppt
- Department of Dermatology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - M Sticherling
- Department of Dermatology, Universitätsklinikum Erlangen, Erlangen, Germany
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30
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Knobler R, Moinzadeh P, Hunzelmann N, Kreuter A, Cozzio A, Mouthon L, Cutolo M, Rongioletti F, Denton CP, Rudnicka L, Frasin LA, Smith V, Gabrielli A, Aberer E, Bagot M, Bali G, Bouaziz J, Braae Olesen A, Foeldvari I, Frances C, Jalili A, Just U, Kähäri V, Kárpáti S, Kofoed K, Krasowska D, Olszewska M, Orteu C, Panelius J, Parodi A, Petit A, Quaglino P, Ranki A, Sanchez Schmidt JM, Seneschal J, Skrok A, Sticherling M, Sunderkötter C, Taieb A, Tanew A, Wolf P, Worm M, Wutte NJ, Krieg T. European Dermatology Forum S1-guideline on the diagnosis and treatment of sclerosing diseases of the skin, Part 1: localized scleroderma, systemic sclerosis and overlap syndromes. J Eur Acad Dermatol Venereol 2017; 31:1401-1424. [PMID: 28792092 DOI: 10.1111/jdv.14458] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [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: 02/15/2017] [Accepted: 06/26/2017] [Indexed: 12/13/2022]
Abstract
The term 'sclerosing diseases of the skin' comprises specific dermatological entities, which have fibrotic changes of the skin in common. These diseases mostly manifest in different clinical subtypes according to cutaneous and extracutaneous involvement and can sometimes be difficult to distinguish from each other. The present guideline focuses on characteristic clinical and histopathological features, diagnostic scores and the serum autoantibodies most useful for differential diagnosis. In addition, current strategies in the first- and advanced-line therapy of sclerosing skin diseases are addressed in detail. Part 1 of this guideline provides clinicians with an overview of the diagnosis and treatment of localized scleroderma (morphea), and systemic sclerosis including overlap syndromes of systemic sclerosis with diseases of the rheumatological spectrum.
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Affiliation(s)
- R Knobler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - P Moinzadeh
- Department of Dermatology and Venereology, University Hospital of Cologne, Cologne, Germany
| | - N Hunzelmann
- Department of Dermatology and Venereology, University Hospital of Cologne, Cologne, Germany
| | - A Kreuter
- Department of Dermatology, Venereology and Allergology, HELIOS St. Elisabeth Klinik Oberhausen, University Witten-Herdecke, Oberhausen, Germany
| | - A Cozzio
- Department of Dermatology, Venereology and Allergology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - L Mouthon
- Service de Médecine Interne, Centre de référence maladies rares: vascularites et sclérodermie systémique, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France
| | - M Cutolo
- Research Laboratories and Academic Division of Clinical Rheumatology, IRCCS San Martino, University Medical School of Genoa, Genoa, Italy
| | - F Rongioletti
- Dermatology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - C P Denton
- Division of Medicine, Centre for Rheumatology, University College London, London, UK
| | - L Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - L A Frasin
- Dermatology Unit, Hospital of Lecco, Lecco, Italy
| | - V Smith
- Department of Rheumatology, Ghent University Hospital, Ghent, Belgium
| | - A Gabrielli
- Department of Clinical and Molecular Science, Università Politecnica delle Marche, Ancona, Italy
| | - E Aberer
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - M Bagot
- Department of Dermatology, Hôpital Saint-Louis, Hôpitaux Universitaires, Paris, France
| | - G Bali
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - J Bouaziz
- Department of Dermatology, Hôpital Saint-Louis, Hôpitaux Universitaires, Paris, France
| | - A Braae Olesen
- Department of Dermatology, University Hospital of Aarhus, Aarhus, Denmark
| | - I Foeldvari
- Hamburg Centre for Pediatric and Adolescent Rheumatology, Schön Klinik Hamburg Eilbek, Hamburg, Germany
| | - C Frances
- Department of Dermatology and Allergology, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, France
| | - A Jalili
- Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - U Just
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - V Kähäri
- Department of Dermatology and Venereology, Turku University Hospital and University of Turku, Turku, Finland
| | - S Kárpáti
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - K Kofoed
- Department of Dermato-Allergology, Herlev and Gentofte University Hospital, Copenhagen, Denmark
| | - D Krasowska
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - M Olszewska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - C Orteu
- Department of Dermatology, Connective Tissue Diseases Service, Royal Free Hospital, London, UK
| | - J Panelius
- Department of Dermatology, Allergology and Venereology, University of Helsinki, and Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - A Parodi
- Department of Dermatology, IRCCS San Martino, University Medical School of Genoa, Genoa, Italy
| | - A Petit
- Department of Dermatology, Hôpital Saint-Louis, Hôpitaux Universitaires, Paris, France
| | - P Quaglino
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - A Ranki
- Department of Dermatology, Allergology and Venereology, Inflammation Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - J M Sanchez Schmidt
- Department of Dermatology, Hospital del Mar-Parc de Salut Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Seneschal
- Department of Dermatology and Pediatric Dermatology, National Centre for Rare Skin Disorders, Hôpital Saint-Andre, University of Bordeaux, Bordeaux, France
| | - A Skrok
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - M Sticherling
- Department of Dermatology, University Hospital of Erlangen, Erlangen, Germany
| | - C Sunderkötter
- Department of Dermatology and Venereology, University Hospital Halle, Halle (Saale), Germany
| | - A Taieb
- Department of Dermatology and Pediatric Dermatology, National Centre for Rare Skin Disorders, Hôpital Saint-Andre, University of Bordeaux, Bordeaux, France
| | - A Tanew
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - P Wolf
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - M Worm
- Department of Dermatology, Venereology and Allergology, University Hospital Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - N J Wutte
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - T Krieg
- Department of Dermatology and Venereology, University Hospital of Cologne, Cologne, Germany
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Abstract
The specific dermatoses of pregnancy represent a heterogeneous group of inflammatory skin diseases related to pregnancy and/or the postpartum period. A clinically relevant classification has been well established over the past 10 years and includes pemphigoid gestationis, polymorphic eruption of pregnancy, intrahepatic cholestasis of pregnancy, and atopic eruption of pregnancy. The hallmark of all four entities is severe pruritus that is accompanied by characteristic skin changes. While some of these dermatoses are distressing only to the mother because of pruritus, others may be associated with significant fetal risks. Early diagnosis and prompt treatment are therefore essential. In this review, we discuss in detail pemphigoid gestationis, polymorphic and atopic eruptions of pregnancy whereas intrahepatic cholestasis of pregnancy is discussed in a separate article (Kremer A, Ständer S, DOI 10.1007/s00105-016-3923-y ). Furthermore, we present a helpful algorithm for diagnosis and management of pruritus in pregnancy.
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Affiliation(s)
| | - M Sticherling
- Hautklinik, Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Deutschland
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Knobler R, Moinzadeh P, Hunzelmann N, Kreuter A, Cozzio A, Mouthon L, Cutolo M, Rongioletti F, Denton CP, Rudnicka L, Frasin LA, Smith V, Gabrielli A, Aberer E, Bagot M, Bali G, Bouaziz J, Braae Olesen A, Foeldvari I, Frances C, Jalili A, Just U, Kähäri V, Kárpáti S, Kofoed K, Krasowska D, Olszewska M, Orteu C, Panelius J, Parodi A, Petit A, Quaglino P, Ranki A, Sanchez Schmidt JM, Seneschal J, Skrok A, Sticherling M, Sunderkötter C, Taieb A, Tanew A, Wolf P, Worm M, Wutte NJ, Krieg T. European dermatology forum S1-guideline on the diagnosis and treatment of sclerosing diseases of the skin, Part 2: Scleromyxedema, scleredema and nephrogenic systemic fibrosis. J Eur Acad Dermatol Venereol 2017; 31:1581-1594. [PMID: 28786499 DOI: 10.1111/jdv.14466] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 06/26/2017] [Indexed: 12/18/2022]
Abstract
The term 'sclerosing diseases of the skin' comprises specific dermatological entities which have fibrotic changes of the skin in common. These diseases mostly manifest in different clinical subtypes according to cutaneous and extracutaneous involvement and can sometimes be difficult to distinguish from each other. The present guideline focuses on characteristic clinical and histopathological features, diagnostic scores and the serum autoantibodies most useful for differential diagnosis. In addition, current strategies in the first- and advanced-line therapy of sclerosing skin diseases are addressed in detail. Part 2 of this guideline provides clinicians with an overview of the diagnosis and treatment of scleromyxedema, scleredema (of Buschke) and nephrogenic systemic sclerosis (nephrogenic fibrosing dermopathy).
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Affiliation(s)
- R Knobler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - P Moinzadeh
- Department of Dermatology and Venereology, University Hospital of Cologne, Cologne, Germany
| | - N Hunzelmann
- Department of Dermatology and Venereology, University Hospital of Cologne, Cologne, Germany
| | - A Kreuter
- Department of Dermatology, Venereology and Allergology, HELIOS St. Elisabeth Klinik Oberhausen, University Witten-Herdecke, Oberhausen, Germany
| | - A Cozzio
- Department of Dermatology, Venereology and Allergology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - L Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Rares: Vascularites et Sclérodermie Systémique, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France
| | - M Cutolo
- Research Laboratories and Academic Division of Clinical Rheumatology, IRCCS San Martino, University Medical School of Genoa, Genoa, Italy
| | - F Rongioletti
- Department of Medical Sciences and Public Health, Dermatology Unit, University of Cagliari, Cagliari, Italy
| | - C P Denton
- Centre for Rheumatology, Division of Medicine, University College London, London, UK
| | - L Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - L A Frasin
- Dermatology Unit, Hospital of Lecco, Lecco, Italy
| | - V Smith
- Department of Rheumatology, Ghent University Hospital, Ghent, Belgium
| | - A Gabrielli
- Department of Clinical and Molecular Science, Università Politecnica delle Marche, Ancona, Italy
| | - E Aberer
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - M Bagot
- Department of Dermatology, Hôpital Saint-Louis, Hôpitaux Universitaires, Paris, France
| | - G Bali
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - J Bouaziz
- Department of Dermatology, Hôpital Saint-Louis, Hôpitaux Universitaires, Paris, France
| | - A Braae Olesen
- Department of Dermatology, University Hospital of Aarhus, Aarhus, Denmark
| | - I Foeldvari
- Hamburg Centre for Pediatric and Adolescent Rheumatology, Schön Klinik Hamburg Eilbek, Hamburg, Germany
| | - C Frances
- Department of Dermatology and Allergology, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, France
| | - A Jalili
- Division of Immunology, Allergy and Infectious Diseases, Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - U Just
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - V Kähäri
- Department of Dermatology and Venereology, Turku University Hospital and University of Turku, Turku, Finland
| | - S Kárpáti
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - K Kofoed
- Department of Dermato-Allergology, Herlev and Gentofte University Hospital, Copenhagen, Denmark
| | - D Krasowska
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - M Olszewska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - C Orteu
- Department of Dermatology, Connective Tissue Diseases Service, Royal Free Hospital, London, UK
| | - J Panelius
- Department of Dermatology, Allergology and Venereology, University of Helsinki, and Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - A Parodi
- Department of Dermatology, IRCCS San Martino, University Medical School of Genoa, Genoa, Italy
| | - A Petit
- Department of Dermatology, Hôpital Saint-Louis, Hôpitaux Universitaires, Paris, France
| | - P Quaglino
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - A Ranki
- Department of Dermatology, Allergology and Venereology, Inflammation Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - J M Sanchez Schmidt
- Department of Dermatology, Hospital del Mar-Parc de Salut Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Seneschal
- Department of Dermatology and Pediatric Dermatology, National Centre for Rare Skin Disorders, Hôpital Saint-Andre, University of Bordeaux, Bordeaux, France
| | - A Skrok
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - M Sticherling
- Department of Dermatology, University Hospital of Erlangen, Erlangen, Germany
| | - C Sunderkötter
- Department of Dermatology and Venereology, University Hospital Halle, Halle (Saale), Germany
| | - A Taieb
- Department of Dermatology and Pediatric Dermatology, National Centre for Rare Skin Disorders, Hôpital Saint-Andre, University of Bordeaux, Bordeaux, France
| | - A Tanew
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - P Wolf
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - M Worm
- Department of Dermatology, Venereology and Allergology, University Hospital Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - N J Wutte
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - T Krieg
- Department of Dermatology and Venereology, University Hospital of Cologne, Cologne, Germany
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Heppt F, Colsman A, Maronna A, Uslu U, Heppt MV, Kiesewetter F, Sticherling M. Influence of TNF-alpha inhibitors and fumaric acid esters on male fertility in psoriasis patients. J Eur Acad Dermatol Venereol 2017; 31:1860-1866. [PMID: 28557008 DOI: 10.1111/jdv.14364] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 04/19/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Is there any influence of a therapy with TNF-alpha inhibitors or fumaric acid esters and of disease activity status on male fertility and sperm quality in patients with psoriasis? METHODS In this monocentric, open-label, prospective study, semen samples were collected from patients receiving either TNF-alpha inhibitors or fumaric acid esters for moderate-to-severe plaque psoriasis. Semen was analysed at baseline before onset of the systemic therapy and monitored every 3 months under therapy. Sperm parameters were assessed according to the current WHO definitions. RESULTS In total, 101 semen specimens from 27 patients were obtained. Mean Psoriasis Area and Severity Index (PASI) score at baseline was 11.05. Only 14.8% of patients showed a normozoospermia without any other abnormal seminal values. 85.2% of patients had at least one sperm/seminal abnormality, including two patients showing an azoospermia. Interestingly, 48.1% showed sperm parameters indicative of genital tract inflammation. Therapy with TNF-alpha inhibitors or fumaric acid esters did not have any negative effects on relevant sperm parameters such as mean total sperm number, sperm concentration, total and progressive motility. No major gonadal dysfunction was observed in any patient. CONCLUSION At baseline, many patients with psoriasis showed abnormal semen/sperm parameters and remarkably elevated leukocytes and values of seminal polymorphonuclear elastase, indicating a genital tract inflammation. Thus, genital tract inflammation may represent an important comorbidity of psoriasis, little attention paid to so far. Regarding treatment with TNF-alpha inhibitors or fumaric acid esters, no major negative (side-) effects on sperm quality were observed.
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Affiliation(s)
- F Heppt
- Department of Dermatology, University Hospital of Erlangen, Erlangen, Germany
| | - A Colsman
- Department of Dermatology, University Hospital of Erlangen, Erlangen, Germany
| | - A Maronna
- Department of Dermatology, University Hospital of Erlangen, Erlangen, Germany
| | - U Uslu
- Department of Dermatology, University Hospital of Erlangen, Erlangen, Germany
| | - M V Heppt
- Department of Dermatology and Allergy, Munich University Hospital (LMU), Munich, Germany
| | - F Kiesewetter
- Department of Dermatology, University Hospital of Erlangen, Erlangen, Germany
| | - M Sticherling
- Department of Dermatology, University Hospital of Erlangen, Erlangen, Germany
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Faustini F, Simon D, Oliveira I, Kleyer A, Haschka J, Englbrecht M, Cavalcante A, Kraus S, Tabosa T, Figueiredo C, Hueber A, Kocijan R, Cavallaro A, Schett G, Sticherling M, Rech J. THU0372 Subclinical Joint Inflammation in Psoriasis Patients without Concomitant Psoriatic Arthritis- A Cross-Sectional and Longitudinal Analysis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1647] [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: 11/04/2022]
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Simon D, Nas K, Faustini F, Kleyer A, Haschka J, Englbrecht M, Hueber A, Kocijan R, Sticherling M, Schett G, Rech J. AB0946 S100A8 but Not S100A9 Level Is Related To The Extent of Erosive Bone Damage in Psoriatic Arthritis Patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5288] [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: 11/04/2022]
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Simon D, Faustini F, Englbrecht M, Kleyer A, Kocijan R, Haschka J, Figueiredo C, Kraus S, Hueber A, Sticherling M, Schett G, Rech J. FRI0560 Comparison of Bone Microstructure of Psoriatic Arthritis and Psoriasis Patients – An HR-PQCT Study of Anabolic and Catabolic Bone Changes. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4134] [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: 11/03/2022]
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Kuhn A, Sigges J, Biazar C, Ruland V, Patsinakidis N, Landmann A, Amler S, Bonsmann G, Haust M, Nyberg F, Bata Z, Mihályi L, Olteanu R, Pujol R, Sánchez‐Schmidt J, Medenica L, Skiljevic D, Reich A, Szepietowski J, Dalle Vedove C, Girolomoni G, Hawro T, Zalewska‐Janowska A, Glaeser R, Huegel R, Jedličková H, Bygum A, Laurinaviciene R, Benoit S, Broecker E, Bahmer F, Aberer E, Wutte N, Lipozencic J, Marinovic B, Sárdy M, Bekou V, Ruzicka T, Frances C, Soutou B, Lee H, Worm M, Gruschke A, Hunzelmann N, Steinbrink K, Romiti R, Sticherling M, Erfurt‐Berge C, Avgerinou G, Papafragkaki D, Antiga E, Caproni M, Mayer B, Volc‐Platzer B, Kreuter A, Tigges C, Heil P, Stingl G. Influence of smoking on disease severity and antimalarial therapy in cutaneous lupus erythematosus: analysis of 1002 patients from the
EUSCLE
database. Br J Dermatol 2014; 171:571-9. [DOI: 10.1111/bjd.13006] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2014] [Indexed: 12/27/2022]
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Simon D, Faustini F, Englbrecht M, Kleyer A, Kocijan R, Haschka J, Kraus S, Hueber A, Sticherling M, Schett G, Rech J. SAT0182 Magnetic Resonance Imaging (MRI) of Hands of Psoriasis Patients: High Incidence of Inflammation. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5412] [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: 11/04/2022]
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40
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Simon D, Faustini F, Englbrecht M, Kleyer A, Kocijan R, Haschka J, Finzel S, Kraus S, Hueber A, Sticherling M, Schett G, Rech J. FRI0227 Analysis of Periarticular Bone Changes in Patients with Cutaneous Psoriasis without Associated Psoriatic Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4337] [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: 11/04/2022]
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Paul C, Puig L, Kragballe K, Luger T, Lambert J, Chimenti S, Girolomoni G, Nicolas J, Rizova E, Lavie F, Mistry S, Bergmans P, Barker J, Reich K, Adamski Z, Altomare G, Aricò M, Aste N, Aubin F, Augustin M, Ayala F, Bachelez H, Baran E, Barker J, Belinchón I, Berbis P, Bernengo M, Bessis D, Beylot‐Barry M, Bordas Orpinell F, Burden D, Bylaite M, Cambazard F, Carazo S, Carrascosa J, Carretero G, Cerio R, Chimenti S, David M, Duval‐Modeste A, Eedy D, Estebaranz L, Filipe P, Flytström I, Fonseca E, Gamanya R, Ghislain P, Giannetti A, Girolomoni G, Gospodinov D, Griffiths C, Grob J, Guillet G, Hernanz Hermosa J, Hoffmann M, Ioannidis D, Jacobi A, Jemec G, Kadurina M, Kaszuba K, Katsambas A, Kemeny L, Kerkhof P, Kragballe K, Kuzmina N, Lambert K, Lázaro P, Lotti T, Luger T, Matz H, Modiano P, Moessner R, Moreno D, Moreno Jímenez J, Mørk N, Mrowietz U, Murphy R, Nicolas J, Nikkels A, Oliveira H, Ormerod A, Ortonne J, Parodi A, Pasternack R, Paul C, Pec J, Peserico A, Philipp S, Piquet L, Plantin P, Puig L, Reich K, Reményik E, Riedl E, Röcken M, Rustin M, Saari S, Saiag P, Salmhofer W, Schadendorf D, Sebastian M, Simaljakova M, Simon J, Spirén A, Stalder J, Stavrianeas N, Sticherling M, Ternowitz T, Thaci D, Thio B, Uhlig D, Valiukeviciene S, Vanaclocha Sebastián F, Wozel G. Transition to ustekinumab in patients with moderate‐to‐severe psoriasis and inadequate response to methotrexate: a randomized clinical trial (
TRANSIT
). Br J Dermatol 2014; 170:425-34. [DOI: 10.1111/bjd.12646] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2013] [Indexed: 12/25/2022]
Affiliation(s)
- C. Paul
- Hôpital Larrey Service de Dermatologie Toulouse cedex 9 31059 France
| | - L. Puig
- Department of Dermatology Hospital de la Santa Creu i Sant Pau Universitat Autònoma de Barcelona 08025 Barcelona Spain
| | - K. Kragballe
- Department of Dermatology Århus University Hospital Århus Sygehus 8000 Århus Denmark
| | - T. Luger
- Department of Dermatology University of Münster D‐48149 Münster Germany
| | - J. Lambert
- Department of Dermatology Ghent University 9000 Ghent Belgium
| | - S. Chimenti
- Policlinico Universitario Tor Vergata Clinica Dermatologica 00133 Rome Italy
| | - G. Girolomoni
- Clinica Dermatologica University of Verona 37126 Verona Italy
| | | | - E. Rizova
- Janssen‐Cilag 1 rue Camille Desmoulins TSA 91003 92787 Issy les Moulineaux, Cedex 9 France
| | - F. Lavie
- Janssen‐Cilag 1 rue Camille Desmoulins TSA 91003 92787 Issy les Moulineaux, Cedex 9 France
| | - S. Mistry
- Janssen 50‐100 Holmers Farm Way High Wycombe Bucks HP12 4EG U.K
| | - P. Bergmans
- Janssen‐Cilag B.V. Postbus 90240 5000 LT Tilburg the Netherlands
| | - J. Barker
- St John's Institute of Dermatology King's College London SE1 9RT U.K
| | - K. Reich
- Dermatologikum Hamburg Stephansplatz 5 20354 Hamburg Germany
- Georg‐August‐University Göttingen Germany
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Sticherling M. Cutaneous lupus erythematosus and cancer risk. Br J Dermatol 2012; 166:913. [DOI: 10.1111/j.1365-2133.2012.10840.x] [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)
- M. Sticherling
- Department of Dermatology, University Hospital of Erlangen, Erlangen, Germany
E‐mail:
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Mrowietz U, Adamczyk A, Augustin M, Boehncke W, Bonnekoh B, Gambichler T, Hengge U, Lippert U, Ludwig RJ, Luger T, Merk H, Norgauer J, Philipp S, Reich K, Röcken M, Rostami-Yazdi M, Schön MP, Scola N, Sticherling M, Thaci D, Viehweg A, Wallbrecht K, Wozel G, Zouboulis C, Neureither M. Neue Erkenntnisse zu Fumarsäureestern (Fumaderm®): Ergebnisse eines Experten-Workshops. J Dtsch Dermatol Ges 2011; 9 Suppl 4:1-13. [DOI: 10.1111/j.1610-0379.2011.07765.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [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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Wolf PP, Sticherling M, Voskens CJ, Schroth M. Pediatric treatment strategies of Pityriasis lichenoides et varioliformis acuta Mucha Habermann-effects and side effects. Klin Padiatr 2011. [DOI: 10.1055/s-0031-1273914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Renner R, Sticherling M. Strahlungs-induzierter subakut kutaner Lupus erythematodes oder außergewöhnliche Radiodermatitis? Akt Dermatol 2010. [DOI: 10.1055/s-0029-1215194] [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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Sticherling M. [Involvement of mucous membranes in papulosquamous diseases]. Hautarzt 2009; 60:891-7. [PMID: 19876609 DOI: 10.1007/s00105-009-1805-2] [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: 11/24/2022]
Abstract
Many skin diseases may affect the oral and genital mucous membranes but involvement is generally uncommon. Mucous membranes are most often affected by lichen planus and less frequently by psoriasis or lupus erythematosus. Macroscopic changes may vary from increased vulnerability, erythema and erosions to leukoplakia. Subjective symptoms of burning sensations or localized pain must be distinguished from underlying psychiatric disorders. Furthermore, neoplasia may complicate chronic lichen planus. Therefore, depending on the location and extent of mucous membrane symptoms, both local and systemic therapy may be necessary. Short- and long-term dermatologic care are required.
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Affiliation(s)
- M Sticherling
- Hautklinik, Universitätsklinikum Erlangen, 91052 Erlangen.
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Müeller RB, Ogilvie A, Schwarz S, Kern P, Schett G, Sticherling M. Adalimumab treatment of a patient with psoriasis suppurativa Hallopeau associated osteoarthropathy. Clin Exp Rheumatol 2009; 27:887. [PMID: 19917179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Renner R, Sticherling M. The different faces of cutaneous lupus erythematosus. GIORN ITAL DERMAT V 2009; 144:135-147. [PMID: 19357621] [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] [Indexed: 05/27/2023]
Abstract
Lupus erythematosus is a chronic and inflammatory multiorgan disease with variable clinical appearance and variable course. Most patients with systemic lupus erythematosus show cutaneous manifestations and conversely, all forms of cutaneous LE may change into a systemic involvement. Specific lesions of cutaneous LE are classified in different subtypes of acute cutaneous lupus erythematosus (ACLE), subacute cutaneous lupus erythematosus (SCLE), chronic cutaneous lupus erythematosus (CDLE) and intermittent cutaneous lupus erythematosus (ICLE) according to clinical, histological and immunoserological parameters. Regular laboratory tests are important to monitor the activity and course of the disease or side effects of the therapy. In case of clinical or laboratory dysfunctions of internal organs, additional technical investigations are necessary. Histology is needed to support clinical diagnosis. A large number of drugs are able to induce SCLE, e.g. hydrochlorothiazide, terbinafine, or angiotensin-converting enzyme inhibitors. Drug-induced SCLE can be differentiated by possible complementary immunoserological parameters. Neonatal lupus can be induced by transplacental transmission of maternal anti-Ro(SS-A) and anti-La(SS-B)-antibodies. Children with neonatal lupus might suffer from congenital atrioventricular block. Their mothers may suffer from active LE, but can be clinically healthy as well. As a consequence, pregnancies at risk should be monitored in short intervals by serial echocardiographic interventions. Protection against UV light is recommended for all types of CLE. There are some topical and many systemic treatment options e.g. topical and systemic glucocorticosteroids, antimalarial drugs, dapsone, azathioprine, or mycophenolate mofetil with different response to skin or organ involvement.
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Affiliation(s)
- R Renner
- Clinic for Dermatology, Venerology and Allergology, University of Leipzig, Germany.
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Pfoch L, Mahler V, Sticherling M. Drug-eluting coronary stents: hypersensitivity reactions to paclitaxel. A case report. Dermatology 2008; 218:52-5. [PMID: 18987464 DOI: 10.1159/000171817] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2008] [Accepted: 05/23/2008] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Drug-eluting stents become increasingly popular for the treatment of coronary artery disease. Consequently, side effects including hypersensitivity reactions have to be anticipated. CASE REPORT Here we report on a patient with an anaphylactic reaction 2 weeks after implantation of a polymer-based paclitaxel-eluting stent (Taxus, Boston Scientific). The patient presented with disseminated wheals, pruritus, bronchial asthma and acute synovitis. The reaction was successfully treated with initial intravenous injection followed by oral antihistamine treatment for 1 month until all stent-bound paclitaxel was assumed to be eluted. Thereafter no further anaphylactic reaction occurred. CONCLUSION This sequence of events points towards a causal relation of the stent implantation and hypersensitivity reaction with a central role of paclitaxel. The increasing use of this type of stent should therefore be carefully monitored for such adverse reactions.
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Affiliation(s)
- L Pfoch
- Department of Dermatology, University Hospital of Erlangen, Erlangen, Germany
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