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Ruiz-Villaverde R, Galan-Gutierrez M, Armario-Hita JC, Rodriguez-Fernandez-Freire L. Efficacy and Pharmacoeconomic Analysis in Real Clinical Practice Conditions of Patients with Plaque Psoriasis Treated with Guselkumab: A Retrospective Multicenter Study. Actas Dermosifiliogr 2024; 115:321-323. [PMID: 37923077 DOI: 10.1016/j.ad.2023.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/15/2023] [Accepted: 10/01/2023] [Indexed: 11/07/2023] Open
Affiliation(s)
- R Ruiz-Villaverde
- Servicio de Dermatología, Hospital Universitario San Cecilio, Instituto Biosanitario de Granada (ibs.GRANADA), Granada, España.
| | - M Galan-Gutierrez
- Servicio de Dermatología, Hospital Universitario San Reina Sofía, IMIBIC, Córdoba, España
| | - J C Armario-Hita
- Servicio de Dermatología, Hospital Universitario de Puerto Real, Cádiz, España
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Ruiz-Villaverde R, Galan-Gutierrez M, Armario-Hita JC, Rodriguez-Fernandez-Freire L. [Translated article] Efficacy and Pharmacoeconomic Analysis in Real Clinical Practice Conditions of Patients with Plaque Psoriasis Treated with Guselkumab: A Retrospective Multicenter Study. Actas Dermosifiliogr 2024; 115:T321-T323. [PMID: 38242431 DOI: 10.1016/j.ad.2023.10.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/01/2023] [Indexed: 01/21/2024] Open
Affiliation(s)
- R Ruiz-Villaverde
- Servicio de Dermatología, Hospital Universitario San Cecilio, Instituto Biosanitario de Granada (ibs.GRANADA), Granada, Spain.
| | - M Galan-Gutierrez
- Servicio de Dermatología, Hospital Universitario San Reina Sofía, IMIBIC, Córdoba, Spain
| | - J C Armario-Hita
- Servicio de Dermatología, Hospital Universitario de Puerto Real, Cádiz, Spain
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Galan-Gutierrez M, Font-Ugalde P, Padilla L, Hernandez-Montoya C, Godoy D, Armario-Hita JC, Ruiz-Villaverde R. Brodalumab: Efficacy, safety, and survival in mid-term (52 weeks) on real clinical practice in Andalucia, Spain. Int J Dermatol 2022; 62:700-706. [PMID: 36495585 DOI: 10.1111/ijd.16527] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 11/17/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Brodalumab is a recombinant monoclonal antibody (IgG2) that binds with high affinity to the human interleukin-17 (IL-17) receptor A and blocks the biological activity of the proinflammatory cytokines IL-17A, IL-17F, IL-17A/F heterodimer, and IL- 25, resulting in inhibition of inflammation and clinical symptoms associated with psoriasis. Its introduction has managed to increase the levels of efficacy, safety (improving that previously presented by the anti-IL-17 class), and survival. MATERIAL AND METHODS Retrospective analysis of a multicenter, observational study of real clinical practice including patients with moderate to severe plaque psoriasis in treatment with brodalumab. This cross-sectional analysis includes information of patients between February 2019 and February 2022. A total of five tertiary hospitals in Andalusia (Spain) participated in this study. Analyses were performed "as observed" using GraphPad Prism version 8.3.0 for Windows. RESULTS Our study included 85 patients, 54 men (63.5%) and 31 women (36.5%), with moderate-severe psoriasis treated with brodalumab. In order to evaluate the efficacy of brodalumab, our patients started with mean Psoriasis Area and Severity Index (PASI) values of 12.8 and body surface area (BSA) of 16.9, as well as a Dermatology Life Quality Index (DLQI) of 15.6, highlighting that they reported that the mean baseline visual analog scale (VAS) pruritus was 6.15. On week 52, mean PASI reached 1.26 and mean BSA 2.3, showing a clear stabilization and even sustained improvement regarding results on week 12. Concerning the brodalumab survival, we obtained 85.8% persistence at week 52. DISCUSSION Brodalumab showed excellent results in the control of psoriasis in the mid-term with an elevated number of patients maintaining treatment after 52 weeks. There were no statistically significant differences in the efficiency, safety, or survival results of brodalumab between patients coming from previous therapies.
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Affiliation(s)
- Manuel Galan-Gutierrez
- Department of Dermatology, Hospital Universitario San Reina Sofía, IMIBIC, Córdoba, Spain
| | - Pilar Font-Ugalde
- Departamento de Ciencias Médicas y Quirúrgicas (Universidad de Córdoba, Spain), Instituto Maimónides de Investigación en Biomedicina de Córdoba (IMIBIC), Córdoba, Spain
| | - Laura Padilla
- Department of Dermatology, Hospital Universitario de Jerez, Cadiz, Spain
| | | | - Daniel Godoy
- Department of Dermatology, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Jose C Armario-Hita
- Department of Dermatology, Hospital Universitario de Puerto Real, Cadiz, Spain
| | - Ricardo Ruiz-Villaverde
- Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain.,Instituto Biosanitario de Granada (ibs.GRANADA), Granada, Spain
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Dodero-Anillo JM, Lozano-Cuadra IC, Rios-Sanchez E, Pedrosa-Martinez MJ, Ruiz-Carrascosa JC, Galan-Gutierrez M, Armario-Hita JC. Optimising the Therapeutic Interval for Biologics in Patients with Psoriasis. Life (Basel) 2022; 12:2075. [PMID: 36556440 PMCID: PMC9787329 DOI: 10.3390/life12122075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/25/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
In our clinical experience, more than half of patients do not present a complete response to biologic drugs, or drug loses its efficacy over time. Plasma determinations of drug and anti-drug antibodies levels are an objective tool for optimisation in these patients; however, established therapeutic ranges are not suitable, so the objective of this study was to study these patients and optimise their healthcare. We have made a retrospective, observational study, using data of plasma levels of drugs and anti-drugs antibodies of infliximab, adalimumab or Etanercept, we summarise all data and make a study of sensitivity, specificity, positive and negative predictive value on current therapeutic ranges. We have found a statistically significant association between subtherapeutic levels and therapeutic failure in psoriasis treated with infliximab and adalimumab. New ranges were found with higher sensitivity than the established ones, we propose 2-10 µg/mL therapeutic range for infliximab, 3-11 µg/mL for adalimumab, and 1-7 µg/mL for etanercept. In conclusion, levels of drug and anti-drug antibodies are a decisive tool for predicting therapeutic response. The current therapeutic ranges may have minimum values that are excessively high, owing to which lowering them significantly increases the sensitivity of the test in all cases, and negative predictive value in the case of etanercept. Further prospective studies are needed to prove the usefulness of these new ranges.
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Ruiz-Villaverde R, Sanchez-Cano D, Martinez-Peinado CM, Galan-Gutierrez M. Verrucous tumor mimicking squamous cell carcinoma in immunocompetent patient. Dermatol Online J 2016; 22:13030/qt93z9c7pm. [PMID: 27267196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 02/16/2016] [Indexed: 06/06/2023] Open
Abstract
Mycobacteria cause a range of diseases in both immunocompetent and immunosuppressed individuals. An increase in non-tuberculous mycobacterial (NTM) infections targeting skin has been described. Many hypotheses have been developed in order to explain it: the increasing burden of immunocompromised individuals, immigration from endemic countries, improved laboratory identification techniques, and changes inhuman behavior that expose individuals to this NTM. Mycobacterium mucogenicum group comprises M. mucogenicum, Mycobacterium aubagnense, and Mycobacterium phocaicum. This group of organisms was first named Mycobacterium chelonae-like organism in 1982. Most clinically significant cases of those organisms involved catheter-related infections. Nevertheless, we report an interesting patient with a cutaneous infection produced by M. mucogenicum mimicking a squamous cell carcinoma; an excellent response to combined therapy with rifampicin and clarythromicin was observed.
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Ruiz-Villaverde R, Sanchez-Cano D, Martinez-Peinado CM, Galan-Gutierrez M. Verrucous tumor mimicking squamous cell carcinoma in immunocompetent patient. Dermatol Online J 2016. [DOI: 10.5070/d3222030098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Ruiz-Villaverde R, Galan-Gutierrez M. Skin nodules with a linear distribution - a case study. Aust Fam Physician 2011; 40:801-802. [PMID: 22003484] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A man, 35 years of age, with an unremarkable past medical history, attended after developing purplish nodules on the left arm. The nodules were in a linear distribution and had developed during recent months after a minor initial injury. The nodules were moderately painful, but it was mainly the appearance of new nodules that motivated him to consult his general practitioner. On dermatological examination, six purple nodules were observed following a linear distribution along the back of the left hand and arm (Figure 1). They were of variable size. Some of the lesions had a discrete superficial ulceration and a serous crust. The patient had no fever. Small lymph nodes were detected in the left axilla. Systemic examination showed no abnormalities. Laboratory data, including full blood count, general biochemistry and urine analysis were normal. Culture was unremarkable. Histopathologic examination revealed a mixed granulomatous and pyogenic inflammatory process. Cigar shaped organisms were identified by periodic acid-Schiff (PAS) staining.
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Ruiz-Villaverde R, Galan-Gutierrez M. Lichenoid drug eruption due to eprosartan/hydrochlorothiacide. Dermatol Reports 2011; 3:e31. [PMID: 25386283 PMCID: PMC4211526 DOI: 10.4081/dr.2011.e31] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2011] [Accepted: 08/24/2011] [Indexed: 11/23/2022] Open
Abstract
We report a case of a 66-year-old male who developed an itchy eruption while taking an antihypertonic drug containing eprosartan and hydrochlorothiacide after sun exposure. The lesions resembled a lichenoid appearance that was confirmed by the histological study. There are few reports in the literature of lichenoid reactions to these compounds, so we review the characteristics of themselves as a potencial cause of drug eruptions.
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Rodríguez-Bujaldón A, Vazquez-Bayo C, Jimenez-Puya R, Galan-Gutierrez M, Moreno-Gimenez J, Rodriguez-Garcia A, Tercedor J, Velez-Garcia A. LEOPARD syndrome: what are café noir spots? Pediatr Dermatol 2008; 25:444-8. [PMID: 18789084 DOI: 10.1111/j.1525-1470.2008.00734.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Lentigines, electrocardiographic abnormalities, ocular hypertelorism, pulmonary stenosis, abnormalities of genitalia, retarded growth, and deafness syndrome (multiple lentigines syndrome) is most often characterized by multiple lentigines and cardiac conduction defects. Café noir spot is a term proposed, by analogy to café au lait spots, for the larger and darkly pigmented patches that are frequently observed in patients with this syndrome. Although presumed by some authors to represent lentigines, the histologic features of café noir spots have not been well documented in the literature. Only two previous cases have been reported in which a biopsy of the café noir spots than melanocytic nevi. We describe the histologic characteristics of seven café noir spots in six patients with lentigines, electrocardiographic abnormalities, ocular hypertelorism, pulmonary stenosis, abnormalities of genitalia, retarded growth, and deafness syndrome. Three lesions represented melanocytic nevi (one with dysplastic features), and four were compatible with lentigo simplex. These findings help our understanding of the histologic spectrum of pigmented lesions in lentigines, electrocardiographic abnormalities, ocular hypertelorism, pulmonary stenosis, abnormalities of genitalia, retarded growth, and deafness syndrome.
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