Secukinumab is a first-in-class interleukin 17A monoclonal antibody that has demonstrated an excellent safety and efficacy profile in phase 3 studies.
To evaluate the effectiveness of secukinumab in ...daily clinical practice and to understand the clinical and epidemiologic characteristics of patients treated with secukinumab in clinical settings.
In this multicenter prospective observational study, we recruited adult patients with moderate-to-severe plaque psoriasis from 12 hospitals in Spain during January-December 2016. These patients were treated with secukinumab and prospectively followed at 12-week intervals for 52 weeks.
In total, 158 patients were recruited to the study. A Psoriasis Area and Severity Index (PASI) score improvement ≥75% over baseline (PASI-75) was achieved by 57%, 83.5%, 89%, and 78.5% of patients at weeks 4, 12, 24, and 52, respectively. PASI-90 was achieved in 27.8%, 62%, 64.6%, and 63.2% of patients at weeks 4, 12, 24, and 52, respectively; PASI-75 and PASI-90 responders were significantly more common among patients with a body mass index <30 kg/cm2 and patients without previous biologic therapy failures.
Observational study. Time from onset of psoriasis was not evaluated.
Secukinumab is a safe treatment with effectiveness rates similar to those found in its phase 3 studies. These rates endure up to a year from start of treatment.
Background
There is limited evidence over the real‐life secukinumab survival in psoriatic patients, especially in the long‐term bio‐naïve subjects, and to date biological treatments have been ...assessed in patients with a chronic and recalcitrant psoriasis. It has been hypothesised that early intensive treatment with biological therapies could decrease pathogenic tissue resident memory (TRm) cells migration and potentially modify the natural course of psoriasis and related comorbidities.
Objectives
To analyze long‐term secukinumab efficacy, safety and survival, and its predictive factors for psoriasis treatment determining also whether early intervention may result in better outcomes for patients.
Methods
Bio‐naïve psoriatic patients under treatment with secukinumab (n = 128 patients) in a daily practice setting were analyzed in a retrospective multicentric study and followed up to 8 years. Drug survival rate, efficacy, posology and safety were reported.
Results
The overall secukinumab survival was 81.9% for an average treatment exposure of 147.9 weeks. The approved posology was the most commonly prescribed regimen (78.7%), and 17.7% could be optimized. An absolut‐PASI ≤3 was reached by 86.6%, 82.6% and 91.7% at the weeks 48,156 and 264, respectively. The incidence of arthritis or psoriasis related comorbidities was low. The response was not influenced by weight, age (>65), gender or the presence of arthritis. No severe adverse events were reported.
Conclusions
In our bio‐naïve series, the high efficacy and long‐term survival rates observed and the low prevalence of arthritis and comorbidities might suggest that early intervention could contribute to modify the course of the disease, but further studies are needed.
Background . Rapid efficacy is an important item to psoriasis patients. Risankizumab, a humanised immunoglobulin G1 monoclonal antibody that inhibits IL‐23, has demonstrated early and sustained ...efficacy in patients with moderated‐to‐severe psoriasis. Effectiveness data in real world, particularly regarding short‐term response, however, are scarce. Objective . To explore the short‐term effectiveness of risankizumab in patients with moderate‐severe psoriasis in normal clinical practice. Methods . This was an observational, retrospective, multicentre study carried out at thirteen hospitals in Valencia, Spain. It was conducted on a sample of adult outpatients over 18 years of age, diagnosed with moderate‐to‐severe psoriasis who received at least one subcutaneous injection of 150 mg of risankizumab. Psoriasis Area and Severity Index (PASI) was used to assess the short‐term (4 weeks) effectiveness of risankizumab. Results . One hundred and sixteen patients (63.8% men) with a mean age (standard deviation (SD)) of 50 (16) years were included in the study. 90.6% were overweight or obese, and 22.7% were biologic‐naïve. The mean (SD) PASI score decreased from 11.9 (7.2) at the baseline to 3.3 (2.7) at week 4, with a median (SD) PASI score reduction of 8.6 (2.3) ( p < 0.05). The absolute PASI score of <2 was reached by 52.6% of patients. Overall, PASI scores of 75, 90, and 100 were achieved in 56%, 37.1%, and 25.9% of patients, respectively, at week 4. PASI 90 was achieved by a significantly higher proportion of naïve patients than biologic‐experience failure patients (59.3% vs. 30.3%; p = 0.01). Conclusion . This study, which reflects our initial risankizumab experience in a real‐life setting, seems to show quick effectiveness in psoriasis treatment after one single dose. This trial is registered with NCT04862286 .
Abstract This retrospective case series examines the efficacy and safety of Bimekizumab in 22 patients with moderate to severe plaque psoriasis in a real‐world clinical setting. The demographic and ...clinical characteristics of the participants, including a mean age of 43.7 years and a gender distribution of 60% male and 40% female, are summarised. Notably, 70% of the patients had previously received systemic therapy, and 50% had concurrent psoriatic arthritis. The evaluation over a 12‐week treatment period revealed a significant reduction in psoriasis area and severity index scores from a baseline mean of 11.5−1.0 at Week 4 and further down to 0.3 by Week 12. Similar improvements were observed in body surface area, physician's global assessment and dermatology life quality index scores. Bimekizumab was well‐tolerated with no reported adverse events, leading to no treatment discontinuations. These findings highlight the potential of Bimekizumab to provide rapid and sustained improvements in patients with moderate to severe plaque psoriasis, underlining its value in clinical practice.
Late reactions to beryllium: report of two cases Costa, Ana Lucas; Silvestre Salvador, Juan Francisco; Pérez-Crespo, María ...
Contact dermatitis,
September 2008, Letnik:
59, Številka:
3
Journal Article
Bacterial (bact)DNA is an immunogenic product that frequently translocates into the blood in cirrhosis. We evaluated bactDNA clearance in patients undergoing liver transplantation (LT) and its ...association with inflammation and clinically relevant complications. We prospectively included patients consecutively admitted for LT in a one-year follow-up study. We evaluated bactDNA before and during the first month after LT, quantifying cytokine response at 30 days. One hundred patients were included. BactDNA was present in the blood of twenty-six patients undergoing LT. Twenty-four of these showed bactDNA in the portal vein, matching peripheral blood-identified bactDNA in 18 cases. Thirty-four patients showed bactDNA in blood during the first month after LT. Median TNF-α and IL-6 levels one month after LT were significantly increased in patients with versus without bactDNA. Serum TNF-α at baseline was an independent risk factor for bactDNA translocation during the first month after LT in the multivariate analysis (Odds ratio (OR) 1.14 1.04 to 1.29, P = 0.015). One-year readmission was independently associated with the presence of bactDNA during the first month after LT (Hazard ratio (HR) 2.75 1.39 to 5.45, P = 0.004). The presence of bactDNA in the blood of LT recipients was not shown to have any impact on complications such as death, graft rejection, bacterial or CMV infections. The rate of bactDNA translocation persists during the first month after LT and contributes to sustained inflammation. This is associated with an increased rate of readmissions in the one-year clinical outcome after LT.
The incidence of postoperative residual curarisation remains unacceptably high. We assessed whether an educational intervention on perioperative neuromuscular block management can reduce it.
In this ...multicentre, cluster randomised crossover trial, centres were allocated to receive an educational intervention either in a first or a second period. The educational intervention consisted of a lecture about neuromuscular management key points, including quantitative neuromuscular monitoring and use of reversal agents. The lecture was streamed to allow repetition. Additionally, memory cards were distributed in each operating theatre. The primary outcome was postoperative residual curarisation in the PACU. Secondary outcomes were frequency of quantitative neuromuscular monitoring, use of reversal agents, and incidence of postoperative pulmonary complications during hospital stay. Measurements were performed before randomisation and after the first and the second period. The effect of the educational intervention was estimated using multivariable mixed effects logistic regression models.
We included 2314 subjects in 34 Spanish centres. Postoperative residual curarisation incidence was not affected by the educational intervention (odds ratio OR 0.90 95% confidence interval {CI}: 0.51–1.58; P=0.717 and 1.30 0.73–2.30; P=0.371 for first and second time-period interaction). The educational intervention increased the quantitative neuromuscular monitor usage (OR 2.04 95% CI: 1.31–3.19; P=0.002), the use of reversal agents was unchanged (OR 0.79 95% CI: 0.50–1.26; P=0.322), and the incidence of postoperative pulmonary complications decreased (OR 0.19 95% CI: 0.10–0.35; P<0.001).
An educational intervention on perioperative neuromuscular block management did not reduce the incidence of postoperative residual curarisation nor increase reversal, despite increased quantitative neuromuscular monitoring. Sugammadex reversal was associated with reduced postoperative residual curarisation. The educational intervention was associated with a decrease in postoperative pulmonary complications.
NCT03128151.
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