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Malvaso D, Chiricozzi A, Fossati B, Antonelli F, Peris K. Efficacy and safety of a combined pharmacological and surgical approach in patients affected by hidradenitis suppurativa: data from a retrospective real-world clinical study. Ital J Dermatol Venerol 2024; 159:190-195. [PMID: 38650499 DOI: 10.23736/s2784-8671.24.07620-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a debilitating chronic skin disease; its therapeutic approach often requires combined medical and surgical treatment. METHODS The aim of this study was to assess the efficacy and safety of the surgical approach combined with different pharmacological treatments, evaluating the proportion of patients achieving the hidradenitis suppurativa clinical response (HiSCR), along with the incidence of postoperative complications, and local recurrence. A retrospective study of HS patients (Hurley I-III) presenting at least one skin lesion requiring surgery was performed. Demographic and clinical data were collected (kind and anatomical location of lesion excised, type of surgical procedure). Further data included: Hurley stage and IHS4 at baseline and week 16, HiSCR at week 16 after surgery, ongoing therapy at the time of surgery (topical, systemic antibiotic, biologics), postoperative complications and local recurrence at week 16. RESULTS Forty-two patients with female predominance (66.7%, 28/42), with a mean age of 30.3 (SD±10.5) years, were enrolled. At week 16, 53% of patients achieved HiSCR, with baseline Hurley III inversely related to HiSCR achievement (P<0.05). No increased incidence of postoperative complications was detected. Three cases of local recurrence were reported at week 16. CONCLUSIONS The results support the efficacy and safety of the combined therapy in the management of HS; no increased risk of complications emerged among patients concomitantly treated with biologics, compared to those on conventional systemic therapy or exclusively treated with surgery.
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Affiliation(s)
- Dalma Malvaso
- Unit of Dermatology, Department of Translational Medicine and Surgery, Sacred Heart Catholic University, Rome, Italy
| | - Andrea Chiricozzi
- Unit of Dermatology, Department of Translational Medicine and Surgery, Sacred Heart Catholic University, Rome, Italy -
- Unit of Dermatology, Department of Medical and Surgical Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Barbara Fossati
- Unit of Dermatology, Department of Medical and Surgical Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Flaminia Antonelli
- Unit of Dermatology, Department of Translational Medicine and Surgery, Sacred Heart Catholic University, Rome, Italy
| | - Ketty Peris
- Unit of Dermatology, Department of Translational Medicine and Surgery, Sacred Heart Catholic University, Rome, Italy
- Unit of Dermatology, Department of Medical and Surgical Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
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Calabrese L, Malvaso D, Coscarella G, Antonelli F, D’Amore A, Gori N, Rubegni P, Peris K, Chiricozzi A. Therapeutic Potential of IL-1 Antagonism in Hidradenitis Suppurativa. Biomolecules 2024; 14:175. [PMID: 38397412 PMCID: PMC10887283 DOI: 10.3390/biom14020175] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/25/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
The immunopathogenesis of HS is partially understood and exhibits features of an autoinflammatory disease; it is associated with the potential involvement of B cells and the contribution of Th1 or Th17 cell subsets. Recently, the pathogenic role of both innate immunity and IL-1 family cytokines in HS has been deeply investigated. Several agents targeting the IL-1 family pathway at different levels are currently available and under investigation for the treatment of HS. HS is still characterized by unmet clinical needs and represents an expanding field in the current scientific research. The aim of this narrative review is to describe the pathological dysregulation of IL-1 family members in HS and to provide an update on therapeutic strategies targeting IL-1 family cytokine signaling. Further clinical and preclinical data may likely lead to the enrichment of the therapeutic armamentarium of HS with IL-1 family cytokine antagonists.
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Affiliation(s)
- Laura Calabrese
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.C.); (D.M.); (G.C.); (F.A.); (N.G.); (K.P.)
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy;
| | - Dalma Malvaso
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.C.); (D.M.); (G.C.); (F.A.); (N.G.); (K.P.)
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli—IRCCS, 00168 Rome, Italy;
| | - Giulia Coscarella
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.C.); (D.M.); (G.C.); (F.A.); (N.G.); (K.P.)
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli—IRCCS, 00168 Rome, Italy;
| | - Flaminia Antonelli
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.C.); (D.M.); (G.C.); (F.A.); (N.G.); (K.P.)
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli—IRCCS, 00168 Rome, Italy;
| | - Alessandra D’Amore
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli—IRCCS, 00168 Rome, Italy;
| | - Niccolò Gori
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.C.); (D.M.); (G.C.); (F.A.); (N.G.); (K.P.)
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli—IRCCS, 00168 Rome, Italy;
| | - Pietro Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy;
| | - Ketty Peris
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.C.); (D.M.); (G.C.); (F.A.); (N.G.); (K.P.)
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli—IRCCS, 00168 Rome, Italy;
| | - Andrea Chiricozzi
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (L.C.); (D.M.); (G.C.); (F.A.); (N.G.); (K.P.)
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli—IRCCS, 00168 Rome, Italy;
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Antonelli F, Ippoliti E, Rosi E, Moltrasio C, Malvaso D, Botti E, Abeni D, Dini V, Cannizzaro MV, Bruni M, Di Nardo L, Fargnoli MC, Romanelli M, Fania L, Bianchi L, Marzano AV, Prignano F, Peris K, Chiricozzi A. Clinical Features and Response to Treatment in Elderly Subjects Affected by Hidradenitis Suppurativa: A Cohort Study. J Clin Med 2023; 12:7754. [PMID: 38137823 PMCID: PMC10744325 DOI: 10.3390/jcm12247754] [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: 11/09/2023] [Revised: 12/15/2023] [Accepted: 12/16/2023] [Indexed: 12/24/2023] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic-relapsing inflammatory skin disease. It usually appears in the second and third decades, but a smaller proportion of patients develop late-onset HS. Geriatric HS, defined as the persistence or the development of HS after the age of 65 years, has been poorly explored. This study aimed to investigate the clinical features, treatment management and response to therapies of HS elderly subjects (≥65 years old). We designed a multicentric observational study, gathering data from seven Italian university hospitals. Demographic and clinical data of HS patients aged over 65 years were collected at baseline, week 12 and week 24. Overall, 57 elderly subjects suffering from HS were enrolled. At baseline, disease severity was predominantly moderate-to-severe, with 45.6% of patients classified as Hurley III. The gluteal phenotype was the most frequently observed; it also appeared to affect patients' quality of life more than other phenotypes. Gluteal involvement was detected in about half (49.1%) of cases and associated with severe stages of the disease. In terms of therapeutic response, Hurley III patients showed the persistency of higher values of mean IHS4, DLQI, itch- and pain-NRS scores compared to Hurley I/II. In conclusion, disease severity in this subpopulation appears high and treatment is often challenging.
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Affiliation(s)
- Flaminia Antonelli
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.A.); (E.I.); (L.D.N.); (K.P.)
- U.O.C. Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.M.); (M.V.C.)
| | - Elena Ippoliti
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.A.); (E.I.); (L.D.N.); (K.P.)
- U.O.C. Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.M.); (M.V.C.)
| | - Elia Rosi
- Section of Dermatology, Department of Health Sciences, University of Florence, 50121 Firenze, Italy; (E.R.); (F.P.)
| | - Chiara Moltrasio
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (C.M.); (A.V.M.)
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milan, Italy
| | - Dalma Malvaso
- U.O.C. Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.M.); (M.V.C.)
| | - Elisabetta Botti
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (E.B.); (L.B.)
- Dermatology Unit, Fondazione Policlinico “Tor Vergata”, 00133 Rome, Italy
| | - Damiano Abeni
- Istituto Dermopatico dell’Immacolata, IDI-IRCCS, Dermatological Research Hospital, 00167 Rome, Italy; (D.A.); (L.F.)
| | - Valentina Dini
- Unit of Dermatology, University of Pisa, 56126 Pisa, Italy; (V.D.); (M.R.)
| | - Maria Vittoria Cannizzaro
- U.O.C. Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.M.); (M.V.C.)
| | - Manfredo Bruni
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.B.); (M.C.F.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy
| | - Lucia Di Nardo
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.A.); (E.I.); (L.D.N.); (K.P.)
- U.O.C. Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.M.); (M.V.C.)
| | - Maria Concetta Fargnoli
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.B.); (M.C.F.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy
| | - Marco Romanelli
- Unit of Dermatology, University of Pisa, 56126 Pisa, Italy; (V.D.); (M.R.)
| | - Luca Fania
- Istituto Dermopatico dell’Immacolata, IDI-IRCCS, Dermatological Research Hospital, 00167 Rome, Italy; (D.A.); (L.F.)
| | - Luca Bianchi
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (E.B.); (L.B.)
- Dermatology Unit, Fondazione Policlinico “Tor Vergata”, 00133 Rome, Italy
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (C.M.); (A.V.M.)
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milan, Italy
| | - Francesca Prignano
- Section of Dermatology, Department of Health Sciences, University of Florence, 50121 Firenze, Italy; (E.R.); (F.P.)
| | - Ketty Peris
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.A.); (E.I.); (L.D.N.); (K.P.)
- U.O.C. Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.M.); (M.V.C.)
| | - Andrea Chiricozzi
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (F.A.); (E.I.); (L.D.N.); (K.P.)
- U.O.C. Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.M.); (M.V.C.)
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Antonelli F, Malvaso D, Caldarola G, Simone CD, Peris K, Chiricozzi A. Infectious adverse events in patients with atopic dermatitis treated with baricitinib. Immunotherapy 2023; 15:1521-1529. [PMID: 37850366 DOI: 10.2217/imt-2023-0078] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
Baricitinib is a JAK1-2 inhibitor recently approved in Europe and Japan for the treatment of moderate-to-severe atopic dermatitis in adult patients at doses of 2 and 4 mg daily. The aim of this article is to discuss the safety profile of baricitinib in atopic dermatitis using data from clinical trials and the supporting literature, with a focus on infectious adverse events. An integrated analysis of safety data from eight clinical trials described infections as the most frequent treatment-emergent adverse events, mainly of mild-to-moderate severity, notably upper respiratory tract infections and herpes simplex exacerbations. Real-world data are still limited and will contribute to precisely profile the patients that might benefit from this treatment.
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Affiliation(s)
- Flaminia Antonelli
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A Gemelli - IRCCS, Rome, 00168, Italy
| | - Dalma Malvaso
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A Gemelli - IRCCS, Rome, 00168, Italy
| | - Giacomo Caldarola
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A Gemelli - IRCCS, Rome, 00168, Italy
| | - Clara De Simone
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A Gemelli - IRCCS, Rome, 00168, Italy
| | - Ketty Peris
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A Gemelli - IRCCS, Rome, 00168, Italy
| | - Andrea Chiricozzi
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A Gemelli - IRCCS, Rome, 00168, Italy
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Malvaso D, Calabrese L, Chiricozzi A, Antonelli F, Coscarella G, Rubegni P, Peris K. IL-17 Inhibition: A Valid Therapeutic Strategy in the Management of Hidradenitis Suppurativa. Pharmaceutics 2023; 15:2450. [PMID: 37896210 PMCID: PMC10609891 DOI: 10.3390/pharmaceutics15102450] [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: 09/12/2023] [Revised: 10/02/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with a significant negative impact on the quality of life of patients. To date, the therapeutic landscape for the management of the disease has been extremely limited, resulting in a profound unmet need. Indeed, adalimumab, an anti-tumor necrosis factor (TNF)-α monoclonal antibody, is the only approved biologic agent for HS, obtaining a therapeutic response in only 50% of HS patients. Numerous clinical trials are currently ongoing to test novel therapeutic targets in HS. The IL-17-mediated cascade is the target of several biologic agents that have shown efficacy and safety in treating moderate-to-severe HS. Both bimekizumab and secukinumab, targeting IL-17 in different manners, have successfully completed phase III trials with promising results; the latter has recently been approved by EMA for the treatment of HS. The aim of this review is to summarize the current state of knowledge concerning the relevant role of IL-17 in HS pathogenesis, highlighting the key clinical evidence of anti-IL-17 agents in the treatment of this disease.
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Affiliation(s)
- Dalma Malvaso
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (D.M.); (L.C.); (F.A.); (G.C.); (K.P.)
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, Italy
| | - Laura Calabrese
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (D.M.); (L.C.); (F.A.); (G.C.); (K.P.)
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy;
| | - Andrea Chiricozzi
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (D.M.); (L.C.); (F.A.); (G.C.); (K.P.)
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, Italy
| | - Flaminia Antonelli
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (D.M.); (L.C.); (F.A.); (G.C.); (K.P.)
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, Italy
| | - Giulia Coscarella
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (D.M.); (L.C.); (F.A.); (G.C.); (K.P.)
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, Italy
| | - Pietro Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy;
| | - Ketty Peris
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (D.M.); (L.C.); (F.A.); (G.C.); (K.P.)
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, Italy
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Quattrini L, Chiricozzi A, Gori N, DI Nardo L, D'Urso DF, Malvaso D, Cornacchia L, Catapano S, Peris K. The psychological burden during COVID-19 pandemic in a cohort of patients affected by moderate-to-severe atopic dermatitis treated with dupilumab. Ital J Dermatol Venerol 2023; 158:365-367. [PMID: 37432395 DOI: 10.23736/s2784-8671.23.07475-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Affiliation(s)
- Laura Quattrini
- Unit of Dermatology, Department of Medical and Surgical Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy -
- Unit of Dermatology, University Department of Translational Medicine and Surgery, Sacred Heart Catholic University, Rome, Italy -
| | - Andrea Chiricozzi
- Unit of Dermatology, Department of Medical and Surgical Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
- Unit of Dermatology, University Department of Translational Medicine and Surgery, Sacred Heart Catholic University, Rome, Italy
| | - Niccolò Gori
- Unit of Dermatology, University Department of Translational Medicine and Surgery, Sacred Heart Catholic University, Rome, Italy
| | - Lucia DI Nardo
- Unit of Dermatology, University Department of Translational Medicine and Surgery, Sacred Heart Catholic University, Rome, Italy
| | - Dario F D'Urso
- Unit of Dermatology, Department of Medical and Surgical Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
- Unit of Dermatology, University Department of Translational Medicine and Surgery, Sacred Heart Catholic University, Rome, Italy
| | - Dalma Malvaso
- Unit of Dermatology, Department of Medical and Surgical Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
- Unit of Dermatology, University Department of Translational Medicine and Surgery, Sacred Heart Catholic University, Rome, Italy
| | - Luigi Cornacchia
- Unit of Dermatology, Department of Medical and Surgical Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
- Unit of Dermatology, University Department of Translational Medicine and Surgery, Sacred Heart Catholic University, Rome, Italy
| | - Silvia Catapano
- Unit of Dermatology, Department of Medical and Surgical Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
- Unit of Dermatology, University Department of Translational Medicine and Surgery, Sacred Heart Catholic University, Rome, Italy
| | - Ketty Peris
- Unit of Dermatology, Department of Medical and Surgical Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
- Unit of Dermatology, University Department of Translational Medicine and Surgery, Sacred Heart Catholic University, Rome, Italy
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Coscarella G, Malvaso D, Mannino M, Caldarola G, Fossati B, De Simone C, Chiricozzi A, Peris K. The preclinical discovery and development of deucravacitinib for the treatment of psoriasis. Expert Opin Drug Discov 2023; 18:1201-1208. [PMID: 37574849 DOI: 10.1080/17460441.2023.2246880] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/08/2023] [Indexed: 08/15/2023]
Abstract
INTRODUCTION Psoriasis is a chronic inflammatory skin disease that most commonly presents as plaque psoriasis. The understanding of the pivotal pathogenetic role of the IL-23/IL-17 axis has dramatically changed the therapeutic approach to the disease. The identification of intracellular signaling pathways mediating IL-23 activity provided the rationale for targeting TYK2. AREAS COVERED This review assesses the underlying rationale that led to development of deucravacitinib, a novel oral TYK2 inhibitor, as a therapeutic option for the treatment of moderate-to-severe psoriasis, primarily focusing on pre-clinical and early phase clinical studies. EXPERT OPINION Innovative therapies used in patients with moderate-to-severe psoriasis include biologic agents and small molecules, which are associated with less adverse events than traditional systemic agents. Deucravacitinib, which selectively targets TYK2, has demonstrated to be effective in treating psoriasis, preserving a more favorable safety profile compared to other JAK inhibitors approved for the treatment of other immune diseases that block the ATP-binding site. Because of its oral administration, deucravacitinib represents an intriguing option in the therapeutic armamentarium of psoriasis, though the evaluation of long-term efficacy and safety is necessary to establish its place-in-therapy.
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Affiliation(s)
- Giulia Coscarella
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
| | - Dalma Malvaso
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Mannino
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
| | - Giacomo Caldarola
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
| | - Barbara Fossati
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
| | - Clara De Simone
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
| | - Andrea Chiricozzi
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
| | - Ketty Peris
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
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8
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Calabrese L, Malvaso D, Antonelli F, Mannino M, Peris K, Chiricozzi A. Investigational systemic drugs for moderate to severe plaque psoriasis: What's new? Expert Opin Investig Drugs 2023; 32:229-243. [PMID: 36852779 DOI: 10.1080/13543784.2023.2184684] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
INTRODUCTION The therapeutic armamentarium for the treatment of psoriasis, a chronic inflammatory skin disease, is now reasonably broad and structured, with several therapeutic agents that demonstrated a successful long-term control of this condition. However, there are still unfulfilled gaps resulting from the inherent limitations of existing therapies, which have paved the way for the identification of new therapeutic strategies or the improvement of the existing ones. AREAS COVERED The aim of this review is to thoroughly explore new therapeutic strategies and novel drugs that are currently in the pipeline for the treatment of psoriasis, focusing primarily on agents that are currently in phase I/II of clinical development. Some of which retrace already existing therapeutic approaches, such as the IL23/Th17 pathway inhibition, while others unveil new and yet unexplored ones. EXPERT OPINION Since the therapeutic landscape of psoriasis is wide, it is not yet clear whether novel agents will fill the remaining gaps in the context of a broader and more diversified set of oral and biologic therapies. Nevertheless, with the development of precision medicine approaches, the development of innovative targeted drugs will still have a therapeutic rationale in psoriasis.
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Affiliation(s)
- Laura Calabrese
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Dalma Malvaso
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.,Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
| | - Flaminia Antonelli
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.,Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
| | - Maria Mannino
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.,Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
| | - Ketty Peris
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.,Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
| | - Andrea Chiricozzi
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.,Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
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9
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Malvaso D, Cappilli S, Di Stefani A. Eruptive follicular plugs in multiple Unna naevi. Australas J Dermatol 2021; 62:e483-e485. [PMID: 34170510 DOI: 10.1111/ajd.13650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/19/2021] [Accepted: 05/23/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Dalma Malvaso
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dermatologia -Università Cattolica del Sacro Cuore, Rome, Italy
| | - Simone Cappilli
- Dermatologia -Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandro Di Stefani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dermatologia -Università Cattolica del Sacro Cuore, Rome, Italy
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10
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Caposiena Caro RD, Chiricozzi A, Sechi A, Molinelli E, Venturini M, Candi E, Malvaso D, Peris K, Patrizi A, Offidani A, Calzavara-Pinton P, Bianchi L. Flares as dynamic predictive factor of response to adalimumab in hidradenitis suppurativa, real-life data. Ital J Dermatol Venerol 2021; 157:240-246. [PMID: 34159775 DOI: 10.23736/s2784-8671.21.07049-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is characterized by periodic worsening of both clinical manifestations and symptoms. The aim was to investigate the role of flare outbreak as a possible predictive factor of response to Adalimumab. METHODS 115 HS patients in treatment with adalimumab, with moderate-severe HS, ≥3 abscesses and inflammatory-nodules (ANs) from 5 Italian centers were included in this retrospective analysis. The information about gender, ages at onset/baseline, therapeutic delay, family history, body mass index, smoking, comorbidities, phenotypes, body areas, severity indexes at baseline was collected. Baseline characteristics, total number and timeline of flares were analysed by regression and survival analysis with Hidradenitis Suppurativa Clinical Response (HiSCR). RESULTS During the observational period, 80.9% of patients developed flares, detecting 252 flares. Univariate model identified five factors associated with the absence of response: age (p-value=0.020), comorbidities (p-value=0.030), genital-perineal involvement (pvalue= 0.004), no response at week-12 (p-value=0.027), and flares outbreak (p-value=0.010). Joint analysis of recurrent and terminal events showed a positive correlation between flare recurrence and no-response (p-value<0.001). Among the identified variables associated with poor response to the therapy: occurrence of a flare before week-12 was the one with the highest risk of no response (p-value<0.001). The limitations are: study's retrospective design, limited number of patients, absence either of a consensus about flare definition, placebo control group or standard therapy of flares during adalimumab therapy. CONCLUSIONS The analysis of a "dynamic" variable, as flares evaluation together with an appropriate clinical baseline assessment can be a useful approach to predict the middle-long-term response to adalimumab.
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Affiliation(s)
| | - Andrea Chiricozzi
- Institute of Dermatology, Università Cattolica - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Andrea Sechi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Marina Venturini
- Department of Dermatology, University of Brescia at ASST-Spedali Civili, Brescia, Italy
| | - Eleonora Candi
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Dalma Malvaso
- Institute of Dermatology, Università Cattolica - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Ketty Peris
- Institute of Dermatology, Università Cattolica - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Annalisa Patrizi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | | | - Luca Bianchi
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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11
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Gori N, Chiricozzi A, Malvaso D, D'Urso DF, Caldarola G, De Simone C, Peris K. Successful Combination of Systemic Agents for the Treatment of Atopic Dermatitis Resistant to Dupilumab Therapy. Dermatology 2021; 237:535-541. [PMID: 33477153 DOI: 10.1159/000512890] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 09/28/2020] [Accepted: 11/03/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Dupilumab, a monoclonal antibody inhibiting the signaling pathway of IL-4/IL-13, was shown to be safe and effective in the treatment of moderate/severe atopic dermatitis (AD) in several clinical trials and real-life experiences, with only a small percentage of patients showing to be resistant or to lose disease control. OBJECTIVES In this study, we investigated the effectiveness and safety in combining dupilumab with systemic agents or phototherapy in patients experiencing an inadequate response to dupilumab. METHODS This retrospective, monocentric, observational study consecutively included patients aged >18 years, with moderate-severe AD, under treatment with dupilumab. In this cohort of patients, we analyzed data of subjects who experienced an inadequate response to dupilumab, even when combined with topical corticosteroids, and for whom an additional systemic treatment or phototherapy was combined to dupilumab. RESULTS In this study, we included a total population of 69 patients treated with dupilumab. In 12/69 patients (17.4%) showing an inadequate response to dupilumab, a combined treatment consisting of dupilumab plus methylprednisolone (n = 5), cyclosporine (n = 4), methotrexate (n = 2), or narrow band-UVB (n = 1) was administered. Overall, after 8 weeks of combined therapy, the majority of patients (11 of 12) obtained an improvement of signs and symptoms of AD. Patients treated with combined therapy did not experience any adverse events, neither did they withdraw treatment because of the occurrence of adverse events. CONCLUSIONS This study suggests that the combination of dupilumab with a conventional drug or phototherapy may represent a valid therapeutic choice, maintaining a good safety profile in AD patients recalcitrant to dupilumab monotherapy.
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Affiliation(s)
- Niccolò Gori
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Dermatologia, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Chiricozzi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Dermatologia, Rome, Italy, .,Università Cattolica del Sacro Cuore, Rome, Italy,
| | - Dalma Malvaso
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Dermatologia, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Dario Francesco D'Urso
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Dermatologia, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Clara De Simone
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Dermatologia, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Ketty Peris
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Dermatologia, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
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12
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Garcovich S, Genovese G, Moltrasio C, Malvaso D, Marzano AV. PASH, PAPASH, PsAPASH, and PASS: The autoinflammatory syndromes of hidradenitis suppurativa. Clin Dermatol 2020; 39:240-247. [PMID: 34272017 DOI: 10.1016/j.clindermatol.2020.10.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory disease usually involving the major skin folds characterized by a multifactorial pathogenesis and a wide spectrum of clinical manifestations. It can also rarely present in association with other diseases as complex clinical syndromes, causing additional diagnostic and therapeutic challenges. Different etiopathologic factors contribute to follicular inflammation and suppurative lesions of syndromic HS, including follicular hyperkeratinization and plugging, as well as activation of autoinflammatory pathways. Patients with syndromic HS frequently have a severe disease course, presenting with atypical skin involvement, signs of systemic inflammation, and resistance to conventional treatments. Systematic classification of syndromic HS is based on clinical, pathogenetic, and genetic factors, but it is constantly evolving due to increased disease awareness. Treatment of syndromic HS is difficult and should be personalized on a case-by-case basis. Investigating syndromic HS can lead to useful insights on genetics and pathogenesis, translating into new clinical approaches for sporadic hidradenitis. We review the classification, clinical presentation, disease associations, and therapeutic management of syndromic HS, focusing mainly on its autoinflammatory syndromes PASH, PAPASH, PsAPASH, and PASS.
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Affiliation(s)
- Simone Garcovich
- Institute of Dermatology, F. Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Genovese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Chiara Moltrasio
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Advanced Diagnostics, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo," Trieste, Italy
| | - Dalma Malvaso
- Institute of Dermatology, F. Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
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Chiricozzi A, Garcovich S, Malvaso D, Giovanardi G, Peris K. COVID-19 occurrence in one secukinumab-treated patient affected by hidradenitis suppurativa and systemic lupus erythematosus. Int J Dermatol 2020; 59:1423-1424. [PMID: 32966593 PMCID: PMC7536954 DOI: 10.1111/ijd.15209] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/24/2020] [Accepted: 09/02/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Andrea Chiricozzi
- Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Simone Garcovich
- Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Dalma Malvaso
- Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulia Giovanardi
- Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Ketty Peris
- Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
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Calabrese L, Malvaso D, Chiricozzi A, Tambone S, D'Urso DF, Guerriero C, Peris K. Baricitinib: therapeutic potential for moderate to severe atopic dermatitis. Expert Opin Investig Drugs 2020; 29:1089-1098. [PMID: 32703039 DOI: 10.1080/13543784.2020.1800639] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Atopic dermatitis (AD) is a chronic inflammatory skin disease mediated by multiple signals including janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathway. Current therapeutic armamentarium consists of a limited number of drugs which may result in the insufficient management of AD. Preclinical evidence regarding inhibition of JAK/STAT led to the development of a promising class of therapeutics, namely, JAK inhibitors. Baricitinib, a novel JAK1/JAK2 inhibitor is currently under investigation in AD clinical trials. AREAS COVERED This review offers an overview of Baricitinib and examines clinical efficacy and safety data in patients with moderate-to-severe AD. EXPERT OPINION Baricitinib showed promising preliminary data in terms of efficacy in phase II and III trials, with a very rapid onset of response and great improvements of itch and sleep disturbances. These aforementioned aspects combined with the advantage of an oral formulation have reduced drug production costs compared to biologic agents and could lead to consideration of baricitinib as a first line systemic treatment. Also, in some countries, it could be a therapeutic option in the case of contraindication or failure of conventional systemic drugs prior to biologic therapies. Data related to long-term safety and efficacy will be important to refine the place-in-therapy of this drug.
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Affiliation(s)
- Laura Calabrese
- A. Gemelli IRCCS, UOC Di Dermatologia, Fondazione Policlinico Universitario , Rome, Italy.,Dermatologia, Università Cattolica Del Sacro Cuore , Rome, Italy
| | - Dalma Malvaso
- A. Gemelli IRCCS, UOC Di Dermatologia, Fondazione Policlinico Universitario , Rome, Italy.,Dermatologia, Università Cattolica Del Sacro Cuore , Rome, Italy
| | - Andrea Chiricozzi
- A. Gemelli IRCCS, UOC Di Dermatologia, Fondazione Policlinico Universitario , Rome, Italy.,Dermatologia, Università Cattolica Del Sacro Cuore , Rome, Italy
| | - Sara Tambone
- A. Gemelli IRCCS, UOC Di Dermatologia, Fondazione Policlinico Universitario , Rome, Italy
| | - Dario Francesco D'Urso
- A. Gemelli IRCCS, UOC Di Dermatologia, Fondazione Policlinico Universitario , Rome, Italy.,Dermatologia, Università Cattolica Del Sacro Cuore , Rome, Italy
| | | | - Ketty Peris
- A. Gemelli IRCCS, UOC Di Dermatologia, Fondazione Policlinico Universitario , Rome, Italy.,Dermatologia, Università Cattolica Del Sacro Cuore , Rome, Italy
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15
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Chiricozzi A, Giovanardi G, Garcovich S, Malvaso D, Caldarola G, Fossati B, Guerriero C, De Simone C, Peris K. Clinical and Ultrasonographic Profile of Adalimumab-treated Hidradenitis Suppurativa Patients: A Real-life Monocentric Experience. Acta Derm Venereol 2020; 100:adv00172. [PMID: 32421198 PMCID: PMC9175054 DOI: 10.2340/00015555-3520] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Ultrasonography has proven useful for diagnosis and treatment monitoring in patients with hidradenitis suppurativa. The aim of this study was to assess the clinical response to adalimumab using ultrasound findings. This prospective study collected data on demographic features, disease severity, and hidradenitis suppurativa findings from patients with hidradenitis suppurativa treated with adalimumab. Generalized estimating equations investigated relationships between disease severity measures and clinical/demographic variables. The study included a total of 41 patients with hidradenitis suppurativa who were treated with adalimumab for a mean ± SD period of 50.8 ± 32.2 weeks; range 6–108 weeks). Clinical improvement was observed during adalimumab therapy, with a progressively greater number of patients achieving HiSCR50 response (36.4% at week 52). Disease duration was identified as the most relevant clinical variable affecting disease severity and treatment response. Treatment response was also influenced by treatment duration, with a 4% greater likelihood of achieving HiSCR50 response at each time-point. At the ultrasound examination, subcutaneous involvement of hidradenitis suppurativa lesions was identified as a predictive negative factor for clinical response to adalimumab (HiSCR50 achievement).
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Affiliation(s)
- Andrea Chiricozzi
- Institute of Dermatology, Catholic University, Largo Agostino Gemelli 8, IT-00168 Rome, Italy. E-mail: Institute of Dermatology, Catholic University, Largo Agostino Gemelli 8, IT-00168 Rome, Italy. E-mail:
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Garcovich S, Giovanardi G, Malvaso D, De Simone C, Peris K. Apremilast for the treatment of hidradenitis suppurativa associated with psoriatic arthritis in multimorbid patients: Case report and review of literature. Medicine (Baltimore) 2020; 99:e18991. [PMID: 32000436 PMCID: PMC7004578 DOI: 10.1097/md.0000000000018991] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Hidradenitis suppurativa is a complex, chronic, difficult to treat condition belonging to the spectrum of cutaneous immune-mediated inflammatory diseases. Systemic treatment options for moderate-severe disease are limited to TNF-alpha antagonists and other biologic agents, with limited clinical evidence. PATIENT CONCERNS We report two adult patients with severe hidradenitis suppurativa presenting concomitant psoriatic arthritis and multiple medical comorbidities. Both were ineligible or resistant to adalimumab, the only biologic drug approved for the treatment of hidradenitis. DIAGNOSIS Both patients were diagnosed with severe Hurley III-stage disease and psoriatic arthritis, showing resistance to first-line systemic treatments and a complex comorbidity profile. INTERVENTIONS Patients underwent treatment with apremilast, an oral phosphodiesterase-4 inhibitor, approved for the treatment of psoriatic arthritis. OUTCOMES After 16 weeks of treatment, a clinically relevant improvement of inflammatory lesions, skin- and arthritis-related pain, and patient-reported outcomes was achieved in both patients. Apremilast was well tolerated and continued up to 48 weeks of treatment. CONCLUSION We report the "real-life" use of apremilast in the treatment of multimorbid patients with hidradenitis suppurativa and review its potential role in the management of this severe condition.
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