1
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Chebani R, Lombart F, Chaby G, Dadban A, Debarbieux S, Viguier MA, Ingen-Housz-Oro S, Pham-Ledard A, Bedane CR, Picard-Dahan C, Berthin C, Dereure O, Konstantinou MP, Castel M, Jouen F, Joly P, Seta V, Duvert-Lehembre S, Le Roux C, Quereux G, Sassolas B, Brenaut E, Sin C, Richard MA, Bérard F, Giusti D, Belmondo T, Gille T, Caux F, Prost-Squarcioni C, Grootenboer-Mignot S, Alexandre M. Omalizumab in the treatment of bullous pemphigoid resistant to first-line therapy: a French national multicentre retrospective study of 100 patients. Br J Dermatol 2024; 190:258-265. [PMID: 37792727 DOI: 10.1093/bjd/ljad369] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Received: 05/17/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Interest in the use of omalizumab to treat bullous pemphigoid (BP) in the event of resistance or contraindication to conventional therapies is currently based on limited evidence. OBJECTIVES To assess the effectiveness and safety of omalizumab in BP and to identify predictive factors in response to treatment. METHODS We conducted a French national multicentre retrospective study including patients with a confirmed diagnosis of BP treated with omalizumab after failure of one or several treatment lines. We excluded patients with clinically atypical BP, as per Vaillant's criteria. The criteria for clinical response to omalizumab were defined according to the 2012 international consensus conference. Anti-BP180-NC16A IgE enzyme-linked immunosorbent assay was performed on sera collected before initiating omalizumab, when available. RESULTS Between 2014 and 2021, 100 patients treated in 18 expert departments were included. Median age at diagnosis was 77 years (range 20-98). Complete remission (CR) was achieved in 77% of patients, and partial remission in an additional 9%. CR was maintained 'off therapy' in 11.7%, 'on minimal therapy' in 57.1%, and 'on non-minimal therapy' in 31.2%. Median time to CR was 3 months (range 2.2-24.5). Relapse rate was 14%, with a median follow-up time of 12 months (range 6-73). Adverse events occurred in four patients. CR was more frequently observed in patients with an increased serum baseline level of anti-BP180-NC16A IgE (75% vs. 41%; P = 0.011). Conversely, urticarial lesions, blood total IgE concentration or eosinophil count were not predictive of CR. Patients with an omalizumab dosage > 300 mg every 4 weeks showed a similar final outcome to those with a dosage ≤ 300 mg every 4 weeks, but control of disease activity [median 10 days (range 5-30) vs. 15 days (range 10-60); P < 0.001] and CR [median 2.4 months (range 2.2-8.2) vs. 3.9 months (range 2.3-24.5); P < 0.001] were achieved significantly faster. CONCLUSIONS We report the largest series to date of BP treated by omalizumab and confirm its effectiveness and safety in this indication. Serum baseline level of anti-BP180-NC16A IgE may predict response to treatment.
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Affiliation(s)
- Réda Chebani
- Department of Dermatology, Amiens University Hospital, Amiens, France
| | - Florian Lombart
- Department of Dermatology, Amiens University Hospital, Amiens, France
| | - Guillaume Chaby
- Department of Dermatology, Amiens University Hospital, Amiens, France
| | - Ali Dadban
- Department of Dermatology, Amiens University Hospital, Amiens, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Christelle Le Roux
- Department of Dermatology and Referral Centre for Autoimmune Bullous Diseases (MALIBUL), Avicenne Hospital, Hôpitaux Universitaires de Paris Seine-Saint-Denis, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
| | | | | | | | | | | | | | | | | | | | - Frédéric Caux
- Department of Dermatology and Referral Centre for Autoimmune Bullous Diseases (MALIBUL), Avicenne Hospital, Hôpitaux Universitaires de Paris Seine-Saint-Denis, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
| | - Catherine Prost-Squarcioni
- Department of Dermatology and Referral Centre for Autoimmune Bullous Diseases (MALIBUL), Avicenne Hospital, Hôpitaux Universitaires de Paris Seine-Saint-Denis, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
| | | | - Marina Alexandre
- Department of Dermatology and Referral Centre for Autoimmune Bullous Diseases (MALIBUL), Avicenne Hospital, Hôpitaux Universitaires de Paris Seine-Saint-Denis, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
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2
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Cordel N, Flament J, Jouen F, Seta V, Tancrède-Bohin E, Dahan CP, Konstantinou MP, Dereure O, Quéreux G, Prost C, Bedane C, Debarbieux S, Lacour JP, Dompmartin A, Wierzbicka-Hainaut E, Villada IB, Oro SIH, Vabres P, Richard MA, Delaporte E, Pham-Ledard A, Leccia MT, Litrowski N, Michel C, Lagrange B, D'Incan M, Abasq C, Duvert-Lehembre S, Dupuy A, Alcaraz I, Breton-Guitarian AL, Lombart F, Estève E, Machet L, Del Giudice P, Fenot M, Belmondo T, Morin F, Guérin O, Benichou J, Tressières B, Joly P. Anti-BP180 IgG antibody ELISA values correlate with adverse pregnancy outcomes in pemphigoid gestationis. J Eur Acad Dermatol Venereol 2023; 37:1207-1214. [PMID: 36802102 DOI: 10.1111/jdv.18973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/27/2023] [Indexed: 02/20/2023]
Abstract
BACKGROUND Adverse pregnancy outcomes (APO) occur in 35% of patients with pemphigoid gestationis (PG). No biological predictor of APO has been established yet. OBJECTIVES To assess a potential relationship between the occurrence of APO and the serum value of anti-BP180 antibodies at the time of PG diagnosis. METHODS Multicentre retrospective study conducted from January 2009 to December 2019 in 35 secondary and tertiary care centres. INCLUSION CRITERIA (i) diagnosis of PG according to clinical, histological and immunological criteria, (ii) ELISA measurement of anti-BP180 IgG antibodies determined at the time of PG diagnosis with the same commercial kit and (iii) obstetrical data available. RESULTS Of the 95 patients with PG included, 42 had one or more APO, which mainly corresponded to preterm birth (n = 26), intrauterine growth restriction (IUGR) (n = 18) and small weight for gestational age at birth (n = 16). From a ROC curve, we identified a threshold of 150 IU ELISA value as the most discriminating to differentiate between patients with or without IUGR, with 78% sensitivity, 55% specificity, 30% positive and 91% negative predictive value. The threshold >150 IU was confirmed using a cross-validation based on bootstrap resampling, which showed that the median threshold was 159 IU. Upon adjusting for oral corticosteroid intake and main clinical predictors of APO, an ELISA value of >150 IU was associated with the occurrence of IUGR (OR = 5.11; 95% CI: 1.48-22.30; p = 0.016) but not with any other APO. The combination of blisters and ELISA values higher than 150 IU led to a 2.4-fold higher risk of all-cause APO (OR: 10.90; 95% CI: 2.33-82.3) relative to patients with blisters but lower values of anti-BP180 antibodies (OR of 4.54; 95% CI 0.92-34.2). CONCLUSION These findings suggest that anti-BP180 antibody ELISA value in combination with clinical markers is helpful in managing the risk of APO, in particular IUGR, in patients with PG.
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Affiliation(s)
- Nadège Cordel
- Department of Dermatology and Clinical Immunology, Guadeloupe University Hospital, Pointe-à-Pitre, Guadeloupe.,Univ Rouen Normandie, FOCIS Center of Excellence PAn'THER, Rouen, France
| | - Jasmine Flament
- Department of Dermatology, Rouen University Hospital, Rouen, France
| | - Fabienne Jouen
- Univ Rouen Normandie, FOCIS Center of Excellence PAn'THER, Rouen, France.,Department of Immunology and biotherapies, Rouen University Hospital, Rouen, France
| | - Vannina Seta
- Department of Dermatology, Cochin Hospital AP-HP, Paris, France
| | | | | | | | - Olivier Dereure
- Department of Dermatology, Saint-Eloi University Hospital, Montpellier, France
| | - Gaëlle Quéreux
- Department of Dermatology, Nantes University Hospital, Nantes, France
| | - Catherine Prost
- Department of Dermatology, Avicenne Hospital AP-HP, Bobigny, France
| | - Christophe Bedane
- Department of Dermatology, Limoges University Hospital, Limoges, France
| | | | | | - Anne Dompmartin
- Department of Dermatology, Caen University Hospital, Caen, France
| | | | | | - Saskia Ingen Housz Oro
- Department of Dermatology, Henri Mondor Hospital, AP-HP and Univ Paris Est Créteil, EpidermE, Créteil, France
| | - Pierre Vabres
- Department of Dermatology, Dijon University Hospital, Dijon, France
| | - Marie-Aleth Richard
- Department of Dermatology, La Timone University Hospital APHM, Marseille, France
| | - Emmanuel Delaporte
- Department of Dermatology, UMR 7268 and North University Hospital APHM, Marseille, France
| | - Anne Pham-Ledard
- Department of Dermatology, University Hospital of Bordeaux, Saint-André Hospital, Bordeaux, France
| | - Marie-Thérèse Leccia
- Department of Dermatology, Allergology and Photobiology, Grenoble University Hospital, Grenoble, France
| | - Noémie Litrowski
- Department of Dermatology, Monod General Hospital, Le Havre, France
| | - Catherine Michel
- Department of Dermatology, Emile Muller Hospital, Mulhouse, France
| | | | - Michel D'Incan
- Department of Dermatology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Claire Abasq
- Department of Dermatology, Brest University Hospital, Brest, France
| | | | - Alain Dupuy
- Department of Dermatology, Rennes University Hospital, Rennes, France
| | - Isabelle Alcaraz
- Department of Infectious diseases and Travel, Gustave Dron Hospital, Tourcoing, France
| | | | - Florian Lombart
- Department of Dermatology, Amiens University Hospital, Amiens, France
| | - Eric Estève
- Department of Dermatology, Orléans Regional Hospital, Orléans, France
| | - Laurent Machet
- Department of Dermatology, Tours University Hospital, Tours, France
| | - Pascal Del Giudice
- Infectiology-Dermatology Unit, Intercommunal Hospital of Fréjus Saint Raphaël, Fréjus, France
| | - Marion Fenot
- Department of Dermatology, Departmental Hospital of Vendée, La Roche-sur-Yon, France
| | - Thibaut Belmondo
- Department of Immunology, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Florence Morin
- Department of Immunology, Saint-Louis Hospital AP-HP, Paris, France
| | - Olivia Guérin
- Department of Biostatistics, Rouen University Hospital
| | - Jacques Benichou
- Department of Biostatistics, Rouen University Hospital.,Univ Rouen Normandie, IRIB, Inserm U1219, Rouen, France
| | - Benoît Tressières
- Centre d'Investigation Clinique Antilles Guyane, INSERM CIC 1424, Pointe-à-Pitre, Guadeloupe
| | - Pascal Joly
- Univ Rouen Normandie, FOCIS Center of Excellence PAn'THER, Rouen, France.,Department of Dermatology, Rouen University Hospital, Rouen, France
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3
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Calmettes V, Badrignans M, Konstantinou MP, Tancrède-Bohin E, Vignon-Pennamen MD, Castel M, Pham-Ledard A, Le Roux-Villet C, Misery L, Schoenlaub P, Tronquoy AF, Cordel N, Ortonne N, Sohier P, Cellier L, Tournier E, De La Salle EM, Le Flahec G, Plantier F, Grootenboer-Mignot S, Jouen F, Hillion B, Aractingi S, Duvert-Lehembre S, Dupin N, Ingen-Housz-Oro S. IgA and IgG/IgA intercellular dermatosis: a clinicopathological case series of 15 patients. J Eur Acad Dermatol Venereol 2022; 36:e896-e898. [PMID: 35694900 DOI: 10.1111/jdv.18325] [Citation(s) in RCA: 1] [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] [Received: 02/23/2022] [Accepted: 06/03/2022] [Indexed: 12/16/2022]
Affiliation(s)
- V Calmettes
- Department of Dermatology, Henri Mondor University Hospital, AP-HP, Créteil, France
| | - M Badrignans
- Department of Pathology, Henri Mondor University Hospital, AP-HP, Créteil, France
| | - M P Konstantinou
- Department of Dermatology, University Hospital of Toulouse, Toulouse, France
| | - E Tancrède-Bohin
- Department of Dermatology, Saint Louis University Hospital, APHP, Paris, France
| | - M D Vignon-Pennamen
- Department of Pathology, Saint Louis University Hospital, APHP, Paris, France
| | - M Castel
- Department of Dermatology, University Hospital of Rouen, Rouen, France
| | - A Pham-Ledard
- Department of Dermatology, CHU Bordeaux and INSERM U1312, Bordeaux, France
| | - C Le Roux-Villet
- Department of Dermatology, University Hospital Avicenne, Bobigny, France
| | - L Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
| | - P Schoenlaub
- Department of Dermatology, Hopital d'Instruction des Armées, Brest, France
| | - A F Tronquoy
- Department of Dermatology, Hospital of Boulogne-sur-Mer, Boulogne-sur-Mer, France
| | - N Cordel
- Department of Dermatology and Clinical Immunology, Guadeloupe University Hospital, Pointe-à-Pitre, France
| | - N Ortonne
- Department of Pathology, Henri Mondor University Hospital, AP-HP, Créteil, France
| | - P Sohier
- Department of Pathology, Cochin Hospital, AP-HP, AP-HP, Centre-Université de Paris, Paris, France
| | - L Cellier
- Department of Pathology, University Hospital of Rouen, Rouen, France
| | - E Tournier
- Derpartment of Pathology, University Hospital of Toulouse, Toulouse, France
| | - E M De La Salle
- Department of Pathology, University Hospital of Lille, Lille, France
| | - G Le Flahec
- Department of Pathology, University Hospital of Brest, Brest, France
| | - F Plantier
- Cabinet de Pathologie Mathurin Moreau, Paris, France
| | | | - F Jouen
- Department of Immunology, University Hospital of Rouen, Rouen, France
| | - B Hillion
- Department of Dermatology, Hospital of Marne la Vallée, Jossigny, France
| | - S Aractingi
- Department of Dermatology, Cochin Hospital, AP-HP, AP-HP, Centre-Université de Paris, Paris, France
| | - S Duvert-Lehembre
- Department of Dermatology, Hospital of Dunkerque, Dunkerque, France.,Department of Dermatology, University Hospital of Lille, Lille, France
| | - N Dupin
- Department of Dermatology, Cochin Hospital, AP-HP, AP-HP, Centre-Université de Paris, Paris, France
| | - S Ingen-Housz-Oro
- Department of Dermatology, Henri Mondor University Hospital, AP-HP, Créteil, France.,Univ Paris Est Créteil EpidermE, Créteil, France
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- French Bullous Diseases Study Group Paris, Paris, France
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4
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Konstantinou MP, Jendoubi F, Fortenfant F, Milhes J, Joly P, Bost C. Successful treatment of recalcitrant pemphigoid gestationis with omalizumab: report of two cases. J Eur Acad Dermatol Venereol 2022; 36:e720-e722. [PMID: 35592910 DOI: 10.1111/jdv.18227] [Citation(s) in RCA: 1] [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] [Received: 02/14/2022] [Accepted: 05/04/2022] [Indexed: 12/17/2022]
Affiliation(s)
- M P Konstantinou
- Dermatology Department, University Hospital of Toulouse, Paul Sabatier University, Toulouse, France
| | - F Jendoubi
- Dermatology Department, University Hospital of Toulouse, Paul Sabatier University, Toulouse, France
| | - F Fortenfant
- Immunology Department, University Hospital of Toulouse, Paul Sabatier University, Toulouse, France
| | - J Milhes
- Immunology Department, University Hospital of Toulouse, Paul Sabatier University, Toulouse, France
| | - P Joly
- Dermatology Department, University Hospital of Rouen, Rouen, France
| | - C Bost
- Immunology Department, University Hospital of Toulouse, Paul Sabatier University, Toulouse, France
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5
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Battesti G, Garcia C, Viguier M, Marchal V, Castel M, Joly P, Ledard AP, Konstantinou MP, Seta V, Cordel N, Duvert-Lehembre S, Tancrède-Bohin E, Belmondo T, Ingen-Housz-Oro S, d'Incan M. Real-life impact of the immunological tests to predict relapse after treatment cessation in patients with bullous pemphigoid: a French multicenter retrospective study. J Am Acad Dermatol 2022; 86:1293-1300. [DOI: 10.1016/j.jaad.2022.01.016] [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] [Received: 10/14/2021] [Revised: 12/10/2021] [Accepted: 01/14/2022] [Indexed: 10/19/2022]
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6
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Reich K, Hansen JB, Puig L, Konstantinou MP, Warren RB. Complete clearance and Psoriasis Area and Severity Index response for brodalumab and ustekinumab by previous treatment history in AMAGINE-2 and AMAGINE-3. J Eur Acad Dermatol Venereol 2021; 35:2034-2044. [PMID: 34076919 DOI: 10.1111/jdv.17433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/26/2021] [Accepted: 05/19/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND The pathway for treatment of psoriasis is partly dependent upon disease severity, and patients may experience inadequate response at any point along the treatment pathway. Patients who repeatedly fail therapy represent a population in whom effective and well-tolerated treatment options are limited. OBJECTIVES To investigate and describe patients achieving Psoriasis Area and Severity Index (PASI) 100 and cumulative treatment benefit over time in patients with moderate-to-severe psoriasis receiving brodalumab or ustekinumab by prior treatment. METHODS We conducted a post hoc analysis of data from two phase 3, randomized, controlled, 52-week AMAGINE trials of brodalumab to describe patients who achieved complete clearance as measured by PASI 100 by prior treatment subgroup (naïve to systemic and biologic treatment, systemic-treated but biologic-naïve, biologic-treated without failure, and biologic-treated with failure). A competing risk model was used to assess cumulative incidence over a 52-week period with outcomes of PASI 100 or inadequate response. Cumulative clinical benefit of treatment was determined with an area under the curve analysis. RESULTS The 52-week cumulative incidence of patients achieving PASI 100 was consistently higher for brodalumab vs. ustekinumab across treatment pathway subgroups (76% vs. 58% in systemic/biologic-naïve patients, 78% vs. 55% in systemic-treated/biologic-naïve patients, 75% vs. 41% in biologic-treated patients without failure, and 70% vs. 30% in biologic-treated patients with failure). Rates of inadequate response were lower with brodalumab compared with ustekinumab across all subgroups. Cumulative treatment benefit was also higher for all subgroups treated with brodalumab compared with those treated with ustekinumab. CONCLUSION Treatment with brodalumab was associated with higher levels of complete clearance and greater cumulative benefit over time compared with ustekinumab, in patients with moderate-to-severe psoriasis, regardless of prior treatment experience.
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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, Hamburg, Germany
| | | | - L Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain
| | | | - R B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, University of Manchester, Manchester, UK
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7
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Konstantinou MP, Lucas P, Uthurriague C, Severino-Freire M, Spenatto N, Gaudin C, Lamant L, Tournier E, Bulai-Livideanu C, Meyer N, Paul C. Langerhans cell histiocytosis associated with chronic myelomonocytic leukaemia both harbouring the same BRAF V600E mutation: efficacy of vemurafenib. J Eur Acad Dermatol Venereol 2020; 35:e120-e121. [PMID: 32757402 DOI: 10.1111/jdv.16850] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/22/2020] [Accepted: 07/30/2020] [Indexed: 01/09/2023]
Affiliation(s)
- M P Konstantinou
- Dermatology Department, Paul Sabatier University, University Hospital of Toulouse, Toulouse, France
| | - P Lucas
- Dermatology Department, Paul Sabatier University, University Hospital of Toulouse, Toulouse, France
| | - C Uthurriague
- Dermatology Department, Paul Sabatier University, University Hospital of Toulouse, Toulouse, France
| | - M Severino-Freire
- Dermatology Department, Paul Sabatier University, University Hospital of Toulouse, Toulouse, France
| | - N Spenatto
- Center of Sexually Transmitted Diseases, Dermatology department and social medicine, University Hospital of Toulouse, Toulouse, France
| | - C Gaudin
- Geriatrics Department, University Hospital of Toulouse, Toulouse, France
| | - L Lamant
- Pathology Department, University Institute of Cancer Toulouse Oncopole and University Hospital of Toulouse, Toulouse, France
| | - E Tournier
- Pathology Department, University Institute of Cancer Toulouse Oncopole and University Hospital of Toulouse, Toulouse, France
| | - C Bulai-Livideanu
- Dermatology Department, Paul Sabatier University, University Hospital of Toulouse, Toulouse, France
| | - N Meyer
- Dermatology Department, IUC and CHU de Toulouse, Toulouse, France
| | - C Paul
- Dermatology Department, Paul Sabatier University, University Hospital of Toulouse, Toulouse, France
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8
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Ferrières L, Konstantinou MP, Bulai Livideanu C, Hegazy S, Tauber M, Amelot F, Paul C. Long-term continuation with secukinumab in psoriasis: association with patient profile and initial psoriasis clearance. Clin Exp Dermatol 2019; 44:e230-e234. [PMID: 31055846 DOI: 10.1111/ced.13999] [Citation(s) in RCA: 10] [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: 04/29/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND There are limited data regarding the long-term continuation with biological therapy for patients with psoriasis. In particular, the reasons for secukinumab discontinuation have not been thoroughly investigated. AIM To better ascertain the real-life continuation of secukinumab in psoriasis, we conducted a retrospective study to evaluate the incidence, causes and factors of secukinumab discontinuation in patients with psoriasis. METHODS All patients treated with secukinumab for psoriasis in the Department of Dermatology (Toulouse University and Larrey Hospital, Toulouse, France), between September 2011 and June 2017, were enrolled in the study. RESULTS Of the 91 patients in the study, 22 (24.2%) discontinued secukinumab. In 14 (15%) patients, the discontinuation was due to loss of efficacy. Two patients stopped treatment because they planned a pregnancy and five patients stopped because of adverse events. A longer disease duration (P = 0.01) and presence of palmoplantar psoriasis (P = 0.01) seem to be predictive factors for treatment failure. Patients reaching 90 or 100% improvement in Psoriasis Area and Severity Index (PASI90 and PASI100, respectively) at weeks 12-16 had a lower risk of long-term treatment discontinuation compared with patients who had less complete clearance (P = 0.04). CONCLUSION Long-term persistence of secukinumab appears to be good, as only 24.2% (n = 22) of the patients in this study discontinued secukinumab over the follow-up period. Loss of efficacy prompted discontinuation in about 14% of patients by the 2-year follow-up. Persistence appears to be lower in patients with palmoplantar psoriasis and in patients previously exposed to many systemic treatments. Optimal therapeutic response at 12-16 weeks as defined by reaching PASI90-100 seems to be predictive of long-term treatment persistence.
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Affiliation(s)
- L Ferrières
- Department of Dermatology, Toulouse University and Larrey Hospital, Toulouse, France
| | - M P Konstantinou
- Department of Dermatology, Toulouse University and Larrey Hospital, Toulouse, France
| | - C Bulai Livideanu
- Department of Dermatology, Toulouse University and Larrey Hospital, Toulouse, France
| | - S Hegazy
- Department of Dermatology, Toulouse University and Larrey Hospital, Toulouse, France
| | - M Tauber
- Department of Dermatology, Toulouse University and Larrey Hospital, Toulouse, France
| | - F Amelot
- Department of Dermatology, Toulouse University and Larrey Hospital, Toulouse, France
| | - C Paul
- Department of Dermatology, Toulouse University and Larrey Hospital, Toulouse, France
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9
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Tauber M, Apoil PA, Richet C, Laurent J, De Bonnecaze G, Mouchon E, Cassagne M, Marguery MC, Hegazy S, Konstantinou MP, Severino M, Uthurriague C, Giordano-Labadie F, Didier A, Paul C. Effect of dupilumab on atopic manifestations in patients treated for atopic dermatitis in real-life practice. Br J Dermatol 2019; 180:1551-1552. [PMID: 30633329 DOI: 10.1111/bjd.17629] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- M Tauber
- Dermatology and Allergology Department, Larrey Hospital, Toulouse University, Toulouse, France.,INSERM-Paul Sabatier Toulouse University, U1056 UDEAR, Purpan Hospital, Toulouse, France
| | - P A Apoil
- Immunology Department, Rangueil Hospital, Toulouse University, Toulouse, France
| | - C Richet
- Dermatology and Allergology Department, Larrey Hospital, Toulouse University, Toulouse, France
| | | | - G De Bonnecaze
- Ear Nose and Throat Department, Larrey Hospital, Toulouse University, Toulouse, France
| | - E Mouchon
- Ear Nose and Throat Department, Larrey Hospital, Toulouse University, Toulouse, France
| | - M Cassagne
- Ophthalmology Department, Pierre Paul Riquet Hospital, Toulouse University, Toulouse, France
| | - M C Marguery
- Dermatology and Allergology Department, Larrey Hospital, Toulouse University, Toulouse, France
| | - S Hegazy
- Dermatology and Allergology Department, Larrey Hospital, Toulouse University, Toulouse, France
| | - M P Konstantinou
- Dermatology and Allergology Department, Larrey Hospital, Toulouse University, Toulouse, France
| | - M Severino
- Dermatology and Allergology Department, Larrey Hospital, Toulouse University, Toulouse, France
| | - C Uthurriague
- Dermatology and Allergology Department, Larrey Hospital, Toulouse University, Toulouse, France
| | - F Giordano-Labadie
- Dermatology and Allergology Department, Larrey Hospital, Toulouse University, Toulouse, France
| | - A Didier
- Pneumology and Allergology Department, Larrey Hospital, Toulouse University, Toulouse, France
| | - C Paul
- Dermatology and Allergology Department, Larrey Hospital, Toulouse University, Toulouse, France.,INSERM-Paul Sabatier Toulouse University, U1056 UDEAR, Purpan Hospital, Toulouse, France
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10
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Börjesson C, Guinard E, Tauber M, Konstantinou MP, Livideanu CB, Mazereeuw-Hautier J, Meyer N, Paul C. Compounded topical preparations in plaque psoriasis: Still a place for it in 2018? Dermatol Ther 2018; 32:e12780. [PMID: 30387924 DOI: 10.1111/dth.12780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 07/09/2018] [Revised: 10/28/2018] [Accepted: 10/31/2018] [Indexed: 11/27/2022]
Abstract
Compounded topical preparations (CTP) were used to treat psoriasis until the last century and have disappeared from guidelines. The present authors report two severe psoriasis patients who were treated with CTP. A man had psoriasis with a PASI of 23 and a body surface area (BSA) of 43%. He had been using daily for several weeks a CTP including minoxidil, clobetasol propionate and hydroxyprogesterone formulated in an alcohol based vehicle. A woman suffered from psoriasis with an annular inflammatory pattern and a central healing. The PASI was 20 and the BSA was 30%. She had been using a CTP daily for 4 months including resorcinol, salicylic acid, 0.05% tretinoin cream, bethamethasone dipropionate cream. Until the 1970s, the dermatological textbooks recommended to treat severe psoriasis with CTP. Nowadays, CTP are considered outdated because of the large therapeutic armamentarium. The stability and benefit risks of the CTP used here were not documented. The use of CTP in psoriasis should be regulated and must be evidence based. Strict protocol and stability evaluation for preparations must be confirmed prior to compounding.
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Affiliation(s)
| | - Elisabeth Guinard
- Dermatologie, Université Paul Sabatier, CHU Toulouse, Toulouse, France
| | - Marie Tauber
- Dermatologie, Université Paul Sabatier, CHU Toulouse, Toulouse, France
| | | | | | | | - Nicolas Meyer
- Dermatologie, Université Paul Sabatier, CHU Toulouse, Toulouse, France.,Onco-Dermatologie, Institut Universitaire du Cancer Toulouse, Toulouse, France
| | - Carle Paul
- Dermatologie, Université Paul Sabatier, CHU Toulouse, Toulouse, France
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11
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Aleissa M, Konstantinou MP, Rigal M, Dahan M, Mazereeuw-Hautier J, Paul C, Bulai Livideanu C. Focal facial hyperhidrosis associated with internal carotid artery dissection successfully treated with botulinum toxin A. J Eur Acad Dermatol Venereol 2018; 32:e314-e316. [PMID: 29430719 DOI: 10.1111/jdv.14864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M Aleissa
- Dermatology Department, Paul Sabatier University, Toulouse University Hospital, Toulouse, France
| | - M P Konstantinou
- Dermatology Department, Paul Sabatier University, Toulouse University Hospital, Toulouse, France
| | - M Rigal
- Neurology Department, Neurovascular Unit, Auch Hospital, Auch, France
| | - M Dahan
- Thoracic Department, Paul Sabatier University, Toulouse University Hospital, Toulouse, France
| | - J Mazereeuw-Hautier
- Dermatology Department, Paul Sabatier University, Toulouse University Hospital, Toulouse, France
| | - C Paul
- Dermatology Department, Paul Sabatier University, Toulouse University Hospital, Toulouse, France
| | - C Bulai Livideanu
- Dermatology Department, Paul Sabatier University, Toulouse University Hospital, Toulouse, France
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12
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Hegazy S, Konstantinou MP, Bulai Livideanu C, Tauber M, Uthurriague C, Paul C. Efficacy of ustekinumab in palmoplantar pustulosis. J Eur Acad Dermatol Venereol 2018; 32:e204-e206. [PMID: 29194805 DOI: 10.1111/jdv.14718] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- S Hegazy
- Department of Dermatology, Hôpital Larrey, Toulouse University, Toulouse, France
| | - M P Konstantinou
- Department of Dermatology, Hôpital Larrey, Toulouse University, Toulouse, France
| | - C Bulai Livideanu
- Department of Dermatology, Hôpital Larrey, Toulouse University, Toulouse, France
| | - M Tauber
- Department of Dermatology, Hôpital Larrey, Toulouse University, Toulouse, France
| | - C Uthurriague
- Department of Dermatology, Hôpital Larrey, Toulouse University, Toulouse, France
| | - C Paul
- Department of Dermatology, Hôpital Larrey, Toulouse University, Toulouse, France
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13
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Casassa EA, Nicol P, Viraben R, Gaudin C, Bulai Livideanu C, Mengelle C, Lamant L, Fortenfant F, Paul C, Konstantinou MP. [Acyclovir-resistant perineal HSV infection revealing chronic lymphoid leukaemia]. Ann Dermatol Venereol 2017; 145:182-186. [PMID: 29221652 DOI: 10.1016/j.annder.2017.10.013] [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: 03/03/2017] [Revised: 07/23/2017] [Accepted: 10/31/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Chronic HSV infection is a cause of chronic perineal ulcerations. We report a case of a chronic and refractory HSV infection revealing chronic lymphoid leukaemia. PATIENTS AND METHODS An 85-year-old woman with an 8-month history of chronic perineal ulcerations was referred to our dermatology department. She had no previous medical history of herpes infection. Skin biopsies ruled out carcinoma but were consistent with HSV infection. A local swab was positive for HSV2. Treatment with valaciclovir and intravenous acyclovir (ACV) at the recommended doses was ineffective. Laboratory tests revealed type-B chronic lymphoid leukaemia. Molecular biology studies confirmed the presence of ACV-resistant HSV via decreased thymidine kinase activity (stop codon: M183stop). Foscarnet was administered for a period of 3 weeks with almost complete healing of the ulcerations. Treatment was stopped prematurely due to acute renal insufficiency and the remaining lesions were treated using imiquimod cream. Valaciclovir was prescribed to prevent further episodes. The condition recurred a mere 11 months later. DISCUSSION The prevalence of ACV-resistant HSV is 0.32 % in immunocompetent patients and 3.5 % in immunocompromised patients. Insufficient dosing regimens or prolonged treatment with TK inhibitors result in the local selection of pre-existing mutant HSV viruses. Foscarnet, a DNA polymerase inhibitor, is the treatment of choice in HSV-resistant infections. ACV-resistant HSV is less virulent and replicates less, with reactivations being mainly due to wild-type HSV latent in the neural ganglia. Valaciclovir can be used as a preventive treatment. To our knowledge, this is the first case of ACV-resistant HSV infection revealing chronic lymphoid leukaemia. CONCLUSION Chronic perineal ulcerations can be the first manifestation of immunodeficiency seen for example with haematological diseases. In the event of clinical resistance of an HSV infection to recommended thymidine kinase inhibitor regimens, the use of foscarnet should be considered.
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Affiliation(s)
- E A Casassa
- Dermatologie, université Paul-Sabatier, Hopital Larrey, CHU de Toulouse, 24 chemin de Pouvourville, 31300 Toulouse, France.
| | - P Nicol
- Dermatologie, université Paul-Sabatier, Hopital Larrey, CHU de Toulouse, 24 chemin de Pouvourville, 31300 Toulouse, France
| | - R Viraben
- Dermatologie, université Paul-Sabatier, Hopital Larrey, CHU de Toulouse, 24 chemin de Pouvourville, 31300 Toulouse, France
| | - C Gaudin
- Gériatrie, université Paul-Sabatier, CHU de Toulouse, 31300 Toulouse, France
| | - C Bulai Livideanu
- Dermatologie, université Paul-Sabatier, Hopital Larrey, CHU de Toulouse, 24 chemin de Pouvourville, 31300 Toulouse, France
| | - C Mengelle
- Virologie, Purpan, université Paul-Sabatier, CHU de Toulouse, 31300 Toulouse, France
| | - L Lamant
- Anatomopathologie, IUCT, université Paul-Sabatier, CHU de Toulouse, 31300 Toulouse, France
| | - F Fortenfant
- Immunologie, université Paul-Sabatier, CHU de Toulouse, 31300 Toulouse, France
| | - C Paul
- Dermatologie, université Paul-Sabatier, Hopital Larrey, CHU de Toulouse, 24 chemin de Pouvourville, 31300 Toulouse, France
| | - M P Konstantinou
- Dermatologie, université Paul-Sabatier, Hopital Larrey, CHU de Toulouse, 24 chemin de Pouvourville, 31300 Toulouse, France
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14
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Aleissa M, Konstantinou MP, Samimi M, Lamant L, Gaboriaud P, Touze A, Ceppi C, Bulai Livideanu C, Paul C. Trichodysplasia spinulosa associated with HIV infection: clinical response to acitretin and valganciclovir. Clin Exp Dermatol 2017; 43:231-233. [PMID: 29028114 DOI: 10.1111/ced.13286] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2017] [Indexed: 11/26/2022]
Affiliation(s)
- M Aleissa
- Paul Sabatier University, University Hospitals of Toulouse, Toulouse, France.,Department of Dermatology, University Hospitals of Toulouse, Toulouse, France
| | - M P Konstantinou
- Paul Sabatier University, University Hospitals of Toulouse, Toulouse, France.,Department of Dermatology, University Hospitals of Toulouse, Toulouse, France
| | - M Samimi
- Unité Mixte de Recherche 1282 Infectiologie et Santé Publique, Centre Hospitalier Universitaire Tours, Université François Rabelais, Tours, France.,Department of Dermatology, Centre Hospitalier Universitaire Tours, Université François Rabelais, Tours, France
| | - L Lamant
- Paul Sabatier University, University Hospitals of Toulouse, Toulouse, France.,Department of Histopathology, University Hospitals of Toulouse, Toulouse, France
| | - P Gaboriaud
- Unité Mixte de Recherche 1282 Infectiologie et Santé Publique, Centre Hospitalier Universitaire Tours, Université François Rabelais, Tours, France
| | - A Touze
- Unité Mixte de Recherche 1282 Infectiologie et Santé Publique, Centre Hospitalier Universitaire Tours, Université François Rabelais, Tours, France
| | - C Ceppi
- Department of Internal Medicine, University Hospital of Nice, Nice, France
| | - C Bulai Livideanu
- Paul Sabatier University, University Hospitals of Toulouse, Toulouse, France.,Department of Dermatology, University Hospitals of Toulouse, Toulouse, France
| | - C Paul
- Paul Sabatier University, University Hospitals of Toulouse, Toulouse, France.,Department of Dermatology, University Hospitals of Toulouse, Toulouse, France
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15
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Hegazy S, Tauber M, Bulai-Livideanu C, Uthuriague C, Giordano-Labadie F, Marguery MC, Regnault MM, Konstantinou MP, Paul C. Systemic treatment of severe adult Atopic dermatitis in clinical practice: analysis of prescribing pattern in a cohort of 241 patients. J Eur Acad Dermatol Venereol 2017; 31:e423-e424. [PMID: 28322469 DOI: 10.1111/jdv.14238] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- S Hegazy
- Department of Dermatology, Hôpital Larrey, Toulouse University, 31059, Toulouse, France
| | - M Tauber
- Department of Dermatology, Hôpital Larrey, Toulouse University, 31059, Toulouse, France
| | - C Bulai-Livideanu
- Department of Dermatology, Hôpital Larrey, Toulouse University, 31059, Toulouse, France
| | - C Uthuriague
- Department of Dermatology, Hôpital Larrey, Toulouse University, 31059, Toulouse, France
| | - F Giordano-Labadie
- Department of Dermatology, Hôpital Larrey, Toulouse University, 31059, Toulouse, France
| | - M C Marguery
- Department of Dermatology, Hôpital Larrey, Toulouse University, 31059, Toulouse, France
| | - M M Regnault
- Department of Dermatology, Hôpital Larrey, Toulouse University, 31059, Toulouse, France
| | - M P Konstantinou
- Department of Dermatology, Hôpital Larrey, Toulouse University, 31059, Toulouse, France
| | - C Paul
- Department of Dermatology, Hôpital Larrey, Toulouse University, 31059, Toulouse, France
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16
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Konstantinou MP, Dutriaux C, Gaudy-Marqueste C, Mortier L, Bedane C, Girard C, Thellier S, Jouary T, Grob JJ, Richard MA, Templier C, Sakji L, Guillot B, Paul C, Meyer N. Ipilimumab in melanoma patients with brain metastasis: a retro-spective multicentre evaluation of thirty-eight patients. Acta Derm Venereol 2014; 94:45-9. [PMID: 23824275 DOI: 10.2340/00015555-1654] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [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: 11/16/2022] Open
Abstract
Treatment with ipilimumab, a monoclonal antibody that antagonizes cytotoxic T-lymphocyte antigen-4 (CTLA-4), results in improved survival of patients with stage IIIc-IV melanoma. However, there is a lack of data on the efficacy of ipilimumab in patients with brain metastases. To evaluate the efficacy of ipilimumab for the treatment of brain metastasis in melanoma, a multicentre, retrospective analysis of 38 patients with brain metastases in melanoma, treated with ipilimumab in the context of the French Expanded Access Program, was performed. Three patients had a 3 partial response, 5 stable disease, 15 disease progression and 15 patients died during the induction phase due to disease progression. Median overall survival was 101 days (range 54-154). The brain metastases control rate was 16% (6/38). Ipilimumab may be effective in a few patients with central nervous system metastasis. However, patients with brain metastases and a low life expectancy may not benefit sufficiently from treatment with ipilimumab.
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Affiliation(s)
- Maria-Polina Konstantinou
- Department of Dermatology, Toulouse III University and Larrey Hospital, 31059 Toulouse Cedex 9, France
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