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Bellinato F, Gisondi P, Dattola A, Richetta AG, Costanzo A, Valenti M, De Simone C, Marzano AV, Zussino M, Pezzolo E, Nacca M, Pellacani G, Girolomoni G. Spesolimab in patients with flare of generalized pustular psoriasis: A multicentre case-series. J Eur Acad Dermatol Venereol 2024; 38:e437-e439. [PMID: 38084869 DOI: 10.1111/jdv.19678] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/17/2023] [Indexed: 04/26/2024]
Affiliation(s)
- F Bellinato
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - P Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - A Dattola
- Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - A G Richetta
- Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - A Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
- Dermatology Unit, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - M Valenti
- Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
- Dermatology Unit, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - C De Simone
- Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - M Zussino
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - E Pezzolo
- Dermatology Unit, Ospedale San Bortolo, Vicenza, Italy
| | - M Nacca
- A.O.R.N. Sant'Anna e San Sebastiano Caserta, Caserta, Italy
| | - G Pellacani
- Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - G Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
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2
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Zoli A, Peluso G, Grimaldi M, De Simone C, D'Agostino MA, Ortolan A. New onset of guttate psoriasis, Hallopeau's continuous acrodermatitis, and psoriatic arthritis after COVID-19 vaccine. Scand J Rheumatol 2024:1-2. [PMID: 38407318 DOI: 10.1080/03009742.2024.2316998] [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: 12/22/2023] [Accepted: 02/07/2024] [Indexed: 02/27/2024]
Affiliation(s)
- A Zoli
- Division of Rheumatology, Catholic University of the Sacred Hearth, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy
| | - G Peluso
- Division of Rheumatology, Catholic University of the Sacred Hearth, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy
| | - M Grimaldi
- Dermatology Unit, Catholic University of the Sacred Hearth, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy
| | - C De Simone
- Dermatology Unit, Catholic University of the Sacred Hearth, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy
| | - M A D'Agostino
- Division of Rheumatology, Catholic University of the Sacred Hearth, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy
| | - A Ortolan
- Division of Rheumatology, Catholic University of the Sacred Hearth, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy
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Chiricozzi A, Ferrucci SM, Di Nardo L, Gori N, Balato A, Ortoncelli M, Maurelli M, Galluzzo M, Munera Campos M, Seremet T, Caldarola G, De Simone C, Ippoliti E, Torres T, Gkalpakiotis S, Conrad C, Carrascosa JM, Bianchi L, Argenziano G, Ribero S, Girolomoni G, Marzano AV, Peris K. Current treatment goals are achieved by the majority of patients with atopic dermatitis treated with tralokinumab: results from a multicentric, multinational, retrospective, cohort study. Expert Opin Biol Ther 2023; 23:1307-1315. [PMID: 38108300 DOI: 10.1080/14712598.2023.2292627] [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: 09/25/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Tralokinumab is a human monoclonal antibody targeting interleukin-13 that is approved for the treatment of moderate-severe atopic dermatitis. Studies analyzing the efficacy and safety of tralokinumab in a real-world setting are scarce. RESEARCH DESIGN AND METHODS A European, multicentric, real-world, retrospective cohort study was defined to assess the effectiveness and safeness profile of tralokinumab, investigating the achievement of pre-specified treatment goals; and to detect potential differences in terms of effectiveness and safeness across some selected patient subcohorts. RESULTS A total of 194 adult patients were included in this study. A significant improvement in physician-assessed disease severity was detected at each follow-up visit as compared with baseline and similar trend was observed for patient-reported outcomes and quality of life. No meaningful difference in effectiveness was found when considering patient age (<65 versus ≥65 years), neither dissecting patient cohort in dupilumab-naive vs dupilumab-treated subjects. Among tralokinumab-treated patients, 88% achieved at least one currently identified real-world therapeutic goal at week 16. CONCLUSIONS This retrospective multicenter study confirmed the effectiveness and safeness of tralokinumab throughout 32 weeks of observation, showing the achievement of therapeutic goals identified in both trial and real-world settings in a large proportion of tralokinumab-treated patients.
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Affiliation(s)
- A Chiricozzi
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - S M Ferrucci
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - L Di Nardo
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - N Gori
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A Balato
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - M Ortoncelli
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - M Maurelli
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - M Galluzzo
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- Dermatology Unit, Fondazione Policlinico "Tor Vergata", Rome, Italy
| | - M Munera Campos
- Department of Dermatology, Germans Trias i Pujol University Hospital (HUGTP), Autonomous University of Barcelona (UAB), Badalona, Spain
| | - T Seremet
- Department of Dermatology, Lausanne University Hospital CHUV and University of Lausanne, Lausanne, Switzerland
| | - G Caldarola
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C De Simone
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - E Ippoliti
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - T Torres
- Department of Dermatology, Centro Hospitalar Universitário de Santo António, University of Porto, Porto, Portugal
| | - S Gkalpakiotis
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic
| | - C Conrad
- Department of Dermatology, Lausanne University Hospital CHUV and University of Lausanne, Lausanne, Switzerland
| | - J M Carrascosa
- Department of Dermatology, Germans Trias i Pujol University Hospital (HUGTP), Autonomous University of Barcelona (UAB), Badalona, Spain
| | - L Bianchi
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- Dermatology Unit, Fondazione Policlinico "Tor Vergata", Rome, Italy
| | - G Argenziano
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - S Ribero
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - G Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - A V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - K Peris
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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4
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Caldarola G, Chiricozzi A, Megna M, Dapavo P, Giunta A, Burlando M, Malagoli P, Dini V, Mariani M, Fabbrocini G, Quaglino P, Bianchi L, Parodi A, Peris K, De Simone C. Real-life experience with ixekizumab in plaque psoriasis: a multi-center, retrospective, 3-year study. Expert Opin Biol Ther 2023; 23:365-370. [PMID: 36927246 DOI: 10.1080/14712598.2023.2193288] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
BACKGROUND Confirmatory data on the long-term effectiveness and safety of ixekizumab in psoriatic patients from real-world studies are needed. OBJECTIVES The primary aim was to evaluate the 3-year drug survival of ixekizumab in the treatment of patients with moderate-to-severe plaque psoriasis, in a multicenter real-world setting. The secondary aim was to assess the influence of predictive factors on the drug survival of ixekizumab. METHODS A retrospective analysis was performed on a cohort of patients with chronic plaque psoriasis, who received at least one dose of ixekizumab before December 2018. The drug survival analysis was performed and descriptively analyzed using Kaplan-Meier survival curves. Multivariable Cox regression analyses were carried out including variables considered to be of clinical importance. RESULTS A total of 306 patients were enrolled. The overall drug survival at 12, 24, and 36 months of treatment with ixekizumab was 92.11%, 83.85%, and 80.19%, respectively. A higher probability (HR 2.34) of drug withdrawal was found among patients who had already received an anti-IL-17 agent compared with bio-naive patients (p 0.017). CONCLUSIONS We found that ixekizumab is a biological agent characterized by long-term effectiveness, not influenced by several clinical factors and associated with a good safety profile.
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Affiliation(s)
- Giacomo Caldarola
- Section of Dermatology, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.,Dermatology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A Chiricozzi
- Section of Dermatology, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.,Dermatology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - M Megna
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - P Dapavo
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - A Giunta
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - M Burlando
- Section of Dermatology, Di.S.Sal. Department of Health Science, San Martino Polyclinic Hospital, University of Genoa, Genoa, Italy
| | - P Malagoli
- Dermatology Unit, Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - V Dini
- Dermatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Mariani
- Section of Hygiene, University Department of Health Sciences and Public Health, Rome, Italy
| | - G Fabbrocini
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - P Quaglino
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - L Bianchi
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - A Parodi
- Section of Dermatology, Di.S.Sal. Department of Health Science, San Martino Polyclinic Hospital, University of Genoa, Genoa, Italy
| | - K Peris
- Section of Dermatology, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.,Dermatology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C De Simone
- Section of Dermatology, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.,Dermatology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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5
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Caruso C, Laterza L, Settanni CR, Colantuono S, Di Mario C, Tolusso B, Castrì F, Gremese E, Scaldaferri F, Armuzzi A, De Simone C, Peris K, Chiricozzi A, Gasbarrini A. Case report: Dupilumab treatment improved type 2 disorders in a patient with IPEX syndrome diagnosis. Front Immunol 2023; 13:995304. [PMID: 36713411 PMCID: PMC9875030 DOI: 10.3389/fimmu.2022.995304] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/18/2022] [Indexed: 01/13/2023] Open
Abstract
We described a case of IPEX syndrome successfully controlled with dupilumab, an anti-IL4 receptor alpha subunit inhibitor. IPEX syndrome is a rare and generally fatal genetic disorder characterized by immune dysregulation, polyendocrinopathy and enteropathy, mostly diagnosed in early childhood. Nonetheless, cases reported in the last 20 years demonstrated that IPEX clinical spectrum encompasses more than the classical triad of early-onset intractable diarrhea, type 1 diabetes and eczema. Atypical cases of IPEX include patients with late-onset of symptoms, single-organ involvement, mild disease phenotypes or rare clinical features. A 21-year-old caucasian man presented with immune dysregulation (hypereosinophilia and elevated IgE), protein-losing enteropathy, polyendocrinopathy (thyroiditis, osteoporosis, delayed puberty), weight loss, eczema manifestations and celiac disease. IPEX syndrome was diagnosed because of the presence of a hemizygous mutation in FOXP3 gene (c.543C>T (p.S181S) in the exon 5). During the course of the disease, the patient developed erosive proctitis, pyoderma gangrenosum, and erythema nodosum. Symptoms improved only after enteral and parenteral corticosteroid therapy and the patient soon developed steroid-dependence. Notwithstanding various therapies including azathioprine, sirolimus, tacrolimus, adalimumab, vedolizumab, the patient failed to achieve a good control of symptoms without steroids. Almost exclusive enteral nutrition with a hypoallergenic, milk-protein free, amino acid-based food for special medical purposes. He continued to lose weight (BMI 14.5 kg/m2) with a consequent high limitation of physical activity and a progressive worsening of the quality of life. In consideration of the poor response to conventional immunosuppressants and the presence of type 2 inflammatory manifestations, treatment with dupilumab at an initial dose of 600 mg, followed by a maintenance dose of 300 mg every other week, according to atopic dermatitis labeled dose, was started and combined to oral budesonide 6 mg/day and 6-mercaptopurine 75 mg/day. The patient experienced a rapid improvement in bowel and skin symptoms, leading to a progressive tapering of steroids. By our knowledge, this is the first report of IPEX syndrome successfully treated by antiIL-4/IL-13 therapy. In this case dupilumab demonstrated to be an effective, safe and steroid-sparing option.
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Affiliation(s)
- C. Caruso
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy,*Correspondence: C. Caruso,
| | - L. Laterza
- UOC di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C. R. Settanni
- UOC di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - S. Colantuono
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - C. Di Mario
- Immunology Core Facility, Gemelli Science Technological Park (GSTeP), Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - B. Tolusso
- Division of Clinical Immunology, A. Gemelli University Hospital Foundation IRCCS, Rome, Italy
| | - F. Castrì
- Dipartimento di Anatomia Patologica, Fondazione Policlinico A. Gemelli, IRCCS, Rome, Italy
| | - E. Gremese
- Immunology Core Facility, Gemelli Science Technological Park (GSTeP), Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy,Division of Clinical Immunology, A. Gemelli University Hospital Foundation IRCCS, Rome, Italy
| | - F. Scaldaferri
- Istituto di Patologia Speciale Medica, Università Cattolica del Sacro Cuore, Rome, Italy,Faculty of Medicine and Surgery, Catholic University of the Sacred Heart, Rome, Italy
| | - A. Armuzzi
- IBD Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - C. De Simone
- Institute of Dermatology, Università Cattolica del Sacro Cuore, Rome, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - K. Peris
- Institute of Dermatology, Università Cattolica del Sacro Cuore, Rome, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A. Chiricozzi
- Institute of Dermatology, Università Cattolica del Sacro Cuore, Rome, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A. Gasbarrini
- Faculty of Medicine and Surgery, Catholic University of the Sacred Heart, Rome, Italy,Faculty of Internal Medicine, Catholic University of the Sacred Heart, Rome, Italy,Internal Medicine and Gastroenterology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Avallone G, Cavallo F, Astrua C, Caldarola G, Conforti C, De Simone C, di Meo N, di Stefani A, Genovese G, Maronese CA, Marzano AV, Parente R, Quaglino P, Roccuzzo G, Tassone F, Zalaudek I, Senetta R, Ribero S. Cutaneous adverse reaction following SARS-CoV-2 vaccine booster dose: a real-life multicentre experience. J Eur Acad Dermatol Venereol 2022; 36:e876-e879. [PMID: 35771093 PMCID: PMC9349823 DOI: 10.1111/jdv.18386] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G Avallone
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - F Cavallo
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - C Astrua
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - G Caldarola
- UOC Dermatologia , Dipartimento di scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A.Gemelli" , IRCCS, Roma
| | - C Conforti
- Dermatology Clinic, Maggiore Hospital, Trieste, Italy
| | - C De Simone
- UOC Dermatologia , Dipartimento di scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A.Gemelli" , IRCCS, Roma.,Sezione di Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del S.Cuore, Roma
| | - N di Meo
- Dermatology Clinic, Maggiore Hospital, Trieste, Italy
| | - A di Stefani
- UOC Dermatologia , Dipartimento di scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A.Gemelli" , IRCCS, Roma
| | - G Genovese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - C A Maronese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - A V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - R Parente
- Department of Pathology, Humanitas-Gradenigo Hospital, Corso Regina Margherita 8, 10153, Turin, Italy
| | - P Quaglino
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - G Roccuzzo
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - F Tassone
- UOC Dermatologia , Dipartimento di scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A.Gemelli" , IRCCS, Roma
| | - I Zalaudek
- Dermatology Clinic, Maggiore Hospital, Trieste, Italy
| | - R Senetta
- Department of Oncology, Pathology Unit, University of Turin, Turin, Italy
| | - S Ribero
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
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7
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Chimenti MS, Galluzzo M, Talamonti M, Campanati A, Bonifati C, Bruni P, Caldarola G, Carpentieri A, Chiricozzi A, De Simone C, Diotallevi F, Esposito M, Fiorella C, Graceffa D, Loconsole F, Hansel K, Mugheddu C, Papini M, Richetta A, Bergamini A, Luchetti MM, Atzori L, Peris K, Offidani A, Stingeni L, Bianchi L. AB0915 GUSELKUMAB REAL WORD DATA: EFFICACY AND SAFETY IN A COHORT OF 69 PATIENTS WITH PSORIATIC ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPsoriasis (PSO) is a systemic immune-mediated disorder, characterized by inflammation skin and joint manifestations: it is known that up to 30% of PsO patients develop PsA.PsO and PsA share common etiopathogenetic pathways, as IL-23/IL-17 axis. In Italy, Guselkumab (GUS), a selective IL-23 inhibitor, was approved in 2018 for the treatment of PsO, and recently it was also approved for PsA therapy. Today, there are few “real-world” studies regarding the use of GUS in PsA patients.ObjectivesA multicenter Italian study group of dermatologists and rheumatologists aimed at evaluate GUS efficacy and safety in patients with concomitant PsO and PsA in real word setting on both skin and joint domains.MethodsAn observational retrospective, multicentric study was performed in 69 PsO patients with a confirmed diagnosis of moderate to severe PsA. PASI and DLQI were used for the evaluation of skin response, and the number swollen/tender joints, presence or absence of dactylitis or enthesitis or axial involvement and painVAS were evaluated for the articular and periarticular efficacy. These analyses were performed at baseline T0 (beginning of the therapy), T1 (12 weeks) and T2 (24 weeks).Results38/69 patients (55,1%) presented oligoarthritis, 31/69 (44,9%) showed polyarthritis, none of the patients had enthesitis or axial involvement. Moreover, co-morbidities were diagnosed: hypertension (52,2%), hypercholesterolemia (34,8%), Hypertriglyceridemia (29%), diabetes (24,6%), obesity (23,2%), HIV-positive (20,3%), psychiatric disorders (17,4%), cardiopathies (15,9%), inflammatory bowel disease (7,3%), Latent Tubercolosis (4,4%), Chronic B-Hepatitis (2,9%), Chronic C-Hepatitis (1,5%). In all these patients, skin and joint responses were evaluated at week 12 and week 24.Concerning skin efficacy, PASI 90 was achieved at week 24. Concerning Joint response: painVAS progressively improved till T2, tender joint count decreased in patients with oligo and polyarthritis at T1 and maintained at T2, while swollen joint count decreased in polyarthritis patients at T1 and maintained at T2. In oligo-arthritis patients, this parameter was not improved. The number of dactylitis did not decrease during the period of study (see Table 1). No safety concerns were reported in this population.ConclusionEfficacy and safety of GUS was confirmed in this study group of PsO patients with concomitant PsA and several comorbidities in a real-life setting.Disclosure of InterestsNone declared
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8
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Fabbrocini G, De Simone C, Dapavo P, Malagoli P, Martella A, Calzavara Pinton P. Long-term maintenance treatment of psoriasis: the role of calcipotriol/betamethasone dipropionate aerosol foam in clinical practice. J DERMATOL TREAT 2021; 33:2425-2432. [PMID: 34694953 DOI: 10.1080/09546634.2021.1998310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 12/22/2022]
Abstract
Most patients with psoriasis present with localized mild-to-moderate disease. In this case, the application of topical treatments in the first-line setting is recommended in most cases.Among different topical options, the fixed-dose combination of betamethasone dipropionate (BD) and vitamin D analogue (Cal) aerosol foam (Enstilar®, Leo Pharma) is approved as first-line topical therapy for the treatment of psoriasis in USA and the EU, due to its high efficacy and its favorable administration scheme.The PSO-LONG was the first trial to report on the long-term efficacy and safety of the Cal/DB foam treatment for the proactive management of psoriasis and now, the indications of Cal/BD foam included its use in the psoriasis maintenance treatment. However, the precise role of this treatment and the potential therapeutic schemes in the long-term management of psoriasis need further clarification.This Position Paper, authored by a group of Italian Expert Dermatologists, critically discusses the long-term management of psoriasis with Cal/BD foam in clinical practice. In particular, the biological rationale in the proactive treatment with Cal/BD foam and current evidence regarding this therapeutic approach are presented, along with its application also in patients with moderate-to-severe disease, difficult-to-treat lesions, or within combination regimens. In addition, strategies to improve adherence to long-term treatment of psoriasis are discussed.
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Affiliation(s)
- G Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - C De Simone
- Department of Dermatology, Catholic University of the Sacred Heart, Policlinico "A. Gemelli", IRCCS, Rome, Italy
| | - P Dapavo
- ASO City of Health and Science, University Dermatological Clinic, Corso Vittorio Emanuele II, 62, Torino, Italy
| | - P Malagoli
- Head Psocare Unit, IRCCS Policlinico San Donato, Piazza Edmondo Malan, 2, San Donato, Milano, Italy
| | - A Martella
- Myskin Dermatology Practice, Tiggiano, Lecce, Italy
| | - P Calzavara Pinton
- Dermatology Department, University of Brescia, ASST Spedali Civili, P.le Spedali Civili, 1, Brescia, Italy
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9
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Goebeler M, Bata-Csörgő Z, De Simone C, Didona B, Remenyik E, Reznichenko N, Stoevesandt J, Ward ES, Parys W, de Haard H, Dupuy P, Verheesen P, Schmidt E, Joly P. Treatment of pemphigus vulgaris and foliaceus with efgartigimod, a neonatal Fc receptor inhibitor: a phase II multicentre, open-label feasibility trial. Br J Dermatol 2021; 186:429-439. [PMID: 34608631 DOI: 10.1111/bjd.20782] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Pemphigus vulgaris and pemphigus foliaceus are potentially life-threatening autoimmune disorders triggered by IgG autoantibodies against mucosal and epidermal desmogleins. There is an unmet need for fast-acting drugs that enable patients to achieve early sustained remission with reduced corticosteroid reliance. OBJECTIVES To investigate efgartigimod, an engineered Fc fragment that inhibits the activity of the neonatal Fc receptor, thereby reducing serum IgG levels, for treating pemphigus. METHODS Thirty-four patients with mild-to-moderate pemphigus vulgaris or foliaceus were enrolled in an open-label phase II adaptive trial. In sequential cohorts, efgartigimod was dosed at 10 or 25 mg kg-1 intravenously with various dosing frequencies, as monotherapy or as add-on therapy to low-dose oral prednisone. Safety endpoints comprised the primary outcome. The study is registered at ClinicalTrials.gov (identifier NCT03334058). RESULTS Adverse events were mostly mild and were reported by 16 of 19 (84%) patients receiving efgartigimod 10 mg kg-1 and 13 of 15 (87%) patients receiving 25 mg kg-1 , with similar adverse event profiles between dose groups. A major decrease in serum total IgG and anti-desmoglein autoantibodies was observed and correlated with improved Pemphigus Disease Area Index scores. Efgartigimod, as monotherapy or combined with prednisone, demonstrated early disease control in 28 of 31 (90%) patients after a median of 17 days. Optimized, prolonged treatment with efgartigimod in combination with a median dose of prednisone 0·26 mg kg-1 per day (range 0·06-0·48) led to complete clinical remission in 14 of 22 (64%) patients within 2-41 weeks. CONCLUSIONS Efgartigimod was well tolerated and exhibited an early effect on disease activity and outcome parameters, providing support for further evaluation as a therapy for pemphigus.
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Affiliation(s)
- M Goebeler
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - Z Bata-Csörgő
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - C De Simone
- Department of Dermatology, Catholic University of the Sacred Heart, Policlinic A. Gemelli, Rome, Italy
| | - B Didona
- Dermatopathic Institute of the Immaculate, Rome, Italy
| | - E Remenyik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - N Reznichenko
- Zaporizhzhya State Medical University, Zaporizhzhya, Ukraine
| | - J Stoevesandt
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - E S Ward
- Centre for Cancer Immunology, University of Southampton, Southampton, UK
| | | | | | | | | | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - P Joly
- Department of Dermatology, Rouen University Hospital, Rouen, France
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10
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Quattrini L, Verardi L, Caldarola G, Peluso G, De Simone C, D'Agostino M. New onset of remitting seronegative symmetrical synovitis with pitting oedema and palmoplantar psoriasis flare-up after Sars-Cov-2 vaccination. J Eur Acad Dermatol Venereol 2021; 35:e727-e729. [PMID: 34236728 PMCID: PMC8447202 DOI: 10.1111/jdv.17502] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/12/2021] [Accepted: 07/02/2021] [Indexed: 12/04/2022]
Affiliation(s)
- L Quattrini
- Institute of Dermatology, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - L Verardi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Institute of Rheumatology, Università Cattolica del Sacro Cuore, Roma, Italy
| | - G Caldarola
- Institute of Dermatology, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - G Peluso
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Institute of Rheumatology, Università Cattolica del Sacro Cuore, Roma, Italy
| | - C De Simone
- Institute of Dermatology, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - M D'Agostino
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Institute of Rheumatology, Università Cattolica del Sacro Cuore, Roma, Italy
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11
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Galluzzo M, Caldarola G, De Simone C, Bernardini N, Moretta G, Pallotta S, Botti E, Campione E, Pirro F, Potenza C, Bianchi L, Peris K. Use of brodalumab for the treatment of chronic plaque psoriasis: a one-year real-life study in the Lazio region, Italy. Expert Opin Biol Ther 2021; 21:1299-1310. [PMID: 34114515 DOI: 10.1080/14712598.2021.1941862] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: Information is limited from real-life studies evaluating the efficacy and safety of brodalumab.Research design and methods: In this real-life study, we retrospectively examined a database of 90 patients with moderate-to-severe psoriasis treated with brodalumab (210 mg, s.c.) and followed for 1 year. Disease severity and treatment response were assessed by the Psoriasis Area and Severity Index (PASI) at baseline and after 4, 12, 24, 36, and 48 weeks. Predictors of a PASI response were evaluated by logistic regression.Results: After 48 weeks, 92.2% of patients (mean age 50.2 ± 15 years) treated with brodalumab achieved a PASI score of <3. PASI score decreased from 17.4 ± 10.3 at baseline to 1.7 ± 3.9 and 1.4 ± 3.7 at 12 and 24 weeks, and PASI 75, 90, and 100 response was achieved in 87.3%, 81.8%, and 72.7% of patients, respectively, at 48 weeks.Univariate regression revealed that previous exposure to anti-IL17A treatment was associated with poorer PASI response between 36 and 48 weeks. In difficult-to-treat cases previously having failed with other biologics, brodalumab significantly improved outcome, leading to complete remission.Conclusion: Brodalumab was observed to be effective and safe in patients with moderate-to-severe chronic psoriasis in a real-world setting.
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Affiliation(s)
- M Galluzzo
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.,Dermatology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - G Caldarola
- Dipartimento Scienze Mediche E Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Dermatologia, Rome, Italy.,Dermatologia, Università Cattolica Del Sacro Cuore, Dermatologia, Rome, Italy
| | - C De Simone
- Dipartimento Scienze Mediche E Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Dermatologia, Rome, Italy.,Dermatologia, Università Cattolica Del Sacro Cuore, Dermatologia, Rome, Italy
| | - N Bernardini
- Dermatology Unit, Sapienza University of Rome, Latina, Italy
| | - G Moretta
- Dermatology Unit, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, Italy
| | - S Pallotta
- Dermatology Unit, Istituto Dermopatico dell'Immacolata IDI-IRCCS, Rome, Italy
| | - E Botti
- Dermatology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy.,Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - E Campione
- Dermatology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy.,Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - F Pirro
- Dipartimento Scienze Mediche E Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Dermatologia, Rome, Italy.,Dermatologia, Università Cattolica Del Sacro Cuore, Dermatologia, Rome, Italy
| | - C Potenza
- Dermatology Unit, Sapienza University of Rome, Latina, Italy
| | - L Bianchi
- Dermatology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy.,Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - K Peris
- Dipartimento Scienze Mediche E Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Dermatologia, Rome, Italy.,Dermatologia, Università Cattolica Del Sacro Cuore, Dermatologia, Rome, Italy
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12
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De Simone C, Mannino M, Sollena P, Deilhes F, Sibaud V, Peris K. Morphea-like changes in the setting of cancer immunotherapy. J Eur Acad Dermatol Venereol 2021; 35:e684-e685. [PMID: 34013609 DOI: 10.1111/jdv.17388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/23/2021] [Accepted: 05/07/2021] [Indexed: 11/29/2022]
Affiliation(s)
- C De Simone
- Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - M Mannino
- Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - P Sollena
- Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - F Deilhes
- Oncodermatology Department, Institut Universitaire du Cancer, Toulouse Oncopole, Toulouse, France
| | - V Sibaud
- Oncodermatology Department, Institut Universitaire du Cancer, Toulouse Oncopole, Toulouse, France
| | - K Peris
- Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
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13
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Dattola A, Balato A, Megna M, Gisondi P, Girolomoni G, De Simone C, Caldarola G, Cama E, Piaserico S, Fargnoli M, Fidanza R, Parodi A, Burlando M, Offidani A, Diotallevi F, Potenza C, Conti A, Chiricozzi A, Campione E, Bianchi L. Certolizumab for the treatment of psoriasis and psoriatic arthritis: a real‐world multicentre Italian study. J Eur Acad Dermatol Venereol 2020; 34:2839-2845. [DOI: 10.1111/jdv.16606] [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: 02/26/2020] [Accepted: 04/21/2020] [Indexed: 01/11/2023]
Affiliation(s)
- A. Dattola
- Department of Dermatology University of Rome“Tor Vergata” Rome Italy
| | - A. Balato
- Department of Advanced Biomedical Sciences University of Naples Federico II Naples Italy
| | - M. Megna
- Department of Clinical Medicine and Surgery University of Naples Federico II Naples Italy
| | - P. Gisondi
- Section of Dermatology and Venereology Department of Medicine University of Verona Verona Italy
| | - G. Girolomoni
- Section of Dermatology and Venereology Department of Medicine University of Verona Verona Italy
| | - C. De Simone
- Institute of Dermatology Catholic University Rome Italy
- Dermatology Unit Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - G. Caldarola
- Institute of Dermatology Catholic University Rome Italy
| | - E. Cama
- Dermatology Unit Department of Medicine University of Padua Padua Italy
| | - S. Piaserico
- Dermatology Unit Department of Medicine University of Padua Padua Italy
| | - M.C. Fargnoli
- Department Dermatology Department of Biotechnological and Applied Clinical Sciences University of L'Aquila L'Aquila Italy
| | - R. Fidanza
- Department Dermatology San Salvatore HospitalUniversity of L'Aquila L'Aquila Italy
| | - A. Parodi
- Section of Dermatology DISSAL San Martino‐IST Polyclinic HospitalUniversity of Genoa Genoa Italy
| | - M. Burlando
- Section of Dermatology DISSAL San Martino‐IST Polyclinic HospitalUniversity of Genoa Genoa Italy
| | - A. Offidani
- Dermatology Unit Department of Clinical and Molecular Sciences Polytechnic Marche University Ancona Italy
| | - F. Diotallevi
- Dermatology Unit Department of Clinical and Molecular Sciences Polytechnic Marche University Ancona Italy
| | - C. Potenza
- Department of Medical‐Surgical Sciences and Bio‐Technologies Sapienza University of Rome, Polo Pontino Terracina Italy
| | - A. Conti
- Dermatology Unit Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
| | - A. Chiricozzi
- Institute of Dermatology Catholic University Rome Italy
- Dermatology Unit Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
- Dermatology Unit Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - E. Campione
- Department of Dermatology University of Rome“Tor Vergata” Rome Italy
| | - L. Bianchi
- Department of Dermatology University of Rome“Tor Vergata” Rome Italy
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14
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Gisondi P, Bellinato F, Conti A, Dapavo P, Piaserico S, De Simone C, Chiricozzi A, Dattola A, Malagoli P, Malara G, Campanati A, Burlando M, Esposito M, Gallo L, Girolomoni G. Consensus on the place in therapy of TNF‐α inhibitors in the treatment of patients with chronic plaque psoriasis. J Eur Acad Dermatol Venereol 2020; 34:e470-e472. [DOI: 10.1111/jdv.16380] [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: 01/26/2020] [Accepted: 03/10/2020] [Indexed: 01/13/2023]
Affiliation(s)
- P. Gisondi
- Department of Medicine Section of Dermatology and Venereology University of Verona Verona Italy
| | - F. Bellinato
- Department of Medicine Section of Dermatology and Venereology University of Verona Verona Italy
| | - A. Conti
- Department of Surgical Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine Dermatology Unit University of Modena and Reggio Emilia Modena Italy
| | - P. Dapavo
- Department of Biomedical Science and Human Oncology Second Dermatologic ClinicUniversity of Turin Turin Italy
| | - S. Piaserico
- Section of Dermatology Department of Medicine University of Padua Padova Italy
| | - C. De Simone
- Institute of Dermatology Catholic University Rome Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - A. Chiricozzi
- Institute of Dermatology Catholic University Rome Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - A. Dattola
- Department of Dermatology University of Rome Tor Vergata Rome Italy
| | - P. Malagoli
- Dermatology Unit Azienda Ospedaliera San Donato Milanese Milan Italy
| | - G. Malara
- Dermatology Unit Grande Ospedale Metropolitano Bianchi Melacrino Morelli Reggio Calabria Italy
| | - A. Campanati
- Department of Clinical and Molecular Sciences Dermatological Clinic Polytechnic Marche University Ancona Italy
| | - M. Burlando
- Section of Dermatology Department of Health Sciences San Martino University Hospital IRCCS University of Genoa Genoa Italy
| | - M. Esposito
- Dermatology Unit Department of Biotechnological and Applied Clinical Sciences University of L'Aquila L'Aquila Italy
| | - L. Gallo
- Section of Dermatology Department of Clinical Medicine and Surgery University of Naples Federico II Naples Italy
| | - G. Girolomoni
- Department of Medicine Section of Dermatology and Venereology University of Verona Verona Italy
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15
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Garcovich S, Bersani FS, Chiricozzi A, De Simone C. Mass quarantine measures in the time of COVID-19 pandemic: psychosocial implications for chronic skin conditions and a call for qualitative studies. J Eur Acad Dermatol Venereol 2020; 34:e293-e294. [PMID: 32330329 PMCID: PMC7267356 DOI: 10.1111/jdv.16535] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- S Garcovich
- Dermatology, Department of Medical and Surgical Sciences, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - F S Bersani
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - A Chiricozzi
- Dermatology, Department of Medical and Surgical Sciences, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C De Simone
- Dermatology, Department of Medical and Surgical Sciences, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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16
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Seneschal J, Lacour JP, Bewley A, Faurby M, Paul C, Pellacani G, De Simone C, Horne L, Sohrt A, Augustin M, Hammond E, Reich K. A multinational, prospective, observational study to estimate complete skin clearance in patients with moderate-to-severe plaque PSOriasis treated with BIOlogics in a REAL world setting (PSO-BIO-REAL). J Eur Acad Dermatol Venereol 2020; 34:2566-2573. [PMID: 32364296 PMCID: PMC7818467 DOI: 10.1111/jdv.16568] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 03/27/2020] [Indexed: 12/16/2022]
Abstract
Background Anti‐tumour necrosis factor (TNF) and anti‐interleukin (IL)‐12/23 biologics revolutionized plaque psoriasis treatment by enabling ≥75% improvement in the Psoriasis Area and Severity Index (PASI 75) in clinical trials. Modern biologics are now reported to achieve PASI 100 (complete skin clearance) in clinical trials. However, real‐world evidence of skin clearance rates with biologics is limited. PSO‐BIO‐REAL was conducted to understand the real‐world burden of plaque psoriasis. Objective The primary objective of this observational study was to estimate the proportion of patients who achieved complete skin clearance at 6 months. Secondary objectives included maintenance of response and evaluation of complete skin clearance at 12 months. Methods PSO‐BIO‐REAL was a multinational, prospective, real‐world, non‐interventional study of skin clearance and patient‐reported outcomes (PROs) with biologics. A total of 846 patients from the United States (32%), France (28%), Italy (22%), the United Kingdom (11%) and Germany (8%) were enrolled and followed for one year. Eligible patients were aged ≥18 years with moderate‐to‐severe plaque psoriasis who had initiated a biologic for plaque psoriasis. Patients could be biologic‐naïve or switching biologics (biologic‐experienced). Assessments were made at baseline and at months 6 and 12. Results At 6 and 12 months, 23% and 26% of patients achieved complete skin clearance, respectively. Prior to study entry, 60% were biologic‐naïve. The proportion of patients achieving complete skin clearance was lower among biologic‐experienced patients (20% at both months 6 and 12) compared with biologic‐naïve patients (25% at month 6, 30% at month 12). The rate of complete skin clearance decreased as the number of prior biologics and baseline comorbidities increased. Conclusion Only one in four patients achieved complete skin clearance after 6 months of treatment with biologics. The study indicates there still is an unmet need for more efficacious biologics for patients with psoriasis.
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Affiliation(s)
- J Seneschal
- Department of Dermatology and Paediatric Dermatology, National Reference Centre for Rare Skin Diseases, Saint-André Hospital, University of Bordeaux, Bordeaux, France
| | - J-P Lacour
- Department of Dermatology, Archet 2 Hospital, University Hospital of Nice, Nice, France
| | - A Bewley
- Department of Dermatology, Barts Health NHS Trust London, London, UK
| | - M Faurby
- LEO Pharma A/S, Ballerup, Denmark
| | - C Paul
- Toulouse University and Larrey Hospital, Toulouse, France
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - C De Simone
- Department of Dermatology, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Rome, Italy
| | - L Horne
- AstraZeneca, Gaithersburg, MD, USA
| | - A Sohrt
- LEO Pharma A/S, Ballerup, Denmark
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, and Skinflammation® Center, Hamburg, Germany
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17
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Caldarola G, Pirro F, Di Stefani A, Talamonti M, Galluzzo M, D'Adamio S, Magnano M, Bernardini N, Malagoli P, Bardazzi F, Potenza C, Bianchi L, Peris K, De Simone C. Clinical and histopathological characterization of eczematous eruptions occurring in course of anti IL-17 treatment: a case series and review of the literature. Expert Opin Biol Ther 2020; 20:665-672. [PMID: 32045273 DOI: 10.1080/14712598.2020.1727439] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [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: 02/07/2023]
Abstract
Background: Real-life data often highlight the side effects of certain drugs not previously reported in randomized controlled trials (RCTs).Objective: To describe cutaneous inflammatory eruptions in psoriatic patients treated with an anti IL-17A agent (secukinumab or ixekizumab).Methods: Retrospective analysis of a cohort of patients with chronic plaque psoriasis who started an anti IL-17A agent between September 2016-February 2019 and who developed cutaneous inflammatory eruptions during treatment. A systematic review of similar events reported in the literature was performed.Results: Data of 468 patients were reviewed and 27 cutaneous inflammatory eruptions of 27 (5.8%) patients were collected. The eruptions appeared after a mean of 16.9 ± 17.0 weeks of therapy showing a classical acute eczema in 11 patients (40.7%), an atopic dermatitis-like rash in 11 patients (40.7%) and a psoriasiform eruption in 5 patients (18.5%). Histopathology of 12/27 cases showed epidermal spongiosis in all these variants.Conclusion: We described the clinic-pathologic features of some eczematous eruptions occurring in psoriatic patients, 3-4 months after treatment initiation with an anti IL-17A agent. Further investigations are needed to explain this phenomenon, that might be defined a paradoxical adverse event, based upon the role of IL17 in eczema pathogenesis.
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Affiliation(s)
- G Caldarola
- Institute of Dermatology, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Dermatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - F Pirro
- Institute of Dermatology, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Dermatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A Di Stefani
- Institute of Dermatology, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Dermatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - M Talamonti
- Dermatology Unit, University of Rome "Tor Vergata", Rome, Italy
| | - M Galluzzo
- Dermatology Unit, University of Rome "Tor Vergata", Rome, Italy
| | - S D'Adamio
- Dermatology Unit, University of Rome "Tor Vergata", Rome, Italy
| | - M Magnano
- Division of Dermatology, Department of Specialized, Clinical and Experimental Medicine, University of Bologna, Bologna, Italy
| | - N Bernardini
- Dermatology Unit, Sapienza University of Rome, Polo Pontino, Terracina, Italy
| | - P Malagoli
- Dermatology Unit, Azienda Ospedaliera San Donato Milanese, Milan, Italy
| | - F Bardazzi
- Division of Dermatology, Department of Specialized, Clinical and Experimental Medicine, University of Bologna, Bologna, Italy
| | - C Potenza
- Dermatology Unit, Sapienza University of Rome, Polo Pontino, Terracina, Italy
| | - L Bianchi
- Dermatology Unit, University of Rome "Tor Vergata", Rome, Italy
| | - K Peris
- Institute of Dermatology, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Dermatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C De Simone
- Institute of Dermatology, Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Dermatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Esposito I, Fossati B, Peris K, De Simone C. A rare case of bullous Sweet's syndrome in a patient with inactive ulcerative colitis. J Eur Acad Dermatol Venereol 2019; 33:e380-e381. [DOI: 10.1111/jdv.15674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- I. Esposito
- Institute of Dermatology Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore Rome Italy
| | - B. Fossati
- Institute of Dermatology Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore Rome Italy
| | - K. Peris
- Institute of Dermatology Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore Rome Italy
| | - C. De Simone
- Institute of Dermatology Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore Rome Italy
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19
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Conti A, Peccerillo F, Amerio P, Balato A, Bardazzi F, Bianchi L, Burlando M, Cannavò S, Chiricozzi A, Dapavo P, De Simone C, Fargnoli M, Gambardella A, Gisondi P, Malagoli P, Malara G, Mugheddu C, Offidani A, Piaserico S, Prignano F, Stingeni L, Pellacani G. Efficacy and safety of switching to ixekizumab in secukinumab nonresponder patients with psoriasis: results from a multicentre experience. Br J Dermatol 2019; 180:1547-1548. [DOI: 10.1111/bjd.17580] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- A. Conti
- Department of Dermatology University of Modena and Reggio Emilia Modena Italy
| | - F. Peccerillo
- Department of Dermatology University of Modena and Reggio Emilia Modena Italy
| | - P. Amerio
- Department of Medicine and Aging Science Dermatologic Clinic, G. D'Annunzio University Chieti Italy
| | - A. Balato
- Department of Dermatology University of Naples Federico II Naples Italy
| | - F. Bardazzi
- Department of Specialized, Clinical and Experimental Medicine Division of Dermatology University of Bologna Bologna Italy
| | - L. Bianchi
- Department of Dermatology University of Rome Tor Vergata Rome Italy
| | - M. Burlando
- Section of Dermatology University of Genoa San Martino Polyclinic Hospital Genoa Italy
| | - S.P. Cannavò
- Department of Clinical and Experimental Medicine – Dermatology University of Messina Messina Italy
| | - A. Chiricozzi
- Department of Dermatology University of Pisa Pisa Italy
| | - P. Dapavo
- Department of Biomedical Science and Human Oncology Second Dermatologic Clinic University of Turin Turin Italy
| | - C. De Simone
- Department of Dermatology Catholic University of the Sacred Heart Rome Italy
| | - M.C. Fargnoli
- Department of Dermatology University of L'Aquila L'Aquila Italy
| | | | - P. Gisondi
- Department of Medicine Section of Dermatology and Venereology University of Verona Verona Italy
| | - P. Malagoli
- Dermatology Unit Azienda Ospedaliera San Donato Milanese Milan Italy
| | - G. Malara
- Dermatology Department Grande Ospedale Metropolitano Bianchi Melacrino Morelli 89124 Reggio Calabria Italy
| | - C. Mugheddu
- Department of Medical Sciences and Public Health Section of Dermatology University of Cagliari Cagliari Italy
| | - A.M. Offidani
- Department of Clinical and Molecular Sciences Dermatology Unit Polytechnic Marche University Ancona Italy
| | - S. Piaserico
- Department of Dermatology University of Padua Padova Italy
| | - F. Prignano
- Department of Dermatology University of Florence Firenze Italy
| | - L. Stingeni
- Department of Medicine Section of Clinical, Allergological and Venereological Dermatology University of Perugia Perugia Italy
| | - G. Pellacani
- Department of Dermatology University of Modena and Reggio Emilia Modena Italy
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20
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Sollena P, Mannino M, Laurenti L, De Simone C, Peris K. Ibrutinib‐associated palmo‐plantar fissures in a patient with Chronic Lymphocytic Leukaemia: a novel cutaneous adverse event. J Eur Acad Dermatol Venereol 2019; 33:e342-e344. [DOI: 10.1111/jdv.15632] [Citation(s) in RCA: 5] [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: 12/29/2022]
Affiliation(s)
- P. Sollena
- Department of Dermatology Fondazione Policlinico A. Gemelli – IRCCS Catholic University of the Sacred Heart Largo A. Gemelli, 8 00168 Rome Italy
| | - M. Mannino
- Department of Dermatology Fondazione Policlinico A. Gemelli – IRCCS Catholic University of the Sacred Heart Largo A. Gemelli, 8 00168 Rome Italy
| | - L. Laurenti
- Department of Hematology Fondazione Policlinico A. Gemelli – IRCCS Catholic University of the Sacred Heart Largo A. Gemelli, 8 00168 Rome Italy
| | - C. De Simone
- Department of Dermatology Fondazione Policlinico A. Gemelli – IRCCS Catholic University of the Sacred Heart Largo A. Gemelli, 8 00168 Rome Italy
| | - K. Peris
- Department of Dermatology Fondazione Policlinico A. Gemelli – IRCCS Catholic University of the Sacred Heart Largo A. Gemelli, 8 00168 Rome Italy
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21
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Gori N, Caldarola G, De Simone C, Moretta G, Peris K. Annular elastolytic giant cell granuloma following herpes zoster infection. J Eur Acad Dermatol Venereol 2019; 33:e334-e335. [PMID: 30980767 DOI: 10.1111/jdv.15627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- N Gori
- Institute of Dermatology, Catholic University - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - G Caldarola
- Institute of Dermatology, Catholic University - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C De Simone
- Institute of Dermatology, Catholic University - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - G Moretta
- Institute of Dermatology, Catholic University - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - K Peris
- Institute of Dermatology, Catholic University - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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22
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Garcovich S, De Simone C, Giovanardi G, Robustelli E, Marzano AV, Peris K. Post-bariatric surgery hidradenitis suppurativa: a new patient subset associated with malabsorption and micronutritional deficiencies. Clin Exp Dermatol 2018; 44:283-289. [PMID: 30144136 DOI: 10.1111/ced.13732] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Bariatric surgery (BS) represents the most effective treatment for morbid obesity and its related complications, potentially ameliorating chronic comorbid inflammatory skin conditions, such as psoriasis and hidradenitis suppurativa (HS). Weight-loss interventions are strongly encouraged in patients with HS, but the resulting effect on the course of the disease has been poorly reported. AIM To describe the effect of BS-associated weight-loss on the course of HS. METHODS This was a retrospective, descriptive study of a hospital-based patient cohort with HS in order to investigate the relationship between exposure to a BS procedure and the HS disease course. Clinical characteristics and BS-related outcomes were retrospectively analysed by chart review for identified cases. Laboratory parameters for selected micronutrients (levels of vitamin A, D and B12, plus zinc and iron) were re-evaluated at a follow-up visit in each post-BS case. Typical patients with HS from the general cohort served as controls for the comparison of vitamin D and zinc serum levels. RESULTS Of 178 patients with HS, 12 patients with incident HS who had undergone a BS procedure were identified. A subset of patients (n = 10) developed initial signs and symptoms of cutaneous suppuration after experiencing weight loss related to malabsorptive bariatric procedures. Post-BS patients with HS presented multiple micronutritional deficiencies and insufficient responses to standard, first-line antibiotic treatments. Of the micronutrients we selected for analysis, zinc was found to be at significantly lower serum levels in post-BS patients with HS compared with typical patients with HS. CONCLUSIONS Post-BS HS may represent a new patient subset, requiring customized clinical management.
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Affiliation(s)
- S Garcovich
- Institute of Dermatology, F. Policlinico Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - C De Simone
- Institute of Dermatology, F. Policlinico Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Giovanardi
- Institute of Dermatology, F. Policlinico Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - E Robustelli
- IRCCS Cà Granda Foundation, Dermatology Unit, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - A V Marzano
- IRCCS Cà Granda Foundation, Dermatology Unit, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - K Peris
- Institute of Dermatology, F. Policlinico Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
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23
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Verdelli A, Coi A, Marzano AV, Antiga E, Cozzani E, Quaglino P, La Placa M, Benucci M, De Simone C, Papini M, Parodi A, Bianchi F, Caproni M. Autoantibody profile and clinical patterns in 619 Italian patients with cutaneous lupus erythematosus. J Eur Acad Dermatol Venereol 2018; 33:742-752. [PMID: 29924416 DOI: 10.1111/jdv.15147] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 05/30/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Anti-nuclear antibodies (ANA), anti-extractable nuclear antigens (ENA) and anti-dsDNA antibodies are often associated with cutaneous lupus erythematosus (CLE), with variable frequency depending on skin subtype. However, specific data based on large case-series on the pathogenetic, diagnostic and prognostic meaning of such autoantibodies are still lacking. OBJECTIVE To characterize the correlations between CLE subtypes as well as LE-non-specific skin lesions and their autoantibody pattern. METHODS Epidemiological, clinical and immunopathological data of 619 Italian patients with CLE and LE-non-specific skin lesions were analysed. Differences in age, sex, clinical features and autoantibody profile were evaluated in each LE subgroup. RESULTS Anti-nuclear antibodies (P < 0.0001), anti-dsDNA (P < 0.0001), ENA (P = 0.001), anti-Sm (P = 0.001), anti-RNP (P = 0.004) and anti-histone (P = 0.005) antibodies were associated with SLE. A strong association between ANA (P < 0.0001) and anti-dsDNA (P < 0.0001) and female gender was also found: positive ANA and positive anti-dsDNA had a higher prevalence among females. Chronic CLE resulted to be negatively associated with ENA (OR = 0.51, P < 0.0001), anti-Ro/SSA (OR = 0.49, P < 0.0001) and anti-dsDNA (OR = 0.37, P < 0.0001). Intermittent CLE resulted to be negatively associated with ENA (OR = 0.50, P = 0.007) and ANA (OR = 0.61, P = 0.025). Subacute CLE resulted to be associated with ENA (OR = 5.19, P < 0.0001), anti-Ro/SSA (OR = 3.83, P < 0.0001), anti-Smith (OR = 2.95, P = 0.004) and anti-RNP (OR = 3.18, P = 0.007). Acute CLE resulted to be strongly associated with anti-dsDNA (OR = 6.0, P < 0.0001) and ANA (OR = 18.1, P < 0.0001). LE-non-specific skin lesions resulted to be significantly associated with systemic involvement. Livedo reticularis was significantly associated with ENA (P = 0.007) and anti-Ro/SSA (P = 0.036). Palpable purpura and periungual telangiectasia were significantly associated with ANA. CONCLUSION According to our findings, some well-known associations between CLE subtypes and autoantibody profile were confirmed; moreover, specific association between autoantibodies and LE-non-specific skin lesions was highlighted. A strict association between anti-ENA and anti-Ro/SSA antibodies and livedo reticularis, ANA and palpable purpura, and ANA and periungual telangiectasia was evidenced.
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Affiliation(s)
- A Verdelli
- Department of Surgery and Translational Medicine, Section of Dermatology, University of Florence, Florence, Italy
| | - A Coi
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - A V Marzano
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, UOC Dermatologia, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - E Antiga
- Department of Surgery and Translational Medicine, Section of Dermatology, University of Florence, Florence, Italy
| | - E Cozzani
- IRCCS-AOU San Martino-IST, Dissal, Section of Dermatology, University of Genoa, Genoa, Italy
| | - P Quaglino
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, Turin, Italy
| | - M La Placa
- Dermology Division, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - M Benucci
- Rheumatology Unit, S. Giovanni di Dio Hospital, Florence, Italy
| | - C De Simone
- Dermatology Department, Policlinico Universitario 'A. Gemelli', Università Cattolica del Sacro Cuore, Rome, Italy
| | - M Papini
- Department of Surgical and Biomedical Sciences, Dermatologic Clinic of Terni, University of Perugia, Perugia, Italy
| | - A Parodi
- IRCCS-AOU San Martino-IST, Dissal, Section of Dermatology, University of Genoa, Genoa, Italy
| | - F Bianchi
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - M Caproni
- Department of Surgery and Translational Medicine, Section of Dermatology, University of Florence, Florence, Italy
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Affiliation(s)
- C De Simone
- Retired Professor and former member of the Faculty of Medicine of the University of L'Aquila, Italy, Chateau d'Oex, 1660, Switzerland
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25
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Gisondi P, Altomare G, Ayala F, Conti A, Dapavo P, De Simone C, Foti C, Idolazzi L, Lubrano E, Malara G, Marchesoni A, Olivieri I, Parodi A, Peris K, Piaserico S, Salvarani C, Scarpa R, Girolomoni G. Consensus on the management of patients with psoriatic arthritis in a dermatology setting. J Eur Acad Dermatol Venereol 2018; 32:515-528. [PMID: 29220551 DOI: 10.1111/jdv.14741] [Citation(s) in RCA: 12] [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] [Received: 10/22/2017] [Accepted: 11/22/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with psoriasis (PsO). Early diagnosis and prompt therapeutic intervention are crucial for limiting PsA progression and prevention of disability. Dermatologists are in a privileged position to detect early PsA. The management of patients with PsA in the dermatology setting is widely variable. OBJECTIVE To provide practical recommendations for the management of patients with PsA in the dermatology setting including early diagnosis and treatment. METHODS A consensus document was written by an expert panel composed by dermatologists (n = 12) and rheumatologists (n = 6). Eleven highly relevant questions were selected and elaborated with answers/statements based on a narrative literature review. The resulting document was discussed in a face-to-face meeting adopting a nominal group technique to reach consensus (i.e. 100% agreement) using the Delphi method. RESULTS A consensus was achieved in defining the following: the clinical characteristics differentiating inflammatory and non-inflammatory signs and symptoms of joint disease; the most important differential diagnoses of PsA in clinical practice; the most useful screening questionnaires, serum laboratory tests and imaging techniques for the detection of early PsA; the criteria for dermatologist to refer patients with PsO to rheumatologist; the criteria for the diagnosis of PsA; the selection of the indices that the dermatologist could use for measuring the activity and severity of PsA in clinical practice; when systemic steroids and/or intra-articular steroid injections are indicated in the treatment of PsA. Finally, systemic treatments including synthetic and biologic disease-modifying antirheumatic drugs to be considered for the treatment of PsA have been reported. CONCLUSIONS The implementations of these practical recommendations could be very helpful for the management of patients with PsA in the dermatology setting including early diagnosis and treatment.
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Affiliation(s)
- P Gisondi
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - G Altomare
- I.R.C.C.S Istituto Ortopedico Galeazzi, Division of Dermatology and Venereology, University of Milan, Milan, Italy
| | - F Ayala
- Department of Dermatology, University of Naples Federico II, Naples, Italy
| | - A Conti
- Department of Head and Neck Surgery, Section of Dermatology, Azienda Ospedaliero Universitaria Policlinico di Modena, Modena, Italy
| | - P Dapavo
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - C De Simone
- Dermatology Department, Catholic University of the Sacred Heart, Rome, Italy
| | - C Foti
- Department of Biomedical Science and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy
| | - L Idolazzi
- Department of Medicine, Section of Rheumatology, University of Verona, Verona, Italy
| | - E Lubrano
- Dipartimento di Medicina e Scienze della Salute "Vincenzo Tiberio", Università degli Studi del Molise, Campobasso, Italy
| | - G Malara
- Unit of Dermatology, Azienda Ospedaliera Papardo, Messina, Italy
| | - A Marchesoni
- Department of Rheumatology, ASST Gaetano Pini-CTO, Milano, Italy
| | - I Olivieri
- Division of Rheumatology, Azienda Ospedaliera San Carlo, Potenza, Italy
| | - A Parodi
- Section of Dermatology, University of Genoa, Genoa, Italy
| | - K Peris
- Dermatology Department, Catholic University of the Sacred Heart, Rome, Italy
| | - S Piaserico
- Department of Medicine, Section of Dermatology, University of Padua, Padua, Italy
| | - C Salvarani
- Division of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, University of Modena and Reggio Emilia, Modena, Reggio Emilia, Italy
| | - R Scarpa
- Department of Medicine, Section of Rheumatology, University of Naples Federico II, Naples, Italy
| | - G Girolomoni
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
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26
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Caldarola G, De Simone C, Moretta G, Poscia A, Peris K. Role of personalized medication training in improving efficacy and adherence to a topical therapy in psoriatic patients. J DERMATOL TREAT 2017; 28:722-725. [DOI: 10.1080/09546634.2017.1328100] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- G. Caldarola
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - C. De Simone
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - G. Moretta
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - A. Poscia
- Department of Public Health, Section of Hygiene, Catholic University of the Sacred Heart, Rome, Italy
| | - K. Peris
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
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27
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Gisondi P, Altomare G, Ayala F, Bardazzi F, Bianchi L, Chiricozzi A, Costanzo A, Conti A, Dapavo P, De Simone C, Foti C, Naldi L, Offidani A, Parodi A, Piaserico S, Prignano F, Rongioletti F, Stingeni L, Talamonti M, Girolomoni G. Italian guidelines on the systemic treatments of moderate-to-severe plaque psoriasis. J Eur Acad Dermatol Venereol 2017; 31:774-790. [PMID: 28244153 DOI: 10.1111/jdv.14114] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 12/21/2016] [Indexed: 02/06/2023]
Abstract
Psoriasis is a common disease, which has a considerable impact on the healthcare system. Therefore, appropriate use of therapeutic resources is very important. Management of psoriasis in daily clinical practice is highly variable because many issues are still debated and not definitely addressed by the evidence-based medicine. Moreover, the different availability and reimbursability of drugs in each country justifies national guidelines. Expert consensus can provide helpful guidelines for optimizing patient care. A total of 20 dermatologists from different areas of Italy and with large experience in the treatment of psoriasis agreed to participate in the guidelines expert panel who aimed to reach consensus on the factors influencing psoriasis severity, the indications for systemic treatments, the parameters to be considered in the choice of treatment, and the factors to be considered in the choice of biological treatment. The recommendations for the use, screening and monitoring of systemic therapies were based on the 2015 S3 European Dermatology Forum/European Academy of Dermatology and Venereology psoriasis guidelines. Recommendations on the treatment of psoriasis in special patient populations were also agreed. The final document was discussed in a meeting moderated by a facilitator with participation of the entire group and adopting a nominal group technique to reach consensus. A statement was regarded as consented when agreement was achieved by at least 75% of the voting experts according to the Delphi procedure.
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Affiliation(s)
- P Gisondi
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - G Altomare
- Department of Dermatology and Venereology, I.R.C.C.S. Istituto Ortopedico Galeazzi, University of Milan, Milano, Italy
| | - F Ayala
- Department of Dermatology, University of Naples Federico II, Napoli, Italy
| | - F Bardazzi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - L Bianchi
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - A Chiricozzi
- Department of Dermatology, University of Pisa, Pisa, Italy
| | - A Costanzo
- Department of Dermatology, Humanitas Research Hospital, Rozzano, Italy
| | - A Conti
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - P Dapavo
- Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Turin, Turin, Italy
| | - C De Simone
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - C Foti
- Department of Biomedical Science and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy
| | - L Naldi
- Department of Dermatology, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - A Offidani
- Department of Clinical and Molecular Sciences, Dermatology Unit, Polytechnic Marche University, Ancona, Italy
| | - A Parodi
- Department of Dermatology, University of Genoa, Genova, Italy
| | - S Piaserico
- Department of Dermatology, University of Padua, Padova, Italy
| | - F Prignano
- Department of Dermatology, University of Florence, Firenze, Italy
| | - F Rongioletti
- Department of Medical Sciences and Public Health, Section of Dermatology, University of Cagliari, Cagliari, Italy
| | - L Stingeni
- Department of Medicine, Section of Clinical, Allergological and Venereological Dermatology, University of Perugia, Perugia, Italy
| | - M Talamonti
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - G Girolomoni
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
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28
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Galluzzo M, Talamonti M, Perino F, Servoli S, Giordano D, Chimenti S, De Simone C, Peris K. Bioelectrical impedance analysis to define an excess of body fat: evaluation in patients with psoriasis. J DERMATOL TREAT 2016; 28:299-303. [DOI: 10.1080/09546634.2016.1254326] [Citation(s) in RCA: 9] [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] [Indexed: 10/20/2022]
Affiliation(s)
- M. Galluzzo
- Department of Dermatology, University of Rome “Tor Vergata”, Rome, Italy
| | - M. Talamonti
- Department of Dermatology, University of Rome “Tor Vergata”, Rome, Italy
| | - F. Perino
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - S. Servoli
- Department of Dermatology, University of Rome “Tor Vergata”, Rome, Italy
| | - D. Giordano
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - S. Chimenti
- Department of Dermatology, University of Rome “Tor Vergata”, Rome, Italy
| | - C. De Simone
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - K. Peris
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
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Abstract
Most studies have reported reduced carnitine levels in the tissues of patients with sepsis, probably due to increased urinary excretion. Because of the increased utilization of fatty acids and ketone bodies as sources of energy in sepsis, the carnitine deficiency can further impair the fuel metabolism and contribute to the unregulated lipid metabolism in these patients. Recently, experimental and clinical studies have shown that carnitine and its congeners are able to: (a) downmodulate the spontaneous and endotoxin (LPS)-triggered overproduction of tumor necrosis factor (TNF)-alpha; (b) ameliorate the lipid metabolism; and (c) reduce the severity of illness, accelerate recovery, and, in some cases, improve survival in experimental septic shock. Many questions concerning the ultimate molecular mechanism of action of these compounds in endotoxaemia are still unanswered. Yet, these compounds may be helpful in patients with sepsis, when associated with conventional therapy, in that they can effectively reduce TNF-alpha levels and ameliorate the host's metabolic processes.
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Affiliation(s)
- G. Famularo
- Infectious Diseases, Department of Experimental Medicine, L'Aquila, Ospedale S., Camillo, Rome, Sigma Tau, Department of Research and Development, Pomezia and Immunology, Institute of Medical Microbiology, Policlinico, Bari, Italy
| | - C. De Simone
- Infectious Diseases, Department of Experimental Medicine, L'Aquila, Ospedale S., Camillo, Rome, Sigma Tau, Department of Research and Development, Pomezia and Immunology, Institute of Medical Microbiology, Policlinico, Bari, Italy
| | - E. Arrigoni Martelli
- Infectious Diseases, Department of Experimental Medicine, L'Aquila, Ospedale S., Camillo, Rome, Sigma Tau, Department of Research and Development, Pomezia and Immunology, Institute of Medical Microbiology, Policlinico, Bari, Italy
| | - E. Jirillo
- Infectious Diseases, Department of Experimental Medicine, L'Aquila, Ospedale S., Camillo, Rome, Sigma Tau, Department of Research and Development, Pomezia and Immunology, Institute of Medical Microbiology, Policlinico, Bari, Italy
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Serri F, De Simone C, Venier A, Rusciani L, Marchetti F. Combination of retinoids and PUVA (Re-PUVA) in the treatment of cutaneous T cell lymphomas. Curr Probl Dermatol 2015; 19:252-7. [PMID: 2404681 DOI: 10.1159/000418097] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- F Serri
- Department of Dermatology, Catholic University of Sacred Heart, Rome, Italy
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Quaglino P, Fava P, Caproni M, Antiga E, De Simone C, Papini M, Parodi A, Novelli M, Osella-Abate S, Ribero S, Sanlorenzo M, Ponti R, Fierro M, Marzano A, Savoia P. Phenotypical characterization of circulating cell subsets in pyoderma gangrenosum patients: the experience of the Italian immuno-pathology group. J Eur Acad Dermatol Venereol 2015; 30:655-8. [DOI: 10.1111/jdv.13100] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 02/17/2015] [Indexed: 12/18/2022]
Affiliation(s)
- P. Quaglino
- Dermatologic Clinic; Department of Medical Sciences; University of Turin; Turin Italy
| | - P. Fava
- Dermatologic Clinic; Department of Medical Sciences; University of Turin; Turin Italy
| | - M. Caproni
- Section of Dermatology; Department of Surgery and Translational Medicine; University of Florence; Florence Italy
| | - E. Antiga
- Section of Dermatology; Department of Surgery and Translational Medicine; University of Florence; Florence Italy
| | - C. De Simone
- Dermatologic Clinic; Catholic University of the Sacred Heart; Rome Italy
| | - M. Papini
- Dermatologic Clinic; Department of Surgical and Biomedical Sciences; University of Terni; Terni Italy
| | - A. Parodi
- Section of Dermatology; DISSAL; IRCCS San Martino- IST; Genoa Italy
| | - M. Novelli
- Dermatologic Clinic; Department of Medical Sciences; University of Turin; Turin Italy
| | - S. Osella-Abate
- Dermatologic Clinic; Department of Medical Sciences; University of Turin; Turin Italy
| | - S. Ribero
- Dermatologic Clinic; Department of Medical Sciences; University of Turin; Turin Italy
| | - M. Sanlorenzo
- Dermatologic Clinic; Department of Medical Sciences; University of Turin; Turin Italy
| | - R. Ponti
- Dermatologic Clinic; Department of Medical Sciences; University of Turin; Turin Italy
| | - M.T. Fierro
- Dermatologic Clinic; Department of Medical Sciences; University of Turin; Turin Italy
| | - A.V. Marzano
- Dermatologic Clinic; Department of Medical and Surgical Physiopathology and Transplants; IRCCS Cà Granda Foundation; University of Milan Policlinic; Milan Italy
| | - P. Savoia
- Dermatologic Clinic; Department of Medical Sciences; University of Turin; Turin Italy
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De Simone C, Farina M, Maiorino A, Fanali C, Perino F, Flamini A, Caldarola G, Sgambato A. TNF-alpha gene polymorphisms can help to predict response to etanercept in psoriatic patients. J Eur Acad Dermatol Venereol 2015; 29:1786-90. [DOI: 10.1111/jdv.13024] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 01/12/2015] [Indexed: 11/28/2022]
Affiliation(s)
- C. De Simone
- Department of Dermatology; Catholic University of the Sacred Heart; Rome Italy
| | - M. Farina
- Institute of General Pathology; Catholic University of the Sacred Heart; Rome Italy
| | - A. Maiorino
- Department of Dermatology; Catholic University of the Sacred Heart; Rome Italy
| | - C. Fanali
- Institute of General Pathology; Catholic University of the Sacred Heart; Rome Italy
| | - F. Perino
- Department of Dermatology; Catholic University of the Sacred Heart; Rome Italy
| | - A. Flamini
- Institute of General Pathology; Catholic University of the Sacred Heart; Rome Italy
| | - G. Caldarola
- Department of Dermatology; Catholic University of the Sacred Heart; Rome Italy
| | - A. Sgambato
- Institute of General Pathology; Catholic University of the Sacred Heart; Rome Italy
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Bardazzi F, Amerio P, Amoruso G, Campanati A, Conti A, De Simone C, Gisondi P, Gualdi G, Guarneri C, Loconsole F, Mazzotta A, Musumeci ML, Odorici G, Piaserico S, Potenza C, Scudeller L. Investigating psoriasis awareness among patients in Italy: validation of a questionnaire. Eur Rev Med Pharmacol Sci 2014; 18:3435-3452. [PMID: 25491619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Psoriasis can have a profound impact on quality of life (QoL) and an awareness of the processes of the disease and its treatment is important in coping with symptoms. Patients do not always understand the potential consequences of their disease and the wide range of effective treatment strategies now available. We designed and validated a questionnaire to investigate patient awareness and understanding of psoriasis including pathogenesis, diagnosis, prognosis and treatment. PATIENTS AND METHODS This was a multicentre, cross-sectional investigation involving 14 psoriasis referral centres in Italy. The focus group technique was used by a panel of experts in psoriasis, to draw-up a list of questions exploring pathogenesis, diagnosis, prognosis, factors influencing clinical course of psoriasis as well as QoL issues and sources of information on their condition. Psychometric properties of the questionnaire were tested on a sample of 240 adult patients with psoriasis (including treatment-naïve and -experienced patients). RESULTS The mean age of patients was 50.3±14.9 years and 34.2% were female. The median time from diagnosis was 13.7 years (IQR 7.3-23.2). The Cronbach alpha was 0.77 and all items showed higher correlations within their own dimensions than to other dimensions. Each domain of awareness was well represented by a single dimension. Mean overall awareness was 59.7±13.1 on a 100-point scale. CONCLUSIONS Our questionnaire was valid in assessing patient awareness in five relevant areas of psoriasis, and can be useful in both the clinical setting and research studies to evaluate patients' knowledge of psoriasis better, with the final aim of reducing the burden of this chronic condition.
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Affiliation(s)
- F Bardazzi
- Department of Experimental, Diagnostic and Specialty Medicine, St. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.
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Crosta ML, Caldarola G, Fraietta S, Craba A, Benedetti C, Coco V, Janiri L, Rinaldi L, De Simone C. Psychopathology and eating disorders in patients with psoriasis. GIORN ITAL DERMAT V 2014; 149:355-361. [PMID: 24819764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM Psoriasis is a multifactorial chronic inflammatory skin disease that often occurs in patients who are overweight or obese. In literature the connections between obesity and eating disorders are well known, but few studies have investigated the link between eating disorders and psoriasis. We hypothesized that Eating Disorders (ED) can be considered a psychogenic cofactors, which contribute to the development of obesity and metabolic syndrome in psoriatic patients, who are frequently prone to psychiatric comorbidity. METHODS From January to April 2011 we enrolled 100 consecutive psoriatic outpatients and a control group of 100 selected non-psoriatic outpatients, matched by age, gender, and BMI to the study group. The assessment battery was composed by the Psoriasis Area Severity Index (PASI) score, the Eating Disorder Inventory (EDI) and the Symptom Checklist-90 Revised (SCL-90-R®). RESULTS Our data showed that most of EDI and SCL-90R subscales was mostly altered in psoriatic population compared to patients without psoriasis. Moreover, we noticed in patients with psoriasis an association between the progressive weight increase and an impairment on most of EDI subscales. CONCLUSION Psoriasis is associated with psychopathological traits, which are frequently found in EDs. Since obesity makes psoriasis less susceptible to therapy and weight loss improves drug response, dermatologists should be alert to suspect the presence of this condition.
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Affiliation(s)
- M L Crosta
- Institute of Psychiatry Catholic University of the Sacred Heart, Rome, Italy -
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Dellegrottaglie S, Russo G, Damiano M, Pagliano P, Ferrara L, De Simone C, Guarini P. A case of acute myocarditis associated with Chlamydia trachomatis infection: role of cardiac MRI in the clinical management. Infection 2014; 42:937-40. [DOI: 10.1007/s15010-014-0631-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 05/10/2014] [Indexed: 11/24/2022]
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Gisondi P, Amerio P, Amoroso GF, Antonucci VA, Bardazzi F, Buongiorno MR, Bruni P, Campanati A, Caproni M, Carlesimo M, Carrera CG, Cianchino G, Cimmino G, Costanzo A, Cozzani E, Dapavo P, D'amico D, De Simone C, Del Giglio M, Di Nuzzo S, Gai F, Galluccio AG, Goffredo A, Gualdi G, Guarneri C, Kokelj F, Lasagni C, Loconsole F, Longo V, Malagoli P, Miracapillo A, Mugheddu C, Parodi A, Pellegrino M, Peserico A, Piaserico S, Pistone G, Potenza C, Plumari A, Stingeni L, Strippoli D, Travaglino M, Girolomoni G. Optimization of systemic treatments for chronic plaque psoriasis. Recommendations for switching and transitioning. GIORN ITAL DERMAT V 2013; 148:1-10. [PMID: 24675369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The aim of this study was to provide practical recommendations for optimizing the use of conventional and biological systemic treatments for moderate-severe chronic plaque psoriasis, particularly in case of transitioning and switching. METHODS A total number of 147 dermatologists from 33 different countries including Italy achieved consensus in providing practical recommendations for the use of conventional and biological treatments for moderate to severe psoriasis based on systematic literature review and/or expert opinion. RESULTS In general, the continuous treatment regimen should be preferred in order to achieve a complete and long-term control of psoriasis. However, the treatment could be stopped or the dose reduced in case of complete disease clearance. A conventional drug could be associated to biological treatment in selected cases. Transitioning and/or switching could be considered in case of inefficacy or intolerance. A period of wash up is required if transitioning or switching is due to safety issues. CONCLUSION This study provides practical suggestions for the optimal use of conventional and biological treatments for chronic plaque psoriasis.
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Affiliation(s)
- P Gisondi
- Clinica Dermatologica, Università degli Studi di Verona, Verona, Italia -
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Gisondi P, Conti A, Galdo G, Piaserico S, De Simone C, Girolomoni G. Ustekinumab does not increase body mass index in patients with chronic plaque psoriasis: a prospective cohort study. Br J Dermatol 2013; 168:1124-7. [PMID: 23320916 DOI: 10.1111/bjd.12235] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Chronic plaque psoriasis is frequently associated with metabolic disorders including obesity. Antitumour necrosis factor α treatments can induce body-weight increase in patients with psoriasis. Information on the effect of ustekinumab on body weight is not available. OBJECTIVES To investigate whether therapy with ustekinumab is associated with changes in body mass index (BMI) in patients with chronic plaque psoriasis. METHODS A prospective, multicentre study comparing the changes in BMI in two closed cohorts of patients with psoriasis during 7-month treatment with ustekinumab (n = 79) or infliximab (n = 83). RESULTS Patients treated for 7 months with infliximab showed a significant (P < 0.001) increase in mean BMI (2.1 ± 4.5%) and body weight (2.5 ± 3.3 kg) compared with patients treated with ustekinumab (0.1 ± 3.3%; 0.6 ± 1.1 kg). Some 45% of patients treated with infliximab had a BMI increase > 2%, compared with only 11% of those receiving ustekinumab (P = 0.01). In the multivariate analysis, all other clinical parameters predicted the BMI increase, except for the use of infliximab. At month 7, 96% of patients treated with infliximab and 82% of patients treated with ustekinumab achieved at least a 50% improvement from their baseline psoriasis area and severity index (PASI 50), and 69% of the infliximab group compared with 58% of the ustekinumab group achieved at least PASI 75. There was no difference in the proportion of PASI 50 and PASI 75 responders between the two groups. CONCLUSIONS In contrast to infliximab, ustekinumab does not increase BMI in patients with chronic plaque psoriasis. This difference could be taken into account in the selection of biologics when treating patients with psoriasis.
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Affiliation(s)
- P Gisondi
- Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy.
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De Simone C, Sollena P, Coco V, Caldarola G. Psoriasis and erythema nodosum: two comorbidities of inflammatory bowel diseases. GIORN ITAL DERMAT V 2013; 148:175-184. [PMID: 23588143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Extra-intestinal manifestations are a relatively common complications of Inflammatory Bowel Diseases (IBD) and skin is one of the organs most commonly affected. Cutaneous findings in IBD patients may be related to different pathogenetic mechanisms and in some cases the etiologic link has not been fully elucidated. In particular, this is the case of psoriasis and erythema nodosum, two of the most frequent skin diseases observed in IBD patients. Aim of this paper was to review the epidemiology and the possible pathogenetic mechanisms implicated in the occurrence of these two dermatosis. In particular, an association between IBD and psoriasis has been observed in several epidemiological studies: psoriasis occurs in about 1-2% of the general population, compared with 3-11% of patients with IBD. Several studies have also evaluated the prevalence of IBD in psoriatic patients, with contrasting results. A common pathogenic pathways between these two conditions seems to be sustained by the responsiveness to therapy with biological treatments, such as anti-Tumor Necrosis Factor (TNF)-alpha agents and ustekinumab (a monoclonal antibody against p40 subunit common to IL-12 and IL-23). On the other hand, although usually idiopathic in half of the patients, erythema nodosum has been associated with a variety of disorders and conditions and IBD accounts for 1-4% of cases.
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Affiliation(s)
- C De Simone
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy.
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De Simone C, Caldarola G, Coco V, Palumbo S, Pocino K, Sgambato A, Maiorino A, Corbi M, Sandri MT, Vendittelli F, Capoluongo E. Circulating endothelial cell levels in psoriatic patients and their modification after an anti-TNF-alpha (Etanercept) treatment. J Eur Acad Dermatol Venereol 2013; 28:590-6. [PMID: 23506557 DOI: 10.1111/jdv.12140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Accepted: 02/18/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Endothelial function in psoriatic patients has been mainly evaluated through a high-resolution ultrasound measurement of flow-mediated vasodilation in the brachial artery, which is an operator-dependent and technically demanding technique: this characteristic, together with different patient selection criteria, could account for the conflicting results emerging from different studies. Recently, Circulating Endothelial Cells (CECs) level has been suggested as a novel biomarker of vascular injury. METHODS The number of CECs was determined by a semi-automated immunomagnetic system (CellSearch system) in peripheral blood of psoriatic patients (n = 48) and healthy subjects (n = 50). In 15 patients, CEC level was also evaluated after 6 months of treatment with an anti-TNF-alpha agent, Etanercept. The plasma levels of high-sensitivity C-reactive Protein (CRP), E-selectin, VEGF and PAI-1 were measured by ELISA. The psoriasis severity was assessed by PASI score. RESULTS A statistically significant difference (P = 0.001) was found between CEC level in psoriatic patients (10.6 ± 9.4 cells/mL) vs. the control group (3.9 ± 0.9 cells/mL). This count inversely correlated with sE-selectin levels (r(2) = 0.16; P = 0.03). After 6 months of therapy, patients experienced a significant (P < 0.05) decrease in CEC levels (3.4 ± 1.3 cells/mL) and in PASI score (from 11.7 ± 8.1 to 2.1 ± 4.0). CONCLUSIONS The elevated CECs level that we found in a sample of high selected psoriatic patients could be expression of endothelial damage. Lowering of CECs count after treatment with Etanercept support the hypothesis that an effective systemic therapy of psoriasis may also improve the endothelial function.
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Affiliation(s)
- C De Simone
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
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Crosta M, Fraietta S, Craba A, Caldarola G, Sollena P, Benedetti C, De Simone C, Rinaldi L. 2553 – Eating disorders in psoriatic patients. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)77234-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Abstract
Current research continues to improve the treatment options available to clinicians for oral bacteriotherapy. Recently, a greater understanding of the role of endogenous digestive microflora has generated renewed interest in the potential of oral bacteriotherapy for the management of a wide spectrum of gastrointestinal and systemic disorders. Several treatment strategies for oral bacteriotherapy have already entered clinical trials and it is hoped that some of these strategies will become widely available in the near future. This review summarises the current status of oral probiotic preparations for bacteriotherapy and discusses any obstacles to their successful clinical development. Newer probiotic preparations include high potency preparations that are greatly enriched in lactic acid bacteria, both in terms of bacterial concentrations and the number of bacterial strains. These preparations have a greater potential for clinical effectiveness than traditional preparations and are entering clinical evaluation especially in patients with inflammatory bowel disease and pouchitis, irritable bowel syndrome, or cryptosporidiosis. The pitfalls of previous clinical investigations of traditional probiotic preparations and the perils of future clinical trials with high potency preparations are discussed in the context of unmet needs and realistic expectations of success. Although considerable progress has been made in oral bacteriotherapy, focused efforts by basic scientists and clinical investigators and continued support from pharmaceutical companies is required to successfully develop probiotics for use in clinical medicine. Newer high potency probiotic preparations appear to have a great advantage over traditional preparations and should be the area of most active biomedical research in the field.
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De Simone C, Maiorino A, Tassone F, D’Agostino M, Caldarola G. Tacrolimus 0.1% ointment in nail psoriasis: a randomized controlled open-label study. J Eur Acad Dermatol Venereol 2012; 27:1003-6. [DOI: 10.1111/j.1468-3083.2012.04642.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Garcovich S, Ruggeri A, D'Agostino M, Ardito F, De Simone C, Delogu G, Fadda G. Clinical applicability of Quantiferon-TB-Gold testing in psoriasis patients during long-term anti-TNF-alpha treatment: a prospective, observational study. J Eur Acad Dermatol Venereol 2011; 26:1572-6. [PMID: 21923840 DOI: 10.1111/j.1468-3083.2011.04220.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Psoriasis patients who are treated with tumour necrosis factor (TNF)-alpha antagonists are at increased risk of reactivation of latent tuberculosis infection (LTBI) and should be adequately screened and monitored during active treatment. OBJECTIVES To evaluate in a prospective study, the performance of Quantiferon-TB-Gold in tube (QFT) in vitro assay compared to the conventional tuberculin skin test (TST) in detecting LTBI among a cohort of non-BCG-vaccinated patients with moderate-to-severe psoriasis during long-term treatment (12 months) with TNF-alpha antagonists. METHODS A total of 50 patients underwent QFT and TST testing at baseline and after 6 and 12 months of continuous anti-TNF-alpha treatment. Diagnosis of LTBI was made on the basis of a positive QFT result and negative chest-radiographic and microbiological assays. Patients with LTBI were subjected to standard isoniazid chemoprophylaxis and after 1 month, they resumed anti-TNF-alpha treatment with subsequent QFT and TST testing after 6 months. In all the cases, a follow-up period of 12 months was observed. RESULTS During the 12-month-study period, 14% of patients presented a QFT conversion. During active anti-TNF-alpha treatment, a QFT conversion was observed in 10% of patients (five cases). Agreement between QFT and TST was moderate (κ=0.408) at screening, good (κ=0.734) after 6 months and fair (κ=0.328) after 12 months of treatment. A total of 18% of patients presented a positive, discordant TST during the study period. CONCLUSIONS A single-test QFT-based screening strategy for LTBI in psoriasis patients receiving long-term anti-TNF-alpha treatment could reduce the incidence of false-positive LTBI cases, preventing unnecessary TB chemoprophylaxis.
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Affiliation(s)
- S Garcovich
- Department of Internal Medicine and Specialist Sciences, Institute of Dermatology, A. Gemelli University Hospital, Catholic University of Sacred Heart, Rome, Italy.
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Bentivoglio A, Fasano A, Piano C, Soleti F, Daniele A, Zinno M, Piccinini C, De Simone C, Tufo T, Meglio M, Cioni B. P7.15 The motor and cognitive effects of extradural motor cortex stimulation for Parkinson's disease: a 1-year prospective open-label study. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60325-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Viladomiu M, Pedragosa M, De Simone C, Hontecillas R, Bassaganya-riera J. VSL#3 and conjugated linoleic acid ameliorate colitis and inflammation-driven colorectal cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Antiga E, Quaglino P, Bellandi S, Volpi W, Del Bianco E, Comessatti A, Osella-Abate S, De Simone C, Marzano A, Bernengo MG, Fabbri P, Caproni M. Regulatory T cells in the skin lesions and blood of patients with systemic sclerosis and morphoea. Br J Dermatol 2010; 162:1056-63. [PMID: 20105169 DOI: 10.1111/j.1365-2133.2010.09633.x] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Systemic sclerosis (SSc) and morphoea are connective tissue diseases characterized by fibrosis of the skin. Although to date their pathogenesis has not been clearly defined, it is thought that autoimmunity may play a role in the development of the skin lesions observed in both these diseases. As regulatory T cells (Tregs) play a key role in the modulation of immune responses, it has recently been suggested that Treg impairment may lead to the development of autoimmune diseases. OBJECTIVES To investigate the presence of Tregs and their immunomodulatory cytokines, transforming growth factor (TGF)-beta and interleukin (IL)-10, in patients with SSc and morphoea. PATIENTS/METHODS Fifteen patients with SSc and 15 with morphoea were enrolled. Immunohistochemistry was applied to identify FoxP3+ (forkhead/winged helix transcription factor) Tregs, TGF-beta+ cells and IL-10+ cells in the skin, cytofluorometry to detect CD4+CD25+FoxP3+ Tregs in the blood, and enzyme-linked immunosorbent assays to analyse TGF-beta and IL-10 serum levels. RESULTS Fewer FoxP3+ Tregs and TGF-beta+ and IL-10+ cells were found in the skin of patients with scleroderma than in controls. Similarly, there were reduced TGF-beta and IL-10 serum levels and fewer circulating CD4+CD25brightFoxP3+ cells in patients with SSc or morphoea, than in controls. CONCLUSIONS The quantitative reduction of Tregs, together with that of TGF-beta and IL-10 serum levels, may be responsible for the loss of tolerance observed in both SSc and morphoea.
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Affiliation(s)
- E Antiga
- Department of Dermatological Sciences, University of Florence, Via della Pergola 58/60, 50121 Florence, Italy
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Caldarola G, De Simone C, Carbone A, Tulli A, Amerio P, Feliciani C. TNFα and its Receptors in Psoriatic Skin, before and after Treatment with Etanercept. Int J Immunopathol Pharmacol 2009; 22:961-6. [DOI: 10.1177/039463200902200411] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Psoriasis is a chronic inflammatory skin condition characterized by inflammatory dermal infiltrate and hyperproliferative keratinocytes. The pathogenesis of this disease is mediated by a dysregulation of the innate immunity and cytokine production. Tumor Necrosis Factor alpha (TNFα) is considered the most important cytokine involved in the pathological mechanism of psoriasis. Recently, several therapies have been introduced for the treatment of psoriasis that try to block TNF alpha activity. Among these treatments Etanercept is a fusion protein that specifically targets TNF alpha. We performed a study on twelve psoriatic patients aimed at evaluating the effect of Etanercept treatment on the production and expression of TNFα and its receptors, in lesional and uninvolved psoriatic skin. We demonstrated that after three month of Etanercept treatment at 50 mg/wk, TNF, TNF-RI and TNF-RII immunostaining in lesional and non-lesional skin samples of patients was greatly reduced, suggesting that this treatment not only acts on stable lesional plaques, but also at a very early stage of the disease.
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Affiliation(s)
| | | | | | - A. Tulli
- Dermatology Department, University of Chieti-Pescara, Chieti, Italy
| | - P. Amerio
- Dermatology Department, University of Chieti-Pescara, Chieti, Italy
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Feliciani C, De Simone C, Amerio P. Dermatological signs during inflammatory bowel diseases. Eur Rev Med Pharmacol Sci 2009; 13 Suppl 1:15-21. [PMID: 19530507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Crohn disease (CD) and UI-cerative Colitis (UC) are characterized by ulcerative lesions of the bowel. Some patients show similar lesions of the skin or oral and/or perianal mucosa. Sometimes these lesions, or some other skin lesions are the first sign of bowel disease. Dermatologists could suspect an inflammatory bowel disease (IBD) during skin lesions such as pyoderma gangrenosum (PG) or erythema nodosum (EN). These entities are very well known by dermatologists and its role is to diagnose internal chronic disease associated to EN or PG. Depending on the associated disease the treatment may vary from steroids to anti TNF biologics.
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Affiliation(s)
- C Feliciani
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy.
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Vena G, Galluccio A, De Simone C, Mastrandrea V, Buquicchio R, La Greca S, Dattola S, Guerra AP, Donato L, Cantoresi F, De Pità O, Pezza M, D'Agostino M, Vernaci R, Miracapillo A, Valenti G, Cassano N. A Multicenter Open-Label Experience on the Response of Psoriasis to Adalimumab and Effect of Dose Escalation in Non-Responders: The Aphrodite Project. Int J Immunopathol Pharmacol 2009; 22:227-33. [DOI: 10.1177/039463200902200125] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
There is much evidence to show the efficacy of adalimumab, a human monoclonal antibody targeting tumour necrosis factor-alpha, in the treatment of plaque psoriasis. In this open-label experience, 147 high-need patients suffering from plaque psoriasis, with a mean Psoriasis Area and Severity Index (PASI) of 18.8, and concomitant psoriatic arthritis (PsA) received subcutaneous injections of 40 mg of adalimumab every other week (EOW). This was actually the dosage regimen recommended for PsA, as the drug had not then been approved for psoriasis at the time of the patients' enrolment. At week 12, an improvement of at least 50% of the PASI (PASI-50) was observed in 111 (77%) patients. Continuation of treatment in responders with adalimumab 40 mg EOW led to a sustained response, with the PASI-50 achieved by 97% of patients in the as-treated analysis at week 24 (PASI-75 in 82% and PASI-90 in 45% out of 109 patients who received EOW injections up to week 24). Thirty subjects who failed to attain the PASI-50 response at week 12 were treated with adalimumab 40 mg every week for a further 12 weeks. At week 24, 80% of these patients obtained a PASI-50 response after dose escalation. Tolerability was good in the majority of patients. Only two patients discontinued treatment because of an adverse event (repeated flu-like episodes and a pleuropericarditis of unknown origin, respectively).
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Affiliation(s)
| | - A. Galluccio
- Unit of Dermatology, Ospedale Fatebenefratelli, Benevento
| | - C. De Simone
- Dermatology Clinic, University ‘Sacro Cuore’, Rome
| | | | | | - S. La Greca
- Dermatology Unit, Ospedale Garibaldi, Catania
| | - S. Dattola
- Dermatology Unit, Melito Porto Salvo (RC)
| | | | | | - F. Cantoresi
- Dermatology Clinic, University ‘La Sapienza’, Rome
| | - O. De Pità
- Istituto Dermopatico dell' lmmacolata; IRCCS, Rome
| | - M. Pezza
- Unit of Dermatology, Ospedale Fatebenefratelli, Benevento
| | | | - R. Vernaci
- Dermatology Unit, Melito Porto Salvo (RC)
| | - A. Miracapillo
- Dermatology Unit, Ospedale Miulli, IRCCS, Acquaviva delle Fonti (BA)
| | - G. Valenti
- Dermatology Unit, Ospedale Pugliese Ciaccio, Catanzaro, Italy
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De Simone C, Caldarola G, D’agostino M, Zampetti A, Amerio P, Feliciani C. Exacerbation of pemphigus after influenza vaccination. Clin Exp Dermatol 2008; 33:718-20. [DOI: 10.1111/j.1365-2230.2008.02835.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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