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2. Long-term proactive management of psoriasis with calcipotriol and betamethasone dipropionate foam: an Italian consensus through a combined nominal group technique and Delphi approach

Author

De Simone, Clara, Dapavo, Paolo, Malagoli, Piergiorgio, Martella, Alessandro, Campanati, Anna, Campione, Elena, Errichetti, Enzo, Franchi, Chiara, Gambardella, Alessio, Megna, Matteo, Osti, Federica, Ribero, Simone, Zagni, Giovanni, Calzavara-Pinton, Piergiacomo, Fabbrocini, Gabriella, Amoruso, Giuseppe Fabrizio, Baglieri, Francesco, Biamonte, Anna Silvia, Bianchelli, Tommaso, Bigi, Laura, Bortoli, Jarno, Brunetti, Bruno, Buligan, Cinzia, Cagni, Elisabetta, Calderoni, Ombretta, Caputo, Alighiero, Carrera, Carlo Giovanni, Carugno, Andrea, Chersi, Karin, Cicchelli, Stefano, De Natale, Flora, Di Maria, Domenico, Ferrari, Angelo Salvatore, Fogli, Emanuela, Forconi, Riccardo, Galeazzi, Augusto, Giovannini, Andrea, Giura, Maria Teresa, Iuculano, Massimo, Lazzaretti, Giuseppe, Leporati, Claudia, Magnanini, Massimiliano, Marconi, Barbara, Maruccia, Adriana, Miglietta, Roberta, Minuti, Anna, Mocci, Luigi, Modica, Sonia, Narcisi, Alessandra, Odorici, Giulia, Pazzaglia, Massimiliano, Peila, Rossana, Pertusi, Ginevra, Pezza, Michele, Pezzullo, Elio, Puccia, Nunzio, Raulo, Umberto, Rossi, Mariateresa, Rusignuolo, Sergio, Sapienza, Giada, Savarese, Catello, Scalisi, Mariaelena, Strippoli, Davide, Stroppiana, Elena, Tiberio, Rossana, Trischitta, Antonino, Tucci, Maria Giovanna, Vaira, Fabrizio, Verrone, Anna, Villa, Lucia, Zagni, Fabio, Zoccali, Andrea, De Simone, C, Dapavo, P, Malagoli, P, Martella, A, Campanati, A, Campione, E, Errichetti, E, Franchi, C, Gambardella, A, Megna, M, Osti, F, Ribero, S, Zagni, G, Calzavara-Pinton, P, Fabbrocini, G, Amoruso, G, Baglieri, F, Biamonte, A, Bianchelli, T, Bigi, L, Bortoli, J, Brunetti, B, Buligan, C, Cagni, E, Calderoni, O, Caputo, A, Carrera, C, Carugno, A, Chersi, K, Cicchelli, S, De Natale, F, Di Maria, D, Ferrari, A, Fogli, E, Forconi, R, Galeazzi, A, Giovannini, A, Giura, M, Iuculano, M, Lazzaretti, G, Leporati, C, Magnanini, M, Marconi, B, Maruccia, A, Miglietta, R, Minuti, A, Mocci, L, Modica, S, Narcisi, A, Odorici, G, Pazzaglia, M, Peila, R, Pertusi, G, Pezza, M, Pezzullo, E, Puccia, N, Raulo, U, Rossi, M, Rusignuolo, S, Sapienza, G, Savarese, C, Scalisi, M, Strippoli, D, Stroppiana, E, Tiberio, R, Trischitta, A, Tucci, M, Vaira, F, Verrone, A, Villa, L, Zagni, F, Zoccali, A, De Simone, Clara, Dapavo, Paolo, Malagoli, Piergiorgio, Martella, Alessandro, Campanati, Anna, Campione, Elena, Errichetti, Enzo, Franchi, Chiara, Gambardella, Alessio, Megna, Matteo, Osti, Federica, Ribero, Simone, Zagni, Giovanni, Calzavara-Pinton, Piergiacomo, Fabbrocini, Gabriella, Amoruso, Giuseppe Fabrizio, Baglieri, Francesco, Biamonte, Anna Silvia, Bianchelli, Tommaso, Bigi, Laura, Bortoli, Jarno, Brunetti, Bruno, Buligan, Cinzia, Cagni, Elisabetta, Calderoni, Ombretta, Caputo, Alighiero, Carrera, Carlo Giovanni, Carugno, Andrea, Chersi, Karin, Cicchelli, Stefano, De Natale, Flora, Di Maria, Domenico, Ferrari, Angelo Salvatore, Fogli, Emanuela, Forconi, Riccardo, Galeazzi, Augusto, Giovannini, Andrea, Giura, Maria Teresa, Iuculano, Massimo, Lazzaretti, Giuseppe, Leporati, Claudia, Magnanini, Massimiliano, Marconi, Barbara, Maruccia, Adriana, Miglietta, Roberta, Minuti, Anna, Mocci, Luigi, Modica, Sonia, Narcisi, Alessandra, Odorici, Giulia, Pazzaglia, Massimiliano, Peila, Rossana, Pertusi, Ginevra, Pezza, Michele, Pezzullo, Elio, Puccia, Nunzio, Raulo, Umberto, Rossi, Mariateresa, Rusignuolo, Sergio, Sapienza, Giada, Savarese, Catello, Scalisi, Mariaelena, Strippoli, Davide, Stroppiana, Elena, Tiberio, Rossana, Trischitta, Antonino, Tucci, Maria Giovanna, Vaira, Fabrizio, Verrone, Anna, Villa, Lucia, Zagni, Fabio, and Zoccali, Andrea

Subjects
Aerosols, long-term, proactive management, Dermatology, psoriasis, Betamethasone, Drug Combinations, Treatment Outcome, Recurrence, consensus, Cal/BD, adherence, consensu, Humans, Dermatologic Agents, psoriasi
Abstract

Background: Although long-term management of psoriasis is paramount, this approach is challenging in clinical practice. In the recent PSO-LONG trial, a fixed-dose combination of betamethasone dipropionate (BD) and calcipotriol (Cal) foam applied twice a week on non-consecutive days for 52 weeks (proactive treatment) reduced the risk of relapse. However, the role of Cal/BD foam in the long-term management of psoriasis needs further clarifications. The ProActive Management (PAM) program, a nationwide Italian project, aims at reaching a consensus on the role of proactive management of psoriasis. Methods: A steering committee generated some statements through the nominal group technique (NGT). The statements were voted by an expert panel in an adapted Delphi voting process. Results: Eighteen statements were proposed, and the majority of them (14/18) reached a consensus during the Delphi voting. The need to provide long-term proactive topical treatment to reduce the risk of relapse for the treatment of challenging diseases sites or in patients where phototherapy or systemic therapies are contraindicated/ineffective was widely recognized. A consensus was reached about the possibility to associate the proactive treatment with systemic and biological therapies, without the need for dose intensification, thus favoring a prolonged remission. Moreover, the proactive treatment was recognized as more effective than weekend therapy in increasing time free from relapses. Approaches to improve adherence, on the other hand, need further investigation. Conclusions: The inclusion in guidelines of a proactive strategy among the effective treatment options will be a fundamental step in the evolution of a mild-moderate psoriasis therapeutic approach.

Published
2022

3. Long-term proactive management of psoriasis with calcipotriol and betamethasone dipropionate foam: an Italian consensus through a combined nominal group technique and Delphi approach.

Author

De Simone C, Dapavo P, Malagoli P, Martella A, Campanati A, Campione E, Errichetti E, Franchi C, Gambardella A, Megna M, Osti F, Ribero S, Zagni G, Calzavara-Pinton P, Fabbrocini G, Amoruso GF, Baglieri F, Biamonte AS, Bianchelli T, Bigi L, Bortoli J, Brunetti B, Buligan C, Cagni E, Calderoni O, Calzavara-Pinton P, Campanati A, Caputo A, Carrera CG, Carugno A, Chersi K, Cicchelli S, De Natale F, De Simone C, Dapavo P, Di Maria D, Errichetti E, Fabbrocini G, Ferrari AS, Fogli E, Forconi R, Franchi C, Galeazzi A, Gambardella A, Giovannini A, Giura MT, Iuculano M, Lazzaretti G, Leporati C, Magnanini M, Malagoli P, Marconi B, Martella A, Maruccia A, Megna M, Miglietta R, Minuti A, Mocci L, Modica S, Narcisi A, Odorici G, Osti F, Pazzaglia M, Peila R, Pertusi G, Pezza M, Pezzullo E, Puccia N, Raulo U, Ribero S, Rossi M, Rusignuolo S, Sapienza G, Savarese C, Scalisi M, Strippoli D, Stroppiana E, Tiberio R, Trischitta A, Tucci MG, Vaira F, Verrone A, Villa L, Zagni F, and Zoccali A

Subjects
Humans, Consensus, Betamethasone, Aerosols, Treatment Outcome, Recurrence, Drug Combinations, Dermatologic Agents therapeutic use, Psoriasis drug therapy
Abstract

Background: Although long-term management of psoriasis is paramount, this approach is challenging in clinical practice. In the recent PSO-LONG trial, a fixed-dose combination of betamethasone dipropionate (BD) and calcipotriol (Cal) foam applied twice a week on non-consecutive days for 52 weeks (proactive treatment) reduced the risk of relapse. However, the role of Cal/BD foam in the long-term management of psoriasis needs further clarifications. The ProActive Management (PAM) program, a nationwide Italian project, aims at reaching a consensus on the role of proactive management of psoriasis., Methods: A steering committee generated some statements through the nominal group technique (NGT). The statements were voted by an expert panel in an adapted Delphi voting process., Results: Eighteen statements were proposed, and the majority of them (14/18) reached a consensus during the Delphi voting. The need to provide long-term proactive topical treatment to reduce the risk of relapse for the treatment of challenging diseases sites or in patients where phototherapy or systemic therapies are contraindicated/ineffective was widely recognized. A consensus was reached about the possibility to associate the proactive treatment with systemic and biological therapies, without the need for dose intensification, thus favoring a prolonged remission. Moreover, the proactive treatment was recognized as more effective than weekend therapy in increasing time free from relapses. Approaches to improve adherence, on the other hand, need further investigation., Conclusions: The inclusion in guidelines of a proactive strategy among the effective treatment options will be a fundamental step in the evolution of a mild-moderate psoriasis therapeutic approach., (© 2022 The Authors. International Journal of Dermatology published by Wiley Periodicals LLC on behalf of the International Society of Dermatology.)

Published
2022
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4. DNA Methylation Events as Markers for Diagnosis and Management of Acute Myeloid Leukemia and Myelodysplastic Syndrome.

Author

Dexheimer GM, Alves J, Reckziegel L, Lazzaretti G, and Abujamra AL

Subjects
Humans, Leukemia, Myeloid, Acute pathology, Myelodysplastic Syndromes pathology, Biomarkers, Tumor genetics, DNA Methylation, Leukemia, Myeloid, Acute genetics, Myelodysplastic Syndromes genetics
Abstract

During the onset and progression of hematological malignancies, many changes occur in cellular epigenome, such as hypo- or hypermethylation of CpG islands in promoter regions. DNA methylation is an epigenetic modification that regulates gene expression and is a key event for tumorigenesis. The continuous search for biomarkers that signal early disease, indicate prognosis, and act as therapeutic targets has led to studies investigating the role of DNA in cancer onset and progression. This review focuses on DNA methylation changes as potential biomarkers for diagnosis, prognosis, response to treatment, and early toxicity in acute myeloid leukemia and myelodysplastic syndrome. Here, we report that distinct changes in DNA methylation may alter gene function and drive malignant cellular transformation during several stages of leukemogenesis. Most of these modifications occur at an early stage of disease and may predict myeloid/lymphoid transformation or response to therapy, which justifies its use as a biomarker for disease onset and progression. Methylation patterns, or its dynamic change during treatment, may also be used as markers for patient stratification, disease prognosis, and response to treatment. Further investigations of methylation modifications as therapeutic biomarkers, which may correlate with therapeutic response and/or predict treatment toxicity, are still warranted.

Published
2017
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