79 results on '"Guarneri, C"'
Search Results
2. Fertility outcomes in men diagnosed with oncohematological diseases who stored their semen for fertility preservation
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Reschini, M., primary, Trubbia, D., additional, Boeri, L., additional, Guarneri, C., additional, Sanzani, E., additional, somigliana, e., additional, and Vigano, P., additional
- Published
- 2024
- Full Text
- View/download PDF
3. Long‐term effectiveness and tolerability of apremilast in patients with moderate‐to‐severe plaque psoriasis: A 5‐year multicentre retrospective study—IL PSO (Italian landscape psoriasis)
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Gargiulo, L., primary, Ibba, L., additional, Malagoli, P., additional, Amoruso, F., additional, Balato, A., additional, Bardazzi, F., additional, Burlando, M., additional, Carrera, C. G., additional, Dapavo, P., additional, Dini, V., additional, Gaiani, F. M., additional, Girolomoni, G., additional, Guarneri, C., additional, Lasagni, C., additional, Loconsole, F., additional, Marzano, A. V., additional, Maurelli, M., additional, Megna, M., additional, Travaglini, M., additional, Costanzo, A., additional, and Narcisi, A., additional
- Published
- 2024
- Full Text
- View/download PDF
4. Comparative effectiveness of tildrakizumab 200 mg versus tildrakizumab 100 mg in psoriatic patients with high disease burden or above 90 kg of body weight: a 16-week multicenter retrospective study - IL PSO (Italian landscape psoriasis)
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Gargiulo, L, Ibba, L, Cascio Ingurgio, R, Malagoli, P, Amoruso, F, Balato, A, Bardazzi, F, Brianti, P, Brunasso, G, Burlando, M, Cagni, A, Caproni, M, Carrera, C, Carugno, A, Caudullo, F, Cuccia, A, Dapavo, P, Di Brizzi, E, Dini, V, Gaiani, F, Gisondi, P, Guarneri, C, Lasagni, C, Licata, G, Loconsole, F, Marzano, A, Megna, M, Mercuri, S, Musumeci, M, Orsini, D, Ribero, S, Ruffo Di Calabria, V, Satolli, F, Strippoli, D, Travaglini, M, Trovato, E, Venturini, M, Zichichi, L, Valenti, M, Costanzo, A, Narcisi, A, Gargiulo, Luigi, Ibba, Luciano, Cascio Ingurgio, Ruggero, Malagoli, Piergiorgio, Amoruso, Fabrizio, Balato, Anna, Bardazzi, Federico, Brianti, Pina, Brunasso, Giovanna, Burlando, Martina, Cagni, Anna E, Caproni, Marzia, Carrera, Carlo G, Carugno, Andrea, Caudullo, Francesco, Cuccia, Aldo, Dapavo, Paolo, Di Brizzi, Eugenia V, Dini, Valentina, Gaiani, Francesca M, Gisondi, Paolo, Guarneri, Claudio, Lasagni, Claudia, Licata, Gaetano, Loconsole, Francesco, Marzano, Angelo V, Megna, Matteo, Mercuri, Santo R, Musumeci, Maria L, Orsini, Diego, Ribero, Simone, Ruffo Di Calabria, Valentina, Satolli, Francesca, Strippoli, Davide, Travaglini, Massimo, Trovato, Emanuele, Venturini, Marina, Zichichi, Leonardo, Valenti, Mario, Costanzo, Antonio, Narcisi, Alessandra, Gargiulo, L, Ibba, L, Cascio Ingurgio, R, Malagoli, P, Amoruso, F, Balato, A, Bardazzi, F, Brianti, P, Brunasso, G, Burlando, M, Cagni, A, Caproni, M, Carrera, C, Carugno, A, Caudullo, F, Cuccia, A, Dapavo, P, Di Brizzi, E, Dini, V, Gaiani, F, Gisondi, P, Guarneri, C, Lasagni, C, Licata, G, Loconsole, F, Marzano, A, Megna, M, Mercuri, S, Musumeci, M, Orsini, D, Ribero, S, Ruffo Di Calabria, V, Satolli, F, Strippoli, D, Travaglini, M, Trovato, E, Venturini, M, Zichichi, L, Valenti, M, Costanzo, A, Narcisi, A, Gargiulo, Luigi, Ibba, Luciano, Cascio Ingurgio, Ruggero, Malagoli, Piergiorgio, Amoruso, Fabrizio, Balato, Anna, Bardazzi, Federico, Brianti, Pina, Brunasso, Giovanna, Burlando, Martina, Cagni, Anna E, Caproni, Marzia, Carrera, Carlo G, Carugno, Andrea, Caudullo, Francesco, Cuccia, Aldo, Dapavo, Paolo, Di Brizzi, Eugenia V, Dini, Valentina, Gaiani, Francesca M, Gisondi, Paolo, Guarneri, Claudio, Lasagni, Claudia, Licata, Gaetano, Loconsole, Francesco, Marzano, Angelo V, Megna, Matteo, Mercuri, Santo R, Musumeci, Maria L, Orsini, Diego, Ribero, Simone, Ruffo Di Calabria, Valentina, Satolli, Francesca, Strippoli, Davide, Travaglini, Massimo, Trovato, Emanuele, Venturini, Marina, Zichichi, Leonardo, Valenti, Mario, Costanzo, Antonio, and Narcisi, Alessandra
- Abstract
Purpose: Tildrakizumab is a selective inhibitor of IL-23 approved for the treatment of moderate-to-severe plaque psoriasis in two dosages. We conducted a 16-week multicenter retrospective study to compare the effectiveness and safety of tildrakizumab 200 mg versus tildrakizumab 100 mg in patients with a high disease burden or high body weight. Materials and methods: Our retrospective study included 134 patients treated with tildrakizumab 200 mg and 364 patients treated with tildrakizumab 100 mg from 28 Italian Dermatology Units affected by moderate-to-severe plaque psoriasis. The patients had a body weight above 90 kg or a high disease burden (Psoriasis Area and Severity Index [PASI] ≥ 16 or the involvement of difficult-to-treat areas). We evaluated the effectiveness of tildrakizumab at the week-16 visit in terms of PASI90, PASI100 and absolute PASI ≤ 2. Results: After 16 weeks of treatment with tildrakizumab 200 mg, PASI90 was reached by 57.5% of patients and PASI100 by 39.6% of patients. At the same time point, 34.3% and 24.2% of patients treated with tildrakizumab 100 mg achieved PASI90 and PASI100, respectively. Conclusions: Our data suggest that tildrakizumab 200 mg has better effectiveness than tildrakizumab 100 mg in patients with a body weight ≥ 90 kg and a high disease burden.
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- 2024
5. A risankizumab super responder profile identified by long‐term real‐life observation‐IL PSO (ITALIAN LANDSCAPE PSORIASIS)
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Gargiulo, L., primary, Ibba, L., additional, Malagoli, P., additional, Amoruso, F., additional, Argenziano, G., additional, Balato, A., additional, Bardazzi, F., additional, Burlando, M., additional, Carrera, C. G., additional, Damiani, G., additional, Dapavo, P., additional, Dini, V., additional, Fabbrocini, G., additional, Franchi, C., additional, Gaiani, F. M., additional, Girolomoni, G., additional, Guarneri, C., additional, Lasagni, C., additional, Loconsole, F., additional, Marzano, A. V., additional, Maurelli, M., additional, Megna, M., additional, Orsini, D., additional, Sampogna, F., additional, Travaglini, M., additional, Valenti, M., additional, Costanzo, A., additional, and Narcisi, A., additional
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- 2023
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6. A risankizumab super responder profile identified by long‐term real‐life observation‐IL PSO (ITALIAN LANDSCAPE PSORIASIS).
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Gargiulo, L., Ibba, L., Malagoli, P., Amoruso, F., Argenziano, G., Balato, A., Bardazzi, F., Burlando, M., Carrera, C. G., Damiani, G., Dapavo, P., Dini, V., Fabbrocini, G., Franchi, C., Gaiani, F. M., Girolomoni, G., Guarneri, C., Lasagni, C., Loconsole, F., and Marzano, A. V.
- Subjects
PSORIASIS ,PATIENT experience ,PATIENTS' attitudes - Abstract
This article examines the effectiveness of risankizumab, a medication used to treat moderate-to-severe plaque psoriasis. The study found that risankizumab was effective in improving psoriasis symptoms, with a high percentage of patients experiencing significant improvement and complete skin clearance. The study also found that patients who had not previously been treated with biologic drugs and those with a shorter disease history had better responses to the treatment. However, the study has some limitations, and further research is needed to fully understand the long-term effects of risankizumab on psoriasis. [Extracted from the article]
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- 2024
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7. COVID 19-associated chilblain-like acral lesions among children and adolescents: an Italian retrospective, multicenter study
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Romita, P., Maronese, C. A., de Marco, A., Balestri, R., Belloni Fortina, A., Brazzelli, V., Colonn, C., Di Lernia, V., El Hachem, May, Fabbrocini, G., Foti, C., Frasin, L. A., Guarneri, C., Guerriero, Cristina, Guida, S., Locatelli, A., Neri, Ilaria, Occella, C., Offidani, A., Oranges, T., Pellacani, G., Stinco, G., Stingeni, L., Barbagallo, T., Campanati, A., Cannavo, S. P., Caroppo, F., Cavalli, R., Costantini, Alessio, Cucchia, R., Diociaiuti, Andrea, Filippeschi, C., Francomano, M., Giancristoforo, S., Giuffrida, R., Martina, E., Monzani, N. A., Nappa, P., Pastorino, C., Patrizi, A., Peccerillo, F., Peris, Ketty, Recalcati, S., Rizzoli, L., Simonetti, O., Vastarella, M., Virdi, A., Marzano, A. V., Bonamonte, D., El Hachem M., Guerriero C., Neri I., Costantini A., Diociaiuti A., Peris K. (ORCID:0000-0002-5237-0463), Romita, P., Maronese, C. A., de Marco, A., Balestri, R., Belloni Fortina, A., Brazzelli, V., Colonn, C., Di Lernia, V., El Hachem, May, Fabbrocini, G., Foti, C., Frasin, L. A., Guarneri, C., Guerriero, Cristina, Guida, S., Locatelli, A., Neri, Ilaria, Occella, C., Offidani, A., Oranges, T., Pellacani, G., Stinco, G., Stingeni, L., Barbagallo, T., Campanati, A., Cannavo, S. P., Caroppo, F., Cavalli, R., Costantini, Alessio, Cucchia, R., Diociaiuti, Andrea, Filippeschi, C., Francomano, M., Giancristoforo, S., Giuffrida, R., Martina, E., Monzani, N. A., Nappa, P., Pastorino, C., Patrizi, A., Peccerillo, F., Peris, Ketty, Recalcati, S., Rizzoli, L., Simonetti, O., Vastarella, M., Virdi, A., Marzano, A. V., Bonamonte, D., El Hachem M., Guerriero C., Neri I., Costantini A., Diociaiuti A., and Peris K. (ORCID:0000-0002-5237-0463)
- Abstract
BACKGROUND: Since the COVID-19 pandemic started, great interest has been given to this disease, especially to its possible clinical presentations. Besides classical respiratory symptoms, dermatological manifestations occur quite often among infected and non-infected patients, particularly in children. A prominent IFN-I response, that is generally higher in children compared to adults, may not only cause chilblain lesions, but it could also prevent infection and viral replication, thus justifying the negative swab results, as well as the absence of relevant systemic symptoms in positive cases. Indeed, reports have emerged describing chilblain-like acral lesions in children and adolescents with either proven or suspected infection. METHODS: Patients aged from 1 to 18 years old were enrolled in this study from 23 Italian dermatological units and were observed for an overall period of 6 months. Clinical pictures were collected along with data on the location and duration of skin lesions, their association with concomitant local and systemic symptoms, presence of nail and/or mucosal involvement, as well as histological, laboratory and imaging findings. RESULTS: One hundred thirty-seven patients were included, of whom 56.9% were females. Mean age was 11.97±3.66 years. The most commonly affected sites were the feet (77 patients, 56.2%). Lesions (48.5%) featured cyanosis, chilblains, blisters, ecchymosis, bullae, erythema, edema, and papules. Concomitant skin manifestations included maculo-papular rashes (30%), unspecified rashes (25%), vesicular rashes (20%), erythema multiforme (10%), urticaria (10%) and erythema with desquamation (5%). Forty-one patients (29.9%) reported pruritus as the main symptom associated with chilblains, and 56 out of 137 patients also reported systemic symptoms such as respiratory symptoms (33.9%), fever (28%), intestinal (27%), headache (5.5%), asthenia (3.5%), and joint pain (2%). Associated comorbid conditions were observed in 9 patients presen
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- 2023
8. Brodalumab for the Treatment of Moderate-to-Severe Psoriasis: An Expert Delphi Consensus Statement
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Fargnoli, Maria Concetta, Bardazzi, F., Bianchi, L., Dapavo, P., Fabbrocini, G., Gisondi, P., Micali, G., Offidani, A. M., Pellacani, G., Skroza, N., Angileri, R. G., Burlando, M., Campanati, A., Carrera, C. G., Chiricozzi, Andrea, Conti, A., Simone, C. D., Di Lernia, V., Errichetti, E., Galluzzo, M., Guarneri, C., Lasagni, C., Lembo, S., Loconsole, F., Megna, M., Musumeci, M. L., Prignano, F., Richetta, A. G., Trovato, E., Venturini, M., Peris, Ketty, Pinton, P. C., Fargnoli M. C., Chiricozzi A. (ORCID:0000-0002-6739-0387), Peris K. (ORCID:0000-0002-5237-0463), Fargnoli, Maria Concetta, Bardazzi, F., Bianchi, L., Dapavo, P., Fabbrocini, G., Gisondi, P., Micali, G., Offidani, A. M., Pellacani, G., Skroza, N., Angileri, R. G., Burlando, M., Campanati, A., Carrera, C. G., Chiricozzi, Andrea, Conti, A., Simone, C. D., Di Lernia, V., Errichetti, E., Galluzzo, M., Guarneri, C., Lasagni, C., Lembo, S., Loconsole, F., Megna, M., Musumeci, M. L., Prignano, F., Richetta, A. G., Trovato, E., Venturini, M., Peris, Ketty, Pinton, P. C., Fargnoli M. C., Chiricozzi A. (ORCID:0000-0002-6739-0387), and Peris K. (ORCID:0000-0002-5237-0463)
- Abstract
Brodalumab is a recombinant, fully human immunoglobulin IgG2 monoclonal antibody specifically targeted against interleukin-17RA that has been approved for the treatment of moderate-to-severe psoriasis in Europe. We developed a Delphi consensus document focused on brodalumab for the treatment of moderate-to-severe psoriasis. Based on published literature and their clinical experience a steering committee drafted 17 statements covering 7 domains specific to the treatment of moderate-to-severe psoriasis with brodalumab. A panel of 32 Italian dermatologists indicated their level of agreement using a 5-point Likert scale (from 1 = “strongly disagree” to 5 = “strongly agree”) using an online modified Delphi method. After the first round of voting (32 participants), positive consensus was reached for 15/17 (88.2%) of the proposed statements. Following a face-to-face virtual meeting, the steering committee decided that 5 statements would form “main principles” and 10 statements formed the final list. After a second round of voting, consensus was reached in 4/5 (80%) of the main principles and 8/10 (80%) for consensus statements. The final list of 5 main principles and 10 consensus statements identify key indications specific to the use of brodalumab in the treatment of moderate-to-severe psoriasis in Italy. These statements aid dermatologists in the management of patients with moderate-to-severe psoriasis.
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- 2023
9. Real-World Apremilast Use for Treatment of Plaque Psoriasis in Italy: Patient Perspective, Characteristics, and Clinical Outcomes from the DARWIN Study
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Giofre, C., Fabbrocini, G., Potenza, C., Tiberio, R., Gisondi, P., Marasca, C., Nuzzo, C. M. A., Benincasa, E., Bianchi, L., Dapavo, P., Parodi, A., Atzori, L., Pasquale, R., Peris, Ketty, Amerio, P., Venturini, M., Schiavo, A. L., Romanelli, Margherita, Richetta, A., Cusano, F., Fargnoli, Maria Concetta, Offidani, A., Guarneri, C., Prignano, F., Corazza, M., Bongiorno, M. R., Loconsole, F., Ori, A., Simoni, L., Amici, C., Palma, L. D., Andreis, D., Trevisan, F., Sala, S., Patane, R., Mele, F., Pernaci, A., Ruberti, S., Trogu, M., Pelicelli, S., Rizzoli, S., Peris K. (ORCID:0000-0002-5237-0463), Romanelli M., Fargnoli M. C., Giofre, C., Fabbrocini, G., Potenza, C., Tiberio, R., Gisondi, P., Marasca, C., Nuzzo, C. M. A., Benincasa, E., Bianchi, L., Dapavo, P., Parodi, A., Atzori, L., Pasquale, R., Peris, Ketty, Amerio, P., Venturini, M., Schiavo, A. L., Romanelli, Margherita, Richetta, A., Cusano, F., Fargnoli, Maria Concetta, Offidani, A., Guarneri, C., Prignano, F., Corazza, M., Bongiorno, M. R., Loconsole, F., Ori, A., Simoni, L., Amici, C., Palma, L. D., Andreis, D., Trevisan, F., Sala, S., Patane, R., Mele, F., Pernaci, A., Ruberti, S., Trogu, M., Pelicelli, S., Rizzoli, S., Peris K. (ORCID:0000-0002-5237-0463), Romanelli M., and Fargnoli M. C.
- Abstract
Introduction: While several European studies have reported real-world apremilast use, patient-perceived benefits, and treatment satisfaction, local reimbursement criteria for apremilast vary and data from Italy are limited. Methods: The cross-sectional DARWIN study enrolled consecutive patients who had initiated apremilast for plaque psoriasis 6 (± 1) months prior to enrolment at a single visit across 24 Italian dermatological sites. Disease severity was assessed using body surface area (BSA) and Physician Global Assessment (PGA). Patient-reported outcomes assessed 6 (± 1) months after apremilast initiation were Dermatology Life Quality Index (DLQI), Patient Benefit Index (PBI), and 9-item Treatment Satisfaction Questionnaire for Medication (TSQM-9). Results: Of 184 patients enrolled between July 2019 and January 2021, 180 were included in the analysis. At apremilast initiation, median (25th–75th percentile) time since psoriasis diagnosis was 8.6 (3.2–22.2) years; median BSA, 10.0% (5.0–16.0); mean (standard seviation, SD) DLQI total score, 13.5 (8.0). Over half (54.9%) of patients with available data reported psoriasis had a very or extremely large effect on their quality of life (QoL); half reported itching (50.6%) and/or special areas involvement (50.0%). Most (73.9%) had comorbidities and were biologic-naïve (81.5%). The most common reasons for initiating apremilast were lack of efficacy of previous treatment (56.7%) and contraindications to other treatments (44.4%). At 6 (± 1) months, most patients were continuing apremilast and/or reported a Global PBI score ≥ 1 (minimum clinical benefit) (86.1% and 90.0%, respectively); approximately half achieved BSA ≤ 3% and/or DLQI total score ≤ 5 (47.1% and 48.5%); 18.8% achieved PGA = 0; mean (SD) TSQM-9 global treatment satisfaction score was 59.0 (24.8). Apremilast was well tolerated; no new safety signals were identified. Conclusions: Patients treated with apremilast for 6 months in Italian clinical practice rep
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- 2023
10. The effect of laser assisted hatching on vitrified-warmed blastocysts: a multicentric randomized controlled trial
- Author
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Alteri, A., primary, Reschini, M., additional, Guarneri, C., additional, Bandini, V., additional, Bertapelle, G., additional, Papaleo, E., additional, Paffoni, A., additional, Viganò, P., additional, and Somigliana, E., additional
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- 2022
- Full Text
- View/download PDF
11. P-438 Fertility outcomes in male cancer recipients of hematopoietic cell transplantation who stored their semen for fertility preservation
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Reschini, M, primary, Cristina, M, additional, Guarneri, C, additional, Filippi, F, additional, Somigliana, E, additional, Boeri, L, additional, and Vigano', P, additional
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- 2022
- Full Text
- View/download PDF
12. P-212 Impact of post-thaw blastocyst culture time prior to transfer on live birth rate in frozen-thawed embryo transfer cycles: a retrospective observational study
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Ciaffaglione, M, primary, Reschini, M, additional, Guarneri, C, additional, Sanzani, E, additional, Cecchele, A, additional, Cucè, V, additional, Posa, A, additional, Balli, M, additional, Mangiarini, A, additional, Pinna, M, additional, Viganò, P, additional, Pisaturo, V, additional, and Restelli, L, additional
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- 2022
- Full Text
- View/download PDF
13. Update on the Management of Pediatric Psoriasis: An Italian Consensus
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Peris, Ketty, Fortina, A. B., Bianchi, L., Fabbrocini, G., Gisondi, P., Balato, A., Bardazzi, F., Bernardini, N., Bonamonte, D., Bongiorno, M. R., Buligan, C., Cusano, F., Del Giudice, M. B. D. F., Hachem, M. E., Fargnoli, Maria Concetta, Gualdi, G., Guarneri, C., Hansel, K., Malara, G., Mazzatenta, C., Micali, G., Narcisi, A., Neri, I., Oranges, T., Panzone, M., Parodi, A., Restano, L., Simonetti, O., Venturini, M., Di Lernia, V., Peris K. (ORCID:0000-0002-5237-0463), Fargnoli M. C., Peris, Ketty, Fortina, A. B., Bianchi, L., Fabbrocini, G., Gisondi, P., Balato, A., Bardazzi, F., Bernardini, N., Bonamonte, D., Bongiorno, M. R., Buligan, C., Cusano, F., Del Giudice, M. B. D. F., Hachem, M. E., Fargnoli, Maria Concetta, Gualdi, G., Guarneri, C., Hansel, K., Malara, G., Mazzatenta, C., Micali, G., Narcisi, A., Neri, I., Oranges, T., Panzone, M., Parodi, A., Restano, L., Simonetti, O., Venturini, M., Di Lernia, V., Peris K. (ORCID:0000-0002-5237-0463), and Fargnoli M. C.
- Abstract
Introduction: Psoriasis affects children with a considerable burden in early life. Treating pediatric psoriasis is challenging also because of the lack of updated specific guidelines. With the recent approval of several biologics for pediatric psoriasis and the ongoing COVID-19 pandemic, the management of young psoriatic patients is facing major changes. A revision of treatment recommendations is therefore needed. Methods: In September 2021, a board of six Italian dermatologists convened to update treatment recommendations. The board issued evidence- and consensus-based statements covering relevant areas of pediatric psoriasis, namely: assessment of psoriasis severity, management of children with psoriasis, and treatment of pediatric psoriasis. To reach consensus, the statements were submitted to a panel of 24 experts in a Delphi process performed entirely via videoconference. A treatment algorithm was produced. Results: There was full consensus that psoriasis severity is determined by the extension/severity of skin lesions, site of lesions, and impact on patient quality of life. Agreement was reached on the need for a multidisciplinary approach to pediatric psoriasis and the importance of patient/parents education. The relevance of vaccinations, including COVID-19 vaccination, for psoriatic children was acknowledged by all participants. Management issues that initially failed to reach consensus included the screening for psoriasis comorbidities and early treatment with biologics to prevent them and the use of telemedicine to facilitate patient follow-up. There was full consensus that topical corticosteroids are the first choice for the treatment of mild pediatric psoriasis, while phototherapy and systemic therapy are used in children with moderate-severe psoriasis. According to the proposed treatment algorithm, biologics are the first line of systemic therapy. Conclusions: Targeted systemic therapies are changing the treatment of moderate-severe pediatric psoriasis
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- 2022
14. Italian adaptation of EuroGuiDerm guideline on the systemic treatment of chronic plaque psoriasis
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Gisondi, P., Fargnoli, M. C., Amerio, P., Argenziano, G., Bardazzi, F., Bianchi, L., Chiricozzi, Andrea, Conti, A., Corazza, M., Costanzo, A., Dapavo, P., De Simone, Clara, Fabbrocini, G., Feliciani, C., Foti, C., Girolomoni, G., Guarneri, C., Marzano, A. V., Micali, G., Offidani, A., Parodi, A., Pellacani, G., Piaserico, S., Prignano, F., Romanelli, M., Rongioletti, F., Rubegni, P., Stinco, G., Stingeni, L., Tomasini, C. F., Venturini, M., Peris, Ketty, Calzavara-Pinton, P., Chiricozzi A. (ORCID:0000-0002-6739-0387), DE Simone C. (ORCID:0000-0002-0898-0045), Peris K. (ORCID:0000-0002-5237-0463), Gisondi, P., Fargnoli, M. C., Amerio, P., Argenziano, G., Bardazzi, F., Bianchi, L., Chiricozzi, Andrea, Conti, A., Corazza, M., Costanzo, A., Dapavo, P., De Simone, Clara, Fabbrocini, G., Feliciani, C., Foti, C., Girolomoni, G., Guarneri, C., Marzano, A. V., Micali, G., Offidani, A., Parodi, A., Pellacani, G., Piaserico, S., Prignano, F., Romanelli, M., Rongioletti, F., Rubegni, P., Stinco, G., Stingeni, L., Tomasini, C. F., Venturini, M., Peris, Ketty, Calzavara-Pinton, P., Chiricozzi A. (ORCID:0000-0002-6739-0387), DE Simone C. (ORCID:0000-0002-0898-0045), and Peris K. (ORCID:0000-0002-5237-0463)
- Abstract
SIDeMaST (Società Italiana di Dermatologia Medica, Chirurgica, Estetica e delle Malattie Sessualmente Trasmesse) contributed to the development of the present guideline on the systemic treatment of chronic plaque psoriasis. With the permission of EuroGuiDerm, SIDeMaST adapted the guideline to the Italian healthcare context to supply a reliable and affordable tool to Italian physicians who take care of patients affected by moderate to severe plaque psoriasis. The content of the guideline includes general information on the scope and purpose, health questions covered, target users and strength/limitations of the guideline, suggestions for disease severity grading and treatment goals. It presents the general treatment recommendations as well as detailed management and monitoring recommendations for the individual drugs including acitretin, cyclosporine, fumarates, methotrexate, adalimumab, apremilast, brodalumab, certolizumab pegol, etanercept, guselkumab, infliximab, ixekizumab, risankizumab, secukinumab, tildrakizumab and ustekinumab. Moreover, the guideline provides guidance for specific clinical situations such as patient with concomitant psoriatic arthritis, inflammatory bowel disease, a history of malignancies, a history of depression, diabetes, viral hepatitis, disease affecting the heart or the kidneys as well as concomitant neurological disease. Advice on how to screen for tuberculosis and recommendations on how to manage patients with a positive tuberculosis test result are given. It further covers treatment for pregnant women or those with childbearing potential. Information on vaccination, immunogenicity and systemic treatment during the COVID-19 pandemic is also provided.
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- 2022
15. Ulcerative necrobiosis lipoidica: case report of an atypical presentation and literature review
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Di Bartolomeo, L., Macca, L., Motolese, A., Guarneri, C., and Guarneri, F.
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Male ,Necrobiosis Lipoidica ,Leg Ulcer ,Humans ,Middle Aged ,Clinical diagnosis ,Epidemiology ,Necrobiosis lipoidica ,Ulceration ,Skin - Abstract
Necrobiosis lipoidica (NL) is a rare chronic granulomatous degenerative skin disease by unknown causes, which is mostly associated with diabetes mellitus, usually presenting with typical plaques of the shins. Although less common, some ulcerative forms may be seen in clinical practice. The occurrence of an atypical presentation in one of our patients was the occasion to review the pertinent literature.
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- 2021
16. Acrokeratosis of Bazex as a sign of thyroid cancer: first description and review of thyroid-associated paraneoplastic dermatoses.
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MACCA, L., MANUELLA, L., TAIBI, R., and GUARNERI, C.
- Abstract
OBJECTIVE: Bazex syndrome is a rare paraneoplastic skin disorder of unknown pathogenesis. Cutaneous findings are usually noticed before the diagnosis of the underlying malignancy, more frequently squamous cell carcinomas of the upper aerodigestive tract or metastasis to cervical lymph nodes. Association with other malignancies has been reported. CASE REPORT: Herein, we describe a case in course of metastatic papillary thyroid carcinoma and review the relevant literature. RESULTS: A bibliographic search was conducted and a total of 8 studies concerning the association were reviewed. CONCLUSIONS: Physicians be aware of unexpected cutaneous conditions as a possible sign of underlying tumors. [ABSTRACT FROM AUTHOR]
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- 2022
17. Sabotaged: Dreams of Utopia in Texas by James Pratt (review)
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Guarneri, Carl J.
- Published
- 2021
18. The unexpected regression of melanocytic naevi.
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Macca, L., Motolese, A., Taibi, R., and Guarneri, C.
- Abstract
A case study of 52-year-old woman who had undergone resection of a stage III cutaneous melanoma of her back 10 years earlier is presented. Topics include examines that she was being treated with nivolumab since 2019 due to the extensive metastasizing in bilateral lung parenchyma, celiac trunk lymph nodes, bilateral ilo-mediastinal recesses and right cardiophrenic angle.
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- 2022
19. Effectiveness of guselkumab in patients with facial and/or genital psoriasis: Interim analysis results at Week 12 from the GULLIVER study.
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Bonifati, C., Lembo, S., Richetta, A. G., Romanelli, M., Satolli, F., Corazza, M., Atzori, L., Lasagni, C., Potenza, C., Savoia, P., Bardazzi, F., Di Lernia, V. G., Bianchi, L., Fabbrocini, G., Giofrè, C., Zichichi, L., Guarneri, C., Pallotta, S., Fargnoli, M. C., and Loconsole, F.
- Subjects
- *
PSORIASIS , *FATIGUE (Physiology) , *QUALITY of life - Abstract
Background Objectives Materials and Methods Results Conclusions Facial (FP) and genital psoriasis (GP) significantly affect patients' quality of life. Despite the advances in treatments, limited data on efficacy and safety are available on these difficult‐to‐treat areas. Guselkumab is an interleukin (IL)‐23 inhibitor which has been proven effective in treating patients with moderate‐to‐severe plaque psoriasis.The aim of this interim analysis was to report the efficacy and safety of guselkumab in the treatment of patients with FP and/or GP.GULLIVER is a 52‐week Italian observational study to evaluate the effectiveness and safety of guselkumab in a real‐life setting in patients with FP and/or GP. Adult patients with facial and/or genital moderate‐to‐severe psoriasis (sPGA score ≥ 3) were included. The primary endpoint of this analysis was the percentage of patients achieving a facial or genital sPGA score of 0 (clear) or 1 (almost clear), at Week 12. The change in the score of the facial or genital sPGA components in patients with a score ≥3 for each sPGA component was assessed. PASI score in patients with a baseline PASI above or below 10 was evaluated.Overall, 351 patients were included in the study; 83.3% of FP and 76.5% of GP patients achieved the primary endpoint. Similar response rates were observed for the facial or genital sPGA components in patients with a baseline facial or genital sPGA score ≥3 in each component. Among patients with a baseline PASI score >10, mean PASI score improved from 19.0 (SD 8.3) to 2.2 (SD 4.8). Forty‐four AEs were observed in 32 patients; two mild and transient AEs (fatigue and nausea) were considered treatment related. No SAEs were observed.Guselkumab, showing to be effective and safe in treating FP and GP, may be a valid therapeutic option for patients with psoriasis localized in these difficult‐to‐treat areas. [ABSTRACT FROM AUTHOR]
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- 2024
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20. Real-life effectiveness and safety of guselkumab in patients with psoriasis who have an inadequate response to ustekinumab: a 104-week multicenter retrospective study - IL PSO (ITALIAN LANDSCAPE PSORIASIS)
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Luigi Gargiulo, Luciano Ibba, Piergiorgio Malagoli, Rosa Giuseppa Angileri, Federico Bardazzi, Nicoletta Bernardini, Martina Burlando, Carlo G. Carrera, Andrea Chiricozzi, Paolo Dapavo, Valentina Dini, Gabriella Fabbrocini, Francesca Maria Gaiani, Marco Galluzzo, Claudia Giofré, Claudio Guarneri, Francesco Loconsole, Giovanna Malara, Lorenzo Marcelli, Matteo Megna, Stefano Piaserico, Marina Talamonti, Antonio Costanzo, Alessandra Narcisi, Gargiulo, L, Ibba, L, Malagoli, P, Angileri, R G, Bardazzi, F, Bernardini, N, Burlando, M, Carrera, C G, Chiricozzi, A, Dapavo, P, Dini, V, Fabbrocini, G, Gaiani, F M, Galluzzo, M, Giofré, C, Guarneri, C, Loconsole, F, Malara, G, Marcelli, L, Megna, M, Piaserico, S, Talamonti, M, Costanzo, A, and Narcisi, A
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Infectious Diseases ,Dermatology - Abstract
Background: Guselkumab is a humanized monoclonal antibody that binds selectively to the p19 subunit of interleukin-23, which has shown efficacy in patients with previous incomplete response to ustekinumab in the NAVIGATE clinical trial. Objectives: We conducted a 104-week multicenter retrospective study to assess the effectiveness and safety of guselkumab in patients affected by plaque psoriasis with an inadequate response to ustekinumab in a real-life setting. Methods: Our retrospective study included 233 adults affected by moderate-to-severe plaque psoriasis, enrolled in 14 different Italian centers, and treated with guselkumab after failing therapy with ustekinumab. Patient characteristics and PASI (Psoriasis Area and Severity Index) score at each visit (baseline, weeks 16, 52 and 104) were recorded. The percentages of patients achieving 75%, 90% and 100% (PASI 75, PASI 90 and PASI 100) improvement in PASI, compared with baseline, were registered. Results: At week 52, PASI 75 was reached by 89.88% of patients, PASI 90 by 71.43%, PASI 100 by 58.83% and absolute PASI ≤ 2 by 90.48%. At week 104, similar effectiveness results were observed. Compared to the NAVIGATE trial, we observed higher rates of PASI 75/90/100. Patients with the involvement of difficult-to-treat areas were significantly less likely to achieve PASI90 and PASI100 at week 16. Obese patients had significantly lower rates of PASI75 and PASI≤2 at week 52. At week 104, comparable responses were observed among all patients' subgroups, regardless of BMI status, involvement of difficult-to-treat areas, presence of cardiometabolic comorbidities and concomitant psoriatic arthritis. No significant safety findings were reported throughout the study. Conclusion: Our data suggest that the efficacy of guselkumab in patients with inadequate response to ustekinumab for plaque psoriasis in "real-life" clinical practice is comparable with NAVIGATE study with higher percentages of patients achieving PASI90 and PASI100 at weeks 16, 52 and 104.
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- 2023
21. Real life long-term efficacy and safety of ixekizumab in moderate-to-severe psoriasis: A 192 weeks multicentric retrospective study-IL PSO (Italian landscape psoriasis)
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Piergiorgio Malagoli, Paolo Dapavo, Giulia Pavia, Fabrizio Amoruso, Giuseppe Argenziano, Federico Bardazzi, Martina Burlando, Carlo G. Carrera, Giovanni Damiani, Valentina Dini, Giampiero Girolomoni, Claudio Guarneri, Francesco Loconsole, Alessandra Narcisi, Francesca Sampogna, Massimo Travaglini, Antonio Costanzo, Malagoli, P., Dapavo, P., Pavia, G., Amoruso, F., Argenziano, G., Bardazzi, F., Burlando, M., Carrera, C. G., Damiani, G., Dini, V., Girolomoni, G., Guarneri, C., Loconsole, F., Narcisi, A., Sampogna, F., Travaglini, M., and Costanzo, A.
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real-life experience ,Interleukin-17 ,Dermatology ,General Medicine ,Antibodies, Monoclonal, Humanized ,Severity of Illness Index ,long-term efficacy ,Treatment Outcome ,ixekizumab ,Quality of Life ,Humans ,Psoriasis ,Dermatologic Agents ,Retrospective Studies - Abstract
Psoriasis is one of the commonest inflammatory skin diseases determining a very high impact on patients' quality of life and daily activities and relationships. Several biologic therapies have been approved through the years for the treatment of moderate-to-severe plaque psoriasis, and efficacy and safety profile have been analyzed in clinical trials. Ixekizumab is an immunoglobulin G subclass 4 monoclonal antibody that selectively targets and binds IL-17A with high specificity and affinity. Inhibiting IL-17A activity, ixekizumab reduces and turns down levels of inflammation, resulting in the clinical improvement of the disease. Long-term efficacy and safety profile of ixekizumab have been investigated and reported in the UNCOVER trials, but in literature there are only few studies based on real life experience. We present the efficacy and safety profile of ixekizumab in a cohort of 779 patients affected by moderate-to-severe plaque psoriasis and treated with ixekizumab in 11 Italian dermatology hospitals, with a follow-up of care until 192 weeks.
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- 2022
22. The paradox of the Italian clinical embryologist in the national public health system: hints towards harmonization of a postgraduate educational curriculum
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Alessandra, Alteri, Liana, Bosco, Sandrine, Chamayou, Valentina, Casciani, Marta, Cervi, Anna, Cecchele, Yoon Sung, Cho, Maria Paola, Costantini, Maria Beatrice, Dal Canto, Silvia, De Stefani, Alessandra, Fraioli, Valentina, Furlan, Filippo, Giacone, Cristina, Guarneri, Antonino, Guglielmino, Mirella, Iaccarino, Alessandro, Miceli, Maria Giulia, Minasi, Luigi, Montano, Tiziana, Notari, Alessio, Paffoni, Simone, Palini, Marco, Reschini, Giovanni, Ruvolo, Paola, Viganó, Aldo, Volpes, Alteri, A, Bosco, L, Chamayou, S, Casciani, V, Cervi, M, Cecchele, A, Cho, YS, Costantini, MP, Dal Canto, MB, De Stefani, S, Fraioli, A, Furlan, V, Giacone, F, Guarneri, C, Guglielmino, A, Iaccarino, M, Miceli, A, Minasi, MG, Montano, L, Notari, T, Paffoni, A, Palini, S, Reschini, M, Ruvolo, G, Vigano, P, and Volpes, A
- Subjects
medically assisted reproduction ,paradox ,Reproductive Medicine ,national health system ,Settore BIO/13 - Biologia Applicata ,Obstetrics and Gynecology ,General Medicine ,Settore BIO/06 - Anatomia Comparata E Citologia ,Clinical embryologist - Abstract
Clinical embryologists are highly trained laboratory professionals with multiple roles, including laboratory, clinical, biobanking and quality system management. In most European countries, clinical embryologists are trained to work in Medically Assisted Reproduction (MAR) centres without a specifically dedicated educational path. The criteria required for employment vary according to the educational structure and the public or private nature of the centre. We have herein described the educational profile required by Italian clinical embryologists to work in MAR centres of the National Health System (NHS). Public centres currently represent 36% of all the Italian MAR clinics. According to the Italian law, a future clinical embryologist must achieve a 3-4 year unpaid post-graduate specialization in a different field, choosing from Genetics, Microbiology, Clinical Pathology or Nutrition. Accesses to the above-mentioned post-graduate courses are themselves very limited. Clinical embryologists are basically trained by senior colleagues. This situation makes inevitably difficult to recruit laboratory staff in NHS centres. Moreover, it represents an emblematic example of the need for an equal training curriculum, possibly ensuring a comparable education quality, mobility of trainees and dissemination of skills for clinical embryologists all over Europe.
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- 2022
23. Italian adaptation of EuroGuiDerm guideline on the systemic treatment of chronic plaque psoriasis
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Paolo GISONDI, Maria C. FARGNOLI, Paolo AMERIO, Giuseppe ARGENZIANO, Federico BARDAZZI, Luca BIANCHI, Andrea CHIRICOZZI, Andrea CONTI, Monica CORAZZA, Antonio COSTANZO, Paolo DAPAVO, Clara DE SIMONE, Gabriella FABBROCINI, Claudio FELICIANI, Caterina FOTI, Giampiero GIROLOMONI, Claudio GUARNERI, Angelo V. MARZANO, Giuseppe MICALI, Annamaria OFFIDANI, Aurora PARODI, Giovanni PELLACANI, Stefano PIASERICO, Francesca PRIGNANO, Marco ROMANELLI, Franco RONGIOLETTI, Pietro RUBEGNI, Giuseppe STINCO, Luca STINGENI, Carlo F. TOMASINI, Marina VENTURINI, Ketty PERIS, Piergiacomo CALZAVARA-PINTON, Gisondi, P., Fargnoli, M. C., Amerio, P., Argenziano, G., Bardazzi, F., Bianchi, L., Chiricozzi, A., Conti, A., Corazza, M., Costanzo, A., Dapavo, P., DE Simone, C., Fabbrocini, G., Feliciani, C., Foti, C., Girolomoni, G., Guarneri, C., Marzano, A. V., Micali, G., Offidani, A., Parodi, A., Pellacani, G., Piaserico, S., Prignano, F., Romanelli, M., Rongioletti, F., Rubegni, P., Stinco, G., Stingeni, L., Tomasini, C. F., Venturini, M., Peris, K., and Calzavara-Pinton, P.
- Subjects
Pandemic ,Female ,Humans ,Pandemics ,Pregnancy ,SARS-CoV-2 ,Ustekinumab ,COVID-19 ,Psoriasis ,Biological products ,Guideline ,Therapeutics ,Dermatology ,Infectious Diseases ,Settore MED/35 ,Settore MED/35 - MALATTIE CUTANEE E VENEREE ,Human - Abstract
SIDeMaST (Società Italiana di Dermatologia Medica, Chirurgica, Estetica e delle Malattie Sessualmente Trasmesse) contributed to the development of the present guideline on the systemic treatment of chronic plaque psoriasis. With the permission of EuroGuiDerm, SIDeMaST adapted the guideline to the Italian healthcare context to supply a reliable and affordable tool to Italian physicians who take care of patients affected by moderate to severe plaque psoriasis. The content of the guideline includes general information on the scope and purpose, health questions covered, target users and strength/limitations of the guideline, suggestions for disease severity grading and treatment goals. It presents the general treatment recommendations as well as detailed management and monitoring recommendations for the individual drugs including acitretin, cyclosporine, fumarates, methotrexate, adalimumab, apremilast, brodalumab, certolizumab pegol, etanercept, guselkumab, infliximab, ixekizumab, risankizumab, secukinumab, tildrakizumab and ustekinumab. Moreover, the guideline provides guidance for specific clinical situations such as patient with concomitant psoriatic arthritis, inflammatory bowel disease, a history of malignancies, a history of depression, diabetes, viral hepatitis, disease affecting the heart or the kidneys as well as concomitant neurological disease. Advice on how to screen for tuberculosis and recommendations on how to manage patients with a positive tuberculosis test result are given. It further covers treatment for pregnant women or those with childbearing potential. Information on vaccination, immunogenicity and systemic treatment during the COVID-19 pandemic is also provided.
- Published
- 2022
24. Real-life effectiveness of tildrakizumab in chronic plaque psoriasis: A 52-week multicentre retrospective study—IL PSO (Italian landscape psoriasis)
- Author
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Alessandra Narcisi, Mario Valenti, Luigi Gargiulo, Luciano Ibba, Fabrizio Amoruso, Giuseppe Argenziano, Federico Bardazzi, Martina Burlando, Carlo Giovanni Carrera, Giovanni Damiani, Paolo Dapavo, Valentina Dini, Chiara Franchi, Giampiero Girolomoni, Claudio Guarneri, Francesco Loconsole, Francesca Sampogna, Massimo Travaglini, Piergiorgio Malagoli, Antonio Costanzo, Narcisi, A., Valenti, M., Gargiulo, L., Ibba, L., Amoruso, F., Argenziano, G., Bardazzi, F., Burlando, M., Carrera, C. G., Damiani, G., Dapavo, P., Dini, V., Franchi, C., Girolomoni, G., Guarneri, C., Loconsole, F., Sampogna, F., Travaglini, M., Malagoli, P., and Costanzo, A.
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Infectious Diseases ,Dermatology ,psoriasis ,Biologics, psoriasis, psoriasis treatment ,Biologics ,psoriasis treatment - Abstract
Background: Tildrakizumab is a humanized monoclonal antibody that binds selectively the p19 subunit of interleukin-23. It is approved for treatment of moderate–severe chronic plaque psoriasis. Objectives: We conducted a 52-week retrospective study to assess the effectiveness and safety of tildrakizumab in a real-life setting. Methods: Our retrospective study included 237 consecutive adults with moderate-to-severe plaque psoriasis, enrolled in 10 different Italian centres, treated with tildrakizumab up to Week 52. Patient characteristics, comorbidities, previous treatments and the PASI (Psoriasis Area and Severity Index) score at each visit (baseline, Week 16, Week 28 and Week 52) were retrieved from the electronic medical records. The percentages of patients achieving 75%, 90% and 100% (PASI 75, PASI 90 and PASI 100) improvement in PASI with respect to baseline PASI were registered. Results: At Week 52, 90.91%, 73.55% and 58.68% of patients achieved a PASI reduction ≥75% (PASI 75), PASI 90 and PASI 100, respectively. An absolute PASI ≤ 2 was reached by 85.95% at Week 52. Compared with Phase 3 clinical trials, we observed similar rates of PASI 75/90 responses and higher percentages of patients achieving PASI 100. Patients who had not responded to previous biologic treatments and patients with cardio-metabolic comorbidities were significantly more likely to achieve PASI 100 at Week 28 and PASI 90 at Week 52. The higher body mass index did not interfere with the odds of reaching PASI 75/90/100 at each time point. No significant safety findings were recorded throughout the study, and none of the patients had to interrupt the treatment because of adverse events. Conclusion: Our data suggest that the efficacy of tildrakizumab for plaque psoriasis in ‘real-life’ clinical practice is comparable with Phase 3 clinical trials with higher percentages of patients achieving complete skin clearance (PASI 100) at Weeks 16, 28 and 52.
- Published
- 2022
25. Secukinumab in the Treatment of Psoriasis: A Narrative Review on Early Treatment and Real-World Evidence.
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Malagoli P, Dapavo P, Amerio P, Atzori L, Balato A, Bardazzi F, Bianchi L, Cattaneo A, Chiricozzi A, Congedo M, Fargnoli MC, Giofrè C, Gisondi P, Guarneri C, Lembo S, Loconsole F, Mazzocchetti G, Mercuri SR, Morrone P, Offidani AM, Palazzo G, Parodi A, Pellacani G, Piaserico S, Potenza C, Prignano F, Romanelli M, Savoia P, Stingeni L, Travaglini M, Trovato E, Venturini M, Zichichi L, and Costanzo A
- Abstract
Psoriasis is a chronic, immune-mediated, inflammatory skin disease, associated with multiple comorbidities and psychological and psychiatric disorders. The quality of life of patients with this disease is severely compromised, especially in moderate-to-severe plaque psoriasis. Secukinumab, a fully humanized monoclonal antibody, was the first anti-interleukin (IL)-17 biologic approved for treating psoriasis. Secukinumab demonstrated long-lasting efficacy and a good safety profile in individuals with plaque psoriasis, and it is associated with an improvement in health-related quality of life. While there is evidence that early treatment with systemic therapy can affect disease progression and improve long-term outcomes in other autoimmune diseases, evidence is limited in psoriasis, especially in real-world settings. This review provides an overview of studies describing the effectiveness of secukinumab in the treatment of psoriasis summarizing the literature and focusing on real-world evidence and early intervention., (© 2024. The Author(s).)
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- 2024
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26. Risankizumab efficacy and safety in psoriatic patients with latent tuberculosis infection: A multicentric real-world study.
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Raimondo A, Amerio P, Balato A, Cusano F, Fargnoli MC, Guarneri C, Ligrone L, Megna M, Musumeci ML, Puca RV, Uzzauto MT, and Lembo S
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- 2024
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27. Conventional in vitro fertilisation rather than intracytoplasmic sperm injection when only one oocyte is retrieved: Time to overcome irrational fears.
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Pisaturo V, Reschini M, Guarneri C, Sanzani E, Paffoni A, and Somigliana E
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- Humans, Female, Retrospective Studies, Pregnancy, Adult, Male, Sperm Injections, Intracytoplasmic, Fertilization in Vitro methods, Oocyte Retrieval, Pregnancy Rate
- Abstract
Background: The use of intracytoplasmic sperm injection (ICSI) currently extends beyond male factor infertility, notably replacing conventional in vitro fertilisation (IVF) in scenarios like limited oocyte availability, where it is used as a precaution against complete fertilisation failure. While existing studies on the use of conventional IVF in such situations provide some reassurance, the available evidence is somewhat insufficient and ICSI is commonly used., Aims: To evaluate whether conventional IVF can be a feasible option when only one oocyte is retrieved., Materials and Methods: A retrospective study was performed to evaluate the fertilisation rate with conventional IVF in women retrieving only one oocyte and whose partner had normal semen. The study aimed at evaluating whether the fertilisation rate was aligned with the threshold indicated by recognized IVF laboratory performance indicators (Vienna Consensus). Clinical pregnancy and live birth rates were secondary outcomes., Results: Out of 304 cycles with a single oocyte inseminated with conventional IVF, 209 achieved normal fertilisation and 82 did not. Thirteen had no mature oocytes. The fertilisation rate was 69% (95% CI: 63-74%) and increased to 72% (95% CI: 66-77%) when immature oocytes were excluded. The fertilisation rate surpassed the minimum competency threshold of the Vienna Consensus (60%), even if below the benchmark value (75%). Clinical pregnancy and live birth rates per oocyte retrieval were 10% and 8%, respectively. Univariate and multivariate analyses failed to identify any predictive factor of fertilisation., Conclusion: Conventional IVF with one oocyte met Vienna Consensus standards even if it fell short of higher benchmarks., (© 2024 Royal Australian and New Zealand College of Obstetricians and Gynaecologists.)
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- 2024
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28. Guidelines How to Integrate Surgery and Targeted Therapy with Biologics for the Treatment of Hidradenitis Suppurativa: Delphi Consensus Statements from an Italian Expert Panel.
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Offidani A, Marzano AV, Peris K, Molinelli E, Bettoli V, Magnoni C, Vaienti L, Pappagallo G, Amerio P, Atzori L, Balato A, Bianchi L, Bongiorno MR, Contedini F, Dapavo P, Di Benedetto G, Dini V, Donini M, Fabbrocini G, Fania L, Foti C, Gatti A, Guarneri C, Malara G, Manfredini M, Morrone P, Naldi L, Parodi A, Potenza C, Schianchi S, Stingeni L, Trovato E, Vaira F, Valenti M, Venturini M, Chiricozzi A, and Prignano F
- Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by recurrent and painful nodules and abscesses in intertriginous skin areas, which can progress to sinus tract formation, tissue destruction, and scarring. HS is highly debilitating and severely impairs the psychological well-being and quality of life of patients. The therapeutic approach to HS is based on medical therapy and surgery. First-line medical therapy includes topical antibiotics, systemic antibiotics, and biologics. Main surgical procedures include deroofing, local excision, and wide local excision. Despite the availability of multiple therapeutic options, the rates of disease recurrence and progression continue to be high. In recent years, the possibility of combining biologic therapy and surgery has raised considerable interest. In a clinical trial, the perioperative use of adalimumab has been associated with greater response rates and improved inflammatory load and pain, with no increased risk of postoperative infectious complications. However, several practical aspects of combined biologic therapy and surgery are poorly defined. In June 2022, nine Italian HS experts convened to address issues related to the integration of biologic therapy and surgery in clinical practice. To this purpose, the experts identified 10 areas of interest based on published evidence and personal experience: (1) patient profiling (diagnostic criteria, disease severity classification, assessment of response to treatment, patient-reported outcomes, comorbidities); (2) tailoring surgery to HS characteristics; (3) wide local excision; (4) presurgery biologic treatment; (5) concomitant biologic and surgical treatments; (6) pre- and postsurgery management; (7) antibiotic systemic therapy; (8) biologic therapy after radical surgery; (9) management of adverse events to biologics; and (10) management of postoperative infectious complications. Consensus between experts was reached using the Estimate-Talk-Estimate method (Delphi Method). The statements were subsequently presented to a panel of 27 HS experts from across Italy, and their agreement was assessed using the UCLA Appropriateness Method. This article presents and discusses the consensus statements., (© 2024 The Author(s). Published by S. Karger AG, Basel.)
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- 2024
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29. The effect of laser-assisted hatching on vitrified/warmed blastocysts: the ALADDIN randomized controlled trial.
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Alteri A, Reschini M, Guarneri C, Bandini V, Bertapelle G, Pinna M, Rabellotti E, Ferrari S, Papaleo E, Paffoni A, Viganò P, and Somigliana E
- Subjects
- Humans, Female, Adult, Pregnancy, Cryopreservation methods, Zona Pellucida, Young Adult, Fertilization in Vitro methods, Infertility therapy, Infertility physiopathology, Infertility diagnosis, Adolescent, Embryo Transfer methods, Embryo Transfer adverse effects, Treatment Outcome, Embryo Culture Techniques, Single Embryo Transfer methods, Single Embryo Transfer adverse effects, Lasers, Male, Blastocyst, Vitrification, Pregnancy Rate, Live Birth
- Abstract
Objective: To evaluate whether laser-mediated assisted hatching (AH) performed on vitrified/warmed blastocysts before embryo transfer can improve live birth rate., Design: The "pArtiaL zonA pelluciDa removal by assisteD hatchINg of blastocysts (ALADDIN)" is a 2-center comparative study with a parallel randomized controlled design., Setting: University hospital., Patients: Participants were recruited between September 2018 and November 2021. They were aged 18-39 years, underwent nondonor in vitro fertilization cycles, and were scheduled for elective single embryo transfer with vitrified/warmed blastocysts. Those with uterine abnormalities, body mass index of >35 kg/m
2 , severe male factor infertility, or performing preimplantation genetic testing were excluded., Intervention: Assisted hatching was performed using a 1,480 nm diode laser, removing approximately one-third of the zona pellucida with continuous 0.2 ms pulses applied from the 1-5 o'clock positions., Main Outcome Measures: The primary outcome was the live birth rate. Secondary end points included clinical pregnancy, miscarriage, multiple pregnancies, preterm births, obstetric and neonatal complications, and congenital anomalies., Results: Overall, 698 participants met the inclusion criteria and were randomized: 352 patients were assigned to the AH arm and 346 to the control arm. Of the participants, 105 (29.8%) and 101 (29.2%), respectively, achieved a live birth after treatment. The relative risk of live birth in patients with vitrified/warmed blastocysts treated with AH was 1.02 (95% confidence interval, 0.86-1.19). Exploratory subgroup analyses for women's age, recruiting centers, indications for in vitro fertilization, method of insemination, blastocyst quality, and days of blastocyst development failed to highlight any clinical situation that could benefit from AH in thawed blastocysts., Conclusion: In patients undergoing frozen embryo transfer with vitrified/warmed blastocysts, laser AH does not improve the live birth rate. Further studies are required to rule out milder but potentially interesting benefits in specific subgroups of patients., Trial Registration: ClinicalTrials.gov: NCT03623659., Competing Interests: Declaration of Interests E.P. reported grants and personal fees from MSD, grants from Ferring, IBSA, TEVA, and Gedeon Richter, grants and personal fees from Merck. P.V. received honoraria for editorial engagements. E.S. received honoraria for presentations at meetings from IBSA and Gedeon Richter, and also is handling 2 research grants from Ferring and IBSA. A.A. has nothing to disclose. M.R. has nothing to disclose. C.G. has nothing to disclose. V.B. has nothing to disclose. G.B. has nothing to disclose. M.P. has nothing to disclose. E.R. has nothing to disclose. S.F. has nothing to disclose. A.P. has nothing to disclose., (Copyright © 2024 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)- Published
- 2024
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30. Long-Term Effectiveness and Safety of Ixekizumab for the Treatment of Moderate-to-Severe Plaque Psoriasis: A Five-Year Multicenter Retrospective Study-IL PSO (Italian Landscape Psoriasis).
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Valenti M, Gargiulo L, Ibba L, Malagoli P, Amoruso F, Balato A, Bardazzi F, Burlando M, Carrera CG, Dapavo P, Dini V, Gaiani FM, Girolomoni G, Guarneri C, Lasagni C, Loconsole F, Marzano AV, Maurelli M, Megna M, Orsini D, Travaglini M, Costanzo A, and Narcisi A
- Abstract
Introduction: The introduction of biological therapies has revolutionized the treatment of moderate-to-severe plaque psoriasis. In particular, ixekizumab, an inhibitor of interleukin-17A, has shown great results in terms of efficacy and safety in both clinical trials and real-world experiences. However, there is a lack of long-term real-world data available for ixekizumab., Methods: We conducted a multicenter real-life study to evaluate the effectiveness and safety of ixekizumab in patients with moderate-to-severe plaque psoriasis. Psoriasis Area and Severity Index score (PASI) was collected at baseline and after 1, 2, 3, 4, and 5 years. The occurrence of any adverse events was recorded at each time point., Results: We enrolled 1096 patients treated with ixekizumab for at least 1 year. At week 52, the percentages of PASI 90 and PASI 100 were 85.04% and 69.07%, respectively. After 5 years of treatment with ixekizumab, out of 145 patients, a PASI 90 response was achieved by 86.90% of patients, while complete skin clearance was reached by 68.28% of patients. We did not observe any new significant safety findings throughout the study period., Conclusion: This study supports the long-term effectiveness and safety of ixekizumab in a real-world setting., (© 2024. The Author(s).)
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- 2024
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31. The impact of a second embryo biopsy for preimplantation genetic testing for monogenic diseases (PGT-M) with inconclusive results on pregnancy potential: results from a matched case-control study.
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Guarneri C, Reschini M, Pinna M, Perego L, Sanzani E, Somigliana E, Sorrentino U, Cassina M, Zuccarello D, and Ciaffaglione M
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- Humans, Biopsy, Embryo Implantation, Genetic Testing, Pregnancy, Male, Adult, Reproductive Techniques, Assisted, Case-Control Studies, Pregnancy Outcome, Infertility, Female, Embryo, Mammalian metabolism
- Abstract
Purpose: To evaluate whether a second biopsy, following a first diagnostic failure on blastocysts tested for preimplantation genetic testing for monogenic diseases (PGT-M), allows to obtain genetic diagnosis and to what extent this procedure can influence clinical pregnancy and live birth rates compared to the PGT-M process with a successful genetic diagnosis from the first biopsy., Methods: Embryos from women who underwent PGT-M in an infertility centre and who had been transferred after two biopsies for genetic analysis (n = 27) were matched in a 1:1 ratio accordingly to women's age (± 1 year) and fertility status (fertile vs infertile), as well as with the study period, with embryos who were transferred after receiving a conclusive PGT result straight after the first biopsy (n = 27). The main evaluated outcome was clinical pregnancy rate following embryo transfers in which healthy embryos were transferred after only one biopsy and those in which an embryo was transferred after being re-biopsied. Live birth rate was the secondary outcome., Results: Clinical pregnancy rate was 52% (95% CI: 34-69) following the transfer of a single-biopsy blastocyst and 30% (95% CI: 16-48) following the transfer of a re-biopsied blastocyst. The likelihood to have a healthy baby was 33% (95% CI: 19-52) following the transfer of a blastocyst biopsied once and 22% (95% CI: 11-41) following the transfer of a re-biopsied blastocyst., Conclusions: The re-biopsy intervention seems to considerably reduce the pregnancy potential of a blastocyst. However, a greater sample size is necessary to clarify this issue definitively., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2024
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32. Switching patterns of biological drugs in patients with psoriasis and psoriatic arthritis: insight from the VALORE database network.
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Spini A, Pellegrini G, Ingrasciotta Y, L'Abbate L, Bellitto C, Carollo M, Leoni O, Zanforlini M, Ancona D, Stella P, Cavazzana A, Scapin A, Lopes S, Belleudi V, Ledda S, Carta P, Rossi P, Ejlli L, Sapigni E, Puccini A, Spila Alegiani S, Massari M, Guarneri C, Gisondi P, and Trifirò G
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- Humans, Male, Female, Middle Aged, Retrospective Studies, Adult, Italy epidemiology, Biosimilar Pharmaceuticals therapeutic use, Biosimilar Pharmaceuticals adverse effects, Arthritis, Psoriatic drug therapy, Psoriasis drug therapy, Drug Substitution, Biological Products therapeutic use, Biological Products adverse effects, Databases, Factual
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Background: Switch patterns among different biologics and from originators to biosimilars (and vice versa) can be complex in patients with psoriasis (PsO) and psoriatic arthritis (PsA)., Objective: The aim of this study was to describe switching patterns of biological drugs in PsO/PsA patients and to explore predictors of multiple switches and switch-back., Research Design and Methods: A large-scale retrospective cohort study was conducted using the Italian VALORE database. Bio-naïve users treated for PsO/PsA during 2010-2022 were included. Time to switch/swap and predictors of multiple switches and switch-back were analyzed., Results: Thirty-thousand seven hundred bio-naïve users were included. At 3 and 5 years of follow-up, patients with at least one switch/swap were 37.1% and 47.8%, respectively. The median time to first switch/swap was significantly shorter ( p < 0.001) for TNF-α inhibitors (2,068 days) than anti-IL (2,780 days). At 1 year of follow-up patients starting with IL-23 switched/swapped biological therapy less frequently than those with anti-IL-12/23 and anti-IL-17 (4.9% vs. 8.7% and 9.4%, respectively). Patients starting with anti-IL-12/23 reported a significantly lower risk of multiple switches and switch-back (0.74, 95% CI, 0.67-0.83; 0.58, 95% CI, 0.44-0.77, respectively) than those with TNF-α inhibitors., Conclusions: Patients with PsO/PsA starting with TNF-α inhibitors switch/swap more rapidly and frequently than those with anti-IL, which are also associated with a reduced risk of multiple switches during follow-up.
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- 2024
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33. Tildrakizumab: the value of a personalized and flexible approach for treating moderate-to-severe plaque psoriasis in patients with high body weight or high disease burden.
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Dapavo P, Burlando M, Guarneri C, Megna M, Narcisi A, Talamonti M, and Gisondi P
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- Humans, Antibodies, Monoclonal therapeutic use, Overweight drug therapy, Treatment Outcome, Cost of Illness, Severity of Illness Index, Body Weight, Psoriasis diagnosis, Psoriasis drug therapy, Biological Products therapeutic use, Antibodies, Monoclonal, Humanized
- Abstract
Introduction: The introduction of biologics for the treatment of plaque psoriasis is one of the major therapeutic advances of the last decades in dermatology. The efficacy of this class of drugs can be influenced by multiple factors including obesity, being overweight, prior treatment failures, and disease severity., Areas Covered: Most of the currently available approved biologics are limited by their lack of dosing flexibility for adapting the therapy to the complexity of real-world patients with psoriasis. Among the class of anti-interleukin-23, tildrakizumab allows a greater dosing flexibility, increasing clinical benefits of patients with high burden of the disease or body weight >90 kg., Expert Opinion: This meta-opinion discusses the clinical data that were foundational for tildrakizumab dosage flexibility, elaborates on the definition of high burden of disease specifically linked to tildrakizumab dosage, and profiles the ideal patient that could benefit from treatment with the higher approved tildrakizumab dosage of 200 mg.
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- 2024
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34. Effectiveness, Tolerability, and Drug Survival of Risankizumab in a Real-World Setting: A Three-Year Retrospective Multicenter Study-IL PSO (ITALIAN LANDSCAPE PSORIASIS).
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Gargiulo L, Ibba L, Malagoli P, Amoruso F, Argenziano G, Balato A, Bardazzi F, Burlando M, Carrera CG, Damiani G, Dapavo P, Dini V, Franchi C, Gaiani FM, Girolomoni G, Guarneri C, Lasagni C, Loconsole F, Marzano AV, Maurelli M, Megna M, Orsini D, Sampogna F, Travaglini M, Valenti M, Costanzo A, and Narcisi A
- Abstract
Background: Risankizumab is a humanized monoclonal antibody that selectively inhibits interleukin-23. It has been approved for moderate-to-severe plaque psoriasis and has shown efficacy and safety in clinical trials and real-world experiences. This study aimed to evaluate the long-term effectiveness, safety, and drug survival of risankizumab in a real-life setting., Materials and Methods: We included patients treated with risankizumab from January 2019 to February 2023. A Psoriasis Area and Severity Index score (PASI) was collected at weeks 0, 16, 28, 52, 104, and 156, when available. The occurrence of any adverse events was recorded at each visit., Results: We enrolled 1047 patients. At week 52, a ≥90% improvement in PASI was observed in 81.44% of patients, with a continuous improvement throughout the study (88.99% and 99.07% at weeks 104 and 156, respectively). After three years of treatment, all patients involving the scalp, palms/soles, and genitalia and 95% of patients with nail psoriasis achieved a complete or almost complete skin clearance. No significant safety findings were observed, and 90.73% of the patients were still on treatment after 36 months., Conclusions: This study supports the long-term effectiveness and safety of risankizumab in a real-world setting, even in patients involving difficult-to-treat areas.
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- 2024
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35. Drug survival of IL-12/23, IL-17 and IL-23 inhibitors for moderate-to-severe plaque psoriasis: a retrospective multicenter real-world experience on 5932 treatment courses - IL PSO (Italian landscape psoriasis).
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Gargiulo L, Ibba L, Malagoli P, Balato A, Bardazzi F, Burlando M, Carrera CG, Damiani G, Dapavo P, Dini V, Gaiani FM, Girolomoni G, Guarneri C, Lasagni C, Loconsole F, Marzano AV, Megna M, Mercuri SR, Travaglini M, Costanzo A, and Narcisi A
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- Humans, Interleukin-23, Interleukin Inhibitors, Retrospective Studies, Interleukin-17, Interleukin-12, Italy, Biological Products therapeutic use, Psoriasis drug therapy
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Introduction: The development of several effective biological drugs for moderate-to-severe plaque psoriasis has dramatically changed the lives of patients. Despite the wide use of interleukin (IL) inhibitors, limited data are available to date regarding long-term treatment persistence., Method: This multicenter retrospective real-world study evaluated 5932 treatment courses across 5300 patients, all treated with interleukin inhibitors. Drug survival was expressed by using the Kaplan-Meier estimator for each biological drug at 6, 12, 24, 36 and 48 months. We also stratified by discontinuation associated with primary or secondary ineffectiveness., Results: In our study, the most prescribed drugs were secukinumab (1412), ixekizumab (1183), and risankizumab (977). After four years of follow-up, risankizumab emerged as the treatment with the highest drug survival overall, as 91.6% of patients were still on treatment. The overall probability of drug survival at four years was comparable for tildrakizumab (83.5%), ixekizumab (82.6%), guselkumab (82.4%) and brodalumab (81.8%). When evaluating only patients who discontinued the treatment because of ineffectiveness, once again risankizumab was the molecule with the highest drug survival at 4 years (93.4%), this time followed by ixekizumab (87%). Our study, in which all IL inhibitors were adequately represented, confirmed a slightly better treatment persistence for IL-23 inhibitors, consistent with other real-world studies., Conclusion: Our experience showed that IL-23 inhibitors, and risankizumab in particular, had a higher probability of drug survival overall during a 4-year follow-up. Risankizumab and ixekizumab were less likely to be discontinued because of ineffectiveness after four years., Competing Interests: LG has been a consultant for Almirall. LI has been a consultant for Almirall. PM has been a speaker for AbbVie, Lilly, Novartis, Janssen-Cilag, Celgene, Leopharma and Almirall. AB has received honoraria for participation in advisory boards, meetings or as speaker for AbbVie, Celgene, Janssen-Cilag, Eli Lilly, Novartis Pharma, Pfizer, Sanofi-Genzyme and UCB Pharma. FB has been a consultant advisor and clinical study investigator for Eli Lilly, Abbvie, Novartis, Leo Pharma, Sandoz, Bristol Myers, Abiogen-Pharma, Celgene and Janssen. MB has acted as a speaker and consultant for AbbVie, Janssen, Amgen, Novartis, Eli Lilly and UCB Pharma. CC has served as a board participant or speaker for Abbvie, Lilly, Janssen, Novartis, Celgene, Almirall and Leopharma. GD served as consultant and/or speaker for AbbVie, Almirall, Bristol-Meyers Squibb, LeoPharma, Novartis, Pfizer, Sanofi and UCB and received unrestricted grants from Pfizer and Almirall. PD has been a speaker for Novartis, Abbvie, Sanofi, UCB, Janssen, Lilly and LeoPharma. FG acted as a speaker or consultant for Novartis, Abbvie, Eli Lilly, Celgene, LeoPharma and Almirall. GG served as consultant and/or speaker for AbbVie, Almirall, Amgen, Biogen, Boehringer-Ingelheim, Bristol-Meyers Squibb, Eli-Lilly, LeoPharma, Novartis, Pfizer, Samsung, Sanofi and UCB. CG has been a scientific consultant/speaker/clinical study investigator for Abbvie, Celgene, Janssen, Eli Lilly, Novartis, Pfizer, Sanofi, Almirall and LEO Pharma. CL declares a conflict of interest with Abbvie, Novartis, Lilly and Almirall. FL served on advisory boards and/or received honoraria for lectures from Abbvie, Janssen-Cilag, Novartis, Lilly and Sanofi. AM reports consultancy/advisory boards disease-relevant honoraria from AbbVie, Boehringer-Ingelheim, Novartis, Pfizer, Sanofi and UCB. MM acted as a speaker or consultant for Abbvie, Eli Lilly, Janssen, Leo-Pharma, UCB and Novartis. AC has served as an advisory board member, consultant and has received fees and speaker’s honoraria or has participated in clinical trials for Abbvie, Almirall, Biogen, LEO Pharma, Lilly, Janssen, Novartis, Pfizer, Sanofi Genzyme and UCB-Pharma. AN has served on advisory boards, received honoraria for lectures and research grants from Almirall, Abbvie, Leo Pharma, Celgene, Eli Lilly, Janssen, Novartis, Sanofi-Genzyme, Amgen and Boehringer Ingelheim. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Gargiulo, Ibba, Malagoli, Balato, Bardazzi, Burlando, Carrera, Damiani, Dapavo, Dini, Gaiani, Girolomoni, Guarneri, Lasagni, Loconsole, Marzano, Megna, Mercuri, Travaglini, Costanzo and Narcisi.)
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- 2024
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36. The paradox of the Italian clinical embryologist in the national public health system: hints towards harmonization of a postgraduate educational curriculum.
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Alteri A, Bosco L, Chamayou S, Casciani V, Cervi M, Cecchele A, Cho YS, Costantini MP, Dal Canto MB, De Stefani S, Fraioli A, Furlan V, Giacone F, Guarneri C, Guglielmino A, Iaccarino M, Miceli A, Minasi MG, Montano L, Notari T, Paffoni A, Palini S, Reschini M, Ruvolo G, Viganó P, and Volpes A
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- Humans, Europe, Curriculum, Italy, Public Health education, Biological Specimen Banks
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Clinical embryologists are highly trained laboratory professionals with multiple roles, including laboratory, clinical, biobanking and quality system management. In most European countries, clinical embryologists are trained to work in Medically Assisted Reproduction (MAR) centres without a specifically dedicated educational path. The criteria required for employment vary according to the educational structure and the public or private nature of the centre. We have herein described the educational profile required by Italian clinical embryologists to work in MAR centres of the National Health System (NHS). Public centres currently represent 36% of all the Italian MAR clinics. According to the Italian law, a future clinical embryologist must achieve a 3-4 year unpaid post-graduate specialization in a different field, choosing from Genetics, Microbiology, Clinical Pathology or Nutrition. Accesses to the above-mentioned post-graduate courses are themselves very limited. Clinical embryologists are basically trained by senior colleagues. This situation makes inevitably difficult to recruit laboratory staff in NHS centres. Moreover, it represents an emblematic example of the need for an equal training curriculum, possibly ensuring a comparable education quality, mobility of trainees and dissemination of skills for clinical embryologists all over Europe.
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- 2023
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37. Long-term efficacy and safety of secukinumab in real life: a 240 weeks multicenter study from Southern Italy.
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Dastoli S, Passante M, Loconsole F, Mortato E, Balato A, Piccolo V, Guarneri C, Macca L, Provenzano E, Valenti G, D'Amico D, Micali G, Musumeci ML, Palazzo G, Foti C, Romita P, Fabbrocini G, Megna M, Sammarra I, Bennardo L, and Patruno C
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- Adult, Male, Humans, Middle Aged, Aged, Retrospective Studies, Quality of Life, Treatment Outcome, Severity of Illness Index, Italy, Antibodies, Monoclonal adverse effects, Psoriasis drug therapy, Psoriasis chemically induced
- Abstract
Background: Long-term real-life data on secukinumab use in psoriasis are limited., Objectives: Determine the long-term effectiveness of secukinumab in moderate-to-severe psoriasis in real-life., Methods: Multicenter retrospective study analyzing data from adult patients treated with secukinumab for at least 192 weeks and up to 240 weeks in Southern Italy, between 2016 and 2021. Clinical data, including concurrent comorbidities and prior treatments were collected. Effectiveness was assessed by Psoriasis Area and Severity Index (PASI), Body Surface Area (BSA), Dermatology Life Quality Index (DLQI) scores at the initiation of secukinumab and at weeks 4, 12, 24, 48, 96, 144, 192, and 240., Results: Two hundred and seventy-five patients (174 males), mean age 50.80 ± 14.78 years, were included; 29.8% had an uncommon localization, 24.4% psoriatic arthritis, 71.6% comorbidities. PASI, BSA, and DLQI improved significantly from week 4 and continued to improve over time. Between weeks 24 and 240, PASI score was mild (≤10) in 97-100% of patients, 83-93% had mild affected BSA (BSA ≤ 3), and 62-90% reported no effect of psoriasis on their quality of life (DLQI 0-1). Only 2.6% of patients reported adverse events and no patient discontinued the treatment during the study period., Conclusions: Secukinumab effectiveness in the long-term treatment of psoriasis is confirmed in real-world.
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- 2023
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38. Surgical treatment of tertiary hyperparathyroidism: does one fit for all?
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Casella C, Guarneri C, Campanile M, Adhoute X, Gelera PP, and Morandi R
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- Humans, Parathyroid Glands surgery, Cohort Studies, Calcium, Retrospective Studies, Parathyroidectomy adverse effects, Parathyroid Hormone, Hypocalcemia complications, Hypercalcemia complications, Hyperparathyroidism, Secondary etiology, Hyperparathyroidism, Secondary surgery, Hypoparathyroidism complications
- Abstract
Background: Tertiary hyperparathyroidism (3HPT) is defined as a condition of excessive autonomous excretion of intact parathyroid hormone (iPTH) with persistent hypercalcemia (>10.5 mg/dL) that lasts for more than 12 months after a successful kidney transplantation, in the context of a long course secondary hyperparathyroidism (2HPT). The chronic high levels of iPTH cause a worsening of graft function, accompanied by systemic symptoms of hypercalcemia. The only curative therapy is parathyroidectomy (PTX). It remains unclear whether total parathyroidectomy with autotransplantation (TPTX-AT) or subtotal parathyroidectomy (SPTX) lead to better outcomes., Aims: The aim of this retrospective, single-institution cohort study is to evaluate the rate of persistent or recurrent disease and postoperative calcium/iPTH disturbances in patients treated with TPTX-AT or SPTX for 3HPT., Methods: A single-center retrospective analysis of 3HPT patients submitted to TPTX-AT or SPTX between 2007-2020 with at least 24 months follow-up was conducted. The outcome parameters included persistence/recurrence of disease, incidence of transitory hypocalcemia, and temporary/permanent hypoparathyroidism., Results: A cohort of 52 patients was analyzed and divided in two groups: 38 (73%) were submitted for TPTX-AT, and 14 patients (27%) were submitted for SPTX. The TPTX-AT population showed lower plasmatic calcium concentrations compared with the SPTX group during the entire follow-up period (p<0.001). There were eight cases (21%) of transitory hypocalcemia in the TPTX-AT group and none in the SPTX group, with p=0.065. Two cases (5%) of temporary hypoparathyroidism occurred in the TPTX-AT group and none in the SPTX group, with p= 0.530. There were no cases of permanent hypoparathyroidism and no cases of persistent disease. No statistical difference was assessed for the recurrence of 3HPT between the TPTX-AT group and the SPTX group (N=1, 3% vs N=1, 7%) (p=0.470)., Conclusion: No significative difference was registered between the TPTX-AT and SPTX groups in terms of persistence/recurrence of disease, incidence of transitory hypocalcemia, and temporary/permanent hypoparathyroidism. Mean calcium levels iPTH values were statistically lower among the TPTX-AT group compared with the SPTX group while remaining always in the range of normality., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Casella, Guarneri, Campanile, Adhoute, Gelera and Morandi.)
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- 2023
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39. Facial naevus count in the identification of patients at higher risk of melanoma.
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Giuffrida R, Zanin Poletto G, Guarneri F, Conforti C, Guarneri C, Hofmann-Wellenhof R, and Zalaudek I
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- Humans, Melanoma diagnosis, Nevus diagnosis, Nevus, Pigmented diagnosis, Skin Neoplasms diagnosis
- Abstract
Competing Interests: Conflicts of interest: the authors declare no conflicts of interest.
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- 2023
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40. Impact of the 2018 revised Pregnancy Prevention Programme by the European Medicines Agency on the use of oral retinoids in females of childbearing age in Denmark, Italy, Netherlands, and Spain: an interrupted time series analysis.
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Durán CE, Riera-Arnau J, Abtahi S, Pajouheshnia R, Hoxhaj V, Gamba M, Alsina E, Martin-Perez M, Garcia-Poza P, Llorente-Garcia A, Gonzalez-Bermejo D, Ibánez L, Sabaté M, Vidal X, Ballarín E, Sanfélix-Gimeno G, Rodríguez-Bernal C, Peiró S, García-Sempere A, Sanchez-Saez F, Ientile V, Ingrasciotta Y, Guarneri C, Tanaglia M, Tari M, Herings R, Houben E, Swart-Polinder K, Holthuis E, Huerta C, Gini R, Roberto G, Bartolini C, Paoletti O, Limoncella G, Girardi A, Hyeraci G, Andersen M, Kristiansen SB, Hallgreen CE, Klungel O, and Sturkenboom M
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Background: In March 2018, the European pregnancy prevention programme for oral retinoids was updated as part of risk minimisation measures (RMM), emphasising their contraindication in pregnant women. Objective: To measure the impact of the 2018 revision of the RMMs in Europe by assessing the utilisation patterns of isotretinoin, alitretinoin and acitretin, contraceptive measures, pregnancy testing, discontinuation, and pregnancy occurrence concomitantly with a retinoid prescription. Methods: An interrupted time series (ITS) analysis to compare level and trend changes after the risk minimisation measures implementation was conducted on a cohort of females of childbearing age (12-55 years of age) from January 2010 to December 2020, derived from six electronic health data sources in four countries: Denmark, Netherlands, Spain, and Italy. Monthly utilisation figures (incidence rates [IR], prevalence rates [PR] and proportions) of oral retinoids were calculated, as well as discontinuation rates, contraception coverage, pregnancy testing, and rates of exposed pregnancies to oral retinoids, before and after the 2018 RMMs. Results: From 10,714,182 females of child-bearing age, 88,992 used an oral retinoid at any point during the study period (mean age 18.9-22.2 years old). We found non-significant level and trend changes in incidence or prevalence of retinoid use in females of child-bearing age after the 2018 RMMs. The reason of discontinuation was unknown in >95% of cases. Contraception use showed a significant increase trend in Spain; for other databases this information was limited. Pregnancy testing was hardly recorded thus was not possible to model ITS analyses. After the 2018 RMM, rates of pregnancy occurrence during retinoid use, and start of a retinoid during a pregnancy varied from 0.0 to 0.4, and from 0.2 to 0.8, respectively. Conclusion: This study shows a limited impact of the 2018 RMMs on oral retinoids utilisation patterns among females of child-bearing age in four European countries. Pregnancies still occur during retinoid use, and oral retinoids are still prescribed to pregnant women. Contraception and pregnancy testing information was limited in most databases. Regulators, policymakers, prescribers, and researchers must rethink implementation strategies to avoid any pregnancy becoming temporarily related to retinoid use., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Durán, Riera-Arnau, Abtahi, Pajouheshnia, Hoxhaj, Gamba, Alsina, Martin-Perez, Garcia-Poza, Llorente-Garcia, Gonzalez-Bermejo, Ibánez, Sabaté, Vidal, Ballarín, Sanfélix-Gimeno, Rodríguez-Bernal, Peiró, García-Sempere, Sanchez-Saez, Ientile, Ingrasciotta, Guarneri, Tanaglia, Tari, Herings, Houben, Swart-Polinder, Holthuis, Huerta, Gini, Roberto, Bartolini, Paoletti, Limoncella, Girardi, Hyeraci, Andersen, Kristiansen, Hallgreen, Klungel and Sturkenboom.)
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- 2023
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41. Hidradenitis suppurativa and psoriasis: the odd couple.
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Macca L, Li Pomi F, Ingrasciotta Y, Morrone P, Trifirò G, and Guarneri C
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Psoriasis and hidradenitis suppurativa are chronic inflammatory skin diseases that can develop together, negatively impacting on the patient's quality of life. We aimed to review the most up-to-date information regarding the epidemiology, pathogenesis, clinical presentation and possible therapeutical choices in patients with both psoriasis and hidradenitis suppurativa, thus linking these two autoimmune and autoinflammatory conditions. A narrative review of articles dating from 2017 to 2022 has been performed using the PubMed database. We analyzed the case reports and case series found in the literature regarding patients who suffered from both psoriasis and HS. Psoriasis arose before hidradenitis suppurativa in the majority of cases, while only a minority of them had hidradenitis suppurativa before psoriasis. Interestingly, some patients suffered from paradoxical hidradenitis suppurativa following biological therapy administered to treat the already present psoriasis. Lastly, new biological drugs have been marketed with great success for the outcome of psoriasis, but similar progress did not happen for hidradenitis. Novel therapeutic approaches and lines of research are needed for the treatment of these pathologies, even if concomitant, in order to improve patient's quality of life., Competing Interests: CG has received consultation fees and/or grants for research projects, advisory panels and giving educational lectures from Wyeth-Pfizer, Abbott Immunology-Abbvie, Janssen-Cilag, Novartis, LEO-Pharma, LEO-Pharma Denmark, Ely-Lilly, Celgene, Merck-Serono, Sanofi-Aventis, Amgen and Almirall. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Macca, Li Pomi, Ingrasciotta, Morrone, Trifirò and Guarneri.)
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- 2023
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42. Brodalumab for the treatment of plaque psoriasis in a real-life setting: a 3 years multicenter retrospective study-IL PSO (Italian landscape psoriasis).
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Gargiulo L, Ibba L, Malagoli P, Amoruso F, Argenziano G, Balato A, Bardazzi F, Burlando M, Carrera CG, Damiani G, Dapavo P, Dini V, Fabbrocini G, Franchi C, Gaiani FM, Girolomoni G, Guarneri C, Lasagni C, Loconsole F, Marzano AV, Megna M, Sampogna F, Travaglini M, Costanzo A, and Narcisi A
- Abstract
Introduction: Brodalumab is a monoclonal antibody that targets the subunit A of the interleukin-17A receptor (IL17RA), inhibiting the signaling of various isoforms of the IL-17 family. It has been approved for the treatment of moderate-to-severe plaque psoriasis after being evaluated in three Phase-3 trials. However, long-term data on brodalumab in a real-life setting are still limited., Methods: The aim of this study was to evaluate the long-term effectiveness and safety of brodalumab in psoriasis. We also assessed the drug survival of brodalumab in a 3 years timespan. We conducted a retrospective multicenter study on 606 patients followed up at 14 Italian dermatology units, all treated with brodalumab according to Italian guidelines. Patients' demographics and disease characteristics were retrieved from electronic databases. At baseline and weeks 12, 24, 52, 104 and 156, we evaluated the psoriasis area and severity index (PASI) score and investigated for adverse events. The proportions of patients reaching 75, 90 and 100% (PASI 75, PASI 90 and PASI 100, respectively) improvement in PASI, compared with baseline, were also recorded., Results: At week 12, 63.53% of the patients reached PASI 90 and 49.17% PASI 100. After 3 years of treatment, 65.22% of patients maintained a complete skin clearance, and 91.30% had an absolute PASI of 2 or less. Patients naïve to biological therapies had better clinical responses at weeks 12, 24 and 52. However, after 2 years of treatment, no significant differences were observed. Body mass index did not interfere with the effectiveness of brodalumab throughout the study. No new safety findings were recorded. After 36 months, 85.64% of our patients were still on treatment with brodalumab., Conclusion: Our data confirm the effectiveness and the safety of brodalumab in the largest real-life cohort to date, up to 156 weeks., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Gargiulo, Ibba, Malagoli, Amoruso, Argenziano, Balato, Bardazzi, Burlando, Carrera, Damiani, Dapavo, Dini, Fabbrocini, Franchi, Gaiani, Girolomoni, Guarneri, Lasagni, Loconsole, Marzano, Megna, Sampogna, Travaglini, Costanzo and Narcisi.)
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- 2023
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43. Actinic Keratoses: A Prospective Pilot Study on a Novel Formulation of 4% 5-Fluorouracil Cream and a Review of Other Current Topical Treatment Options.
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Toffoli L, Dianzani C, Bonin S, Guarneri C, Guarneri F, Giuffrida R, Zalaudek I, and Conforti C
- Abstract
Background: Actinic keratosis (AK) is one of the most common skin diseases, with a low risk of progression into invasive squamous cell carcinoma. We aim to assess efficacy and safety of a novel formulation of 5-Fluorouracil (5-FU) 4% with once daily application for the treatment of multiple AKs., Methods: A pilot study was performed on 30 patients with a clinical and dermoscopic diagnosis of multiple AKs, enrolled between September 2021 and May 2022 at the Dermatology Departments of two Italian hospitals. Patients were treated with 5-FU 4% cream once daily for 30 consecutive days. The Actinic Keratosis Area and Severity Index (AKASI) was calculated before starting therapy, and at each follow-up, to assess objective clinical response., Results: The cohort analyzed included 14 (47%) males and 16 (53%) females (mean age: 71 ± 12 years). A significant decrease in AKASI score at both 6 and 12 weeks ( p < 0.0001) was observed. Only three patients (10%) discontinued therapy, and 13 patients (43%) did not report any adverse reactions; no unexpected adverse events were observed., Conclusions: In the setting of topical chemotherapy and immunotherapy, the new formulation of 5-FU 4% proved to be a highly effective treatment for AKs and field cancerization.
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- 2023
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44. Brodalumab for the Treatment of Moderate-to-Severe Psoriasis: An Expert Delphi Consensus Statement.
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Fargnoli MC, Bardazzi F, Bianchi L, Dapavo P, Fabbrocini G, Gisondi P, Micali G, Offidani AM, Pellacani G, Skroza N, Angileri RG, Burlando M, Campanati A, Carrera CG, Chiricozzi A, Conti A, Simone C, Di Lernia V, Errichetti E, Galluzzo M, Guarneri C, Lasagni C, Lembo S, Loconsole F, Megna M, Musumeci ML, Prignano F, Richetta AG, Trovato E, Venturini M, Peris K, and Pinton PC
- Abstract
Brodalumab is a recombinant, fully human immunoglobulin IgG2 monoclonal antibody specifically targeted against interleukin-17RA that has been approved for the treatment of moderate-to-severe psoriasis in Europe. We developed a Delphi consensus document focused on brodalumab for the treatment of moderate-to-severe psoriasis. Based on published literature and their clinical experience a steering committee drafted 17 statements covering 7 domains specific to the treatment of moderate-to-severe psoriasis with brodalumab. A panel of 32 Italian dermatologists indicated their level of agreement using a 5-point Likert scale (from 1 = "strongly disagree" to 5 = "strongly agree") using an online modified Delphi method. After the first round of voting (32 participants), positive consensus was reached for 15/17 (88.2%) of the proposed statements. Following a face-to-face virtual meeting, the steering committee decided that 5 statements would form "main principles" and 10 statements formed the final list. After a second round of voting, consensus was reached in 4/5 (80%) of the main principles and 8/10 (80%) for consensus statements. The final list of 5 main principles and 10 consensus statements identify key indications specific to the use of brodalumab in the treatment of moderate-to-severe psoriasis in Italy. These statements aid dermatologists in the management of patients with moderate-to-severe psoriasis.
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- 2023
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45. Real-life effectiveness and safety of guselkumab in patients with psoriasis who have an inadequate response to ustekinumab: A 104-week multicenter retrospective study - IL PSO (ITALIAN LANDSCAPE PSORIASIS).
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Gargiulo L, Ibba L, Malagoli P, Angileri RG, Bardazzi F, Bernardini N, Burlando M, Carrera CG, Chiricozzi A, Dapavo P, Dini V, Fabbrocini G, Gaiani FM, Galluzzo M, Giofré C, Guarneri C, Loconsole F, Malara G, Marcelli L, Megna M, Piaserico S, Talamonti M, Costanzo A, and Narcisi A
- Subjects
- Adult, Humans, Retrospective Studies, Treatment Outcome, Severity of Illness Index, Antibodies, Monoclonal adverse effects, Double-Blind Method, Ustekinumab therapeutic use, Psoriasis complications, Psoriasis drug therapy
- Abstract
Background: Guselkumab is a fully human monoclonal antibody that binds selectively to the p19 subunit of interleukin-23, which has shown efficacy in patients with previous incomplete response to ustekinumab in the NAVIGATE clinical trial. [Correction added on [28-02-2023], after first online publication: 'humanized monoclonal antibody' has been changed to 'fully human monoclonal antibody' in the preceding sentence.] OBJECTIVES: We conducted a 104-week multicenter retrospective study to assess the effectiveness and safety of guselkumab in patients affected by plaque psoriasis with an inadequate response to ustekinumab in a real-life setting., Methods: Our retrospective study included 233 adults affected by moderate-to-severe plaque psoriasis, enrolled in 14 different Italian centres, and treated with guselkumab after failing therapy with ustekinumab. Patient characteristics and PASI (Psoriasis Area and Severity Index) score at each visit (baseline, weeks 16, 52 and 104) were recorded. The percentages of patients achieving 75%, 90% and 100% (PASI 75, PASI 90 and PASI 100) improvement in PASI, compared with baseline, were registered., Results: At week 52, PASI 75 was reached by 89.88% of patients, PASI 90 by 71.43%, PASI 100 by 58.83% and absolute PASI ≤2 by 90.48%. At week 104, similar effectiveness results were observed. Compared to the NAVIGATE trial, we observed higher rates of PASI 75/90/100. Patients with the involvement of difficult-to-treat areas were significantly less likely to achieve PASI90 and PASI100 at week 16. Obese patients had significantly lower rates of PASI75 and PASI ≤2 at week 52. At week 104, comparable responses were observed among all patients' subgroups, regardless of BMI status, involvement of difficult-to-treat areas, presence of cardiometabolic comorbidities and concomitant psoriatic arthritis. No significant safety findings were reported throughout the study., Conclusion: Our data suggest that the efficacy of guselkumab in patients with inadequate response to ustekinumab for plaque psoriasis in 'real-life' clinical practice is comparable with NAVIGATE study with higher percentages of patients achieving PASI90 and PASI100 at weeks 16, 52 and 104., (© 2023 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.)
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- 2023
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46. COVID 19-associated chilblain-like acral lesions among children and adolescents: an Italian retrospective, multicenter study.
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Romita P, Maronese CA, DE Marco A, Balestri R, Belloni Fortina A, Brazzelli V, Colonna C, DI Lernia V, El Hachem M, Fabbrocini G, Foti C, Frasin LA, Guarneri C, Guerriero C, Guida S, Locatelli A, Neri I, Occella C, Offidani A, Oranges T, Pellacani G, Stinco G, Stingeni L, Barbagallo T, Campanati A, Cannavò SP, Caroppo F, Cavalli R, Costantini A, Cucchia R, Diociaiuti A, Filippeschi C, Francomano M, Giancristoforo S, Giuffrida R, Martina E, Monzani NA, Nappa P, Pastorino C, Patrizi A, Peccerillo F, Peris K, Recalcati S, Rizzoli L, Simonetti O, Vastarella M, Virdi A, Marzano AV, and Bonamonte D
- Subjects
- Adult, Female, Humans, Adolescent, Child, Infant, Child, Preschool, Male, Retrospective Studies, Pandemics, SARS-CoV-2, Erythema complications, Italy epidemiology, Blister complications, Cyanosis complications, COVID-19 complications, COVID-19 diagnosis, COVID-19 epidemiology, Chilblains diagnosis, Chilblains etiology, Chilblains epidemiology, Exanthema complications
- Abstract
Background: Since the COVID-19 pandemic started, great interest has been given to this disease, especially to its possible clinical presentations. Besides classical respiratory symptoms, dermatological manifestations occur quite often among infected and non-infected patients, particularly in children. A prominent IFN-I response, that is generally higher in children compared to adults, may not only cause chilblain lesions, but it could also prevent infection and viral replication, thus justifying the negative swab results, as well as the absence of relevant systemic symptoms in positive cases. Indeed, reports have emerged describing chilblain-like acral lesions in children and adolescents with either proven or suspected infection., Methods: Patients aged from 1 to 18 years old were enrolled in this study from 23 Italian dermatological units and were observed for an overall period of 6 months. Clinical pictures were collected along with data on the location and duration of skin lesions, their association with concomitant local and systemic symptoms, presence of nail and/or mucosal involvement, as well as histological, laboratory and imaging findings., Results: One hundred thirty-seven patients were included, of whom 56.9% were females. Mean age was 11.97±3.66 years. The most commonly affected sites were the feet (77 patients, 56.2%). Lesions (48.5%) featured cyanosis, chilblains, blisters, ecchymosis, bullae, erythema, edema, and papules. Concomitant skin manifestations included maculo-papular rashes (30%), unspecified rashes (25%), vesicular rashes (20%), erythema multiforme (10%), urticaria (10%) and erythema with desquamation (5%). Forty-one patients (29.9%) reported pruritus as the main symptom associated with chilblains, and 56 out of 137 patients also reported systemic symptoms such as respiratory symptoms (33.9%), fever (28%), intestinal (27%), headache (5.5%), asthenia (3.5%), and joint pain (2%). Associated comorbid conditions were observed in 9 patients presenting with skin lesions. Nasopharyngeal swabs turned out positive in 11 patients (8%), whereas the remainder were either negative (101, 73%) or unspecified (25, 18%)., Conclusions: COVID-19 has been credited as the etiology of the recent increase in acro-ischemic lesions. The present study provides a description of pediatric cutaneous manifestations deemed to be potentially associated with COVID-19, revealing a possible association between acral cyanosis and nasopharyngeal swab positivity in children and teenagers. The identification and characterization of newly recognized patterns of skin involvement may aid physicians in diagnosing cases of asymptomatic or pauci-symptomatic COVID patients.
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- 2023
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47. Progestin-primed ovarian stimulation for fertility preservation in women with cancer: A comparative study.
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Filippi F, Reschini M, Polledri E, Cecchele A, Guarneri C, Vigano P, Fustinoni S, Platteau P, and Somigliana E
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- Humans, Female, Progestins therapeutic use, Chorionic Gonadotropin, Retrospective Studies, Ovulation Induction methods, Steroids, Gonadotropin-Releasing Hormone, Fertilization in Vitro methods, Fertility Preservation methods, Infertility, Female therapy, Neoplasms
- Abstract
Background: In women scheduled for cancer treatment, oocytes cryopreservation is a well-established procedure. Random start protocols have been a substantial improvement in this setting, allowing to prevent delay in the initiation of cancer treatments. However, there is still the need to optimize the regimen of ovarian stimulation, to make treatments more patient-friendly and to reduce costs., Methods: This retrospective study compares two periods (2019 and 2020), corresponding to two different ovarian stimulation regimens. In 2019, women were treated with corifollitropin, recombinant FSH and GnRH antagonists. Ovulation was triggered with GnRH agonists. In 2020, the policy changed, and women were treated with a progestin-primed ovarian stimulation (PPOS) protocol with human menopausal gonadotropin (hMG) and dual trigger (GnRH agonist and low dose hCG) Continuous data are reported as median [Interquartile Range]. To overcome expected changes in baseline characteristics of the women, the primary outcome was the ratio between the number of mature oocytes retrieved and serum anti-mullerian hormone (AMH) in ng/ml., Results: Overall, 124 women were selected, 46 in 2019 and 78 in 2020. The ratio between the number of mature oocytes retrieved and serum AMH in the first and second period was 4.0 [2.3-7.1] and 4.0 [2.7-6.8], respectively (p = 0.80). The number of scans was 3 [3-4] and 3 [2-3], respectively (p<0.001). The total costs of the drugs used for ovarian stimulation were 940 € [774-1,096 €] and 520 € [434-564 €], respectively (p<0.001)., Conclusions: Random start PPOS with hMG and dual trigger represents an easy and affordable ovarian stimulation protocol for fertility preservation in women with cancer, showing similar efficacy and being more friendly and economical., Competing Interests: The authors of this manuscript have the following competing interests: E.S. received honoraria for presentations at meetings from Gedeon-Richter and Merck-Serono. He is also handling two grants of research from Ferring. None of the remaining authors reported any conflict of interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2023 Filippi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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- 2023
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48. Treatment of erosive pustular dermatosis of the scalp: our experience and review of unconventional topical drugs.
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Di Bartolomeo L, Ceravolo I, Borgia F, Vaccaro F, Guarneri C, and Vaccaro M
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- Humans, Aged, Administration, Topical, Dapsone therapeutic use, Alopecia drug therapy, Scalp pathology, Scalp Dermatoses drug therapy, Scalp Dermatoses pathology
- Abstract
Background: Erosive pustular dermatosis of the scalp (EPDS) is a rare inflammatory disorder of elderly individuals, characterized by relapsing pustular and eroded lesions of the scalp, which may lead to scarring alopecia. Treatment is challenging and classically based on topical and/or oral corticosteroids., Case Report: From 2008 to 2022, we treated fifteen cases of EPDS. We used mainly topical and systemic steroids with good results. Nevertheless, several non-steroidal topical drugs have been described in literature for the treatment of EPDS. We have carried out a brief review of these treatments., Conclusions: Topical calcineurin inhibitors represent a valuable alternative to steroids to avoid skin atrophy. Emerging evidence about other topical treatments, such as calcipotriol, dapsone, zinc oxide, together with photodynamic therapy, are evaluated in our review.
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- 2023
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49. Pilomatrix Carcinoma: Report of Two Cases of the Head and Review of the Literature.
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Toffoli L, Bazzacco G, Conforti C, Guarneri C, Giuffrida R, Zelin E, di Meo N, and Zalaudek I
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- Middle Aged, Humans, Female, Skin Neoplasms pathology, Bone Neoplasms, Breast Neoplasms, Hair Diseases diagnosis, Hair Diseases pathology, Carcinoma
- Abstract
Background: Pilomatrix carcinoma (PC) is a rare skin tumor arising from hair follicle matrix cells. It is locally aggressive with a high rate of local recurrence after surgical excision. Few cases in the literature have been described and the management is not well defined., Objectives: The aim of this study was to present two cases of PC located on the head and review the relevant literature about epidemiology, clinical and dermoscopic evaluation, characteristics of local and distant metastases, local recurrence rate and management of this rare skin tumor., Methods: We consulted databases from PubMed, Research Gate and Google Scholar, from January 2012 to November 2022. We reviewed the literature and reported two additional cases., Results: We selected 52 tumors in middle-aged to older patients located mostly on the head. Dermoscopy evaluation was rarely performed in the pre-operative diagnostic setting. The most definitive treatment was wide local excision, but local recurrences were common. In total, we observed 11 cases of recurrences and 9 patients with locoregional or distant metastases. Four patients received adjuvant radiotherapy, two patients needed chemotherapy and local cancer therapy and one patient received radiochemotherapy., Conclusion: Our reports and the review of the literature can provide a better awareness and management of this rare tumor.
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- 2023
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50. Real-life effectiveness of tildrakizumab in chronic plaque psoriasis: A 52-week multicentre retrospective study-IL PSO (Italian landscape psoriasis).
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Narcisi A, Valenti M, Gargiulo L, Ibba L, Amoruso F, Argenziano G, Bardazzi F, Burlando M, Carrera CG, Damiani G, Dapavo P, Dini V, Franchi C, Girolomoni G, Guarneri C, Loconsole F, Sampogna F, Travaglini M, Malagoli P, and Costanzo A
- Subjects
- Adult, Humans, Retrospective Studies, Severity of Illness Index, Treatment Outcome, Italy, Psoriasis drug therapy
- Abstract
Background: Tildrakizumab is a humanized monoclonal antibody that binds selectively the p19 subunit of interleukin-23. It is approved for treatment of moderate-severe chronic plaque psoriasis., Objectives: We conducted a 52-week retrospective study to assess the effectiveness and safety of tildrakizumab in a real-life setting., Methods: Our retrospective study included 237 consecutive adults with moderate-to-severe plaque psoriasis, enrolled in 10 different Italian centres, treated with tildrakizumab up to Week 52. Patient characteristics, comorbidities, previous treatments and the PASI (Psoriasis Area and Severity Index) score at each visit (baseline, Week 16, Week 28 and Week 52) were retrieved from the electronic medical records. The percentages of patients achieving 75%, 90% and 100% (PASI 75, PASI 90 and PASI 100) improvement in PASI with respect to baseline PASI were registered., Results: At Week 52, 90.91%, 73.55% and 58.68% of patients achieved a PASI reduction ≥75% (PASI 75), PASI 90 and PASI 100, respectively. An absolute PASI ≤ 2 was reached by 85.95% at Week 52. Compared with Phase 3 clinical trials, we observed similar rates of PASI 75/90 responses and higher percentages of patients achieving PASI 100. Patients who had not responded to previous biologic treatments and patients with cardio-metabolic comorbidities were significantly more likely to achieve PASI 100 at Week 28 and PASI 90 at Week 52. The higher body mass index did not interfere with the odds of reaching PASI 75/90/100 at each time point. No significant safety findings were recorded throughout the study, and none of the patients had to interrupt the treatment because of adverse events., Conclusion: Our data suggest that the efficacy of tildrakizumab for plaque psoriasis in 'real-life' clinical practice is comparable with Phase 3 clinical trials with higher percentages of patients achieving complete skin clearance (PASI 100) at Weeks 16, 28 and 52., (© 2022 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.)
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- 2023
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