23 results on '"Dini, V"'
Search Results
2. Bimekizumab for the Treatment of Plaque Psoriasis With Involvement of Genitalia: A 16-Week Multicenter Real-World Experience - IL PSO (Italian Landscape Psoriasis)
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Orsini, D, Malagoli, P, Balato, A, Bianchi, L, Brianti, P, Buononato, D, Burlando, M, Caldarola, G, Campanati, A, Campione, E, Carrera, C, Carugno, A, Cusano, F, Dapavo, P, Dattola, A, De Simone, C, Dini, V, Esposito, M, Fargnoli, M, Gaiani, F, Gargiulo, L, Gisondi, P, Giunta, A, Ibba, L, Lasagni, C, Loconsole, F, Maione, V, Mortato, E, Marzano, A, Maurelli, M, Megna, M, Mercuri, S, Narcisi, A, Offidani, A, Paolino, G, Parodi, A, Pellacani, G, Potestio, L, Quaglino, P, Richetta, A, Romano, F, Sena, P, Venturini, M, Assorgi, C, Costanzo, A, Orsini, Diego, Malagoli, Piergiorgio, Balato, Anna, Bianchi, Luca, Brianti, Pina, Buononato, Dario, Burlando, Martina, Caldarola, Giacomo, Campanati, Anna, Campione, Elena, Carrera, Carlo G, Carugno, Andrea, Cusano, Francesco, Dapavo, Paolo, Dattola, Annunziata, De Simone, Clara, Dini, Valentina, Esposito, Maria, Fargnoli, Maria C, Gaiani, Francesca M, Gargiulo, Luigi, Gisondi, Paolo, Giunta, Alessandro, Ibba, Luciano, Lasagni, Claudia, Loconsole, Francesco, Maione, Vincenzo, Mortato, Edoardo, Marzano, Angelo V, Maurelli, Martina, Megna, Matteo, Mercuri, Santo R, Narcisi, Alessandra, Offidani, Annamaria, Paolino, Giovanni, Parodi, Aurora, Pellacani, Giovanni, Potestio, Luca, Quaglino, Pietro, Richetta, Antonio G, Romano, Francesca, Sena, Paolo, Venturini, Marina, Assorgi, Chiara, Costanzo, Antonio, Orsini, D, Malagoli, P, Balato, A, Bianchi, L, Brianti, P, Buononato, D, Burlando, M, Caldarola, G, Campanati, A, Campione, E, Carrera, C, Carugno, A, Cusano, F, Dapavo, P, Dattola, A, De Simone, C, Dini, V, Esposito, M, Fargnoli, M, Gaiani, F, Gargiulo, L, Gisondi, P, Giunta, A, Ibba, L, Lasagni, C, Loconsole, F, Maione, V, Mortato, E, Marzano, A, Maurelli, M, Megna, M, Mercuri, S, Narcisi, A, Offidani, A, Paolino, G, Parodi, A, Pellacani, G, Potestio, L, Quaglino, P, Richetta, A, Romano, F, Sena, P, Venturini, M, Assorgi, C, Costanzo, A, Orsini, Diego, Malagoli, Piergiorgio, Balato, Anna, Bianchi, Luca, Brianti, Pina, Buononato, Dario, Burlando, Martina, Caldarola, Giacomo, Campanati, Anna, Campione, Elena, Carrera, Carlo G, Carugno, Andrea, Cusano, Francesco, Dapavo, Paolo, Dattola, Annunziata, De Simone, Clara, Dini, Valentina, Esposito, Maria, Fargnoli, Maria C, Gaiani, Francesca M, Gargiulo, Luigi, Gisondi, Paolo, Giunta, Alessandro, Ibba, Luciano, Lasagni, Claudia, Loconsole, Francesco, Maione, Vincenzo, Mortato, Edoardo, Marzano, Angelo V, Maurelli, Martina, Megna, Matteo, Mercuri, Santo R, Narcisi, Alessandra, Offidani, Annamaria, Paolino, Giovanni, Parodi, Aurora, Pellacani, Giovanni, Potestio, Luca, Quaglino, Pietro, Richetta, Antonio G, Romano, Francesca, Sena, Paolo, Venturini, Marina, Assorgi, Chiara, and Costanzo, Antonio
- Abstract
Introduction: Genital involvement is observed in approximately 60% of patients with psoriasis, presenting clinicians with formidable challenges in treatment. While new biologic drugs have emerged as safe and effective options for managing psoriasis, their efficacy in challenging-to-treat areas remains inadequately explored. Intriguingly, studies have shown that interleukin (IL)-17 inhibitors exhibit effectiveness in addressing genital psoriasis. Objectives: We aimed to determine the effectiveness profile of bimekizumab in patients affected by moderate-to-severe plaque psoriasis with involvement of genitalia. Methods: Bimekizumab, a dual inhibitor of both IL-17A and IL-17F, was the focus of our 16-week study, demonstrating highly favorable outcomes for patients with genital psoriasis. The effectiveness of bimekizumab was evaluated in terms of improvement in Static Physician's Global Assessment of Genitalia (sPGA-G) and Psoriasis Area and Severity Index. Results: Sixty-five adult patients were enrolled. Remarkably, 98.4% of our participants achieved a clear sPGA-G score (s-PGA-g=0) within 16 weeks. Moreover, consistent improvements were observed in PASI scores, accompanied by a significant reduction in the mean Dermatology Life Quality Index (DLQI), signifying enhanced quality of life. Notably, none of the patients reported a severe impairment in their quality of life after 16 weeks of treatment. In our cohort of 65 patients, subgroup analyses unveiled that the effectiveness of bimekizumab remained unaffected by prior exposure to other biologics or by obesity. Conclusions: Our initial findings suggest that bimekizumab may serve as a valuable treatment option for genital psoriasis. Nevertheless, further research with larger sample sizes and longer-term follow-up is imperative to conclusively validate these results.
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- 2024
3. 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
4. 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.
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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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5. Cord Blood Serum Levels of IL-31 and CCL17, Cutaneous Markers, and Development of Atopic Dermatitis.
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D'Erme AM, Fidanzi C, Bevilacqua M, Bieber T, Tuoni C, Paolicchi A, Franzini M, Morganti R, Papadia F, Janowska A, Dini V, and Romanelli M
- Abstract
Importance: Atopic dermatitis (AD) is the most prevalent chronic skin condition characterized by inflammation and itching. Currently, there is no reliable method for identifying which newborns might have an increased risk of developing AD., Objective: To evaluate the predictive value of serological biomarkers, such as CCL17/thymus- and activation-regulated chemokine, CCL18, CCL22, CCL27, IL-31, and thymus stromal lymphopoietin, with transepidermal water loss (TEWL) and hydration rate and the development of AD in infants., Design, Setting, and Participants: This observational prospective study included 40 consecutive full-term newborns from a single university hospital in Pisa, Italy. The cutaneous markers of infants were assessed at 1, 6, and 12 months of age, while the biomarkers from the 10-mL sample of cord blood taken at birth were measured after delivery. Data were collected from March to December 2018 and analyzed from January to April 2019., Main Outcomes and Measures: Level of serological biomarkers associated with TEWL and hydration rate, as well as the emergence of AD during the first 12 months of life., Results: All 40 included infants (27 male [68%]) completed the study. At 6 months, 16 infants presented symptoms and signs of AD (AD group) and 24 did not (non-AD group). Infants with AD signs had statistically significant anterior cubital fossa TEWL values at 1, 6, and 12 months of age compared to those without AD signs. No statistically significant correlations were observed between the TEWL measured at the anterior part of knee and hydration rate at the anterior cubital fossa at first month in the 2 groups. With regard to the blood biomarkers, at birth those in the AD group vs the non-AD group had statistically significant higher levels of CCL17/thymus- and activation-regulated chemokine (median [IQR], 716 [509-951] pg/mL vs 419 [24-566] pg/mL; P = .003) and IL-31 (median [IQR], 212 [114-409] pg/mL vs 97 [52-277] pg/mL; P = .04); in contrast, no statistically significant serum level differences were registered for thymus stromal lymphopoietin (median [IQR], 105 [66-295] pg/mL vs 88 [43-187] pg/mL), CCL18 (median [IQR], 1236 [1115-1605] pg/mL vs 1255 [1188-1677] pg/mL), CCL22 (median [IQR], 1032 [936-1454] pg/mL vs 1096 [932-1536] pg/mL), and CCL27 (median [IQR], 172 [122-251] pg/mL vs 120 [90-265] pg/mL)., Conclusions and Relevance: In this observational study, the analysis of TEWL at the anterior cubital fossa area occurred prior to and correlated with the clinical signs of AD. Quantification of cytokines indicated that assessing cord blood serum levels of CCL17 and IL-31 could offer new perspectives in identifying newborns who might be susceptible to AD. Larger studies are needed to validate these findings.
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- 2024
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6. Real-life effectiveness and safety of baricitinib in patients with severe alopecia areata: A 24-week Italian study.
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Piraccini BM, Pampaloni F, Cedirian S, Quadrelli F, Bruni F, Rapparini L, Caro G, Acri MC, Ala L, Rossi A, Pellacani G, Lacarrubba F, Micali G, Dall'Oglio F, Vastarella M, Cantelli M, Nappa P, Diluvio L, Bianchi L, Gnesotto L, Sechi A, Naldi L, Tassone F, Peris K, Caldarola G, Pinto LM, Girolomoni G, Marangoni F, Bellinato F, Gisondi P, Scandagli I, Prignano F, Pimpinelli N, Tomasini C, Barruscotti S, De Simoni E, Simonetti O, Ambrogio F, Foti C, Boccaletti V, Fraghì A, Marzano AV, Mattioli MA, Rocca L, Barbareschi M, Ferrucci SM, Gallo G, Ribero S, Quaglino P, Balestri R, Ioris T, Caposiena Caro RD, Zalaudek I, Vagnozzi E, Fargnoli MC, Caponio C, Rubegni P, Cinotti E, Trovato E, Romanelli M, Dini V, Manzo Margiotta F, Feliciani C, de Felici Del Giudice MB, Atzori L, Sanna S, Lembo S, Raimondo A, Magnano M, and Starace M
- Abstract
Background: Alopecia areata is an autoimmune condition characterized by rapid hair loss in the scalp, eyebrows and eyelashes, for which treatments are limited. Baricitinib, an oral inhibitor of Janus kinases 1 and 2, has been recently approved to treat alopecia areata., Materials and Methods: We conducted a retrospective study involving 23 medical centres across Italy, enrolling patients affected by severe alopecia areata (SALT >50), for more than 6 months. Clinical and trichoscopic assessment was performed at each visit and impact on quality of life, anxiety and depression were evaluated using the Skindex-16 and the Hospital Anxiety and Depression Scale (HADS), respectively., Results: A total of 118 patients were enrolled, with a mean age of 39 years and a mean SALT >95. The mean value of the SALT score decreased from an average of 96.6 (±8.23 sd) to 48 (±35.2 sd) after 24 weeks of treatment and 42.3% of patients achieved a SALT 30, 31.3% a SALT 20 and 20.3% a SALT 10 by Week 24. Trichoscopic signs showed fewer yellow dots and black dots significantly earlier than hair regrowth. Adverse events during the treatment period (mild laboratory test abnormalities) were reported in 12.7% patients. No drop-out were registered., Conclusion: Data on the effectiveness and safety of baricitinib are promising and support the use of this drug in severe forms of AA, also in the early stages. We also suggest performing trichoscopy in order to reveal early response to therapy., (© 2024 European Academy of Dermatology and Venereology.)
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- 2024
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7. Interleukin-1 family cytokines and soluble receptors in hidradenitis suppurativa.
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Manzo Margiotta F, Gambino G, Pratesi F, Michelucci A, Pisani F, Rossi L, Dini V, Romanelli M, and Migliorini P
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- Humans, Male, Adult, Female, Middle Aged, Interleukin-1 blood, Interleukin-1 Receptor-Like 1 Protein blood, Interleukin-33 blood, Case-Control Studies, Young Adult, Hidradenitis Suppurativa blood, Interleukin-18 blood, Interleukin 1 Receptor Antagonist Protein blood, Severity of Illness Index, Receptors, Interleukin-1 Type II blood
- Abstract
Hidradenitis suppurativa (HS) is a chronic skin disease, characterized by clinical inflammation of the hair follicle with the recurrence of abscesses, nodules, and tunnels. Recently, several studies suggested a role of IL-1 family (IL-1F) cytokines in eliciting and sustaining the disease. The aim of this work is to perform a comprehensive analysis of IL-1F cytokines, soluble inhibitors and receptors in a cohort of HS patients not treated with biological agents. Sixteen patients affected by HS and 16 healthy controls were recruited; clinical data were collected and disease severity evaluated by means of the International HS Severity Score System (IHS4). Serum levels of IL-1F cytokines, inhibitors and receptors were measured using a Multiplex Assays. IL-18 and free IL-18 levels were significantly higher in patients vs controls. Among soluble inhibitors, IL-1Ra, IL-1R2 and ST2/IL-1R4 were significantly increased. IL-18, free IL-18 and IL-33 levels are strongly correlated with IHS4. Also the inhibitors IL-1Ra and IL-18BP show a correlation with IHS4. The data obtained in this study confirm the involvement of IL-1F cytokines in mediating the disease and determining its severity and suggest a possible role for IL-18 as novel serum biomarker of active disease., (© 2024 The Author(s). Experimental Dermatology published by John Wiley & Sons Ltd.)
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- 2024
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8. Evaluation of post-surgical complications of hidradenitis suppurativa lesions explored with presurgical ultra-high frequency ultrasound mapping.
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Dini V, Michelucci A, Granieri G, Zerbinati N, Margiotta FM, and Romanelli M
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- Humans, Retrospective Studies, Male, Female, Adult, Middle Aged, Wound Healing, Preoperative Care, Hidradenitis Suppurativa surgery, Hidradenitis Suppurativa diagnostic imaging, Postoperative Complications epidemiology, Ultrasonography
- Abstract
Objective: Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the hair follicle. Its treatment often requires a surgical approach. The aim of our study was to evaluate the occurrence of post-surgical complications following a new standard of surgical management. This included presurgical lesion mapping by ultra-high frequency ultrasound (UHFUS) with a 70MHz probe. Postoperative management was based on the principles of HS-TIME (time, inflammation/infection, moisture, edges)., Method: A single-centre, retrospective study was conducted by the Department of Dermatology of the University of Pisa. Patients with moderate and severe HS, refractory to previous medical and surgical therapies, were enrolled. All of the patients were treated with wide surgical excision of lesions, previously explored through a UHFUS evaluation with VEVO MD (Fujifilm VisualSonics, Inc., Canada) using a 48MHz and a 70MHz ultrasound probe. Following surgery, all patients were treated with secondary intention healing following the principles of HS-TIME. For each patient, we assessed the occurrence of post-surgical complications at follow-up visit six months after surgery. For each patient we assessed the occurrence of early post-surgical complications at every follow-up visit after surgery until complete wound healing. The occurrence of delayed complications was then assessed in all patients with an observation time after complete healing of >3 months (n=23)., Results: A total of 26 patients were enrolled in the study. There were no reported cases of post-surgical bleeding or haematoma occurrence, while three (11.5%) patients developed minor surgical site infection. The average severity of pain decreased from a numerical rating scale of 5.3 immediately after surgery to 1.3 after four weeks. The average healing time was 33.3±16.8 days, and only five (19.2%) patients reported a complete wound healing time of >6 weeks. Focusing on delayed complications: 1/23 (4.3%) patient had hypertrophic scarring; 2/23 (8.7%) patients reported dysaesthesia; and 2/23 (8.7%) cases of clinical relapse were reported. No cases of limited mobility at the surgery site were registered., Conclusion: The findings of the study demonstrated the efficacy of a novel surgical protocol, including a preoperative ultrasound evaluation and appropriate postoperative wound management. Further prospective studies are needed to validate the observed results; however, we conclude that the low recurrence rates and post-surgical complications confirmed that our proposed protocol would represent an effective strategy for the management of patients with HS eligible for surgical therapy.
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- 2024
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9. Wound area severity index (WASI): A novel tool for assessing and predicting healing times in hidradenitis suppurativa postsurgical wounds.
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Michelucci A, Manzo Margiotta F, Innocenti S, Vietina A, Granieri G, Janowska A, Morganti R, Romanelli M, and Dini V
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- Humans, Surgical Wound, Female, Time Factors, Male, Adult, Middle Aged, Hidradenitis Suppurativa surgery, Wound Healing, Severity of Illness Index
- Abstract
Hidradenitis suppurativa (HS) presents challenges in management due to its chronic nature and high risk of recurrence. Post-surgical wound care plays a crucial role in treatment, even if standardized methods for assessing and predicting healing times are lacking. The aim of the study is to introduce the Wound Area Severity Index (WASI) as a novel tool to guide clinicians in assessing postsurgical wound progression and predicting potential healing times. A team of wound healing experts assessed 93 post-surgical HS wounds resulting from wide excision and secondary intention healing. For each wound healing time, wound area, wound bed score (WBS), and WASI were evaluated. WASI includes four parameters: area, temperature, depth and wound Bed, each with four severity levels. The total WASI score ranges from 4 to 16. Spearman correlation and Kruskal-Wallis tests were employed for statistical analysis. WASI strongly correlated with wound healing time (rho: 0.813, p < 0.001). Higher WASI scores were associated with prolonged healing, while lower scores indicated almost healed wounds. The WASI score has proven to be more highly predictive of healing times when compared to the individual parameter of the Area (moderate positive correlation, r: 0.77) and the WBS (negative correlation, r: -0.72). A total WASI score of 4 corresponded to a median healing time of 7 days, while a score exceeding 9 suggested a median healing time of 56 days. WASI has proven to be a valuable tool for assessing and predicting healing times in post-surgical HS wounds. Its simplicity, cost-effectiveness, and ability to integrate multiple parameters make it a promising addition to wound care practice., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
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- 2024
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10. EMPATHY Life in Psoriasis: Embracing Patients' Well-Being in Their Journey of Moderate-to-Severe Psoriasis.
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Prignano F, Campione E, Parodi A, Vegni E, Bardazzi F, Borroni RG, Burlando M, Cinotti E, Dini V, Giacchetti A, Giofrè C, Megna M, Zichichi L, and Fargnoli MC
- Abstract
Background: Psoriasis is a chronic inflammatory skin condition that affects millions of individuals worldwide, impacting their physical and emotional well-being. The management of psoriasis requires effective communication and a strong physician-patient relationship. Objective: We aim to develop a novel algorithm to enhance patient well-being and care in moderate-to-severe psoriasis, considering the time constraints that dermatologists have in public hospitals. Methods: This project employed a multidisciplinary approach, involving collaboration between 14 experienced dermatologists (referred to as Key Opinion Leaders: KOLs) and a psychologist. During three separate meetings (an initial virtual session, a face-to-face meeting, and a final virtual meeting), an algorithm (Embracing Patients' Well-being in their Journey of Moderate-to-Severe psoriasis: EMPATHY), describing the patient's reception through the entire first visit and follow-up visits, was developed and refined. Results: The EMPATHY algorithm provides a step-by-step approach from the moment the patient arrives at reception, through the first visit and on to subsequent visits. This algorithm fills a critical gap in the existing guidelines by specifically addressing how to foster empathy during psoriasis patient visits within time-limited consultations. The algorithm outlines patient-centered strategies at each visit. Key aspects include creating a welcoming environment, active listening, respecting privacy, tailoring communication styles, and managing patient expectations. Conclusions: The EMPATHY algorithm represents a novel and promising approach to improving patient care and well-being in moderate-to-severe psoriasis. Developed together by dermatologists and a psychologist, this algorithm offers healthcare providers practical guidance for managing both initial and follow-up patient visits. While further validation is necessary, the potential for adapting the EMPATHY algorithm to diverse healthcare settings and patient populations holds promise for improving patient outcomes across various chronic conditions.
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- 2024
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11. Presurgical Mapping With Ultra-high Frequency Ultrasound of Hidradenitis Suppurativa Lesions Treated With Wide Local Excision and Secondary Intention Healing.
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Michelucci A, Fidanzi C, Manzo Margiotta F, Granieri G, Salvia G, Janowska A, Romanelli M, and Dini V
- Abstract
Background: Hidradenitis suppurativa (HS) is a challenging chronic inflammatory condition often requiring surgical intervention, such as wide local excision. Preoperative mapping with ultra-high frequency ultrasound (UHFUS) enables detailed assessment of lesion extension, particularly identifying tunnels and fistulas, facilitating surgical planning., Objective: This study aimed to analyze recurrence rates of HS lesions previously mapped with UHFUS and treated with wide excision and secondary intention healing., Materials and Methods: A retrospective single-center study enrolled 40 patients with HS undergoing wide excision surgery after UHFUS mapping. Patients were assessed weekly until complete healing and then every 3 months, evaluating clinical and sonographic signs of relapse and pain using the visual analogue scale., Results: Results showed a population predominantly composed of women (65%) with a mean age of 39 years and a medium HS-Hurley score of 2.5. Over a 22-month follow-up, only 10% experienced clinical relapse, achieving an 90% total remission rate. Pain scores decreased significantly from Week 0 to Week 4., Conclusion: The study highlights the clinical challenge of HS management, particularly regarding surgical planning and lesion margin definition. The remission rate observed in this study suggests the effectiveness of UHFUS-guided surgical approaches. Future studies should extend observation periods to further validate these findings., (Copyright © 2024 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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12. 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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13. Monoclonal Antibodies in the Management of Inflammation in Wound Healing: An Updated Literature Review.
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Manzo Margiotta F, Michelucci A, Fidanzi C, Granieri G, Salvia G, Bevilacqua M, Janowska A, Dini V, and Romanelli M
- Abstract
Chronic wounds pose a significant clinical challenge due to their complex pathophysiology and the burden of long-term management. Monoclonal antibodies (mAbs) are emerging as a novel therapeutic option in managing difficult wounds, although comprehensive data on their use in wound care are lacking. This study aimed to explore existing scientific knowledge of mAbs in treating chronic wounds based on a rationale of direct inhibition of the main molecules involved in the underlying inflammatory pathophysiology. We performed a literature review excluding primary inflammatory conditions with potential ulcerative outcomes (e.g., hidradenitis suppurativa). mAbs were effective in treating wounds from 16 different etiologies. The most commonly treated conditions were pyoderma gangrenosum (treated with 12 different mAbs), lipoid necrobiosis, and cutaneous vasculitis (each treated with 3 different mAbs). Fourteen mAbs were analyzed in total. Rituximab was effective in 43.75% of cases (7/16 diseases), followed by tocilizumab (25%, 4/16 diseases), and both etanercept and adalimumab (18.75%, 3/16 conditions each). mAbs offer therapeutic potential for chronic wounds unresponsive to standard treatments. However, due to the complex molecular nature of wound healing, no single target molecule can be identified. Therefore, the use of mAbs should be considered as a translational approach for limited cases of multi-resistant conditions.
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- 2024
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14. Local Management of Malignant and Unresectable Fungating Wounds: PEBO Assessment.
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Janowska A, Davini G, Dini V, Iannone M, Morganti R, and Romanelli M
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- Humans, Male, Female, Aged, Middle Aged, Bandages, Odorants, Exudates and Transudates, Aged, 80 and over, Pain Management methods, Skin Ulcer therapy, Skin Ulcer etiology, Skin Ulcer diagnosis, Wound Healing, Quality of Life
- Abstract
Malignant fungating wounds (MFWs) represent a major problem for public health. The most common symptoms associated with MFWs are pain, exudate, bleeding and odor. The aim of the study was to optimize the local management and dressing of MFWs. We developed a standardized 4- step approach to MFWs based on Pain, Exudate, Bleeding and Odor management in a case series of 24 patients: we call this the PEBO approach. We analyzed etiologies, localization, Quality of Life (QoL), pain and clinical signs and symptoms. We assessed the ulcers at baseline, after two weeks and after one month. In our study, most patients showed an improvement in the QoL using PEBO approach, although some experienced a deterioration in their general clinical conditions. Non-cytolesive cleansing, atraumatic dressings were applied to allow pain relief. Non-adherent dressings were combined with a secondary dressing in the case of exudate. Achieving hemostasis with dressing or medication is a priority in MFW management. Antibacterial dressings and odor absorbent dressings were used for odor absorption. Surgical debridement, adherent dressing and occlusive dressings were avoided. Dressing changes were programmed twice a week for four weeks. PEBO simplified the complex aspects of this type of ulcer, and could help physicians, nurses, and also the rest of the team, including the patients themselves and their family, in the multidisciplinary palliative care of MFWs., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2024
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15. 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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16. Switch from adalimumab to brodalumab as a possible trigger factor for the onset of pyoderma gangrenosum.
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Salvia G, Bevilacqua M, Manzo Margiotta F, Michelucci A, Granieri G, Fidanzi C, Dini V, Romanelli M, and Mazzatenta C
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- Humans, Female, Drug Substitution, Middle Aged, Male, Psoriasis drug therapy, Dermatologic Agents adverse effects, Dermatologic Agents therapeutic use, Pyoderma Gangrenosum chemically induced, Pyoderma Gangrenosum drug therapy, Adalimumab adverse effects, Antibodies, Monoclonal, Humanized adverse effects, Antibodies, Monoclonal, Humanized therapeutic use
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- 2024
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17. Risankizumab as a Therapeutic Approach for Recalcitrant Pyoderma Gangrenosum.
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Michelucci A, Manzo Margiotta F, Granieri G, Salvia G, Fidanzi C, Bevilacqua M, Panduri S, Romanelli M, and Dini V
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- Humans, Middle Aged, Off-Label Use, Treatment Outcome, Antibodies, Monoclonal therapeutic use, Pyoderma Gangrenosum drug therapy, Pyoderma Gangrenosum diagnosis
- Abstract
Abstract: Pyoderma gangrenosum (PG) is a neutrophilic dermatosis that is challenging to diagnose and treat. Clinicians frequently use fast-acting corticosteroids, which are subsequently combined with slower-acting immunosuppressants to progressively taper the corticosteroid dosage. Current research is focused on the use of monoclonal antibodies (mAbs) directed against target molecules involved in the pathogenesis of PG. However, available data on their efficacy are based on sporadic case reports and clinical experiences, so the authors aimed to evaluate the efficacy of risankizumab, an anti-interleukin-23 mAb, in the management of two complex PG cases. The authors enrolled two patients with PG who were already treated with immunosuppressive therapies. Their management was based on the off-label use of an mAb directed against the p19 subunit of interleukin-23: risankizumab. Patients received subcutaneous injections of 150 mg at the start of treatment, at week 4, and then every 10 weeks thereafter. Systemic therapy was combined with local management of ulcers, based on the principles of TIME (tissue, infection, moisture balance, and epithelialization) applied to the inflammatory and noninflammatory phases of PG. Clinical resolution was obtained at week 24 for patient 1 and week 16 for patient 2 and was maintained until week 40, without adverse effects or disease recurrence. These clinical cases demonstrate that risankizumab is a valid tool in terms of efficacy and safety for complicated cases of multirefractory PG when provided in parallel with local personalized wound management., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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18. Bimekizumab for the Treatment of Plaque Psoriasis with Involvement of Genitalia: A 16-Week Multicenter Real-World Experience - IL PSO (Italian Landscape Psoriasis).
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Orsini D, Malagoli P, Balato A, Bianchi L, Brianti P, Buononato D, Burlando M, Caldarola G, Campanati A, Campione E, Carrera CG, Carugno A, Cusano F, Dapavo P, Dattola A, De Simone C, Dini V, Esposito M, Fargnoli MC, Gaiani FM, Gargiulo L, Gisondi P, Giunta A, Ibba L, Lasagni C, Loconsole F, Maione V, Mortato E, Marzano AV, Maurelli M, Megna M, Mercuri SR, Narcisi A, Offidani A, Paolino G, Parodi A, Pellacani G, Potestio L, Quaglino P, Richetta AG, Romano F, Sena P, Venturini M, Assorgi C, and Costanzo A
- Abstract
Introduction: Genital involvement is observed in approximately 60% of patients with psoriasis, presenting clinicians with formidable challenges in treatment. While new biologic drugs have emerged as safe and effective options for managing psoriasis, their efficacy in challenging-to-treat areas remains inadequately explored. Intriguingly, studies have shown that interleukin (IL)-17 inhibitors exhibit effectiveness in addressing genital psoriasis., Objectives: We aimed to determine the effectiveness profile of bimekizumab in patients affected by moderate-to-severe plaque psoriasis with involvement of genitalia., Methods: Bimekizumab, a dual inhibitor of both IL-17A and IL-17F, was the focus of our 16-week study, demonstrating highly favorable outcomes for patients with genital psoriasis. The effectiveness of bimekizumab was evaluated in terms of improvement in Static Physician Global Assessment of Genitalia (sPGA-G) and Psoriasis Area and Severity Index., Results: Sixty-five adult patients were enrolled. Remarkably, 98.4% of our participants achieved a clear sPGA-G score (s-PGA-g = 0) within 16 weeks. Moreover, consistent improvements were observed in Psoriasis Area and Severity Index scores, accompanied by a significant reduction in the mean Dermatology Life Quality Index, signifying enhanced quality of life. Notably, none of the patients reported a severe impairment in their quality of life after 16 weeks of treatment. In our cohort of 65 patients, subgroup analyses unveiled that the effectiveness of bimekizumab remained unaffected by prior exposure to other biologics or by obesity., Conclusions: Our initial findings suggest that bimekizumab may serve as a valuable treatment option for genital psoriasis. Nevertheless, further research with larger sample sizes and longer-term follow-up is imperative to conclusively validate these results.
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- 2024
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19. Melanoma Arising on a Nevus After Tattooing.
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Fidanzi C, Mori N, Bevilacqua M, Romanelli M, Dini V, and Janowska A
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- Male, Humans, Adult, Melanoma diagnosis, Melanoma etiology, Tattooing adverse effects, Skin Neoplasms diagnosis, Skin Neoplasms etiology, Nevus, Pigmented pathology
- Abstract
The pathogenetic relationship between tattooing and the development of malignant melanoma has not been demonstrated yet, but there are numerous instances documented in the literature where both benign and malignant lesions have developed on tattoos. We report the case of a 39-year-old man with a melanoma that arose on a nevus on the back after tattooing. Since the identification of melanocytes lesions can be heavily hindered by large tattoos, implementing a dedicated screening process with regular monitoring of the tattooed region could be necessary to prevent potential diagnostic delays.
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- 2024
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20. Paradoxical Eczematous Eruptions in Patients with Psoriasis Treated with Biological Therapy.
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Michelucci A, Fidanzi C, Manzo Margiotta F, Ciccarese G, Panduri S, Iannone M, Romanelli M, and Dini V
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- 2024
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21. An approach to diagnosis and management of patients with pyoderma gangrenosum from an international perspective: results from an expert forum.
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Haddadin OM, Ortega-Loayza AG, Marzano AV, Davis MDP, Dini V, Dissemond J, Hampton PJ, Navarini AA, Shavit E, Tada Y, Yamamoto T, and Alavi AA
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- Humans, Patients, Pyoderma Gangrenosum diagnosis, Pyoderma Gangrenosum therapy
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- 2024
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22. 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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23. 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
- Subjects
- Humans, Interleukin-23, Interleukin Inhibitors, Retrospective Studies, Interleukin-17, Interleukin-12, Italy, Biological Products therapeutic use, Psoriasis drug therapy
- Abstract
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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