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The aim of this study is analysis of time to relapse after discontinuation of biologic treatment and identification of factors associated with risk of relapse. The analysis used real-world data of 705 patients treated with biologic drugs (adalimumab [ADA], ustekinumab, infliximab, and etanercept) in Poland in 2013-2019. Time to relapse was analyzed by Kaplan-Meier estimator. Data was stratified by the number of prior relapses. Determinants of risk to relapse were analyzed with Prentice-Williams-Peterson model. Kaplan-Meier estimate of time to the first relapse was 276 days, to the second relapse was 246 days, to the third relapse was 218 days, and to the fourth relapse was 178 days. In multidimensional analysis statistically significant variables affecting risk of relapse were the following: biologic naivety (hazard ratio [HR] 0.707), ADA (HR 0.787), psoriasis area and severity index at the last follow-up visit (HR 1.049), abnormal hemoglobin level (HR 0.794), and abnormal lymphocyte counts (HR 1.278). The findings of this study suggest that periods to relapse after discontinuation of biologic drugs become shorter with the number of prior relapses experienced by the patient. Ninety-five percentage of observed relapses occurred within 613 days of the end of the first treatment cycle, within 478 of the second cycle and within 351 days of the third cycle., (© 2021 Wiley Periodicals LLC.)

Non-melanoma skin cancers (NMSCs) are the most common malignancies diagnosed in Caucasian populations. Basal cell carcinoma (BCC) is the most frequent skin cancer, followed by squamous cell carcinoma (SCC). Unfortunately, most European cancer registries do not record individual types of NMSC. To evaluate the incidence of primary BCCs and SCCs regarding age, sex, tumour site and tumour subtype to determine trends in epidemiology of both cancers. Retrospective analysis of BCCs and SCCs diagnosed and treated across seven sites in Poland from 1999 to 2019. We recorded 13,913 NMSCs occurring in 10,083 patients. BCC represented 85.2% of all cases. SCC patients were older than BCC patients (77.1 ± 11.3 years vs. 70.1 ± 12.3 years, p < 0.01). The nodular subtype was the most common subtype of BCC, followed by the superficial and infiltrative subtypes. The superficial BCC subtype was more common on photoprotected areas (p < 0.01), whereas the nodular BCC subtype occurred on the face (p < 0.01). The high-risk SCC subtypes were more common on face compared to low-risk SCC subtypes (p < 0.01). BCC and SCC are common malignancies developing at various ages and anatomical sites. These data underline the need for better registration policies regarding NMSC in order to improve prevention and treatment strategies for these tumours.

Objectives: To evaluate the use of biological agents for the treatment of psoriasis and to explore country-specific differences within six Central and Eastern European (CEE) countries, namely Bulgaria, Croatia, the Czech Republic, Hungary, Poland and Romania., Methods: A literature overview on the epidemiology and disease burden of psoriasis in CEE was conducted. The number of patients treated with biologics was obtained from patient registries, ministries of health, national professional societies and health insurance funds. Biological treatment rates were estimated by two different methods: (i) as a proportion of all psoriasis patients of a country (assuming a common prevalence of psoriasis 2%) and (ii) per 100,000 population. Moreover, we provide a detailed comparison of drug coverage policies and guidelines regulating the treatment with biologics in psoriasis., Results: On average 0.25% of all psoriasis patients, or five psoriasis patients out of 100,000 inhabitants are treated with biologics embedding a 14.6-fold difference between the six countries. Bulgaria, Croatia and Poland lag behind the other three countries in the use of biologics. The significant differences among CEE countries cannot be explained by variations in prices of biologics, cost-effectiveness or budget impact of biologics. It seems that the time since coverage decision, the fewer number of covered biologics, the more restrictive criteria to be eligible for covered treatment in terms of baseline Psoriasis Area and Severity Index and Dermatology Life Quality Index scores, and the maximum duration of treatment allowed are responsible for the majority of the differences., Conclusions: There exists a disconnect between the European psoriasis treatment guidelines and the various CEE country-specific biologic coverage eligibilities. The cost of biologic therapy for psoriasis is not solely and directly responsible for the different use rates amongst the CEE countries. Psoriasis may not be perceived by all payers as a serious disease that can be successfully treated in a cost-effective manner., (© 2015 European Academy of Dermatology and Venereology.)

Unlabelled: Morbidity on allergic diseases has been increasing in the last years. They are becoming important medical, social and economical problem all over the world. Allergic rhinitis and asthma are one of the most common allergic diseases. Specific allergen immunotherapy (SIT) has additional effects, not shared by pharmacological therapy; it has long-lasting preventive effect, especially the capacity to modify the natural course of the allergic diseases., The Aim of the Study: To evaluate the clinical efficacy and costs of specific immunotherapy in patients with allergic diseases., Material and Methods: The study were carried out on the group of 83 allergic patients treated with three-years subcutaneous SIT Clinical efficacy of SIT, costs of SIT and costs of one-year symptomatic treatment before and after SIT were assessed., Results: Three-years subcutaneous allergen-specific immunotherapy decreases allergic symptoms about 80% and reduces costs of symptoms-relieving drug about 70%. Patients with allergic bronchial asthma gain most clinical and economical benefits with SIT while presence of atopic dermatitis is correlated with less effective immunotherapy., Conclusion: From public payer's and patient's perspective, SIT essentially reduces costs of symptoms-relieving treatment, especially in patients with allergic bronchial asthma. It can be a premise to consider to increase a level of refund of specific immunotherapy in Poland.

Non-melanoma skin cancers, including basal cell carcinoma and squamous cell carcinoma are most frequently observed neoplasms worldwide. Their incidence has steadily been growing. Cutaneous squamous cell carcinoma is more common than basal cell carcinoma in dark complexion individuals. Every year, more than one million new cases of non-melanoma skin cancers (NMSC) are identified in the United States, which is roughly estimated to account for 50% of all cancers in this country. In this article, two illustrative cases are presented, which demonstrate the risk factors for cutaneous squamous cell carcinoma development, emphasizing the relationships and synergistic interactions in the process of carcinogenesis.