Novel combination biologic therapy for recalcitrant psoriasis and psoriatic arthritis in a medically complex patient
Australas J Dermatol. 2021 Nov 23. doi: 10.1111/ajd.13752. Online ahead of print.ABSTRACTFor patients who do not achieve adequate disease control on biologic monotherapy, or monotherapy with an oral-systemic agent such as methotrexate, combination biologic therapy may be considered. To the best of our knowledge, we report the first case assessing the safety and efficacy of the combination of an interleukin-23 (IL-23) inhibitor (risankizumab) with a tumour necrosis factor-α (TNF-α) inhibitor (golimumab) in the treatment of psoriasis and psoriatic arthritis. After twelve months of treatment with risankizumab and golimumab, our patient experienced a significant improvement in his psoriasis and psoriatic arthritis without any adverse effects to date.PMID:34813085 | DOI:10.1111/ajd.13752
Conclusions (i.e., comparable) are based on an overlap of pairwise 95 percent credible intervals.1c. PASI 90 is defined as at least 90 percent improvement from baseline in the PASI score. The PASI score grades the amount of surface area on each body region that is covered by PsO plaques and the severity of plaques for their redness, thickness, and scaliness.13 PASI 90 was not a controlled endpoint in DISCOVER-1 or -2.8,9d. TREMFYA q4w dosing is not currently FDA-approved.2e. The PsA-modified vdH-S score combines erosion and joint space narrowing scores derived from radiographs of joints in body regions impacted by PsA.14 T...
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The spondyloarthritides (SpA) are a group of overlapping chronic immune-mediated inflammatory diseases, the most common being psoriatic arthritis (PsA) and axial spondyloarthritis. Other, less common diseases within the SpA family include reactive arthritis, enteropathic arthritis and SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis). Shared features include a propensity to affect the peripheral and axial skeleton through enthesitis and synovitis, cutaneous and/or nail psoriasis, uveitis, inflammatory bowel disease, the absence of rheumatoid factor and an increased frequency of HLA-B27 variants.
Exp Ther Med. 2022 Feb;23(2):152. doi: 10.3892/etm.2021.11075. Epub 2021 Dec 17.ABSTRACTLong considered a skin-limited condition, psoriasis is currently defined as a chronic, immune-mediated inflammatory disease, presenting, besides the skin changes, important systemic manifestations, the most common being: psoriatic arthritis, cardiovascular disease, metabolic syndrome, diabetes, inflammatory bowel disease and nonalcoholic steatohepatitis. It is a disease with a strong psycho-emotional and social impact, both through skin changes such as pruritic, scaly erythematous plaques, and through the association of comorbidities th...
We present the case of a 49-year-old female patient with diabetes and psoriasis and psoriatic arthritis treated with an adalimumab biosimilar who developed a severe PAE of the palmoplantar pustular type. Treatment with adalimumab was stopped and the patient switched to ixekizumab which was successful. When a paradoxical r eaction develops during biologic therapy, especially when it is severe as in our patient, switching to another class of biologics is advised.
The approval is the second indication for the anti-interleukin 23 monoclonal antibody after approval for plaque psoriasis was granted in 2019.News Alerts
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It remains unclear whether patients with COVID-19 and those who receive biologic therapy for psoriasis or psoriatic arthritis have an increased risk of infection or of a worse outcome. Piaserico et al. performed an analysis of the quality and potential limitations of 25 published studies on the risk and outcomes of COVID-19 in this patient population. A high risk of bias was identified in all the publications, and none of the studies reached a score of ≥75% on the Newcastle-Ottawa Scale, w hich measures study quality.
CONCLUSION: Excessive Matrix metalloproteinases activity is associated with articular destruction. Their levels can reflect disease activity, structural damage, and response to TNFi in patients with spondyloarthritis. Nevertheless, further studies are needed to confirm these results.PMID:35049445 | DOI:10.2174/2772432817666220113112809
CONCLUSIONS: Unsupervised clustering analysis revealed differences in circulating memory Th cells between psoriasis and PsA patients compared to HC; however, no specific subset was identified characterizing subclinical PsA patients.PMID:35045868 | DOI:10.1186/s13075-021-02714-5