Rapid Efficacy of riSankizumab in pretibial psoriasis invOLVEment: RESOLVE.

Background: Despite extraordinary improvements in the management of psoriasis in recent times, some areas of the body, such as the pretibial area, still show an unsatisfactory response and a more significant impact on patient quality of life. This multicentre study focuses on psoriasis affecting sensitive areas (particularly the pretibial area), its impact on quality of life and the therapeutic response to risankizumab. Methods: This multicentre prospective observational study recruited patients with moderate-to-severe psoriasis with pretibial area involvement. All patients underwent treatment with risankizumab (150 mg every 3 weeks), and efficacy was assessed after 24 weeks. Results: The study included 128 patients with a mean age of 51 years, suffering from moderate-to-severe psoriasis with involvement of the pretibial area with median total Psoriasis Area Severity Index score of 17.05 and Dermatology Life Quality Index of 16.27. The group was further divided into two sub-groups: the 'mother patch' group, in whom the very first psoriatic plaque appeared in the pretibial region (45 patients), and the 'non-mother patch' group, in whom the psoriatic lesion in the pretibial region was present but not as the first manifestation (83 patients). In order to better assess the involvement of psoriasis in the pretibial area, the pretibial plaque lesion severity index was also calculated at baseline in all patients: extent 2.75, erythema 2.64, infiltration 2.45 and desquamation 2.38. All participants in this study showed a good therapeutic response, with a reduction in all scores. Conclusions: The pretibial area is becoming an object of therapeutic interest due to some resistance to clearance and the consequent impairment of patient quality of life. This study showed that risankizumab can give favourable therapeutic results not only in patients with moderate-to-severe psoriasis with involvement of the difficult-to-treat areas but particularly in patients with recalcitrant plaques in the pretibial area.

Effectiveness and safety of secukinumab in patients with moderate-severe psoriasis: A multicenter real-life study.

This study assessed the effectiveness and safety of secukinumab in patients with moderate-severe psoriasis vulgaris in a real-world setting. A total of 120 patients (35.8% women; mean age 49.8 years) were enrolled. Mean PASI significantly decreased from 12.0 ± 6.6 at baseline to 4.7 ± 3.2 and 2.3 ± 4.0 at 3 and 12 months, respectively (P < .001). Patients with two or more lines of prior biological therapies had poorer persistence to therapy at 12 months (71%) vs those who were bio-naïve (93%) or patients with only one prior failure with a biological agent (88%) (log-rank = 9.33; P = .009). Multivariate regression analysis showed that patients beyond the second line of treatment had an increased risk of discontinuing secukinumab (HR: 3.6; 95% CI 1.3-10.2), while those without comorbidities had a lower risk (HR: 0.31; 95% CI 0.1-0.8). Our study confirms the effectiveness and safety of secukinumab in a real-life setting for psoriatic disease.

What's new in the treatment of eczemas.

BACKGROUND: We have conducted an open label, non-comparative study in order to assess the efficacy and tolerability of Dexyane Med in combination with corticosteroids in patients with chronic hand eczema (CHE) and contact eczema (CE) in a real-life setting. METHODS: Twenty patients, 10 with CHE and 10 with CE, have been enrolled in the study. After the enrollment and the baseline evaluation, patients were treated with topical mometasone once daily and Dexyane Med once daily for one week, followed by Dexyane Med twice daily for three weeks. After the enrollment visit, patients were seen at the end of treatment, after four weeks. A telephone contact was foreseen at the second week. During the visits, mTLSS Score (CHE patients only), IGA Score and VAS for pruritus and pain were calculated. Patients' satisfaction was recorded during the phone contact after two weeks of treatment and at the final visit. Tolerability was evaluated at the end of the study. RESULTS: All patients experienced a remarkable improvement in mTLSS Score, IGA Score (from a mean of 2.8 to 0.5) and VAS (from 4.5 to 0.6 for pruritus and from 2.9 to 0.3 for pain). The treatment was well tolerated and all patients were satisfied or very satisfied either at the second week or at the end of the study. CONCLUSIONS: Our study has shown that the treatment of chronic hand eczema and contact eczema with a medical device administered twice a day for three weeks, following a one week treatment in combination with a topical corticosteroid, is effective in decreasing the burden of symptoms and well tolerated. To confirm our data, further controlled trials are warranted in order to explore the efficacy and tolerability of Dexyane Med in different types of eczema.

Retrospective analysis of the effectiveness and costs of traditional treatments for moderate-to-severe psoriasis: A single-center, Italian study.

BACKGROUND: Current guidelines recommend the use of systemic therapy and phototherapy for the treatment of moderate-to-severe plaque psoriasis. OBJECTIVES: To evaluate the effectiveness, impact on health status perception, and costs of traditional systemic therapies and phototherapy in real-life patients with moderate-to-severe psoriasis. METHODS: Retrospective analysis of data from 100 psoriatic patients referring to a dermatology clinic in Italy and treated with traditional therapies. RESULTS: Patients were predominantly treated with cyclosporine (72%). Cyclosporine was associated with fewer treatment discontinuations due to lack of efficacy (37%) compared with methotrexate (65%), acitretin (67%) and phototherapy (50%). Rates of treatment discontinuation due to adverse events were: cyclosporine (24%), methotrexate (9%), acitretin (25%) and phototherapy (0%). Improvements in PASI scores were comparable between treatments. The need for topical therapy was reduced with cyclosporine versus other therapies (35% vs 71%, p = 0.0009); respectively, 33% of patients treated with cyclosporine versus 14% of patients receiving other therapies perceived an improvement in their health status (p = 0.0018). Mean total per-patient direct costs of the first treatment cycle were higher with cyclosporine than with other therapies (€1812.85 vs €648.90, p < 0.0001). CONCLUSIONS: Cyclosporine was effective even if more expensive than other traditional therapies. Nevertheless patients' perception of improvement was quite low.