Real-world data from a single Greek centre on the use of secukinumab in plaque psoriasis: effectiveness, safety, drug survival, and identification of patients that sustain optimal response.

BACKGROUND: Few studies have investigated the long-term outcomes of secukinumab in real-life psoriasis treatment where diverse patient profiles require a personalized approach. OBJECTIVES: To determine long-term performance of secukinumab in moderate-to-severe plaque psoriasis, and identify potential clinical factors predictive of sustained optimal response under real-world conditions. METHODS: In this 78-week, single-centre, retrospective study, effectiveness, safety and drug survival of secukinumab were evaluated. Effectiveness data are reported as observed. Co-primary endpoints were absolute Psoriasis Area and Severity Index (PASI) ≤3 at week 4, 16, 52, 78, and clinical predictors of PASI ≤3 and PASI100 responses at week 52 and 78. RESULTS: A total of 85 patients (75.3% male; mean age 48.6 years) were included. Absolute PASI ≤3 was achieved in 73% and 83% of patients at week 52 and 78, respectively. PASI 75/90/100 responses at week 52 (71.6%, 50.8%, and 40.3%, respectively) were sustained at week 78 (73.6%, 64.2%, and 45.3%, respectively). Median absolute PASI remained low at week 52/78 (0.9/0.6, respectively), while mean absolute PGA also sustained low (0-1) values after 16-78 weeks. Investigator's Global Assessment 0/1 response rate was maintained by week 52/78 (72/83%, respectively). The drug survival rate of secukinumab at week 78 was 79.1%. Treatment was discontinued in 17.9% of patients after an average of 41.7 weeks, mainly due to loss of effectiveness (10.4%). A total of 27% experienced adverse events, without critical safety concerns. Based on multivariate analysis, advanced body mass index (BMI) and presence of ≥3 comorbidities decreased the chance of achieving PASI ≤3 at week 78 [OR (95% CI) 0.78 (0.64-0.97); P = 0.024, and OR (95% CI) 0.045 (0.002-0.83); P = 0.037, respectively]. CONCLUSIONS: Secukinumab showed consistently high effectiveness in this real-life cohort, with an acceptable safety profile. Over time, persistence of PASI ≤3 response appears to be lower in patients with high BMI or multiple comorbidities.

A multicenter, prospective, observational study examining the impact of risk factors, such as BMI and waist circumference, on quality of life improvement and clinical response in moderate-to-severe plaque-type psoriasis patients treated with infliximab in routine care settings of Greece.

BACKGROUND: Obesity has been associated with moderate-to-severe plaque psoriasis severity and PASI 75 response attainment of biologic therapies, but findings are inconsistent. OBJECTIVE: This study aimed to examine the association of body mass index (BMI) and waist circumference (WC) on disease severity, to identify potential patient characteristics associated with response attainment and to assess the impact of infliximab on the patients' health-related quality of life (HRQoL) among infliximab-treated patients in the routine care setting of Greece. METHODS: This was a multicenter, prospective, observational study of adult moderate-to-severe plaque psoriasis patients who had initiated treatment with originator infliximab within 2 weeks prior to enrolment. Postenrolment visits occurred at 14 ± 4, 30 ± 4 and 54 ± 4 weeks following treatment onset. RESULTS: Between October 2012 and June 2014, 136 eligible patients (62.5% males) with a median age of 48.6 years, BMI of 29.6 kg/m2 and WC of 107.0 cm at enrolment were recruited by 21 dermatology hospital/private offices. All patients had received prior psoriasis treatment(s); 62.5% were biologic-naïve. Mean baseline psoriasis area severity index (PASI) and Dermatology Quality of Life Index (DLQI) scores were 23.4 ± 13.6 and 15.0 ± 8.3, respectively. A low correlation was observed between WC at enrolment and baseline PASI [ρ = 0.324 (P < 0.001)]. Over a median 48.4 weeks of infliximab exposure, 89.3% of the per protocol set achieved a PASI 75 response. At 14, 30 and 54 weeks, the PASI 75 attainment rate was 66.4%, 74.8% and 76.6%, respectively; the clinically meaningful DLQI improvement (≥5 point decrease) rate was 68.9%, 75.7% and 69.8%, respectively. BMI category and abdominal obesity at enrolment did not impact PASI 75 or DLQI improvement rate attainment. CONCLUSION: In the routine care of Greece, infliximab reduced disease activity and improved the quality of life of moderate-to-severe psoriasis patients through 1 year of treatment, independent of their BMI and WC.

Study of heat-stress levels in naturally ventilated sheep barns during heat waves: development and assessment of regression models.

It is well documented that heat-stress burdens sheep welfare and productivity. Peak heat-stress levels are observed when high temperatures prevail, i.e. during heat waves; however, continuous measurements inside livestock buildings are not usually available for long periods so as to study the variation of summer heat-stress levels for several years, especially during extreme hot weather. Α methodology to develop a long time series of summer temperature and relative humidity inside naturally ventilated sheep barns is proposed. The accuracy and the transferability of the developed linear regression models were verified. Temperature Humidity Index (THI) was used to assess sheep's potential heat-stress. Τhe variation of THI inside a barn during heat wave and non-heat wave days was examined, and the results were comparatively assessed. The analysis showed that sheep were exposed to moderate, severe, and extreme severe heat-stress in 10, 21 and 66 % of hours, respectively, during heat wave days, while the corresponding values during non-heat wave days were 14, 33 and 43 %, respectively. The heat load on sheep was much higher during heat wave events than during non-heat wave periods. Additionally, based on the averaged diurnal variation of THI, it was concluded that extreme severe heat-stress conditions were prevailing between 1000 and 2400 hours local time during heat wave days. Cool off night periods were never and extremely rarely detected during heat wave and non-heat wave days, respectively.

An experimental helical-tubular photobioreactor for continuous production of Nannochloropsis sp.

An experimental helical-tubular photobioreactor has been designed for controlled, continuous production of Nannochloropsis sp. Its main advantages are: (1) combination of large ratio of culture volume to surface area along with the optimised light penetration depth, (2) easy control of temperature and contaminants, (3) effective spatial distribution of fresh air and CO(2), (4) better CO(2) transfer through extensive interface surface between fresh air and culture-liquid medium and (5) novel automated flow-through sensor providing continuous cell concentration monitoring. Nannochloropsis sp. population density reached maximum value under rather high temperatures and combined natural and artificial light conditions. An average daily increase of 30 x 10(6)cells ml(-1) was obtained at population densities above 350 x 10(6)cells ml(-1) allowing daily harvesting rates of at least 10% the total volume. Measured cellular density productivity data and estimated volumetric productivity range of 1.10-3.03 g l(-1)day(-1), are among the highest Nannochloropsis sp. productivities reported in the literature.