RESUMEN
Over the past few years, venereal or sexually transmitted infections (STIs) have been on the rise worldwide requiring additional specialized monographic consultations to specifically treat STIs. Therefore, the Spanish Academy of Dermatology and Venereology (AEDV) Research Working Group on STIs and HIV has drafted this document with the necessary requirements in terms of infrastructure, personnel, technology, specific materials for sample collection, and needs for current therapeutic options. Strict emphasis is placed on the protection of patient privacy. A health care circuit model is outlined too. Additionally, a section has been included on contact tracking and reporting, key elements for the effective prevention and control of STIs. These clinical practice guidelines seek to establish a clinical action framework adapted to the current challenges posed by STIs and HIV in the dermatology, venereology, and multidisciplinary settings.
Asunto(s)
Enfermedades de Transmisión Sexual , Venereología , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades de Transmisión Sexual/terapia , Humanos , Venereología/normas , Grupo de Atención al Paciente , España , Infecciones por VIH , Trazado de Contacto , Dermatología/normas , ConfidencialidadRESUMEN
BACKGROUND: Prediction of the response to a biological treatment in psoriasis patients would allow efficient treatment allocation. OBJECTIVE: To identify polymorphisms associated with secukinumab response in psoriasis patients in a daily practice setting. METHODS: We studied 180 SNPs in patients with moderate-to-severe plaque psoriasis recruited from 15 Spanish hospitals. Treatment effectiveness was evaluated by absolute PASI ≤3 and ≤1 at 6 and 12 months. Individuals were genotyped using a custom Taqman array. Multiple logistic regression models were generated. Sensitivity, specificity and area under the curve (AUC) were analysed. RESULTS: A total of 173 patients were studied at 6 months, (67% achieved absolute PASI ≤ 3 and 65% PASI ≤ 1) and 162 at 12 months (75% achieved absolute PASI ≤ 3 and 64% PASI ≤ 1). Multivariable analysis showed the association of different sets of SNPs with the response to secukinumab. The model of absolute PASI≤3 at 6 months showed best values of sensitivity and specificity. Four SNPs were associated with the capability of achieving absolute PASI ≤ 3 at 6 months. rs1801274 (FCGR2A), rs2431697 (miR-146a) and rs10484554 (HLCw6) were identified as risk factors for failure to achieve absolute PASI≤3, while rs1051738 (PDE4A) was protective. AUC including these genotypes, weight of patients and history of biological therapy was 0.88 (95% CI 0.83-0.94), with a sensitivity of 48.6% and specificity of 95.7% to discriminate between both phenotypes. CONCLUSION: We have identified a series of polymorphisms associated with the response to secukinumab capable of predicting the potential response/non-response to this drug in patients with plaque psoriasis.
RESUMEN
Childhood-onset psoriasis generally follows an indolent course but patients with moderate or severe disease may require systemic treatment. The aim of this study was to determine the relative proportion of children and young people aged up to 21 years with moderate to severe psoriasis in the BIOBADADERM registry and to analyze the characteristics of these patients, treatments used, and adverse events. Of the 3946 patients in the registry, 24 were aged 21 years or younger. They had mean age of 16.1 years on starting treatment. When the registry was started, they had a Psoriasis Area and Severity Index of 9.4 and 67% were being treated with a conventional systemic drug. Treatment was discontinued in 14 patients (58%) due to adverse events or a loss or lack of effectiveness. In conclusion, the BIOBADADERM registry shows that young people account for a small proportion of psoriasis patients receiving systemic treatment, and they are more likely to be treated using conventional systemic drugs.
Asunto(s)
Productos Biológicos , Psoriasis , Adolescente , Productos Biológicos/uso terapéutico , Niño , Humanos , Psoriasis/inducido químicamente , Psoriasis/tratamiento farmacológico , Psoriasis/epidemiología , Sistema de RegistrosAsunto(s)
Síndromes Paraneoplásicos , Pénfigo , Anticuerpos , Humanos , Pénfigo/tratamiento farmacológicoAsunto(s)
Anilidas/efectos adversos , Carcinoma Basocelular/tratamiento farmacológico , Enfermedades del Cabello/inducido químicamente , Proteínas Hedgehog/antagonistas & inhibidores , Piridinas/efectos adversos , Neoplasias Cutáneas/tratamiento farmacológico , Anciano , Anciano de 80 o más Años , Anilidas/farmacología , Anilidas/uso terapéutico , Humanos , Masculino , Piridinas/farmacología , Piridinas/uso terapéuticoAsunto(s)
Prurito , Humanos , Masculino , Prurito/etiología , Prurito/terapia , Terapia Ultravioleta/efectos adversosAsunto(s)
Anticuerpos Monoclonales/uso terapéutico , Fármacos Dermatológicos/uso terapéutico , Psoriasis/tratamiento farmacológico , Adulto , Anticuerpos Monoclonales Humanizados , Humanos , Masculino , Persona de Mediana Edad , Inducción de Remisión , Estudios Retrospectivos , Insuficiencia del Tratamiento , Ustekinumab/uso terapéuticoAsunto(s)
Alopecia Areata/tratamiento farmacológico , Enfermedades Autoinmunes/tratamiento farmacológico , Drogas en Investigación/uso terapéutico , Azetidinas/uso terapéutico , Ensayos Clínicos como Asunto , Humanos , Masculino , Nitrilos , Piperidinas/uso terapéutico , Inhibidores de Proteínas Quinasas/uso terapéutico , Purinas , Pirazoles/uso terapéutico , Pirimidinas/uso terapéutico , Pirroles/uso terapéutico , Sulfonamidas/uso terapéuticoRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Adulto , Persona de Mediana Edad , Prurito/etiología , Prurito/radioterapia , Terapia PUVA/métodos , Terapia Ultravioleta/métodos , Agua/efectos adversos , Estudios Retrospectivos , Antagonistas de los Receptores Histamínicos/uso terapéutico , Fototerapia/métodos , Triamcinolona/administración & dosificaciónRESUMEN
No dipsonible
Asunto(s)
Humanos , Guantes Quirúrgicos , Infección de la Herida Quirúrgica/prevención & control , Enfermedades de la Piel/cirugía , United States Food and Drug Administration , 50303RESUMEN
No disponible