RESUMO
BACKGROUND: IL-23 inhibitors are the latest class of biologic drugs approved for moderate-to-severe psoriasis. OBJECTIVES: to investigate real-life safety and efficacy of tildrakizumab. METHODS: demographic data, medical history, psoriasis disease history, PASI, DLQI, BSA, NAPSI were recorded at weeks 0, 12, 24, 36. RESULTS: PASI, BSA, DLQI and NAPSI all decreased rapidly during the 36 week follow-up period. PASI score reduced from 12.28 to 4.65 by week 12, followed by a further decrease to 1.18 at week 36 Multiple logistic regression showed that smoking, BMI ≥30, ≥3 comorbidities, previous systemic traditional or biologic drugs, psoriatic arthritis nor difficult-to-treat areas influenced the reduction of PASI and NAPSI scores during treatment with tildrakizumab (P > .05). CONCLUSIONS: we assessed a good performance of tildrakizumab in patients with multiple comorbidities, multi-failure, elderly patients, and in subjects with psoriatic arthritis.
Assuntos
Artrite Psoriásica , Psoríase , Humanos , Idoso , Artrite Psoriásica/tratamento farmacológico , Resultado do Tratamento , Psoríase/tratamento farmacológico , Itália/epidemiologia , Índice de Gravidade de DoençaRESUMO
Autoimmune bullous diseases are a heterogeneous group of diseases characterized by the development of cutaneous and mucosal vesicles, blisters, and finally erosions. The common pathogenetic mechanism is the presence of autoantibodies targeting structural proteins of the skin and mucous membranes (demosomes and hemidesmosomes): in the case of pemphigus, the antigens are intraepidermal, whereas in the case of pemphigoid, dermatitis herpetiformis, and epidermolysis bullosa acquisita they are subepidermal. Mucosal involvement typically affects the oral and ocular mucosa, but in some cases, the upper airways or the upper digestive tract are affected. The burden on patients' lives could be severe due to the impairment of normal feeding or breathing. In other cases, they may represent paraneoplastic syndromes. Since autoimmune bullous diseases may result in significant morbidity and mortality, depending on the grade of cutaneous and mucosal involvement, a prompt therapeutic approach is mandatory and, in recalcitrant cases, may be challenging. The first line therapy consists of corticosteroids, both topical and systemic. Once remission or control of the acute phase is obtained, adjuvant therapies need to be introduced in order to spare the corticosteroid load and minimize side effects such as iatrogenic diabetes or osteoporosis. Herein, we describe all current therapeutic approaches to autoimmune bullous diseases, also including emerging therapies.
Assuntos
Doenças Autoimunes , Epidermólise Bolhosa Adquirida , Penfigoide Bolhoso , Pênfigo , Dermatopatias Vesiculobolhosas , Doenças Autoimunes/diagnóstico , Doenças Autoimunes/tratamento farmacológico , Epidermólise Bolhosa Adquirida/diagnóstico , Epidermólise Bolhosa Adquirida/tratamento farmacológico , Humanos , Pênfigo/diagnóstico , Pênfigo/tratamento farmacológico , Dermatopatias Vesiculobolhosas/diagnóstico , Dermatopatias Vesiculobolhosas/tratamento farmacológicoAssuntos
COVID-19 , Telemedicina , Assistência Ambulatorial , Humanos , Itália/epidemiologia , Pandemias , SARS-CoV-2 , ÚlceraAssuntos
Infecções por Coronavirus/transmissão , Homossexualidade Masculina , Pneumonia Viral/transmissão , Doenças Virais Sexualmente Transmissíveis/transmissão , Betacoronavirus , COVID-19 , Teste para COVID-19 , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Fezes/virologia , Humanos , Masculino , Pandemias , Pneumonia Viral/epidemiologia , Fatores de Risco , SARS-CoV-2RESUMO
Riassunto. La pandemia da covid-19 ha comportato un incremento dell'uso degli antibiotici e dell'antibiotico-resistenza negli ospedali, sia negli Stati Uniti che in Europa, causando un aumento della morbilità e della mortalità nei pazienti ospedalizzati per la covid-19. Come in altri ospedali anche noi abbiamo documentato un incremento delle colonizzazioni e infezioni da germi multiresistenti. In questo studio siamo andati a valutare, nel nostro ospedale, come è cambiata la prevalenza delle infezioni ematiche da Klebsiella pneumoniae resistente ai carbapenemici nel periodo 2019-primo quadrimestre del 2021 (prima e durante la diffusione della pandemia covid-19). I nostri dati documentano un incremento significativo delle infezioni ematiche da Klebsiella pneumoniae resistente ai carbapenemici e un incremento dell'uso e dei costi per ceftazidime/avibactam.
Assuntos
COVID-19 , Klebsiella pneumoniae , Humanos , SARS-CoV-2RESUMO
BACKGROUND: Real-world data for guselkumab, the first interleukin-23 inhibitor approved to treat moderate-to-severe psoriasis, are scarce. This study represents the first 60-week, real-life, multicenter, retrospective experience to investigate the effectiveness, safety, tolerability, and drug retention of guselkumab in psoriatic patients. RESEARCH DESIGN AND METHODS: Clinical information was collected at baseline and at weeks 12, 24, 36, 48, and 60. RESULTS: The mean baseline Psoriasis Activity Severity Index (PASI) reduced from 14.2 to 3.1 at week 12 and decreased to around 0 at weeks 36, 48, and 60. PASI 75, PASI 90, and PASI 100 were 100%, 96.8%, and 83.9% at week 60, respectively. Multiple logistic regression analysis showed that neither body mass index >30, smoking, ≥3 comorbidities, difficult-to-treat areas, nor a failure to ≥2 prior biologic treatments significantly influenced PASI reduction (p > 0.05). CONCLUSIONS: Our findings confirm guselkumab as an appropriate therapeutic option in routine clinical practice, especially when dealing with complex patients with comorbidities or previous failure to biologic treatments.