Tildrakizumab is an IL-23-inhibitor that has been approved to treat plaque psoriasis. However, few reports have become available on its efficacy profile in the real-world. Our objective was to study the mid-term efficacy of tildrakizumab in patients with moderate-to-severe psoriasis in the Spanish routine clinical practice setting. This was a retrospective multicenter study that included a total of 91 psoriatic patients on tildrakizumab. The mean Psoriasis Area and Severity Index (PASI) was 9.09 (SD, 5.30). The overall tildrakizumab survival rate was 93.47% for a mean treatment exposure of 30.18 weeks (SD, 16.57). No drug discontinuation was associated with drug tolerability, or adverse reactions. Absolute PASI ≤3 was reached by 91.3% and 96.5% of the patients on weeks 28 and 52, respectively. Response was not impacted by weight, age (>65), metabolic syndrome, presence of arthritis, or previous number of biological therapies used. Based on our own experience tildrakizumab is an effective strategy to treat plaque psoriasis and difficult-to-treat-areas.
BACKGROUND AND OBJECTIVE: Risankizumab - a humanized monoclonal antibody that targets the p19 subunit of IL-23 - has been recently approved to treat moderate-to-severe plaque psoriasis. Real-world data based on a representative pool of patients are currently lacking. OBJECTIVE: To assess the mid- and long-term safety and efficacy profile of risankizumab in patients with moderate-to-severe psoriasis in the routine clinical practice. METHODS: This was a retrospective and multicenter study of consecutive psoriatic patients on risankizumab from April 2020 through November 2022. The primary endpoint was the number of patients who achieved a 100% improvement in their Psoriasis Area and Severity Index (PASI) (PASI100) on week 52. RESULTS: A total of 510 patients, 198 (38.8%) women and 312 (61.2%) men were included in the study. The mean age was 51.7±14.4 years. A total of 227 (44.5%) study participants were obese (body mass index [BMI] >30kg/m2). The mean baseline PASI score was 11.4±7.2, and the rate of patients who achieved PASI100 on week 52, 67.0%. Throughout the study follow-up, 21%, 50.0%, 59.0%, and 66% of the patients achieved PASI100 on weeks 4, 16, 24, and 40, respectively. The number of patients who achieved a PASI ≤2 was greater in the group with a BMI ≤30kg/m2 on weeks 4 (P=.04), 16 (P=.001), and 52 (P=.002). A statistically significantly greater number of patients achieved PASI100 in the treatment-naïve group on weeks 16 and 52 (P=.001 each, respectively). On week 16 a significantly lower number of participants achieved PASI100 in the group with psoriatic arthropathy (P=.04). Among the overall study sample, 22 (4.3%) patients reported some type of adverse event and 20 (3.9%) discontinued treatment. CONCLUSIONS: Risankizumab proved to be a safe and effective therapy for patients with moderate-to-severe psoriasis in the routine clinical practice.
El diagnóstico diferencial clínico entre los hemangiomas congénitos (HC) y los infantiles (HI) es complicado pero esencial para el tratamiento. El marcador inmunohistoquímico GLUT-1 ayuda a distinguirlos, sin embargo, la biopsia no es habitual. Se diseñó un estudio retrospectivo incluyendo los HI y a los HC diagnosticados en un hospital terciario en un periodo de 3 años, con el objetivo de describir y comparar los principales aspectos clínicos, epidemiológicos y terapéuticos. Se incluyeron un total de 107 hemangiomas, 34 HC (NICH/PICH/RICH), 70 HI y 3 pendientes de clasificar. El HI superficial de cabeza y cuello fue el tumor más frecuente. El tronco fue la localización más frecuente de los HC. Los factores de riesgo estudiados fueron más frecuentes en el grupo de los HI. Para los HI, el tipo de respuesta obtenida fue independiente de las variables (sexo, fecundación in vitro, profundidad, localización y tipo de tratamiento) (AU)
Distinguishing between congenital and infantile hemangiomas is challenging, but essential for appropriate treatment. The immunohistochemical marker glucose transporter type 1 is helpful, but biopsies are uncommon in this setting. The aim of this retrospective study was to describe and compare epidemiological, clinical, and treatment characteristics of congenital and infantile hemangiomas diagnosed at a tertiary care hospital over 3 years. We studied 107 hemangiomas: 34 congenital hemangiomas (rapidly involuting, partially involuting, and noninvoluting), 70 infantile hemangiomas, and 3 hemangiomas pending classification. Superficial infantile hemangiomas of the head and neck were the most prevalent tumors. Congenital hemangiomas were most often located on the trunk. Studied risk factors were more common in patients with infantile hemangiomas. In this group of patients, treatment response was independent of sex, in vitro fertilization, lesion depth and location, and type of treatment (AU)
Humans , Male , Female , Hemangioma/congenital , Hemangioma/diagnosis , Skin Neoplasms/congenital , Skin Neoplasms/diagnosis , Propranolol/administration & dosage , Timolol/administration & dosage , Retrospective Studies , Diagnosis, Differential , Risk Factors , Hemangioma/drug therapy , Skin Neoplasms/drug therapy
Distinguishing between congenital and infantile hemangiomas is challenging, but essential for appropriate treatment. The immunohistochemical marker glucose transporter type 1 is helpful, but biopsies are uncommon in this setting. The aim of this retrospective study was to describe and compare epidemiological, clinical, and treatment characteristics of congenital and infantile hemangiomas diagnosed at a tertiary care hospital over 3 years. We studied 107 hemangiomas: 34 congenital hemangiomas (rapidly involuting, partially involuting, and noninvoluting), 70 infantile hemangiomas, and 3 hemangiomas pending classification. Superficial infantile hemangiomas of the head and neck were the most prevalent tumors. Congenital hemangiomas were most often located on the trunk. Studied risk factors were more common in patients with infantile hemangiomas. In this group of patients, treatment response was independent of sex, in vitro fertilization, lesion depth and location, and type of treatment (AU)
El diagnóstico diferencial clínico entre los hemangiomas congénitos (HC) y los infantiles (HI) es complicado pero esencial para el tratamiento. El marcador inmunohistoquímico GLUT-1 ayuda a distinguirlos, sin embargo, la biopsia no es habitual. Se diseñó un estudio retrospectivo incluyendo los HI y a los HC diagnosticados en un hospital terciario en un periodo de 3 años, con el objetivo de describir y comparar los principales aspectos clínicos, epidemiológicos y terapéuticos. Se incluyeron un total de 107 hemangiomas, 34 HC (NICH/PICH/RICH), 70 HI y 3 pendientes de clasificar. El HI superficial de cabeza y cuello fue el tumor más frecuente. El tronco fue la localización más frecuente de los HC. Los factores de riesgo estudiados fueron más frecuentes en el grupo de los HI. Para los HI, el tipo de respuesta obtenida fue independiente de las variables (sexo, fecundación in vitro, profundidad, localización y tipo de tratamiento) (AU)
Humans , Male , Female , Hemangioma/congenital , Hemangioma/diagnosis , Skin Neoplasms/congenital , Skin Neoplasms/diagnosis , Propranolol/administration & dosage , Timolol/administration & dosage , Retrospective Studies , Diagnosis, Differential , Risk Factors , Hemangioma/drug therapy , Skin Neoplasms/drug therapy
Distinguishing between congenital and infantile hemangiomas is challenging, but essential for appropriate treatment. The immunohistochemical marker glucose transporter type 1 is helpful, but biopsies are uncommon in this setting. The aim of this retrospective study was to describe and compare epidemiological, clinical, and treatment characteristics of congenital and infantile hemangiomas diagnosed at a tertiary care hospital over 3 years. We studied 107 hemangiomas: 34 congenital hemangiomas (rapidly involuting, partially involuting, and noninvoluting), 70 infantile hemangiomas, and 3 hemangiomas pending classification. Superficial infantile hemangiomas of the head and neck were the most prevalent tumors. Congenital hemangiomas were most often located on the trunk. Studied risk factors were more common in patients with infantile hemangiomas. In this group of patients, treatment response was independent of sex, in vitro fertilization, lesion depth and location, and type of treatment.
Hemangioma, Capillary , Hemangioma , Skin Neoplasms , Humans , Infant , Retrospective Studies , Tertiary Care Centers , Hemangioma/diagnosis , Hemangioma/epidemiology , Hemangioma/therapy , Biopsy , Skin Neoplasms/diagnosis , Skin Neoplasms/epidemiology , Skin Neoplasms/therapy , Treatment Outcome
Objetivo: Evaluar la efectividad, la seguridad, la calidad de vida y la satisfacción de pacientes con psoriasis palmo-plantar (PP) no pustulosa tratados con espuma de calcipotriol y betametasona dipropionato (Cal/BD).Material y métodos: Estudio observacional, prospectivo. Se incluyeron pacientes adultos con diagnóstico de psoriasis no controlada con afectación PP para los que estuviera indicado iniciar tratamiento tópico con Cal/BD. Las variables recogidas fueron: demográficas (sexo y edad), antropométricas (índice de masa corporal (IMC)), relacionadas con la patología (Body Surface Area (BSA) categorizado como <10% o bien ≥10%) y relacionadas con el tratamiento (tratamientos farmacológicos previos).Para evaluar la efectividad y la seguridad del tratamiento se empleó el Palmoplantar Psoriasis Area Severity Index (PPASI) y el Physicians Global Assessment (PGA), y se recogió la incidencia y gravedad de los efectos adversos. Para valorar la calidad de vida se utilizó el Dermatology Life Quality Index (DLQI), así como el Treatment Satisfaction Questionnaire for Medication (TSQM-14) para valorar la satisfacción del paciente con el tratamiento a las 4 semanas. Las variables de efectividad y de calidad de vida se evaluaron al inicio y a las 4 semanas de tratamiento, calculándose la diferencia en términos absolutos entre ambas.Resultados: Se incluyeron 19 pacientes (11 mujeres) con una edad de 59 (RIQ 11,4) años y un IMC de 25,9 (RIQ 6,0) kg/m2, todos ellos con un BSA <10%, previamente pretratados con tratamientos tópicos (74%; 14/19), acitretino (48%; 9/19) e inmunosupresores (26%; 5/19), entre otros. (AU)
Objective: To evaluate effectiveness, safety, quality of life and satisfaction of patients with non-pustular palmo-plantar (PP) psoriasis treated with calcipotriol and betamethasone (Cal/BD) foam.Material and methods: Observational, prospective study. We included adult patients with a diagnosis of uncontrolled PP psoriasis in which topical treatment was indicated. Demographic (sex and age), anthropometric (body mass index (BMI)), related to the pathology (Body Surface Area (BSA) categorized as <10% or ≥10%) and related to the treatment (previous pharmacological treatments) variables were studied. To evaluate effectiveness and safety of the treatment, Palmoplantar Psoriasis Area Severity Index (PPASI) and Physicians Global Assessment (PGA) were used, and the incidence and severity of the adverse effects were collected. To assess quality of life, Dermatology Life Quality Index (DLQI) was used, as well as Treatment Satisfaction Questionnaire for Medication (TSQM-14) to assess patient satisfaction with treatment at the 4th week. The variables of effectiveness and quality of life were evaluated at the beginning and at 4th week of treatment, calculating the difference in absolute terms between them.Results: We included 19 patients (11 women) with a median of 59 (IQR 11.4) years old and a BMI of 25.9 (IQR 6.0) kg/m2. All the patients showed a BSA <10% and were previously treated with topical treatments (74%; 14/19), acitretin (48%; 9/19) and immunosuppressants (26%; 5/19), among others. (AU)
Humans , Psoriasis , Drug Therapy , Patients , Quality of Life , Therapeutics
Objetivo: Evaluar y comparar el tiempo de persistencia y analizar los motivos de suspensión con fármacos antagonistas del factor de necrosis tumoral (anti-TNF) frente a antagonistas de interleucinas (anti-IL) en primera línea de tratamiento biológico en pacientes con psoriasis.Material y métodos: Estudio retrospectivo observacional realizado entre 01/2010 y 05/2019. Se incluyeron pacientes adultos diagnosticados de psoriasis moderada-grave en tratamiento con anti-TNF o anti-IL en primera línea de tratamiento biológico. Se estudiaron variables demográficas y relacionadas con el tratamiento, calculándose el tiempo de persistencia con el fármaco de estudio, así como las suspensiones de tratamiento. Resultados: Se incluyeron 94 pacientes (39 mujeres) con una media de 49 años (desviación estándar 13,0), 46 (48,9%) pacientes tratados con anti-TNF (35/46 adalimumab y 11/46 etanercept) y 48 (51,1%) pacientes tratados con anti-IL (26/48 secukinumab, 15/48 ustekinumab y 7/48 ixekizumab). El tiempo de persistencia en primera línea de tratamiento biológico fue de 18,4 (rango intercuartílico (RIQ) 22,2) meses, siendo 9,3 (RIQ 21,7) meses superior en los pacientes tratados con anti-IL (24,7 vs. 15,4 meses; p=0,002). A la finalización del seguimiento el 38,3% (36/94) de la población había interrumpido el tratamiento, debido a: falta de efectividad (34,8% (16/46) anti-TNF vs. 14,6% (7/48) anti-IL; p=0,003), eventos adversos (2,2% (1/46) anti-TNF) y otros motivos (17,4% (8/46) anti-TNF vs. 8,3% (4/48) con anti-IL; p>0,05). Conclusiones: El tiempo de persistencia en primera línea de tratamiento biológico fue de 18,4 meses, siendo significativamente superior en los pacientes tratados con anti-IL. El principal motivo de suspensión fue la falta de efectividad en ambos grupos de tratamiento. (AU)
Objective: To evaluate and compare the time of persistence and to analyse the discontinuation reasons with tumor necrosis factor antagonists (anti-TNF) vs. interleukin antagonists (anti-IL) as first line with biological treatments in patients with psoriasis. Material and methods: Retrospective observational study carried out between 01/2010 and 05/2019. Adult patients diagnosed with moderate to severe psoriasis in treatment with anti-TNF or anti-IL as first line with biological treatments were included. Demographic and treatment-related variables were studied, calculating the time of persistence with the study drug, as well as treatment discontinuations. Results: We included 94 patients (39 women) with a mean of 49 years (standard deviation 13.0), 46 (48.9%) patients treated with anti-TNF (35/46 adalimumab and 11/46 etanercept) and 48 (51.1%) patients treated with anti-IL (26/48 secukinumab, 15/48 ustekinumab and 7/48 ixekizumab). Persistence time with biological treatment in first line was 18.4 (interquartile range (IQR) 22.2) months, being 9.3 (IQR 21.7) months higher in patients treated with anti-IL (24.7 vs. 15.4 months; p=0.002). At the end of the follow-up, 38.3% (36/94) of the population had discontinued their treatments. The reasons for discontinuation were: lack of effectiveness (34.8% (16/46) anti-TNF vs. 14.6% (7/48) anti-IL; p=0.003), side effects (2.2% (1/46) anti-TNF) and other reasons (17.4% (8/46) anti-TNF vs. 8.3% (4/48) anti-IL; p>0.05). Conclusion: The persistence time with biological treatment in first line was 18.4 months, being significantly higher in the anti-IL group. The main reason of discontinuation was lack of effectiveness in both groups of treatment. (AU)
Humans , Psoriasis , Drug Therapy , Biological Products , Psoriasis/drug therapy , Necrosis/drug therapy , Retrospective Studies
No disponible
Humans , Male , Female , Child, Preschool , Lichenoid Eruptions/diagnosis , Dermatitis, Atopic/complications , Retrospective Studies , Pruritus/etiology
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Humans , Male , Adult , Infectious Mononucleosis/chemically induced , Infectious Mononucleosis/complications , Infectious Mononucleosis/diagnosis , Exanthema/complications , Exanthema/diagnosis , Acetaminophen/therapeutic use , Penicillins/adverse effects , Rest , Analgesia/methods , Diagnosis, Differential
Amoxicillin-Potassium Clavulanate Combination/adverse effects , Drug Eruptions/etiology , Exanthema/chemically induced , Infectious Mononucleosis/drug therapy , beta-Lactamase Inhibitors/adverse effects , Adult , Amoxicillin-Potassium Clavulanate Combination/therapeutic use , Drug Combinations , Drug Eruptions/diagnosis , Exanthema/diagnosis , Humans , Male , beta-Lactamase Inhibitors/therapeutic use
Birt-Hogg-Dube Syndrome/complications , Colonic Polyps/complications , Adenoma/etiology , Adenoma/surgery , Biopsy , Birt-Hogg-Dube Syndrome/pathology , Colectomy , Colonic Polyps/pathology , Colonoscopy , Colorectal Neoplasms/etiology , Colorectal Neoplasms/surgery , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Proto-Oncogene Proteins/genetics , Tumor Suppressor Proteins/genetics
