ABSTRACT
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.
ABSTRACT
TITLE: Microcefalia primaria hereditaria de tipo 5. No todo es virus del Zika.
Subject(s)
Microcephaly/diagnosis , Diagnosis, Differential , Humans , Infant, Newborn , Male , Zika Virus Infection/diagnosisABSTRACT
Aneurysmal dilatation of the sinus of Valsalva is a rare structural cardiac abnormality in children. It appears to be more common in Asia. It may be clinically silent for many years but these defects frequently coexist with other cardiac malformations, causing, when rupture occurs, unexpected symptoms that are not explained by the original defects. We report a case of ruptured aneurysm of the sinus of Valsalva in a 12-year-old boy diagnosed with ventricular septal defect in the neonatal period with an uneventful course. The boy suddenly developed acute prechordal pain, symptoms of low heart output and systolic-diastolic murmur. The diagnosis of ruptured aneurysm of the sinus of Valsalva was based on echocardiography. Surgical treatment was required to close the ventricular septal defect and repair the aorta, without valvular replacement. The postoperative course was uneventful. We conclude that is extremely important to have a degree high suspicion of this entity in previously asymptomatic children, with or without cardiac anomalies, who suddenly present this kind of heart failure and abrupt changes in cardiac auscultation.
Subject(s)
Aortic Rupture/complications , Heart Septal Defects, Ventricular/complications , Sinus of Valsalva , Child , Humans , MaleABSTRACT
La dilatación aneurismática del seno de Valsalva es una anomalía estructural cardíaca poco frecuente en la infancia, de mayor prevalencia en los países asiáticos. Habitualmente cursa de forma asintomática, pero debe tenerse presente que con frecuencia coexisten junto a otros defectos cardíacos y, al producirse la rotura, éstos pueden seguir una evolución inesperada e inexplicable. Se presenta un caso de rotura de aneurisma del seno de Valsalva observado en un niño de 12 años de edad, diagnosticado durante el período neonatal de una comunicación interventricular, de evolución favorable, que presentó bruscamente dolor precordial acompañado de síntomas de bajo gasto y cambio en la auscultación cardíaca. El diagnóstico de rotura de aneurisma del seno de Valsalva se estableció mediante ecocardiografía. Precisó tratamiento quirúrgico consistente en cierre de la comunicación interventricular y reparación aórtica sin recambio valvular. El postoperatorio transcurrió sin incidencias. Se concluye destacando la importancia de tener un alto índice de sospecha de esta entidad ante un niño previamente asintomático, con o sin cardiopatía de base, que presente bruscamente un cuadro con insuficiencia cardíaca y cambio brusco en la auscultación cardíaca (AU)
