Incidencia de cáncer cutáneo distinto del melanoma en pacientes tratados con PUVA oral / Incidence of non-melanoma skin cancer in patients treated with psoralen and ultraviolet A therapy

Introducción: Los trabajos que determinan la incidencia de cáncer cutáneo no melanoma (CCNM) en la población tratada con psoralenos orales+UVA son heterogéneos, dependen de la localización geográfica de la población estudiada y tienen períodos de seguimiento cortos. El objetivo del trabajo es determinar la seguridad a largo plazo de la PUVAterapia y en concreto determinar la incidencia de CCNM en los pacientes tratados con PUVAterapia oral en el área mediterránea. Material y método: Se ha realizado un estudio longitudinal de seguimiento retrospectivo, recogiendo 234 pacientes tratados con PUVA sistémico entre 1982 y 1996 con un seguimiento hasta mayo de 2017. Se ha calculado la densidad de incidencia de CCNM bruta y ajustada por edad mediante estandarización directa. Resultados: En 22 pacientes se diagnosticaron 50 neoplasias. La prevalencia de CCNM en pacientes tratados con fototerapia fue del 10,3%. El tiempo medio de seguimiento fue de 21 años. la densidad de incidencia bruta-ajustada de CCNM fue de 554,4-183,9 casos/100.000 pacientes tratados-año. La densidad de incidencia bruta-ajustada de carcinoma basocelular fue de 352,3-111,2 casos/100.000 pacientes y la de carcinoma epidermoide de 229-77,7 casos/100.000 pacientes. Conclusión: La incidencia de cáncer cutáneo en los pacientes tratados con PUVAterapia es superior a la descrita en la población mediterránea

Introduction: Studies reporting incidences of non-melanoma skin cancer (NMSC) are heterogeneous, depend on the geographic area of the studied population and are often short-term. The aim of this study is to determine the incidence of NMSC in patients treated with oral PUVA therapy in the Mediterranean area. Material and methods: A retrospective, observational study was carried out with a sample of 234 patients treated with systemic PUVA between 1982 and 1996, carrying out a historical follow-up until May 2017. The incidencedensity rate of CCNM (crude and adjusted) was calculated by direct standardisation. The incidence of CCNM was compared with that reported in the general population in a similar geographical area. Results: 50 neoplasms were diagnosed in 22 patients. The prevalence of CCNM in patients treated with phototherapy was 10.3%. The mean follow-up time was 21 years. The crude-adjusted incidence density rate of CCNM was 554.4-183.9 cases/100,000 treated patients per year. The crude-adjusted incidence density rate of basal cell carcinoma was 352.3-111.2 cases/100.000 patients and of squamous cell carcinoma was 229-77.7 cases /100,000 patients. Conclusion: PUVA therapy is associated with an increased risk of CCNM inthe Mediterranean population

A prospective multicenter study assessing effectiveness and safety of secukinumab in a real-life setting in 158 patients.

BACKGROUND: Secukinumab is a first-in-class interleukin 17A monoclonal antibody that has demonstrated an excellent safety and efficacy profile in phase 3 studies. OBJECTIVE: To evaluate the effectiveness of secukinumab in daily clinical practice and to understand the clinical and epidemiologic characteristics of patients treated with secukinumab in clinical settings. METHODS: In this multicenter prospective observational study, we recruited adult patients with moderate-to-severe plaque psoriasis from 12 hospitals in Spain during January-December 2016. These patients were treated with secukinumab and prospectively followed at 12-week intervals for 52 weeks. RESULTS: In total, 158 patients were recruited to the study. A Psoriasis Area and Severity Index (PASI) score improvement ≥75% over baseline (PASI-75) was achieved by 57%, 83.5%, 89%, and 78.5% of patients at weeks 4, 12, 24, and 52, respectively. PASI-90 was achieved in 27.8%, 62%, 64.6%, and 63.2% of patients at weeks 4, 12, 24, and 52, respectively; PASI-75 and PASI-90 responders were significantly more common among patients with a body mass index <30 kg/cm2 and patients without previous biologic therapy failures. LIMITATIONS: Observational study. Time from onset of psoriasis was not evaluated. CONCLUSION: Secukinumab is a safe treatment with effectiveness rates similar to those found in its phase 3 studies. These rates endure up to a year from start of treatment.

Incidence of non-melanoma skin cancer in patients treated with psoralen and ultraviolet A therapy. / Incidencia de cáncer cutáneo distinto del melanoma en pacientes tratados con PUVA oral.

INTRODUCTION: Studies reporting incidences of non-melanoma skin cancer (NMSC) are heterogeneous, depend on the geographic area of the studied population and are often short-term. The aim of this study is to determine the incidence of NMSC in patients treated with oral PUVA therapy in the Mediterranean area. MATERIAL AND METHODS: A retrospective, observational study was carried out with a sample of 234 patients treated with systemic PUVA between 1982 and 1996, carrying out a historical follow-up until May 2017. The incidencedensity rate of CCNM (crude and adjusted) was calculated by direct standardisation. The incidence of CCNM was compared with that reported in the general population in a similar geographical area. RESULTS: 50 neoplasms were diagnosed in 22 patients. The prevalence of CCNM in patients treated with phototherapy was 10.3%. The mean follow-up time was 21 years. The crude-adjusted incidence density rate of CCNM was 554.4-183.9 cases/100,000 treated patients per year. The crude-adjusted incidence density rate of basal cell carcinoma was 352.3-111.2 cases/100.000 patients and of squamous cell carcinoma was 229-77.7 cases /100,000 patients. CONCLUSION: PUVA therapy is associated with an increased risk of CCNM inthe Mediterranean population.