Outcome following a short period of adalimumab dose escalation as rescue therapy in psoriatic patients

Background: Advances in biologic treatments have led to a new therapeutic frontier for moderate-to-severe psoriasis. Nevertheless, the efficacy of anti-TNFα decreases with time, requiring adjustments to maintain valuable Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) responses. Objectives: To evaluate the efficacy and safety of adalimumab dose escalation (40 mg, subcutaneous, once a week for 24 weeks) in psoriatic adult patients with secondary loss of response (PASI ≥50 to ≤75 or PASI≥75 and DLQI ≥5). Materials and Methods: A multicentre, observational study involving different Italian third-level referral centres for psoriasis enrolled a total of 64 adult patients with moderate-to-severe psoriasis who were treated with adalimumab and experienced a secondary loss of response. Primary end-points were PASI< 75 or PASI ≥50 to ≤ 75 with DLQI ≤ 5, and the secondary end-point was the ability to maintain a therapeutic response, resuming adalimumab every other week. Results: At Week 16 and Week 24, 29/64 (45.3%) and 35/64 (54.6%) responded based on PASI, and mean DLQI was 4.9 and 4.09, respectively. At Week 36 and Week 48, 45.3% and 28.1% patients achieved the second end-point, respectively. No adverse events were recorded except for one patient with recurrent tonsillitis. Conclusion: Adalimumab escalation could be considered in cases with loss of response before switching to alternative biologic therapy

PsoBioVax: A multicentric Italian case–control study of the immunological response to anti‐SARS‐CoV‐2 vaccine among psoriatic patients under biological therapy

Dear Editor, The role of vaccination has been crucial in limiting COVID-19.1 The efficacy of vaccines among patients with immunemediated inflammatory disease has been investigated showing promising results.2 Patients with psoriasis under biological treatment had a valid response to the COVID-19 vaccine

Delayed granulomatous reaction to hyaluronic acid gel injection

Injectable hyaluronic acid (HA) derivatives are the most used resorbable dermal fillers used for soft tissue augmentation. While their use is considered safe, there have been reports of cutaneous granulomatous reactions.We describe the clinical, radiological, and cytological findings in a patient who presented a full year after cosmetic treatment with HA injections and discuss the various treatment options. Level of Evidence: Level V, therapeutic study

Culture and low-carbon energy transitions

How does culture influence low-carbon energy transitions? How can insights about cultural influences guide energy planners and policymakers trying to stimulate transitions, particularly at a time of rapid technological change? This Review examines the influence of culture on a selection of low-carbon technologies and behavioural practices that reflect different dimensions of sustainability. Based on a typology of low-carbon technology and behaviour, we explore the cultural dimensions of four specific cases: eco-driving, ridesharing, automated vehicles and whole-house retrofits. We conclude with recommendations for those seeking to analyse, understand, develop, demonstrate and deploy low-carbon innovations for sustainable energy transitions

A Reduction in Social Security Contributions: Which Alternatives for Financing Coverage?

This paper uses the INTIMO model of the Italian economy to analyze the economic impacts of a reduction in social security contributions. This manoeuvre is intended to reduce the tax wedge on labour cost. There is a wide choice of ways to neutralize the revenue effects of a lower tax yield, because several of the existing taxes could be increased and new ones could be introduced. In this study, alternative financing coverages are developed and applied in the model. The results of the study show that substituting different taxes for social security contributions affects the cost of production, and impacts vary with industries. A reduction in contributions compensated for by an increase in value-added tax produces the best results in terms of short-term economic indicators, but the improvement in environmental conditions—not analyzed in this study—achieved by energy taxes could be a very important target and could justify the recourse to this tool.Interindustry model, social security contributions, taxation,