Effectiveness of Ixekizumab in Elderly Patients for the Treatment of Moderate-to-Severe Psoriasis: Results From a Multicenter, Retrospective Real-Life Study in the Lazio Region

Introduction: This was an observational, retrospective, multicenter study, enrolling elderly patients (>65 years old) treated with ixekizumab with a diagnosis of psoriasis (PsO) and/or psoriatic arthritis (PsA) during the period 2020 to 2023. Objectives: We sought to investigate the efficacy of ixekizumab in elderly patients in the treatment of moderate to severe psoriasis. Methods: We included 73 patients with psoriasis (32.9%), psoriatic arthritis (1.4%) and both of them (PsO-PsA 65.8%), attending the outpatient clinics of seven Italian referral center for psoriasis in Lazio region: Policlinico Umberto I Università Roma La Sapienza, Sant’Andrea Università di Roma La Sapienza, Polo Pontino Università Roma La Sapienza, Fondazione Policlinico Universitario A. Gemelli, Università Campus Biomedico Roma, Istituto Dermopatico dell’Immacolata, and Policlinico Tor Vergata. We collected data related to the characteristics of the patients (age, sex, body mass index) and of the disease (age at onset, duration of psoriasis, previous treatments). The severity of psoriasis was measured with the Psoriasis Area and Severity Index (PASI) score at baseline and after 16, 24, 52, 104 and 156 weeks of treatment. Results: PASI90 was achieved by all the patients in week 16 and remained stable until the end of the study. PASI100 has been achieved by 55.1% of patients at weeks 16 and by 81.3% at week 104. A statistically significant difference has been highlighted between baseline and all the other time points (p<0.0001) for PASI score. A similar trend was observed for VAS score and DLQI score. Conclusions: Ixekizumab was effective and with a good safety profile in psoriatic patients over 65 years. No significant adverse events were reported

Adherence to the Mediterranean diet model and psoriatic disease (skin, joint and metabolic expression of psoriasis)

Psoriasis is a chronic disease, characterized by systemic inflammation with skin, joint and metabolic involvement. The most common tools to evaluate the severity of each disease is respectively the Psoriasis Area Severity Index (PASI) and the Disease Activity Index for Psoriatic Arthritis (DAPSA). The association between psoriasis and obesity and the role of visceral fat in producing an inflammatory state have been demonstrated. The Mediterranean Diet (MD) has been recommended as a model of healthy diet on the basis of scientific evidence and considered as an adjuvant therapy for all patients affected by chronic inflammatory diseases. Our study evaluated the association between adherence to MD (assessed with the Predimed questionnaire) and psoriatic disease severity. 80 patients (40 with psoriasis and 40 with psoriatic arthritis) were evaluated for disease severity (PASI, DAPSA) and were assessed for Metabolic Syndrome according to the International Diabetes Federation (IDF) definition. To evaluate adherence to the MD, each patient was administered the Predimed questionnaire which includes 14 questions. Our study shows a correlation between low adherence to MD and a high expression of psoriasis, considering cutaneous, joint symptoms and the metabolic profile

Linagliptin-induced bullous pemphigoid

Bullous pemphigoid (BP) is an autoimmune disease that can be induced by several drugs. In the literature 21 cases of BP probably associated to the use of gliptins have been reported. We describe one female patient who developed BP 5 months after the introduction of linagliptin into her anti-diabetic therapy (metformin and repaglinide). Clinical diagnosis of BP was confirmed by histological examination of a lesional skin biopsy and direct immunofluorescence of perilesional skin. Oral anti-diabetic therapy was substituted with subcutaneous injection of insuline. In addition, i.v. methylprednisolone (1mg/kg/day for ten days than tapered) and azathioprine (100mg/day) were administered for 12 weeks achieving complete regression of the cutaneous lesions. Considering the possible relationship between BP and gliptins, a clinical surveillance for cutaneous disorders is advisable in patients undergoing this treatment

Effectiveness of risankizumab in the treatment of palmoplantar psoriasis: a 52-week Italian real-life experience

Background: Data on the treatment of palmoplantar psoriasis (PP) are scarce, representing a therapeutic challenge. This study aims to assess the efficacy and safety of risankizumab in a population of patients with psoriasis with a palmoplantar involvement, over a 52- week treatment period. Methods: We performed a retrospective analysis in a cohort of patients with PP, with or without involvement of other skin sites. Palmoplantar Psoriasis Area and Severity Index (ppPASI) was assessed at baseline and after 4, 16, 28 and 52 weeks, to evaluate the PP severity. Results: Sixteen patients were enrolled. The rates of ppPASI90 responses constantly increased during the period of observation and were 18.7%, 62.2%, 75.0% and 81.2% at weeks 4, 16, 28 and 52, respectively. Only two patients suspended treatment because of ineffectiveness at week 16. Conclusion: Our data from a series of 16 patients reveal that risankizumab could represent an effective and safe therapeutic choice in patients with PP

A strange perianal ulcer

N/

Linear IgA bullous dermatosis in a two-year-old child: possible association with aspirin

A child with linear IgA bullous dermatosis, appeared after after administration of aspirin, is herein reported

Risankizumab for the treatment of moderate-to-severe psoriasis: A multicenter, retrospective, 1 year real-life study

Several new biologic agents targeting IL23/Th17 axis, such as risankizumab, have been developed for the treatment of psoriasis. The aim of the present study was to analyze the efficacy and safety of risankizumab in patients with moderate-to-severe psoriasis over a 52-week period. A multicentric retrospective study was conducted in patients who initiated risankizumab between July 2019 and December 2020. Psoriasis Area and Severity Index-PASI was measured at baseline and after 4, 16, 28 and 52 weeks. Clinical responses were evaluated by PASI75, PASI90 and PASI100 at the same timepoints. Potential safety issues and adverse events (AEs) were collected. Univariable and multivariable logistic regressions were performed for variables predicting clinical response. One hundred and twelve patients with psoriasis were included. PASI90 response was achieved by 17.86% of patients at week 4, 72.22% at week 16, 91.0% at week 28 and 95.24% at week 52 (as observed analysis). No associations between the considered variables and the efficacy endpoints were retrieved, influence of variables such as Body Mass Index (BMI), baseline PASI or previous biologics were not shown. No serious safety issues or discontinuations related to adverse events were reported. Risankizumab showed high efficacy and a favorable safety profile, regardless of patient- and disease-related factors

Secukinumab in moderate-to-severe plaque psoriasis: a multi-center, retrospective, real-life study up to 52 weeks observation

Objectives: To evaluate efficacy and safety of the anti-IL-17 drug secukinumab in a real-life large cohort of patients with moderate-to-severe plaque psoriasis in Central Italy. Methods: Multicenter, retrospective study with an observation period of up to 52\ua0weeks. Efficacy was assessed by Psoriasis Area and Severity Index (PASI) score; clinical and laboratory examinations were performed at baseline and at weeks 4, 12, 24, 36, and 52. Results: A 90% and a 100% PASI score reduction (PASI90 and PASI100) were reported in 67.5% and 55% of patients at week 12, respectively. A rapid improvement of skin lesions was observed particularly in young patients and in patients na\uefve to biologics: at week 4, the achievement of PASI90 and PASI100 was higher in younger patients (odds ratio [OR] 0.95, and 0.95; p\ua0=\ua00.003, and 0.005, respectively); PASI90 was achieved by 42.0% of patients na\uefve to biologics and by 17.0% of patients with prior exposure to biologics (PBT) (OR 0.24; p\ua0=\ua00.001); and PASI100 was reached by 25.5% of na\uefve patients and 9.8% of PBT (OR 0.28; p\ua0=\ua00.015).The drug was well tolerated. Conclusion: Secukinumab was effective in this real-life analysis, with rapid clinical improvement and long-term maintenance of results