Limitations of current monoclonal antibodies for plaque-type psoriasis and an outlook for the future

Raimondo, A.; Balato, Anna; Megna, Matteo; Balato, Nicola

doi:10.1080/14712598.2018.1479738

Cited by 13 publications

(18 citation statements)

References 25 publications

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“…Secukinumab introduced a new era in the management of psoriasis, shifting possible psoriasis treatment outcomes from PASI75 to a 90% reduction of PASI score (PASI90) or complete response (100% reduction in PASI scores; PASI100), which are now recognized goals for the treatment of psoriasis in Italian guidelines [12,13]. Numerous factors must be considered when selecting appropriate treatment for a patient with psoriasis, including commonly-associated comorbidities (such as psoriatic arthritis, obesity and cardiovascular disease), patient age and concomitant infections [14,15].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of secukinumab in Italian patients with psoriasis: an 84 week, multicenter, retrospective real-world study

Megna

Costanzo

Argenziano

et al. 2019

Expert Opinion on Biological Therapy

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Background: Long term data on the real-life use of secukinumab are scant. The aim of this study was to investigate the real-life effectiveness, safety and treatment persistence of secukinumab in patients with moderate-to-severe psoriasis. Research design and methods: This 84-week, multicenter (n = 7) retrospective study analyzed data from patients who initiated and received at least 6 months of secukinumab treatment between June 2016 and June 2018 in the Campania region of Italy. Patient demographic and treatment characteristics, duration of treatment and reasons for discontinuation as well as Psoriasis Area and Severity Index (PASI), Body Surface Area (BSA), and Dermatology Life Quality Index (DLQI) scores were assessed. Results: 324 patients (63% male, mean age 50.2 years) were enrolled and received a mean 11.7 months of secukinumab treatment. Overall, 9.5% discontinued secukinumab, including 5.2% who discontinued due to secondary inefficacy and 1.8% due to adverse events. PASI, BSA and DLQI scores were significantly improved from baseline at every follow-up visit (p < 0.001) and mean PASI decreased from 15.3 ± 6.3 at baseline to 0.5 ± 1.0 at week 84. Secukinumab had comparable effectiveness in biologic naïve and non-naïve patients. Conclusions: This study confirmed the effectiveness and safety of secukinumab in real-world patients with psoriasis.

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Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of secukinumab in Italian patients with psoriasis: an 84 week, multicenter, retrospective real-world study

Megna

Costanzo

Argenziano

et al. 2019

Expert Opinion on Biological Therapy

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“…Psoriasis is an immune-mediated inflammatory skin disorder that affects 2.5% of the population worldwide. While the exact etiology of psoriasis is unknown, genetic and environmental factors are important in disease development ( 36 , 37 ). Moreover, the immune system plays a crucial role in the overall disease pathogenesis, with various innate and adaptive immune cells and pro-inflammatory mediators involved at different stages of the disease ( 38 ).…”

Section: Psoriasis As Immune-mediated Diseasementioning

confidence: 99%

“…Indeed, the IL-23/Th17 cell signaling axis effects on keratinocytes and infiltrating immune cells in the skin has shaped the current disease model of Pso. Therefore, psoriatic disease is understood as a patterned response to chronic activation of the IL-23/Th17 axis ( 36 ). Recently, it has been identified T-regulatory cells expressing IL-17A in which, Foxp3 expression is progressively lost, whereas RORγ expression is increased ( 39 , 40 ).…”

Section: Psoriasis As Immune-mediated Diseasementioning

confidence: 99%

Psoriasis, Cardiovascular Events, and Biologics: Lights and Shadows

et al. 2018

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Nowadays, it is well established a link between psoriasis and cardiovascular (CV) diseases. A series of different overlapping mechanisms including inflammation, homeostasis dysregulation, and genetic susceptibility are thought to underlie this association. Advances in understanding the molecular patterns involved in the complex scenario of psoriasis have highlighted a tight correlation with atherosclerosis. Indeed, common profiles are shared in term of inflammatory cytokines and cell types. In the last decade, the management of psoriasis patients has been revolutionized with the introduction of biological therapies, such as tumor necrosis factor-alpha (TNF-α), interleukin (IL)-12/23, and IL-17 inhibitors. In clinical setting, the effectiveness of these therapies as well as the incidence of CV events is related to the type of biologics. In particular, anti-TNF-α agents seem to reduce these events in psoriasis patients whereas anti-IL-12/23 agents related CV events reduction still remain to clarify. It has to be taken into account that IL-12/23 inhibitors have a shorter post-marketing surveillance period. An even more restricted observational time is available for anti-IL-17 agents. IL-17 is associated with psoriasis, vascular disease, and inflammation. However, IL-17 role in atherosclerosis is still debated, exerting both pro-atherogenic and anti-atherogenic effects depending on the specific context. In this review, we will discuss the differences between the onset of CV events in psoriasis patients, referred to specific biological therapy and the underlying immunological mechanism. Given the development of new therapeutic strategies, the investigation of these inhibitors impact on heart failure outcome is extremely important.

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“…Immune-mediated inflammation of the skin is a key feature of PSO that can be modified by different genetic and environmental factors. Whereas the role of Th1 cells response driven by IFN-γ and IL-12 in PSO has been established for over three decades, recent developments added the importance of the chronic activation of IL-23 and Th17 axis, in which IL-23 maintains the activity of Th17 cells [ 85 ].…”

Section: Molecular Background Of Links Between Pso and Ath Developmentmentioning

confidence: 99%

Psoriasis and Atherosclerosis—Skin, Joints, and Cardiovascular Story of Two Plaques in Relation to the Treatment with Biologics

Wierzbowska−Drabik

Lesiak

Skibińska

et al. 2021

IJMS

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It is known that both psoriasis (PSO) limited to the skin and psoriatic arthritis (PSA) increase the risk of cardiovascular complications and atherosclerosis progression by inducing systemic inflammatory response. In recent decades, the introduction of biological medications directed initially against TNF-α and, later, different targets in the inflammatory cascade brought a significant breakthrough in the efficacy of PSO/PSA treatment. In this review, we present and discuss the most recent findings related to the interplay between the genetics and immunology mechanisms involved in PSO and PSA, atherosclerosis and the development of cardiac dysfunction, as well as the current PSO/PSA treatment in view of cardiovascular safety and prognosis.

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Limitations of current monoclonal antibodies for plaque-type psoriasis and an outlook for the future

Cited by 13 publications

References 25 publications

Effectiveness and safety of secukinumab in Italian patients with psoriasis: an 84 week, multicenter, retrospective real-world study

Effectiveness and safety of secukinumab in Italian patients with psoriasis: an 84 week, multicenter, retrospective real-world study

Psoriasis, Cardiovascular Events, and Biologics: Lights and Shadows

Psoriasis and Atherosclerosis—Skin, Joints, and Cardiovascular Story of Two Plaques in Relation to the Treatment with Biologics

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