Safety concerns with current treatments for psoriasis in the elderly

Caprio, Roberta Di; Caiazzo, Giuseppina; Cacciapuoti, Sara; Fabbrocini, Gabriella; Scala, Emanuele; Balato, Anna

doi:10.1080/14740338.2020.1728253

Cited by 23 publications

(15 citation statements)

References 82 publications

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“…Percentage of patients achieving a severity level of 0 or 1 in erythema, induration and desquamation per body region at baseline and at week 16 erythema (Figure 1), induration (Figure 2), and desquamation (Figure 3…”

Section: Resultsmentioning

confidence: 99%

“…In addition, there is no evidence of drug-drug interactions with FAEs as with other systemic treatments [15]. Thus, psoriasis therapy should be individually based and consider comorbidities, concomitant medications, or contraindications [16]. Licensed FAEs contain DMF, which has been identified as the main active component [17,18] exerting anti-inflammatory properties against several molecular targets including, HCA2 and Nrf2 pathways [19,20].…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of dimethyl fumarate treatment for moderate-to-severe plaque psoriasis: presentation extracts from the 29^th EADV virtual congress, 29-31 October 2020

Mrowietz¹,

Kerkhof

Schoenenberger

et al. 2021

Expert Review of Clinical Immunology

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Background:The 29th EADV Virtual Congress took place between the 29th-31st of October 2020. On October 29th, there was a Session on systemic treatment in which Professors Ulrich Mrowietz and Mar Llamas-Velasco presented the latest research on the efficacy of dimethyl fumarate (DMF) treatment for moderate-to-severe plaque psoriasis (BRIDGE and DIMESKIN 1 studies, respectively). The accepted DMF abstract from Professor Matthias Augustin, on the SKILL study, is also presented here. Results: Data from either prospective interventional (BRIDGE) or non-interventional (DIMESKIN 1, SKILL) studies among patients with moderate-to-severe psoriasis showed that DMF provides a positive efficacy profile in all four body regions included in the Psoriasis Area and Severity Index assessment (head and neck, trunk, upper and lower extremities) and a particularly interesting profile (strong efficacy) in the head and neck region. These findings may be of special interest to patients with scalp psoriasis who have been using topical therapies for a long time. Patient-reported outcomes (quality of life, pruritus) also improved during the 24 weeks of DMF treatment. The safety profile of DMF was similar to the previously described with fumaric acid esters. Conclusions: In summary, these results confirm the favorable efficacy and safety profile of DMF in longterm treatment.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of dimethyl fumarate treatment for moderate-to-severe plaque psoriasis: presentation extracts from the 29^th EADV virtual congress, 29-31 October 2020

Mrowietz¹,

Kerkhof

Schoenenberger

et al. 2021

Expert Review of Clinical Immunology

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show abstract

“…However, psoriasis management may be challenging in these patients, as they frequently have multiple comorbidities and related polypharmacy, and increased rates of AEs. Additionally, the development of immunosenescence, which is a progressive functional impairment of the immune system related to ageing, may result in an increased susceptibility to infections and cancers, further complicating the approach to treatment of elderly patients 22 . Despite the fact that moderate to severe psoriasis is increasingly observed in the elderly population, data regarding the therapeutic management of these patients are limited 22 .…”

Section: Discussionmentioning

confidence: 99%

Anti‐interleukin‐23 for psoriasis in elderly patients: guselkumab, risankizumab and tildrakizumab in real‐world practice

Ruggiero

Fabbrocini

Cinelli

et al. 2021

Clin Experimental Derm

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Summary Background Elderly patients (aged ≥ 65 years) represent an increasing proportion of patients with psoriasis and 15% of these have moderate to severe disease. Biologics are being used frequently in this group of patients even though safety and efficacy data are limited. In addition, owing to anti‐interleukin (IL)‐23 therapies being a relatively recent option, no data have been reported about their use in elderly patients with psoriasis. Aim To evaluate and compare the safety and efficacy of guselkumab, risankizumab and tildrakizumab in real‐world practice in elderly patients. Methods This was a single‐centre retrospective study that enrolled patients aged ≥ 65 years with moderate to severe plaque psoriasis, treated with guselkumab, risankizumab or tildrakizumab. The length of the study for each group depended on the drug (44 weeks for risankisumab, 40 weeks for guselkumab and 28 weeks for tildrakizumab, owing to its more recent availability in Italy). Results In total, 34 patients were enrolled (n = 20 on guselkumab; n = 8 on risankizumab; n = 6 on tildrakizumab). At Week 4, 29.4% reached 90% improvement in Psoriasis Area and Severity Index (PASI90) and 8.8% reached 100% improvement in PASI (PASI100); at Week 28, PASI90 and PASI100 was reached by 58.8% and 29.4%, respectively. At the final follow‐up (Week 40 or 44, depending on drug), data were available only for the risankizumab (Week 40) and guselkumab (Week 44) and groups, and showed that 71.4% of patients had reached PASI90 and 53.5% had reached PASI100. Four patients (11.7%) discontinued treatment. No significant differences were found between the three groups. The limitations of the study included its retrospective nature of the study, small sample size, and different numbers of patients and follow‐up duration for the different groups (highest for guselkumab, lowest for tildrakizumab). Conclusion The three anti‐IL‐23 therapies assessed are promising, safe and effective options in elderly patients, and there was no significant difference between them. However, more data are needed to confirm our results and to understand their role in the management of this group of patients.

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“…Since only few data were available regarding BerEP4 positivity in extracutaneous NEC, 10 we additionally assessed whether EpCAM expression might help to distinguish MCC from extracutaneous NEC. For this purpose, BerEP4 staining was performed in a previously described set of extracutaneous poorly differentiated NEC 4 including 37 small cell NEC and seven large cell NECs.…”

Section: Berep4 Positivity In Merkel Cell Carcinoma: a Potential Diagmentioning

confidence: 99%

Apremilast efficacy and safety in elderly psoriasis patients over a 48‐week period

Megna

Fabbrocini

Camela

et al. 2020

Acad Dermatol Venereol

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Safety concerns with current treatments for psoriasis in the elderly

Cited by 23 publications

References 82 publications

Efficacy of dimethyl fumarate treatment for moderate-to-severe plaque psoriasis: presentation extracts from the 29^th EADV virtual congress, 29-31 October 2020

Efficacy of dimethyl fumarate treatment for moderate-to-severe plaque psoriasis: presentation extracts from the 29^th EADV virtual congress, 29-31 October 2020

Anti‐interleukin‐23 for psoriasis in elderly patients: guselkumab, risankizumab and tildrakizumab in real‐world practice

Apremilast efficacy and safety in elderly psoriasis patients over a 48‐week period

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Safety concerns with current treatments for psoriasis in the elderly

Cited by 23 publications

References 82 publications

Efficacy of dimethyl fumarate treatment for moderate-to-severe plaque psoriasis: presentation extracts from the 29th EADV virtual congress, 29-31 October 2020

Efficacy of dimethyl fumarate treatment for moderate-to-severe plaque psoriasis: presentation extracts from the 29th EADV virtual congress, 29-31 October 2020

Anti‐interleukin‐23 for psoriasis in elderly patients: guselkumab, risankizumab and tildrakizumab in real‐world practice

Apremilast efficacy and safety in elderly psoriasis patients over a 48‐week period

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Product

Resources

About

Efficacy of dimethyl fumarate treatment for moderate-to-severe plaque psoriasis: presentation extracts from the 29^th EADV virtual congress, 29-31 October 2020

Efficacy of dimethyl fumarate treatment for moderate-to-severe plaque psoriasis: presentation extracts from the 29^th EADV virtual congress, 29-31 October 2020