Treatment of acrodermatitis continua of hallopeau with ixekizumab

Miller, Austinn C.; Holland, Timothy E; Cohen, David J.

doi:10.1080/09546634.2019.1628170

Cited by 13 publications

(14 citation statements)

References 7 publications

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“…2 Most recently, a growing number ofmostly successfultreatment experiences with biologics targeting tumor necrosis factor (TNF)-a, interleukin (IL)-17 or IL-(12)/23 and new small molecules (phosphodiesterase type 4 inhibitor) approved for plaque type psoriasis have been published. 2,7,8,[11][12][13][14][15][16][17][18][19] A recent review suggests a treatment algorithm starting with topical glucocorticoids under occlusion as first-line therapy, escalating to either cyclosporin, acitretin, adalimumab, etanercept, infliximab or ustekinumab as first-line systemic treatment, followed by systemic glucocorticoids, methotrexate or photo (chemo)therapy as second-line systemic therapies. 20 However, there is no clear recommendation which of the first-line systemic therapies to begin with.…”

Section: Introductionmentioning

confidence: 99%

Treatment of acrodermatitis continua of Hallopeau: A case series of 39 patients

Kromer

Loewe

Schaarschmidt

et al. 2020

The Journal of Dermatology

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Acrodermatitis continua of Hallopeau (ACH) is a rare chronic inflammatory skin disease. Treatment is extremely challenging and mostly based on empirics as there is only scarce evidence from case reports and few small case series. In this retrospective study, patients with ACH treated at five university medical centers were analyzed according to patient and disease characteristics and treatment experience. We identified 39 patients with ACH with a mean age of 54.4 years at onset, of whom 22 (56.4%) were female. A total of 115 systemic treatment courses were analyzed with methotrexate as the most common therapy (27.0%). Overall, effectiveness of systemic treatments was low (excellent response rate: 14.8%). Among non‐biologics, excellent response was noted in 21.1% (4/19) of treatment courses with methotrexate, followed by acitretin (13.3%; 2/15). Among biologics, guselkumab (excellent response: 100%; 2/2), secukinumab (excellent response: 42.9%; 3/7) and adalimumab (excellent response: 20.0%; 2/10) were most efficacious. The median drug survival was 7.0 months and did not differ significantly between the subgroup of non‐biologic and biologic therapies. To our knowledge, this is the largest case series in ACH investigating patient characteristics and treatment outcomes. Based on our treatment experience, we suggest a treatment algorithm starting with acitretin or methotrexate as first‐line therapy, followed by biologics. Cyclosporin may be used for short‐term control. However, none of the applied systemic therapies yielded satisfying efficacy in our cohort. In patients with primary non‐response, switch of treatment should be evaluated timely on an individual basis, considering possible irreversible disease complications such as nail loss. More research with prospective design is needed to further evaluate traditional and also particularly newer antipsoriatic drugs in ACH.

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Section: Introductionmentioning

confidence: 99%

Treatment of acrodermatitis continua of Hallopeau: A case series of 39 patients

Kromer

Loewe

Schaarschmidt

et al. 2020

The Journal of Dermatology

View full text Add to dashboard Cite

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“…Based on recent reports of successful treatment of ACH with anti-interleukin (IL) 17 biologic agents(Galluzzo, D'Adamio, Teoli, Bianchi, & Talamonti, 2019;Miller, Holland, & Cohen, 2019), therapy with brodalumab was considered. Based on recent reports of successful treatment of ACH with anti-interleukin (IL) 17 biologic agents(Galluzzo, D'Adamio, Teoli, Bianchi, & Talamonti, 2019;Miller, Holland, & Cohen, 2019), therapy with brodalumab was considered.…”

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confidence: 99%

“…Based on recent reports of successful treatment of ACH with anti-interleukin (IL) 17 biologic agents(Galluzzo, D'Adamio, Teoli, Bianchi, & Talamonti, 2019;Miller, Holland, & Cohen, 2019), therapy with brodalumab was considered. Indeed, anti-TNFα, anti-IL12/23, and anti-IL1 agents were proven to be effective in some cases of ACH(Smith et al, 2019).More recently, encouraging results were reported for anti-IL17 agents since both secukinumab(Galluzzo et al, 2019) and ixekizumab(Miller et al, 2019) were reported to be efficacious in severe and recalcitrant cases of ACH. The drug was administered subcutaneously at the dose of 210 mg at weeks 0-2, followed by 210 mg every 2 weeks.…”

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confidence: 99%

“…Previous treatments with topical and systemic corticosteroids, cyclosporine, and methotrexate improved the disease only slightly and temporarily. Based on recent reports of successful treatment of ACH with anti-interleukin (IL) 17 biologic agents (Galluzzo, D'Adamio, Teoli, Bianchi, & Talamonti, 2019;Miller, Holland, & Cohen, 2019), therapy with brodalumab was considered. Brodalumab is a human anti-IL17 receptor A monoclonal antibody.…”

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confidence: 99%

“…More recently, encouraging results were reported for anti-IL17 agents since both secukinumab (Galluzzo et al, 2019) and ixekizumab (Miller et al, 2019) were reported to be efficacious in severe and recalcitrant cases of ACH. Very recently, a case of ACH recalcitrant to the treatment with anti-IL17 agents secukinumab and ixekizumab and successfully treated with brodalumab was reported (Milani-Nejad & Kaffenberger, 2019).…”

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confidence: 99%

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