Use of Secukinumab in a Cohort of Erythrodermic Psoriatic Patients: A Pilot Study

Damiani, Giovanni; Pacifico, Alessia; Russo, Filomena; Pigatto, Paolo D.; Bragazzi, Nicola Luigi; Bonifati, C.; Morrone, Aldo; Watad, Abdulla; Adawi, Mohammad

doi:10.3390/jcm8060770

Cited by 26 publications

(31 citation statements)

References 25 publications

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“…The role of lifestyle and the environment is suggested as modulators of the efficacy of psoriasis treatments. Abuse of alcohol, cannabis, and tobacco affects the treatment response of biologics in psoriasis [ 32 ]. Evidence regarding the effects of the environmental contaminant TCDD via AHR activation on the pathogenesis of psoriasis has accumulated [ 31 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Rapamycin Alleviates 2,3,7,8-Tetrachlorodibenzo-p-dioxin-Induced Aggravated Dermatitis in Mice with Imiquimod-Induced Psoriasis-Like Dermatitis by Inducing Autophagy

Kim

Kang

et al. 2021

IJMS

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Recently, the mTOR signaling has emerged as an important player in the pathogenesis of psoriasis. We previously found that 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-induced psoriatic skin inflammation was related to the inhibition of autophagy in keratinocytes. However, the effects and detailed molecular mechanisms of the mTOR inhibitor rapamycin and TCDD on psoriasis in vivo remain to be elucidated. In this study, we aimed to evaluate the effects of rapamycin and TCDD on skin lesions in imiquimod (IMQ)-induced psoriasis using a mouse model. TCDD aggravated skin inflammation in an IMQ-induced psoriatic mouse model. Furthermore, TCDD increased the expression of aryl hydrocarbon receptor (AHR), CYP1A1, proinflammatory cytokines, oxidative stress markers (NADPH oxidase (Nox) 2, Nox4), and phosphorylated P65NF-ĸB, whereas the expression of autophagy-related factors and the antioxidant marker nuclear factor-erythroid 2-related factor 2 (NRF2) decreased. Rapamycin reduced the aggravated skin inflammation induced by TCDD and restored TCDD-induced autophagy suppression and the increase of AHR expression, oxidative stress, and inflammatory response in the skin lesions of a psoriatic mouse model. In conclusion, we demonstrated that rapamycin alleviates TCDD-induced aggravated dermatitis in mice with imiquimod-induced psoriasis-like dermatitis through AHR and autophagy modulation.

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Section: Discussionmentioning

confidence: 99%

Rapamycin Alleviates 2,3,7,8-Tetrachlorodibenzo-p-dioxin-Induced Aggravated Dermatitis in Mice with Imiquimod-Induced Psoriasis-Like Dermatitis by Inducing Autophagy

Kim

Kang

et al. 2021

IJMS

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“…Bertelsen et al 22 found that IκBζ (NFKBIZ) plays a key role in the efficacy of secukinumab. Smoking and drinking alcohol may affect the efficacy of secukinumab for EP 23 . Personalized plans can be created according to patient characteristics to ensure drug retention rates and reduce adverse reactions.…”

Section: Discussionmentioning

confidence: 99%

Two cases of refractory erythrodermic psoriasis effectively treated with secukinumab and a review of the literature

Liu

Jin

Sun

et al. 2021

Dermatologic Therapy

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Erythrodermic psoriasis (EP), which accounts for 1 to 2.25% of all psoriatic cases, typically occurs in patients with poor control of existing psoriasis. Secukinumab yields rapid and sustained improvements of signs and symptoms in patients with plaque psoriasis. Currently, clinical data on the treatment of EP with secukinumab are scarce. We describe two adult patients with severe EP, including one male and one female who were both ineligible for or resistant to acitretin or methotrexate treatment and had additional diseases. The patients underwent treatment with secukinumab using the standard regimen. After 4 weeks of treatment, a 75% reduction in the Psoriasis Area and Severity Index score (PASI 75) was achieved in both patients. Secukinumab was well tolerated and was continued for at least 32 weeks of treatment. We report the clinical use of secukinumab in the treatment of EP and review its potential role in the management of this severe condition.

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“…Secukinumab is a human IgG monoclonal antibody that selectively binds to the interleukin 17A (IL‐17A) inhibiting the releasing of proinflammatory cytokines and chemokines, and its efficacy in the treatment of EP has been reported in several cases 26,29,30 . A recent pilot study evaluated the use of secukinumab in 13 EP patients: 10 of them were responders at week 52 and achieved PASI 90 or PASI 100 without recurrence or adverse reactions 34 . Regarding dialyzed EP patients, only one case has been reported, in a dialyzed 61‐years‐old Japanese female, who developed the erythroderma after discontinuation of the topical steroid therapy, successfully treated with secukinumab 32 .…”

Section: Discussionmentioning

confidence: 99%

Erythrodermic psoriasis in a dialyzed patient successfully treated with Secukinumab

Pizzatti

Mugheddu

Sanna

et al. 2020

Dermatologic Therapy

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Erythrodermic psoriasis is a severe, life‐threatening condition with additional complications, when occurring in hemodialyzed patients, as the majority of treatments are contraindicated. A 44‐years‐old man, of Philippine origins, with a 15‐years‐history of psoriasis treated with cyclosporine developed progressive hypertension and renal insufficiency. Despite drug dismission, renal function worsen to end‐stage, and hemodialysis was necessary three times a week. Phototherapy was not able to control the skin condition, progressing to erythroderma, and after nephrology consultation, the patient consent to the off‐label secukinumab treatment, at the standard regimen (300 mg subcutaneously once weekly at weeks 0‐4 followed by 300 mg every 4 weeks). Seven days after the first injection, a rapid improvement was noted, with the psoriasis area severity index (PASI) score passing from 31.5 to 17.6. At the 52‐week‐follow‐up visit, the patient was completely clarified, without any side effects. The case supports secukinumab effectiveness and safety in difficult patients, including erythrodermic psoriasis with end‐stage renal failure, as drug plasma levels seem not to be affected by hemodialysis. Results are rapidly achieved, and long term maintained, with the additional advantage of a very comfortable monthly administration.

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Use of Secukinumab in a Cohort of Erythrodermic Psoriatic Patients: A Pilot Study

Cited by 26 publications

References 25 publications

Rapamycin Alleviates 2,3,7,8-Tetrachlorodibenzo-p-dioxin-Induced Aggravated Dermatitis in Mice with Imiquimod-Induced Psoriasis-Like Dermatitis by Inducing Autophagy

Rapamycin Alleviates 2,3,7,8-Tetrachlorodibenzo-p-dioxin-Induced Aggravated Dermatitis in Mice with Imiquimod-Induced Psoriasis-Like Dermatitis by Inducing Autophagy

Two cases of refractory erythrodermic psoriasis effectively treated with secukinumab and a review of the literature

Erythrodermic psoriasis in a dialyzed patient successfully treated with Secukinumab

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