scholarly journals EXPERIENCE OF THE LONG-TERM USE OF ANTICYTOKINE THERAPY IN PSORIASIS

2017 ◽  
Vol 20 (3) ◽  
pp. 163-166
Author(s):  
Violetta A. Kovtunova ◽  
V. V Dumchenko ◽  
E. G Bakhmutova ◽  
T. A Tkachenko ◽  
E. Yu Yanchevskaya ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Therapeutic Response ◽  
Biological Therapy ◽  
Combined Therapy ◽  
Severe Form ◽  
Genetic Characteristics ◽  
Biological Products ◽  
Factor Α ◽  
And Control

Increasing the effectiveness of treatment and restoring the quality of life in patients with moderate to severe and severe forms of psoriasis is one of the most important trends in modern dermatology. The appearance of biological products in the late XXth century opened new opportunities in the treatment and control of the course of the disease in patients suffering from moderate and severe forms of psoriasis. Conducting maintenance system treatment with biological products reduces the severity of course of dermatosis, and in some cases prevents the occurrence of disease relapses. Despite the increasing popularity of anti-cytokine drugs, there are difficulties in the treatment of choice of the therapy in some cases. Among the main reasons for the lack of response to ongoing biological therapy are the genetic characteristics of the patient and the immunogenicity of the drugs. Failures in the use of biological therapy can also result a low concentration of the drug before the next administered dose. It has been proven that the combined use of methotrexate and infliximab inhibits the development of anti-drug antibodies that are associated with the development of a low therapeutic response. The article describes the clinical observation of a patient suffering for 20 years from a severe form of psoriasis and psoriatic arthritis. The experience of long-term (about 10 years) prescription of the biological preparation infliximab with sufficient clinical response without additional use of methotrexate is shown. The results of successful combined therapy of psoriatic erythroderma and psoriatic arthritis with infliximab and acitretin in order to reduce the immunogenicity of the tumor necrosis factor α blocker and avoid the ”escape” effect are described. The data of restoration of a good therapeutic response to systemic biological therapy with infliximab after administration of acitretin are presented.

Spinal epidural abscess associated with infliximab treatment for psoriatic arthritis

2008 ◽  
Vol 9 (3) ◽  
pp. 261-264 ◽  
Author(s):  
Adam P. Smith ◽  
Michael J. Musacchio ◽  
John E. O'toole
Keyword(s):  
Psoriatic Arthritis ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Infliximab Treatment ◽  
First Case ◽  
Factor Α ◽  
Spinal Epidural ◽  
Rheumatological Diseases ◽  
Necrosis Factor

Tumor necrosis factor–α inhibitors are used to treat numerous chronic inflammatory and rheumatological diseases, such as Crohn disease, rheumatoid arthritis, and psoriatic arthritis. Because the mechanism of these inhibitors is to decrease the body's inflammatory response, the primary complication of treatment is infection. The authors present the first case of a spinal epidural abscess in a patient receiving long-term infliximab therapy for severe psoriatic arthritis. Infliximab and its side-effect profile are discussed, along with other associated complications.

Long-term survival of biological therapy in psoriatic arthritis: 18-year analysis of a cohort in a tertiary hospital

2021 ◽  
Author(s):  
Lourdes Mateo Soria ◽  
Águeda Prior-Español ◽  
Mihail Mihaylov Grigorov ◽  
Susana Holgado-Pérez ◽  
María Aparicio-Espinar ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Biological Therapy ◽  
Tertiary Hospital ◽  
Term Survival ◽  
Long Term Survival

scholarly journals POS1058 SUBCLINICAL DACTYLITIS: COMPARATIVE STUDY OF THERAPEUTIC RESPONSE WITH TNF INHIBITORS, SECUKINUMAB AND USTEKINUMAB

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 807.2-808
Author(s):  
C. Guillén-Astete ◽  
Á. Andreu-Suárez ◽  
V. García García
Keyword(s):  
Retrospective Study ◽  
Psoriatic Arthritis ◽  
Therapeutic Response ◽  
Biological Therapy ◽  
Biologic Therapy ◽  
Tnf Inhibitors ◽  
Ultrasound Scan ◽  
Biologic Therapies ◽  
Fat Tissue ◽  
Group 14

Background:Non tender dactylitis has been recently associated with synovitis, tenosynovitis and enthesitis without fat tissue hyperemia. Dactylitis is a remarkable hallmark of spondyloarthritis and particularly in psoriatic arthritis. Also, dactylitis has been recognized as one of the most difficult musculoskeletal feature of the disease to treat. It has been of interest to compare the effectiveness of available therapies in cases of clinical dactylitis, however, the efficacy on subclinical dactylitis has not studied yet.Objectives:To determine the effectiveness of three different biological therapy approaches in subclinical (non-tender) dactylitis in patients diagnosed by psoriatic arthritis in terms of changes detected by ultrasound scan.Methods:A retrospective ultrasound record-based study was conducted to compare the findings of ultrasonographic studies performed before and 6 months after the start of one of the following biologic therapies in patients diagnosed by psoriatic arthritis: TNF-inhibitors, secukinumab and ustekinumab. We included patients with a complete before-after ultrasound scan of the hands from three different rheumatology clinics. To be considered as a subclinical dactylitis two conditions were had to be achieved: non tender finger and absence of fat tissue hyperemia.Results:Patients included: 22 on TNF-inhibitors (28 subclinical dactylitis), 14 on secukinumab (17 subclinical dactylitis) and 13 on ustekinumab (16 subclinical dactylitis). Median of line of treatment of each biologic therapy: 1, 3 and 3, respectively. In the TNF-inhibtors group, 14/28 achieved synovitis resolution, 12/26 achieved tenosynovitis resolution and 2/28 achieved enthesitis resolution. In the secukinumab group, 11/17 achieved synovitis resolution, 11/17 achieved tenosynovitis resolution and 13/17 achieved enthesitis resolution. In the ustekinumab group, 10/16 achieved synovitis resolution, 10/15 achieved tenosynovitis resolution and 13/16 achieved enthesitis resolution. Complete dactylitis resolution was achieved in 12/28, 11/17 and 10/16 patients, respectively. Differences on independent success ratio of secukinumab and ustekinumab were not statistically significative, however both groups had higher rates of independent success compared to TNF-inhibitors group (P<0.05, both cases). The line of treatment did not affect the resolution rate of non-TNF-inhibitors group.Conclusion:This is –as far as our knowledge know- the first study comparing the effect of different therapies on subclinical dactylitis. Besides the inherit limitations of a retrospective study, it seems to point that both secukinumab and ustekinumab are better therapeutic options than TNF-inhibitors. Of course, prospective further studies are needed.Disclosure of Interests:None declared.

scholarly journals Biologic therapies for the treatment of psoriatic arthritis

2021 ◽  
Vol 64 (2) ◽  
pp. 124-129
Author(s):  
Tae-Jong Kim
Keyword(s):  
Psoriatic Arthritis ◽  
Kinase Inhibitors ◽  
Phosphodiesterase Inhibitors ◽  
Janus Kinase ◽  
Interleukin 12 ◽  
Interleukin 17 ◽  
Dramatic Improvement ◽  
Functional Impairments ◽  
Biological Products ◽  
Factor Α

Psoriatic arthritis (PsA) is a chronic inflammatory rheumatic disease commonly associated with plaque psoriasis that, manifests with peripheral arthritis, dactylitis, enthesitis, and axial involvement. PsA can be progressive and harmful, resulting in joint deformities, functional impairments, low quality of life, and increased mortality. It was found that both non-pharmacologic and pharmacologic treatment could improve conditions of PsA. Recently launched biological products have become the main therapeutic agents used for treating PsA unresponsive to conventional disease modifying anti-rheumatic drugs. This paper aims at introducing available biologics for PsA management in Korea. The tumor necrosis factor-α inhibitor was the first approved biological product to show outstanding efficacy for treating PsA. Ustekinumab, designed for blocking interleukin-12/23, has been approved and widely used. Interleukin-17 inhibitors such as secukinumab and ixekizumab have also been introduced to improve the symptoms of PsA. It was found that many patients with PsA experienced a dramatic improvement in their condition after using these biological products. Additionally, new immunological modulators such as phosphodiesterase inhibitors and Janus kinase inhibitors were approved for the treatment of PsA.

Suppressed, but Not Forgotten

2011 ◽  
Vol 70 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Beat Meier ◽  
Anja König ◽  
Samuel Parak ◽  
Katharina Henke
Keyword(s):  
Memory Trace ◽  
Thought Suppression ◽  
Test Phase ◽  
Indirect Test ◽  
Final Test ◽  
Test Experiment ◽  
And Control ◽  
Cue Words ◽  
The Impact

This study investigates the impact of thought suppression over a 1-week interval. In two experiments with 80 university students each, we used the think/no-think paradigm in which participants initially learn a list of word pairs (cue-target associations). Then they were presented with some of the cue words again and should either respond with the target word or avoid thinking about it. In the final test phase, their memory for the initially learned cue-target pairs was tested. In Experiment 1, type of memory test was manipulated (i.e., direct vs. indirect). In Experiment 2, type of no-think instructions was manipulated (i.e., suppress vs. substitute). Overall, our results showed poorer memory for no-think and control items compared to think items across all experiments and conditions. Critically, however, more no-think than control items were remembered after the 1-week interval in the direct, but not in the indirect test (Experiment 1) and with thought suppression, but not thought substitution instructions (Experiment 2). We suggest that during thought suppression a brief reactivation of the learned association may lead to reconsolidation of the memory trace and hence to better retrieval of suppressed than control items in the long term.

Ixekizumab in the Management of Non-Selected Out Patients with Moderate to Severe Psoriasis -New Data and Personal Clinical Experience

2018 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Clinical Experience ◽  
Personal Experience ◽  
Therapeutic Response ◽  
Systemic Disease ◽  
Severe Psoriasis ◽  
Adequate Treatment ◽  
Scalp Psoriasis ◽  
Number Of Patients ◽  
Genital Psoriasis

Introduction: Too many patients with moderate to severe psoriasis do not receive adequate treatment. This means a vast undersupply in the treatment of patients with psoriasis. Only biologics fulfill the whole range of the treatment of psoriasis – psoriasis does not affect only skin but the whole organism: It is a systemic disease! Between the biologics are evident differences concerning the effect. Discussion: Based on broad personal experience in the management of patients with moderate to severe psoriasis new data from clinical studies with ixekizumab are examined. This contains new data on long-term-efficacy of ixekizumab, effectiveness in special localizations (scalp psoriasis, nail psoriasis, palmoplantar psoriasis, genital psoriasis) as well as safely data and experience on patients switched to ixekizumab from other biologics. Personal clinical experience is based on >300 non-selected outpatients with moderate to severe psoriasis, >250 patients on biological therapies, > 50 patients with ixekizumab. Conclusions: Focusing on a relevant number of patients switched from secukinumab to ixekizumab due to first or secondary loss of efficacy significant differences between both IL-17A-inhibitors mainly in terms of efficacy and speed of therapeutic response are shown. Finally the correlation between PASI-90-/PASI-100 response and significant changes in DLQI are highlighted.

Sign in / Sign up

Export Citation Format

Share Document