Biologic Therapy in Psoriasis (Part II): Efficacy and Safety of New Treatment Targeting IL23/IL-17 Pathways

2018 ◽  
Vol 18 (12) ◽  
pp. 964-978 ◽  
Author(s):  
Elisa Molinelli ◽  
Anna Campanati ◽  
Valerio Brisigotti ◽  
Annamaria Offidani
Keyword(s):  
Biologic Therapy ◽  
Efficacy And Safety ◽  
New Treatment ◽  
Treatment Targeting

scholarly journals Apremilast in the treatment of psoriatic arthritis: a perspective review

2017 ◽  
Vol 9 (2) ◽  
pp. 45-53 ◽  
Author(s):  
Michael Reed ◽  
David Crosbie
Keyword(s):  
Psoriatic Arthritis ◽  
Biologic Therapy ◽  
Clinical Trial Data ◽  
Trial Data ◽  
Efficacy And Safety ◽  
Biologic Therapies ◽  
Phosphodiesterase 4 ◽  
Psoriatic Disease ◽  
New Treatment ◽  
Orally Active

Apremilast is an orally-active small molecule which inhibits phosphodiesterase-4 (PDE4). Clinical trials have demonstrated its efficacy and safety in psoriatic arthritis (PsA) and psoriasis. Established therapeutic options have variable effectiveness across the different domains of psoriatic disease. Whilst biologic therapies have proven to be of significant benefit to many patients, not all patients respond, and others are not eligible or do not tolerate biologic therapy. We review the mechanism of action, pharmacokinetics and clinical trial data with regards to both efficacy and safety for apremilast and consider where this new treatment may be positioned in the treatment of PsA.

scholarly journals Use of Biologic Agents in Ocular Manifestations of Rheumatic Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Courtney L. Kraus ◽  
Susan M. Culican
Keyword(s):  
Rheumatic Disease ◽  
Disease Burden ◽  
Biologic Therapy ◽  
Signs And Symptoms ◽  
Biologic Agents ◽  
Efficacy And Safety ◽  
Ocular Manifestations ◽  
Wide Range ◽  
Treatment Paradigm ◽  
Rheumatic Conditions

Biologic agents have dramatically shifted the treatment paradigm for rheumatic disease. Use of these agents can decrease disease burden, allow the patient to be weaned from corticosteroids, and reduce the likelihood of relapse. Eye disease associated with rheumatic conditions may present with a wide range of signs and symptoms. This coexisting pathology should not be overlooked and should be considered a reason for initiation or continuation of biologic therapy. Additionally, many of the ocular manifestations of rheumatic disease respond preferentially to specific targeting molecules. This paper summarizes the available studies on the use, efficacy, and safety of biologic agents in the treatment of ocular manifestations of rheumatic disease.

scholarly journals Efficacy and safety of adalimumab as the first- and second-line biologic therapy for children with juvenile idiopathic arthritis under four years of age

2020 ◽  
Vol 42 (3) ◽  
pp. 231-236
Author(s):  
Ekaterina Alexeeva ◽  
Tatyana Dvoryakovskaya ◽  
Rina Denisova ◽  
Tatyana Sleptsova ◽  
Kseniya Isaeva ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Biologic Therapy ◽  
Second Line ◽  
Efficacy And Safety

IMpower150: Analysis of efficacy in patients (pts) with liver metastases (mets).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 9012-9012 ◽  
Author(s):  
Mark A. Socinski ◽  
Robert M. Jotte ◽  
Federico Cappuzzo ◽  
Tony S. K. Mok ◽  
Howard West ◽  
...  
Keyword(s):  
Efficacy And Safety ◽  
Wild Type ◽  
Poor Prognostic Factor ◽  
Risk Of Death ◽  
Metastatic Nsclc ◽  
New Treatment ◽  
Metastatic Sites ◽  
To Receive ◽  
Clinical Trial Information

9012 Background: Atezolizumab (atezo) + bevacizumab (bev) + chemo (carboplatin + paclitaxel [CP]; ABCP) showed improved PFS and OS vs bev + CP (BCP) in pts with chemo-naive NSCLC (IMpower150). Benefit with ABCP vs BCP extended to key subgroups, including pts with baseline (BL) liver mets, which is a poor prognostic factor in metastatic NSCLC. Similar outcomes were not seen with atezo + chemo (IMpower150 [atezo + CP; ACP]; IMpower130; IMpower132), suggesting that the addition of bev to atezo + chemo is important for conferring clinical benefit in these pts. Here we further explore characteristics and responses of pts with BL liver mets in IMpower150. Methods: 1202 ITT pts were randomized 1:1:1 to receive ABCP, ACP or BCP. Doses were: A, 1200 mg; B, 15 mg/kg; C, AUC 6 mg/mL/min; P, 200 mg/m2. Coprimary endpoints were OS and investigator-assessed PFS in ITT–wild-type pts. Exploratory analyses included efficacy and safety in pts with liver mets. Results: The data capture ≥ 20-mo follow-up in ITT pts (data cutoff: Jan 22, 2018). 162 pts had BL liver mets (ABCP, n = 52; ACP; n = 53; BCP, n = 57), with a median of 3 metastatic sites and median BL tumor SLD of 109 mm (range, 10-249). BL characteristics in these pts were generally balanced across study arms. PFS and OS were improved with ABCP vs BCP (Table). Gr 3-4 treatment-related AEs occurred in 52.1%, 36.5% and 54.5% of pts with liver mets in the ABCP, ACP and BCP arms, respectively. Conclusions: ABCP reduced the risk of death in pts with liver mets by 48% vs BCP and may represent an important new treatment option for this population. Clinical trial information: NCT02366143. [Table: see text]

scholarly journals New Treatment Options for Chronic Constipation: Mechanisms, Efficacy and Safety

2011 ◽  
Vol 25 (suppl b) ◽  
pp. 29B-35B ◽  
Author(s):  
Michael Camilleri
Keyword(s):  
Bile Acid ◽  
Serotonin Receptor ◽  
Treatment Options ◽  
Chloride Ion ◽  
New Drugs ◽  
Receptor Subtype ◽  
Efficacy And Safety ◽  
Guanylate Cyclase C ◽  
Patient Responsiveness ◽  
New Treatment

The present review has several objectives, the first of which is to review the pharmacology and selectivity of serotonergic agents to contrast the older serotonergic agents (which were withdrawn because of cardiac or vascular adverse effects) with the newer generation serotonin receptor subtype 4 agonists. Second, the chloride ion secretagogues that act through the guanylate cyclase C receptor are appraised and their pharmacology is compared with the approved medication, lubiprostone. Third, the efficacy and safety of the application of bile acid modulation to treat constipation are addressed. The long-term studies of surgically induced excess bile acid delivery to the colon are reviewed to ascertain the safety of this therapeutic approach. Finally, the new drugs for opiate-induced constipation are introduced. Assuming these drugs are approved, practitioners will have a choice; however, patient responsiveness will be based on trial and error. Nevertheless, the spectrum of mechanisms and demonstrated efficacy and safety augur well for satisfactory treatment outcomes.

scholarly journals Biological Treatments in Inflammatory Bowel Disease: A Complex Mix of Mechanisms and Actions

Biologics ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 189-210
Author(s):  
Lorena Ortega Moreno ◽  
Samuel Fernández-Tomé ◽  
Raquel Abalo
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Treatment Guidelines ◽  
Efficacy And Safety ◽  
Pharmacological Treatments ◽  
Action Mechanism ◽  
Biological Treatments ◽  
Inflammatory Bowel ◽  
New Treatment

Inflammatory bowel disease (IBD) is a chronic disease that requires lifelong medication and whose incidence is increasing over the world. There is currently no cure for IBD, and the current therapeutic objective is to control the inflammatory process. Approximately one third of treated patients do not respond to treatment and refractoriness to treatment is common. Therefore, pharmacological treatments, such as monoclonal antibodies, are urgently needed, and new treatment guidelines are regularly published. Due to the extremely important current role of biologics in the therapy of IBD, herein we have briefly reviewed the main biological treatments currently available. In addition, we have focused on the mechanisms of action of the most relevant groups of biological agents in IBD therapy, which are not completely clear but are undoubtfully important for understanding both their therapeutic efficacy and the adverse side effects they may have. Further studies are necessary to better understand the action mechanism of these drugs, which will in turn help us to understand how to improve their efficacy and safety. These studies will hopefully pave the path for a personalized medicine.

scholarly journals Efficacy and Safety of Abatacept, Adalimumab, and Etanercept in Pediatric Patients With Juvenile Idiopathic Arthritis

2021 ◽  
Vol 26 (2) ◽  
pp. 157-162
Author(s):  
Andrea M. Goettel ◽  
Josh DeClercq ◽  
Leena Choi ◽  
Thomas B. Graham ◽  
Amy A. Mitchell
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Adverse Effects ◽  
Chart Review ◽  
Biologic Therapy ◽  
Retrospective Chart Review ◽  
Physician Global Assessment ◽  
Efficacy And Safety ◽  
Injection Site Reactions ◽  
Significant Difference ◽  
Specialty Pharmacy

OBJECTIVE The lack of randomized controlled trials comparing biologics for the treatment of juvenile idiopathic arthritis (JIA) has led to wide variation in treatment approaches. The objective of this study is to compare the efficacy and safety of abatacept, adalimumab, and etanercept in JIA patients treated at a tertiary pediatric institution. METHODS This was a single-center, retrospective chart review of patients initiated on abatacept, adalimumab, or etanercept from December 1, 2015, to August 31, 2018, at Monroe Carell Jr. Children's Hospital at Vanderbilt (VCH). The primary outcome was the change in the Physician Global Assessment (PGA) score after 4 to 6 months of biologic therapy. Secondary outcomes included change in laboratory markers of JIA disease activity, change in the number of joints with active disease or limitation of motion, reduction in corticosteroid dose, adverse effects, adherence among patients who have their medications filled at the institution's specialty pharmacy, and reason for discontinuation of therapy. RESULTS A total of 139 patients were included, with a median age of 13 years. Most patients, 80.6%, experienced a reduction in their PGA score after starting biologic therapy. There was not a statistically significant difference among the agents (p = 0.64). Adverse effects were reported in only 26.6% of patients, with the most frequent being injection site reactions or pain (n = 35). Ultimately, 32% of patients discontinued biologic therapy with a lack of efficacy being the most common reason. CONCLUSIONS Abatacept, adalimumab, and etanercept were not significantly different in efficacy and safety for the treatment of JIA at this single institution.

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