scholarly journals Neurological Complications of Biological Treatment of Psoriasis

Life ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 118
Author(s):  
Mateusz Kamil Ożóg ◽  
Beniamin Oskar Grabarek ◽  
Magdalena Wierzbik-Strońska ◽  
Magdalena Świder
Keyword(s):  
Nervous System ◽  
Side Effects ◽  
Biological Treatment ◽  
Biological Therapy ◽  
Neurological Complications ◽  
Tnf Alpha ◽  
Biological Drugs ◽  
Discontinuation Of Treatment ◽  
The Relationship ◽  
Alpha Therapy

In the available literature, little attention has been paid to the assessment of psoriasis and the biological therapy used for it and the nervous system. The purpose of this article is to discuss the relationship between psoriasis and the nervous system as well as to analyze the mechanisms that lead to neurological complications during anticytokine therapies in psoriasis. However, this connection requires further analysis. The use of biological drugs in psoriasis, although it yields positive therapeutic results, is not without numerous side effects. Serious neurological side effects of the therapy are most often visible with the use of anti-TNF-alpha, which is why patients should be monitored for their potential occurrence. Early detection of complications and rapid discontinuation of treatment with the drug may potentially increase the patient’s chances of a full recovery or improvement of his/her neurological condition. It also seems reasonable that, in the case of complications occurring during anti-TNF-alpha therapy, some of the drugs from other groups should be included in the therapy.

scholarly journals AB0779 DOES DACTYLITIS/ENTESITIS PREDICT THE RESPONSE TO A SPECIFIC BIOLOGICAL TREATMENT IN PSORIATIC ARTHRITIS?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1687.2-1688
Author(s):  
C. Guillén-Astete ◽  
P. Zurita-Prada ◽  
C. Urrego-Laurín
Keyword(s):  
Biological Treatment ◽  
Biological Therapy ◽  
Secondary Analysis ◽  
Tnf Alpha ◽  
Biological Therapies ◽  
First Line ◽  
Electronic Survey ◽  
Multiple Factors ◽  
Patient Association ◽  
Alpha Therapy

Background:Spondylarthritis are diseases with a pathophysiological focus in enthesis with a different extent of synovial component. In the event of therapeutic failure with DMARDs, the clinician may consider biological therapy with anti-TNF drugs or other targets such as IL23 Despite this, most patients receive first-line anti-TNFs. Given that IL19 and IL23 activity is recognized at the level of the enthesis.Objectives:To evaluate whether the presence of dactylitis/entesitis could be useful in the choice of a particular biological therapy.Methods:A secondary analysis of a previous study was performed based on an electronic survey completed by patients with PsoA and distributed among members of the patient association “Acción Psoriasis”. Records from 191 respondents who had received at least one biological therapy were included. Patients were grouped according to the presence or absence of dactylitis or enthesitis. The rate of need to progress to the next therapeutic biologic line was compared.Results:61 patients reported dactylitis and 155 enthesitis. Distribution of treatments in patients with dactylitis: 33 patients received an anti-TNF-alpha, 11 Secukinumab and 12 Ustekinumab. 15 patients in the group receiving an anti-TNF-alpha had to substitute another treatment within 2 years (45.4%). 3 patients in each of the remaining groups had to substitute treatment within 2 years (27.2% and 25%, respectively). Compared to those receiving anti-TNF-alpha therapy, patients treated with Secukinumab or Ustekinumab had greater therapeutic persistence at 2 years (P<0.001, in both cases). Distribution of treatments in patients with enthesitis (not including dactylitis): 115 received an antiTNF-alpha, 25 received Secukinumab and 18 received Ustekinumab. 38 patients who received an anti-TNF-alpha had to substitute it within 2 years (24.5%). 4 patients who received Secukinumab and 3 who received Ustekinumab had to substitute their treatments in less than 2 years (16% and 16.6%, respectively). Compared to patients receiving anti-TNF-alpha therapy, patients treated with Secukinumab and Ustekinumab had a higher proportion of therapeutic persistence at 2 years (P<0.05 for both cases).Conclusion:The presence of dactylitis more than enthesitis, is associated with a higher proportion of therapeutic persistence in those patients treated with anti-IL17 or anti-IL23 therapies. Although there are multiple factors that condition the choice of biological therapies in patients with PsoA, the presence of enthesitis and dactilitis (understood as polyenthesitis) should be considered among the most important ones.Disclosure of Interests:None declared

scholarly journals AB0287 HEMATOLOGICAL SIDE EFFECTS OF BIOLOGICAL THERAPY IN RHEUMATOLOGY: DATA FROM THE TUNISIAN REGISTER

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1442.2-1442
Author(s):  
H. Bettaieb ◽  
S. Boussaid ◽  
S. Jemmali ◽  
S. Rekik ◽  
E. Cheour ◽  
...  
Keyword(s):  
Side Effects ◽  
Biological Treatment ◽  
Blood Count ◽  
Biological Therapy ◽  
National Registry ◽  
Close Monitoring ◽  
Female Ratio ◽  
Therapy Initiation ◽  
Male Female Ratio ◽  
The Mean

Background:During the last decade, the treatment of chronic inflammatory rheumatism (CIR) has been greatly improved with the advent of biotherapy.However, the use of biological treatment can lead to a number of side effects including abnormalities in the blood count.Objectives:The aim of this study was to assess the different hematological side effects of biological treatment in patients with rheumatoid arthritis (RA) and spondyloarthitis (SA).Methods:This study included patients with RA (ACR/EULAR 2010) and SA (ASAS 2009) registred with the Tunisian Biologic National Registry (BINAR).Patients were followed and treated with biologics for 2 years of less. Clinical data relative to biological treatment, including haematological side effects, have been collected.Results:Two hundred and ninety-eight patients (178 women and 111 men) were included in the study.The mean age was 49.2 ± 14.1 years. The male/female ratio was 0.6. The mean diseases durations for RA and SA were respectively 6.7 ± 3.5 years and 6.5 ±3.6 years.Anti-TNFα agents were prescribed in 87.9% of patients (n = 263) with respectively: Infliximab (20.4%) Etanercept (23.1%), Adalimumab (24.6%) and Certolizumab (26.5%).Tocilizumab and Rituximab were prescribed in 10.4% and 5% of the patients, respectively.Blood count abnormalities were noted in 15.4 % of patients (n=46).Neutropenia was the most frequently anomaly met on the hemogram (9.1%) followed by anemia (3.4%) and thrombocytopenia (3%). Pancytopenia was found in 11.4% of patients (n=34).The median time between biological therapy initiation and the onset of hematologic manifestations was 4.8 months [1-12]. Biological treatment was interrupted in two patients.In the other cases, the biological treatment was maintained with close monitoring of blood cell count. No case of death related to these hematological disturbances has been reported.Conclusion:In our registry, hematological side effects of biological treatment were found in 15.4% of cases and were noted with a median delay of 4.8 [1-12] months after the treatment initiation. Further studies are needed to confirm our preliminary results.Disclosure of Interests:None declared

Non-metastatic neurological manifestations of malignancy

2018 ◽  
Author(s):  
Nerissa Jordan
Keyword(s):  
Nervous System ◽  
Side Effects ◽  
Antibody Formation ◽  
Neurological Complications ◽  
Cns Infection ◽  
Neurological Manifestations ◽  
Local Effects ◽  
Immune Mediated ◽  
Neuronal Proteins ◽  
Systemic Malignancy

Neurological complications of systemic malignancy are frequent. They may reflect direct local effects of the tumour; CNS infection; side effects of chemotherapy or radiotherapy; nutritional or metabolic derangements; or a paraneoplastic syndrome. The paraneoplastic neurological syndromes are a group of disorders associated with a malignancy outside the nervous system. The pathophysiology is immune-mediated, with the tumour’s expression of neuronal proteins invoking antibody formation, which in turn results in neurological symptoms. This chapter will mainly focus on these syndromes.

scholarly journals Psoriasis, Vitiligo, and Biologic Therapy: Case Report and Narrative Review

2021 ◽  
pp. 372-378
Author(s):  
Martina Burlando ◽  
Andrea Muracchioli ◽  
Emanuele Cozzani ◽  
Aurora Parodi
Keyword(s):  
Case Report ◽  
Biological Therapy ◽  
Biologic Therapy ◽  
Narrative Review ◽  
Tnf Alpha ◽  
Biological Drugs ◽  
Immune Mediated ◽  
New Onset

Psoriasis and vitiligo are 2 multifactorial immune-mediated diseases, partially sharing pathogenetic underpinnings. Their coexistence in the same patient, although uncommon, is documented in the literature. Further, several cases of vitiligo induced by biological drugs in psoriatic patients are reported. However, improvements in psoriasis and pre-existing vitiligo after the introduction of biological therapy are also described. To date, anti-TNF-alpha is the most cited group of biological drugs that induce new-onset vitiligo or progression of pre-existence vitiligo in psoriatic patients. Even anti-IL-12/23 class would seem to induce vitiligo (as in our case) or even worse it. Anti-IL-17 drugs induce a progression of pre-existing vitiligo while, to date, no cases are reported in literature considering anti-IL-23 class.

scholarly journals Epidemiology, predictors and clinical aspects of loss of response to biological therapy

2012 ◽  
Vol 153 (5) ◽  
pp. 163-173
Author(s):  
Katalin Lőrinczy ◽  
Pál Miheller ◽  
Sándor Lajos Kiss ◽  
Péter László Lakatos
Keyword(s):  
Biological Treatment ◽  
Biological Therapy ◽  
Clinical Symptoms ◽  
Biological Agent ◽  
Clinical Aspects ◽  
Optimal Method ◽  
Loss Of Response ◽  
Monitoring Drug ◽  
The Relationship

In the last two decades, the treatment paradigms for Crohn’s disease and ulcerative colitis have significantly changed inclusive of a continuously increasing role of biological therapy (anti TNFs). Some patients, however, experience lack or loss of response to biological treatment, and in such cases the management of patients is often empirical. In this review, the authors aim to summarize the available data regarding epidemiology and predictors of loss of response to biological therapy considering the clinical factors and the relationship between serum concentrations, antibodies against biological agents, respectively. Monitoring drug levels and antibodies is expected to play an important role in the management of loss of response (i.e. to confirm adherence, allow dose adjustment, or provide rationale for switching to another biological agent or to a different class of biological agent) in the coming years. The optimal method of detection and cut-off values are, however, not clear. In clinical practice, meticulous complex assessment of clinical symptoms, confirmation of active disease by endoscopic or radiological imaging, and excluding complications remain necessary. Orv. Hetil., 2012, 153, 163–173.

Postsynaptic neuronal geometry and synaptic effectiveness

1987 ◽  
Vol 45 ◽  
pp. 690-697
Author(s):  
C.J. Wilson
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Synaptic Function ◽  
Postsynaptic Neuron ◽  
Synaptic Inputs ◽  
Partial Analysis ◽  
Postsynaptic Cell ◽  
Neuronal Geometry ◽  
The Relationship ◽  
Complex Scale

Most central nervous system neurons receive synaptic input from hundreds or thousands of other neurons, and the computational function of such neurons results from the interactions of inputs on a large and complex scale. In most situations that have yielded to a partial analysis, the synaptic inputs to a neuron are not alike in function, but rather belong to distinct categories that differ qualitatively in the nature of their effect on the postsynaptic cell, and quantitatively in the strength of their influence. Many factors have been demonstrated to contribute to synaptic function, but one of the simplest and best known of these is the geometry of the postsynaptic neuron. The fundamental nature of the relationship between neuronal shape and synaptic effectiveness was established on theoretical grounds prior to its experimental verification.

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