Asunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/complicaciones , Cuidados Críticos/organización & administración , Dermatitis Exfoliativa/tratamiento farmacológico , Neumonía Viral/complicaciones , Psoriasis/tratamiento farmacológico , Talidomida/análogos & derivados , COVID-19 , Infecciones por Coronavirus/virología , Dermatitis Exfoliativa/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/virología , Psoriasis/complicaciones , SARS-CoV-2 , Talidomida/uso terapéuticoAsunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Dermatología/organización & administración , Control de Infecciones/organización & administración , Neumonía Viral/epidemiología , Psoriasis/terapia , COVID-19 , Infecciones por Coronavirus/prevención & control , Humanos , Italia , Pandemias/prevención & control , Neumonía Viral/prevención & control , SARS-CoV-2Asunto(s)
Anticuerpos Monoclonales Humanizados/administración & dosificación , Fármacos Dermatológicos/administración & dosificación , Psoriasis/tratamiento farmacológico , Adulto , Anticuerpos Monoclonales Humanizados/efectos adversos , Fármacos Dermatológicos/efectos adversos , Esquema de Medicación , Sustitución de Medicamentos , Femenino , Humanos , Inyecciones Subcutáneas , Interleucina-17/antagonistas & inhibidores , Interleucina-17/inmunología , Masculino , Persona de Mediana Edad , Psoriasis/inmunología , Resultado del TratamientoRESUMEN
BACKGROUND: The number of elderly patients with psoriasis is steadily increasing in the Western world; nevertheless, they are frequently excluded from biological clinical trials and described as a high-risk group for adverse events. Thus, there is lack of information concerning safety and effectiveness of available treatments for psoriasis in the elderly, particularly about new biological systemic drugs. OBJECTIVE: Our aim was to describe our experience with all biological therapies currently used in the elderly (>65 years) psoriatic patients. METHODS: A retrospective multicentric review of clinical records of all psoriatic patient aged 65 years or older actually receiving biological drugs (etanercept, adalimumab, infliximab, golimumab, certolizumab pegol, ustekinumab or secukinumab) was undertaken. RESULTS: Our study population included 266 elderly psoriatic patients actually receiving any biological therapy (adalimumab 31.2%, ustekinumab 28.9%, etanercept 20.3%, secukinumab 15%, infliximab 3%, golimumab 1% and certolizumab pegol 0.6%). The PASI score at the baseline (week 0) ranged from 4 to 54; mean ± SD, 16.5 ± 7.1, which changed after biological administration to 3.7 ± 8 at week 16, 1.6 ± 2.1 at week 28 and 1.2 ± 2.1 at week 52. Among 266 elderly psoriatic patients, 25 adverse events were reported during the observation period. The most frequent events were infections with 12 (48%) reports, followed by malignancies with four (16%) reports. CONCLUSIONS: To date, our study represents the widest experience on the use of biological drugs in elderly psoriatic patients. We found that all biologics for psoriasis showed a great efficacy also in elderly people, and the rate and the type of adverse effects were similar to the younger patients. In conclusion, the age alone should not limit our therapeutic options. Further observational study using multiple data sources is needed to evaluate long-term effectiveness and safety for elderly psoriatic patients.
Asunto(s)
Productos Biológicos/uso terapéutico , Fármacos Dermatológicos/uso terapéutico , Psoriasis/tratamiento farmacológico , Adalimumab/uso terapéutico , Anciano , Anticuerpos Monoclonales/uso terapéutico , Anticuerpos Monoclonales Humanizados , Productos Biológicos/efectos adversos , Certolizumab Pegol/uso terapéutico , Fármacos Dermatológicos/efectos adversos , Etanercept/uso terapéutico , Femenino , Humanos , Infliximab/uso terapéutico , Italia , Masculino , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Ustekinumab/uso terapéuticoAsunto(s)
Anticuerpos Monoclonales/uso terapéutico , Psoriasis/tratamiento farmacológico , Adulto , Anciano , Anticuerpos Monoclonales Humanizados , Dermatitis Exfoliativa/tratamiento farmacológico , Dermatitis Exfoliativa/etiología , Humanos , Masculino , Persona de Mediana Edad , Psoriasis/complicaciones , Psoriasis/patología , Inducción de Remisión , Enfermedades Cutáneas VesiculoampollosasRESUMEN
AIM: The aim of this study was to provide practical recommendations for optimizing the use of conventional and biological systemic treatments for moderate-severe chronic plaque psoriasis, particularly in case of transitioning and switching. METHODS: A total number of 147 dermatologists from 33 different countries including Italy achieved consensus in providing practical recommendations for the use of conventional and biological treatments for moderate to severe psoriasis based on systematic literature review and/or expert opinion. RESULTS: In general, the continuous treatment regimen should be preferred in order to achieve a complete and long-term control of psoriasis. However, the treatment could be stopped or the dose reduced in case of complete disease clearance. A conventional drug could be associated to biological treatment in selected cases. Transitioning and/or switching could be considered in case of inefficacy or intolerance. A period of wash up is required if transitioning or switching is due to safety issues. CONCLUSION: This study provides practical suggestions for the optimal use of conventional and biological treatments for chronic plaque psoriasis.