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Plaque psoriasis in children and adolescents – the role of etanercept  [cached]
Ricceri F,Tripo L,Pescitelli L,Prignano F
Psoriasis: Targets and Therapy , 2012,
Abstract: Federica Ricceri, Lara Tripo, Leonardo Pescitelli, Francesca PrignanoDivision of Clinical, Preventive and Oncology Dermatology, Department of Critical Care Medicine and Surgery, University of Florence, Florence, ItalyBackground: Childhood-onset psoriasis affects approximately one-third of the psoriatic population. Among many potential treatments of childhood psoriasis, biological agents are emerging as a valuable option in the management of this disease. In Europe, etanercept has recently been approved for children aged 6 years and over. Data from a well-designed clinical trial indicate that in children, etanercept effectively reduces psoriasis symptoms, with beneficial effects evident as early as 4 weeks after the onset of therapy. The treatment is generally well tolerated; mild injection site reactions are the most common adverse events reported in the literature. Published data of etanercept use in children show promising results, but further clinical studies are necessary to confirm its long-term efficacy and safety.Keywords: pediatric psoriasis, anti-TNF-α, etanercept
Plaque psoriasis in children and adolescents – the role of etanercept
Ricceri F, Tripo L, Pescitelli L, Prignano F
Psoriasis: Targets and Therapy , 2012, DOI: http://dx.doi.org/10.2147/PTT.S26032
Abstract: que psoriasis in children and adolescents – the role of etanercept Review (1330) Total Article Views Authors: Ricceri F, Tripo L, Pescitelli L, Prignano F Published Date June 2012 Volume 2012:2 Pages 25 - 28 DOI: http://dx.doi.org/10.2147/PTT.S26032 Received: 12 April 2012 Accepted: 07 May 2012 Published: 11 June 2012 Federica Ricceri, Lara Tripo, Leonardo Pescitelli, Francesca Prignano Division of Clinical, Preventive and Oncology Dermatology, Department of Critical Care Medicine and Surgery, University of Florence, Florence, Italy Background: Childhood-onset psoriasis affects approximately one-third of the psoriatic population. Among many potential treatments of childhood psoriasis, biological agents are emerging as a valuable option in the management of this disease. In Europe, etanercept has recently been approved for children aged 6 years and over. Data from a well-designed clinical trial indicate that in children, etanercept effectively reduces psoriasis symptoms, with beneficial effects evident as early as 4 weeks after the onset of therapy. The treatment is generally well tolerated; mild injection site reactions are the most common adverse events reported in the literature. Published data of etanercept use in children show promising results, but further clinical studies are necessary to confirm its long-term efficacy and safety.
Potential role of ustekinumab in the treatment of chronic plaque psoriasis
Santo Raffaele Mercuri, Luigi Naldi
Biologics: Targets and Therapy , 2010, DOI: http://dx.doi.org/10.2147/BTT.S4921
Abstract: tential role of ustekinumab in the treatment of chronic plaque psoriasis Review (4575) Total Article Views Authors: Santo Raffaele Mercuri, Luigi Naldi Published Date May 2010 Volume 2010:4 Pages 119 - 129 DOI: http://dx.doi.org/10.2147/BTT.S4921 Santo Raffaele Mercuri1, Luigi Naldi2 1Unità di Dermatologia, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele, Università Vita-Salute, Milano, Italy; 2Centro Studi GISED, Fondazione per la Ricerca Ospedale Maggiore, Unità di Dermatologia, Ospedali Riuniti, Bergamo, Italy Abstract: Psoriasis is a relatively common, chronic and disabling skin disease, with an immune-related pathogenesis and a genetic background which may be triggered by several environmental factors including smoking and infections. There is no cure but several treatment options are available. The treatment of psoriasis is far from being satisfactory due to impractical modalities of topical treatment and suboptimal safety profile of the systemic treatments available. In the last few years, parallel to an improved understanding of the disease pathogenesis, there has been a boost in research on new agents for the treatment of psoriasis. Ustekinumab, a monoclonal antibody targeting the p40 subunit of interleukin (IL)-12 and IL-23, is one such new agent. Psoriasis and its management are briefly reviewed before focusing on the evidence for ustekinumab in the treatment of chronic plaque psoriasis through a systematic search of the main registries of ongoing trials up to December 2009. Ustekinumab proved to be very effective short term in the control of clinical manifestations in psoriasis compared with placebo and with etanercept. Long-term and comparative data are still limited. There is a need for continuing research on the long-term effectiveness and safety of the drug.
Potential role of ustekinumab in the treatment of chronic plaque psoriasis
Santo Raffaele Mercuri,Luigi Naldi
Biologics: Targets and Therapy , 2010,
Abstract: Santo Raffaele Mercuri1, Luigi Naldi21Unità di Dermatologia, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele, Università Vita-Salute, Milano, Italy; 2Centro Studi GISED, Fondazione per la Ricerca Ospedale Maggiore, Unità di Dermatologia, Ospedali Riuniti, Bergamo, ItalyAbstract: Psoriasis is a relatively common, chronic and disabling skin disease, with an immune-related pathogenesis and a genetic background which may be triggered by several environmental factors including smoking and infections. There is no cure but several treatment options are available. The treatment of psoriasis is far from being satisfactory due to impractical modalities of topical treatment and suboptimal safety profile of the systemic treatments available. In the last few years, parallel to an improved understanding of the disease pathogenesis, there has been a boost in research on new agents for the treatment of psoriasis. Ustekinumab, a monoclonal antibody targeting the p40 subunit of interleukin (IL)-12 and IL-23, is one such new agent. Psoriasis and its management are briefly reviewed before focusing on the evidence for ustekinumab in the treatment of chronic plaque psoriasis through a systematic search of the main registries of ongoing trials up to December 2009. Ustekinumab proved to be very effective short term in the control of clinical manifestations in psoriasis compared with placebo and with etanercept. Long-term and comparative data are still limited. There is a need for continuing research on the long-term effectiveness and safety of the drug.Keywords: ustekinumab, chronic plaque psoriasis
A cost–utility analysis of etanercept for the treatment of moderate-to-severe psoriasis in Italy
Giorgio L Colombo, Sergio Di Matteo, Ketty Peris, Maria Concetta Fargnoli, et al.
ClinicoEconomics and Outcomes Research , 2009, DOI: http://dx.doi.org/10.2147/CEOR.S7348
Abstract: cost–utility analysis of etanercept for the treatment of moderate-to-severe psoriasis in Italy Review (5666) Total Article Views Authors: Giorgio L Colombo, Sergio Di Matteo, Ketty Peris, Maria Concetta Fargnoli, et al. Published Date October 2009 Volume 2009:1 Pages 53 - 59 DOI: http://dx.doi.org/10.2147/CEOR.S7348 Giorgio L Colombo1, Sergio Di Matteo2, Ketty Peris3, Maria Concetta Fargnoli3, Maria Esposito4, Annamaria Mazzotta4, Sergio Chimenti4 1Faculty of Pharmacy, University of Pavia, Pavia, Italy; 2S.A.V.E. Studi Analisi Valutazioni Economiche, Milan, Italy; 3Department of Dermatology, University of L’Aquila, L’Aquila, Italy; 4Department of Dermatology, University of Rome Tor Vergata, Rome, Italy Introduction: Biologic therapies have proven efficacious for patients with moderate-to-severe psoriasis. However, their economic value compared with standard of care in Italy has not been explored. This study estimates the cost-effectiveness of intermittent therapy with etanercept in patients with moderate-to-severe plaque-type psoriasis in comparison with nonsystemic therapy in Italy. Methods: This study employs cost–utility analysis using a Markov model adapted from the British “York model”. It compares the cost per quality-adjusted life-year (QALY) of intermittent etanercept (25 mg twice weekly) versus nonsystemic therapy. Data on efficacy and changes in quality of life were derived from three etanercept clinical trials. Direct costs of treating psoriasis patients, including hospitalizations and dermatology clinic visits, were taken from an Italian cost-of-illness study. Extrapolations were made to evaluate the cost-effectiveness of intermittent etanercept versus nonsystemic therapy over a period of ten years. Results: For the group of patients with moderate and severe plaque psoriasis (initial Psoriasis Area and Severity Index [PASI ≥ 10]) the incremental cost-effectiveness ratio (ICER) for etanercept compared with nonsystemic therapy was €33,216/QALY; for the group of patients with severe psoriasis (PASI ≥ 20), the ICER was €25,486/QALY. Conclusions: Within the Italian health care system, intermittent etanercept is a cost-effective therapeutic option compared with nonsystemic therapy for the group of patients with moderate and severe plaque psoriasis. For patients with PASI ≥ 20, cost-effectiveness of etanercept is even greater.
Potential role of ixekizumab in the treatment of moderate-to-severe plaque psoriasis  [cached]
Ren V,Dao Jr H
Clinical, Cosmetic and Investigational Dermatology , 2013,
Abstract: Vicky Ren,1 Harry Dao Jr2 1Baylor College of Medicine , School of Medicine, 2Department of Dermatology, Baylor College of Medicine Houston, TX, USA Background: Psoriasis is a debilitating autoimmune skin disease that affects 2%–3% of the world's population. Patients with moderate-to-severe plaque psoriasis suffer from a decreased quality of life as well as comorbidities. Newer biological agents have been shown to be more effective than traditional therapies. In this article, we assess the potential role of ixekizumab, an anti-interleukin (IL)-17 antibody, in treating moderate-to-severe plaque psoriasis. Method: We reviewed PubMed for articles regarding ixekizumab and the epidemiology and management of plaque psoriasis. Results: In a Phase I clinical trial, treatment with ixekizumab resulted in both clinical and histopathologic improvement of psoriasis, which suggests that IL-17 may be a key driver in the pathogenesis of psoriasis. In a Phase II clinical trial, treatment with ixekizumab resulted in rapid clinical improvement of psoriasis, which lends further support to its role as an effective treatment for patients with chronic moderate-to-severe plaque psoriasis. Reductions in Psoriasis Area and Severity Index (PASI) score are comparable to those associated with currently marketed biologics. Conclusion: Literature concerning the effects of ixekizumab on chronic moderate-to-severe plaque psoriasis is currently limited to two clinical trials. Results suggest that ixekizumab shows great therapeutic promise. However, more large-scale and long-term trials are needed to establish safety and efficacy. Keywords: IL-17, PASI, adalimumab, etanercept, infliximab, ustekinumab, biologics
Infliximab for the treatment of plaque psoriasis  [cached]
Jennifer S Gall,Robert E Kalb
Biologics: Targets and Therapy , 2008,
Abstract: Jennifer S Gall, Robert E KalbState University of New York at Buffalo, School of Medicine and Biomedical Sciences, Department of Dermatology, NY, USAAbstract: Infliximab is a monoclonal antibody that targets tumor necrosis factor-α (TNFα). It is used in the treatment of a number of inflammatory disorders including severe plaque psoriasis. TNFα is thought to have a major role in psoriasis by promoting an inflammatory infiltrate into the skin and inducing keratinocyte proliferation and preventing keratinocyte apoptosis, which directly contributes to the characteristic plaque skin lesions. Based on four randomized, placebo-controlled, double-blind clinical trials and nine open-label uncontrolled trials of the use of infliximab in plaque psoriasis, it was found that infliximab is a highly efficacious, rapid, sustainable, and relatively safe therapy. Yet as with any biologic, caution is recommended in its use as infusion reactions, lupus-like syndromes, infections, malignancies including lymphomas, as well as other rare events have been reported.Keywords: infliximab, psoriasis, plaque
Infliximab in the treatment of plaque type psoriasis  [cached]
Rosita Saraceno,Andrea Saggini,Lucia Pietroleonardo,Sergio Chimenti
Clinical, Cosmetic and Investigational Dermatology , 2009,
Abstract: Rosita Saraceno, Andrea Saggini, Lucia Pietroleonardo, Sergio ChimentiDepartment of Dermatology, University of Rome Tor Vergata, Rome, Viale Oxford 81, Rome, ItalyAbstract: Psoriasis is a chronic and immunomediated skin disease characterized by erythematous scaly plaques. Psoriasis affects approximately 1% to 3% of the Caucasian population. Tumor necrosis factor alpha (TNF-α) is a proinflammatory cytokine that plays a critical role in the pathogenesis of psoriasis. Infliximab is an anti-TNF-α drug widely used for the treatment of plaque type psoriasis and psoriatic arthritis. Controlled clinical trials demonstrated that infliximab is characterized by a high degree of clinical response in moderate to severe plaque psoriasis. Moreover infliximab showed rapid efficacy in nail psoriasis which represents a therapeutic challenge for dermatologists and a relevant source of distress for patients with plaque psoriasis. This anti-TNF-α has an encouraging safety profile, especially as long as physicians are watchful in prevention and early diagnosis of infections and infuse reactions. The efficacy, tolerability and safety profiles suggest infliximab as a suitable anti-psoriatic drug in the long-term treatment of a chronic disease such as plaque-type psoriasis.Keywords: psoriasis, nail psoriasis, infliximab, long-term treatment
Etanercept in psoriasis: the evidence of its therapeutic impact  [cached]
Andrew Thomson
Core Evidence , 2007,
Abstract: Andrew ThomsonCore Medical Publishing, Knutsford, UKIntroduction: Psoriasis is a chronic inflammatory skin condition for which there is no cure. Treatment options are designed to control the disease symptoms and improve patients’ quality of life, and physical and mental function. Established treatments can be effective but are also limited by tolerability, convenience, cosmetic, and economic issues. Etanercept, a fully human soluble tumor necrosis factor (TNF) receptor protein, is a recently approved systemic treatment for chronic moderate to severe plaque psoriasis.Aim: To evaluate the evidence for the therapeutic value of etanercept in psoriasis.Evidence review: There is clear evidence that etanercept 25 mg or 50 mg twice per week reduces physician-assessed severity of psoriasis and can lead to clearing when compared with placebo. There is substantial evidence that etanercept improves patients’ quality of life as determined by both disease-specific and generic instruments. Emerging evidence includes improvements in symptoms associated with depression and fatigue. The tolerability of etanercept in patients with psoriasis appears to be similar to placebo. Initial indications from clinical trials suggest that there is no increased risk of infection or malignancy in etanercept-treated patients with psoriasis. The most common adverse events are reversible injection site reactions. Economic evidence is at present limited, although intermittent etanercept 25 mg is considered cost effective in patients with severe disease unsuitable for systemic treatment.Clinical value: Etanercept is an effective and efficient treatment for patients with moderate to severe psoriasis that may be suitable for intermittent use.Key words: etanercept, evidence, psoriasis, TNF inhibitor, treatment
Infliximab in the treatment of plaque type psoriasis
Rosita Saraceno, Andrea Saggini, Lucia Pietroleonardo, Sergio Chimenti
Clinical, Cosmetic and Investigational Dermatology , 2009, DOI: http://dx.doi.org/10.2147/CCID.S3413
Abstract: fliximab in the treatment of plaque type psoriasis Review (10217) Total Article Views Authors: Rosita Saraceno, Andrea Saggini, Lucia Pietroleonardo, Sergio Chimenti Published Date April 2009 Volume 2009:2 Pages 27 - 37 DOI: http://dx.doi.org/10.2147/CCID.S3413 Rosita Saraceno, Andrea Saggini, Lucia Pietroleonardo, Sergio Chimenti Department of Dermatology, University of Rome Tor Vergata, Rome, Viale Oxford 81, Rome, Italy Abstract: Psoriasis is a chronic and immunomediated skin disease characterized by erythematous scaly plaques. Psoriasis affects approximately 1% to 3% of the Caucasian population. Tumor necrosis factor alpha (TNF-α) is a proinflammatory cytokine that plays a critical role in the pathogenesis of psoriasis. Infliximab is an anti-TNF-α drug widely used for the treatment of plaque type psoriasis and psoriatic arthritis. Controlled clinical trials demonstrated that infliximab is characterized by a high degree of clinical response in moderate to severe plaque psoriasis. Moreover infliximab showed rapid efficacy in nail psoriasis which represents a therapeutic challenge for dermatologists and a relevant source of distress for patients with plaque psoriasis. This anti-TNF-α has an encouraging safety profile, especially as long as physicians are watchful in prevention and early diagnosis of infections and infuse reactions. The efficacy, tolerability and safety profiles suggest infliximab as a suitable anti-psoriatic drug in the long-term treatment of a chronic disease such as plaque-type psoriasis.
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