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Psoriasis: HELP
Articles from Rome, IT
Based on 407 articles published since 2008
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These are the 407 published articles about Psoriasis that originated from Rome, IT during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17
1 Guideline Treating axial spondyloarthritis and peripheral spondyloarthritis, especially psoriatic arthritis, to target: 2017 update of recommendations by an international task force. 2018

Smolen, Josef S / Schöls, Monika / Braun, Jürgen / Dougados, Maxime / FitzGerald, Oliver / Gladman, Dafna D / Kavanaugh, Arthur / Landewé, Robert / Mease, Philip / Sieper, Joachim / Stamm, Tanja / Wit, Maarten de / Aletaha, Daniel / Baraliakos, Xenofon / Betteridge, Neil / Bosch, Filip van den / Coates, Laura C / Emery, Paul / Gensler, Lianne S / Gossec, Laure / Helliwell, Philip / Jongkees, Merryn / Kvien, Tore K / Inman, Robert D / McInnes, Iain B / Maccarone, Mara / Machado, Pedro M / Molto, Anna / Ogdie, Alexis / Poddubnyy, Denis / Ritchlin, Christopher / Rudwaleit, Martin / Tanew, Adrian / Thio, Bing / Veale, Douglas / Vlam, Kurt de / van der Heijde, Désirée. ·Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria. · 2nd Department of Medicine, Hietzing Hospital, Vienna, Austria. · Health Consult, Vienna, Austria. · Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany. · Department of Rheumatology, Paris Descartes University, Paris, France. · Department of Rheumatology, St Vincent's University Hospital, Dublin, Ireland. · Division of Rheumatology, University of Toronto, Toronto, Ontario, Canada. · Division of Rheumatology, University of California, San Diego, CA, USA. · Amsterdam Rheumatology & Immunology Center, Amsterdam, The Netherlands. · Division of Rheumatology Research, Swedish-Providence St. Joseph Health System, University of Washington, Seattle, WA, USA. · Department of Gastroenterology, Infectiology and Rheumatology, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Berlin, Germany. · Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria. · Department of Medical Humanities, VU University Medical Centre, Amsterdam, The Netherlands. · Neil Betteridge Associates, UK. · Ghent University Hospital, Ghent, Belgium. · Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK. · Department of Medicine, University of California, San Francisco, CA, USA. · Department of Rheumatology, UPMC Univ Paris 06, GRC-UPMC 08 (EEMOIS); AP-HP, Pitié Salpêtrière Hospital, Paris, France. · Institute of Molecular Medicine, University of Leeds, Leeds, UK. · Seayn Medical, Voorschoten, The Netherlands. · Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. · University Health Network and University of Toronto, Toronto, Ontario, Canada. · University of Glasgow, College of Medical Veterinary and Life Sciences, Glasgow, UK. · A.DI.PSO. (Associazione per la Difesa degli Psoriasici)-PE.Pso.POF (Pan European Psoriasis Patients' Organization Forum), Rome, Italy. · Centre for Rheumatology & MRC Centre for Neuromuscular Diseases, University College London, London, UK. · Division of Rheumatology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, USA. · German Rheumatism Research Centrer, Berlin, Germany. · Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center Rochester, New York, NY, USA. · Division of Internal Medicine and Rheumatology, Klinikum Bielefeld, Bielefeld, Germany. · Department of Dermatology, Medical University of Vienna, Vienna, Austria. · Department of Dermatology, Erasmus Medical Center, Erasmus University, Rotterdam, The Netherlands. · Department of Rheumatology, Klinikum Bielefeld, Bielefeld, Germany. · Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium. · Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. ·Ann Rheum Dis · Pubmed #28684559.

ABSTRACT: Therapeutic targets have been defined for axial and peripheral spondyloarthritis (SpA) in 2012, but the evidence for these recommendations was only of indirect nature. These recommendations were re-evaluated in light of new insights. Based on the results of a systematic literature review and expert opinion, a task force of rheumatologists, dermatologists, patients and a health professional developed an update of the 2012 recommendations. These underwent intensive discussions, on site voting and subsequent anonymous electronic voting on levels of agreement with each item. A set of 5 overarching principles and 11 recommendations were developed and voted on. Some items were present in the previous recommendations, while others were significantly changed or newly formulated. The 2017 task force arrived at a single set of recommendations for axial and peripheral SpA, including psoriatic arthritis (PsA). The most exhaustive discussions related to whether PsA should be assessed using unidimensional composite scores for its different domains or multidimensional scores that comprise multiple domains. This question was not resolved and constitutes an important research agenda. There was broad agreement, now better supported by data than in 2012, that remission/inactive disease and, alternatively, low/minimal disease activity are the principal targets for the treatment of PsA. As instruments to assess the patients on the path to the target, the Ankylosing Spondylitis Disease Activity Score (ASDAS) for axial SpA and the Disease Activity index for PSoriatic Arthritis (DAPSA) and Minimal Disease Activity (MDA) for PsA were recommended, although not supported by all. Shared decision-making between the clinician and the patient was seen as pivotal to the process. The task force defined the treatment target for SpA as remission or low disease activity and developed a large research agenda to further advance the field.

2 Guideline European S3-Guideline on the systemic treatment of psoriasis vulgaris - Update Apremilast and Secukinumab - EDF in cooperation with EADV and IPC. 2017

Nast, A / Spuls, P I / van der Kraaij, G / Gisondi, P / Paul, C / Ormerod, A D / Saiag, P / Smith, C H / Dauden, E / de Jong, E M / Feist, E / Jobling, R / Maccarone, M / Mrowietz, U / Papp, K A / Reich, K / Rosumeck, S / Talme, T / Thio, H B / van de Kerkhof, P / Werner, R N / Dressler, C. ·Division of Evidence-Based Medicine, Department of Dermatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. · Department of Dermatology, Academic Medical Center, Amsterdam, The Netherlands. · Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy. · Department of Dermatology, Paul Sabatier University, Toulouse, France. · Department of Dermatology, Aberdeen Royal Infirmary, Aberdeen, UK. · Service de Dermatologie, Hôpital Ambroise Paré Université Paris V, Boulogne, France. · St Johns Institute of Dermatology, Guys and St Thomas' Hospital Foundation Trust, London, UK. · Hospital Universitario de la Princesa, Madrid, Spain. · Radboud University medical center and Radboud University, Nijmegen, The Netherlands. · Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany. · Cambridge, UK. · Roma, Italy. · Department of Dermatology, Psoriasis-Center University Medical Center Schleswig Holstein, Kiel, Germany. · Waterloo, Canada. · Dermatologikum Hamburg, Hamburg, Germany. · Section of Dermatology and Venereology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden. ·J Eur Acad Dermatol Venereol · Pubmed #28895202.

ABSTRACT: -- No abstract --

3 Guideline Treatment of severe psoriasis in children: recommendations of an Italian expert group. 2017

Fortina, Anna Belloni / Bardazzi, Federico / Berti, Samantha / Carnevale, Claudia / Di Lernia, Vito / El Hachem, Maya / Neri, Iria / Gelmetti, Carlo Mario / Lora, Viviana / Mazzatenta, Carlo / Milioto, Mirella / Moretta, Gaia / Patrizi, Annalisa / Peris, Ketty / Villani, Alberto. ·Pediatric Dermatology Unit, Department of Medicine, University of Padua, Via Gallucci, 4, 35128, Padova, Italy. anna.bellonifortina@gmail.com. · Dermatology Unit, Department of Specialistic, Diagnostic and Experimental Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. · Dermatology Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. · Dermatology Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy. · Dermatology Unit, Arcispedale S. Maria Nuova IRCCS, Reggio Emilia, Italy. · Pediatric Dermatology Unit, Fondazione IRCCS Ca' Granda "Ospedale Maggiore Policlinico", Milan Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy. · Center for the Study and Treatment of Psoriasis, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy. · Dermatology Unit, "Campo di Marte" Hospital, Azienda USL 2, Lucca, Italy. · Dermatology Unit, Ospedale Civico di Cristina Benfratelli, Palermo, Italy. · Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy. · General Pediatrics and Infectious Disease, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy. ·Eur J Pediatr · Pubmed #28836064.

ABSTRACT: This article provides comprehensive recommendations for the systemic treatment of severe pediatric psoriasis based on evidence obtained from a systematic review of the literature and the consensus opinion of expert dermatologists and pediatricians. For each systemic treatment, the grade of recommendation (A, B, C) based on the treatment's approval by the European Medicines Agency for childhood psoriasis and the experts' opinions is discussed. The grade of recommendation for narrow-band-ultraviolet B phototherapy, cyclosporine, and retinoids is C, while that for methotrexate is C/B. The use of adalimumab, etanercept, and ustekinumab has a grade A recommendation. No conventional systemic treatments are approved for pediatric psoriasis. Adalimumab is approved by the European Medicines Agency as a first-line treatment for severe chronic plaque psoriasis in children (≥ 4 years old) and adolescents. Etanercept and ustekinumab are approved as second-line therapy in children ≥ 6 and ≥ 12 years, respectively. CONCLUSION: A treatment algorithm as well as practical tools (i.e., tabular summaries of differential diagnoses, treatment mechanism of actions, dosing regimens, control parameters) are provided to assist in therapeutic reasoning and decision-making for individual patients. These treatment recommendations are endorsed by major Italian Pediatric and Dermatology Societies. What is Known: • Guidelines for the treatment of severe pediatric psoriasis are lacking and most traditional systemic treatments are not approved for use in young patients. Although there has been decades of experience with some of the traditional agents such as phototherapy, acitretin, and cyclosporine in children, there are no RCTs on their pediatric use while RCTs investigating new biologic agents have been performed. What is New: • In this manuscript, an Italian multidisciplinary team of experts focused on treatment recommendations for severe forms of psoriasis in children based on an up-to-date review of the literature and experts' opinions.

4 Guideline European League Against Rheumatism (EULAR) recommendations for the management of psoriatic arthritis with pharmacological therapies: 2015 update. 2016

Gossec, L / Smolen, J S / Ramiro, S / de Wit, M / Cutolo, M / Dougados, M / Emery, P / Landewé, R / Oliver, S / Aletaha, D / Betteridge, N / Braun, J / Burmester, G / Cañete, J D / Damjanov, N / FitzGerald, O / Haglund, E / Helliwell, P / Kvien, T K / Lories, R / Luger, T / Maccarone, M / Marzo-Ortega, H / McGonagle, D / McInnes, I B / Olivieri, I / Pavelka, K / Schett, G / Sieper, J / van den Bosch, F / Veale, D J / Wollenhaupt, J / Zink, A / van der Heijde, D. ·Sorbonne Universités, UPMC Univ Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS), Paris, France Department of rheumatology, AP-HP, Pitié Salpêtrière Hospital, Paris, France. · Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria Second Department of Medicine, Hietzing Hospital, Vienna, Austria. · Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands. · EULAR, representing People with Arthritis/Rheumatism in Europe (PARE), London, UK. · Research Laboratory and Clinical Division of Rheumatology, Department of Internal Medicine, University of Genova, Viale Benedetto, Italy. · Medicine Faculty, Paris Descartes University, Paris, France Rheumatology B Department, APHP, Cochin Hospital, Paris, France. · Leeds NIHR Musculoskeletal Biomedical Research Unit, LTHT, Leeds, UK Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. · Department of Clinical Immunology & Rheumatology, Amsterdam Rheumatology Center, Amsterdam, The Netherlands Atrium Medical Center, Heerlen, The Netherlands. · North Devon, UK. · Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria. · Rheumazentrum Ruhrgebiet, Herne and Ruhr-Universität Bochum, Herne, Germany. · Department of Rheumatology and Clinical Immunology, Charité-University Medicine Berlin, Germany. · Arthritis Unit, Department of Rheumatology, Hospital Clínic and IDIBAPS, Barcelona, Spain. · Belgrade University School of Medicine, Belgrade, Serbia. · Department of Rheumatology, St. Vincent's University Hospital and Conway Institute, University College Dublin, Dublin, Ireland. · Section of Rheumatology, Department of Clinical Sciences, Lund University, Lund, Sweden Sweden and School of Business, Engineering and Science, Halmstad University, Halmstad, Sweden. · Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK. · Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. · Laboratory of Tissue Homeostasis and Disease, Skeletal Biology and Engineering Research Center, KU Leuven, Belgium Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium. · Department of Dermatology, University Hospital Münster, Münster, Germany. · A.DI.PSO. (Associazione per la Difesa degli Psoriasici)-PE.Pso.POF (Pan European Psoriasis Patients' Organization Forum), Rome, Italy. · Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK. · Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza, Italy. · Institute and Clinic of Rheumatology Charles University Prague, Czech Republic. · Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany. · Department of Rheumatology, Campus Benjamin Franklin, Charité, Berlin, Germany. · Ghent University Hospital, Ghent, Belgium. · Centre for Arthritis and Rheumatic Disease, Dublin Academic Medical Centre, St. Vincent's University Hospital, Dublin, Ireland. · Schoen Klinik Hamburg, Rheumatology and Clinical Immunology, Hamburg, Germany. · Department of Rheumatology and Clinical Immunology, German Rheumatism Research Centre Berlin, Charité-University Medicine Berlin, Germany. ·Ann Rheum Dis · Pubmed #26644232.

ABSTRACT: BACKGROUND: Since the publication of the European League Against Rheumatism recommendations for the pharmacological treatment of psoriatic arthritis (PsA) in 2012, new evidence and new therapeutic agents have emerged. The objective was to update these recommendations. METHODS: A systematic literature review was performed regarding pharmacological treatment in PsA. Subsequently, recommendations were formulated based on the evidence and the expert opinion of the 34 Task Force members. Levels of evidence and strengths of recommendations were allocated. RESULTS: The updated recommendations comprise 5 overarching principles and 10 recommendations, covering pharmacological therapies for PsA from non-steroidal anti-inflammatory drugs (NSAIDs), to conventional synthetic (csDMARD) and biological (bDMARD) disease-modifying antirheumatic drugs, whatever their mode of action, taking articular and extra-articular manifestations of PsA into account, but focusing on musculoskeletal involvement. The overarching principles address the need for shared decision-making and treatment objectives. The recommendations address csDMARDs as an initial therapy after failure of NSAIDs and local therapy for active disease, followed, if necessary, by a bDMARD or a targeted synthetic DMARD (tsDMARD). The first bDMARD would usually be a tumour necrosis factor (TNF) inhibitor. bDMARDs targeting interleukin (IL)12/23 (ustekinumab) or IL-17 pathways (secukinumab) may be used in patients for whom TNF inhibitors are inappropriate and a tsDMARD such as a phosphodiesterase 4-inhibitor (apremilast) if bDMARDs are inappropriate. If the first bDMARD strategy fails, any other bDMARD or tsDMARD may be used. CONCLUSIONS: These recommendations provide stakeholders with an updated consensus on the pharmacological treatment of PsA and strategies to reach optimal outcomes in PsA, based on a combination of evidence and expert opinion.

5 Guideline European S3-Guidelines on the systemic treatment of psoriasis vulgaris--Update 2015--Short version--EDF in cooperation with EADV and IPC. 2015

Nast, A / Gisondi, P / Ormerod, A D / Saiag, P / Smith, C / Spuls, P I / Arenberger, P / Bachelez, H / Barker, J / Dauden, E / de Jong, E M / Feist, E / Jacobs, A / Jobling, R / Kemény, L / Maccarone, M / Mrowietz, U / Papp, K A / Paul, C / Reich, K / Rosumeck, S / Talme, T / Thio, H B / van de Kerkhof, P / Werner, R N / Yawalkar, N. ·Division of Evidence Based Medicine, Department of Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany. · Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy. · Department of Dermatology, Aberdeen Royal Infirmary, Aberdeen, UK. · Service de Dermatologie, Hôpital Ambroise Paré Université Paris V, Boulogne, France. · Clinical Lead for Dermatology, St Johns Institute of Dermatology, St Thomas' Hospital, London, UK. · Department of Dermatology, Academic Medical Center, Amsterdam, The Netherlands. · Third Faculty of Medicine, Department of Dermatology, Charles University, Prague, Czech Republic. · Department of Dermatology, Hôpital Saint-Louis, Paris, France. · St. Johns Institute of Dermatology, St. Thomas' Hospital, London, UK. · Hospital Universitario de la Princesa, Madrid, Spain. · University Medical Center Nijmegen St Radboud, Nijmegen, The Netherlands. · Medizinische Klinik mit Schwerpunkt Rheumatologie u. klinische Immonologie, Charité - Universitätsmedizin Berlin, Berlin, Germany. · Cambridge, UK. · SZTE Borgyogyaszati Klinika, Szeged, Hungary. · Roma, Italy. · Department of Dermatology, Psoriasis-Center University Medical Center Schleswig Holstein, Kiel, Germany. · Waterloo, Canada. · Department of Dermatology, Paul Sabatier University, Toulouse, France. · Dermatologikum Hamburg, Hamburg, Germany. · Section of Dermatology and Venereology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden. · Department of Dermatology, Erasmus University, Rotterdam, The Netherlands. · Department of Dermatology, University Hospital Nijmegen, Nijmegen, The Netherlands. · Department of Dermatology, Inselspital, Universitätsklinik für Dermatologie, Bern, Switzerland. ·J Eur Acad Dermatol Venereol · Pubmed #26481193.

ABSTRACT: -- No abstract --

6 Editorial MANAGEMENT OF PSORIATIC ARTHRITIS: SHOULD THE INTERACTION BETWEEN DERMATOLOGISTS AND RHEUMATOLOGISTS IN CLINICAL PRACTICE BE INTENSIFIED? 2015

Migliore, A / Cusano, F / Bianchi, G / Malara, G / Epis, O / De Pità, O. ·U.O. Reumatologia, Ospedale San Pietro, Roma, Italy. · U. O. C. Dermatologia, Azienda Ospedaliera “G. Rummo”, Benevento, Italy. · U.O. Reumatologia, ASL3, Azienda Sanitaria Genovese, Genova, Italy. · U.O. Dermatologia Ospedale Papardo, Messina Italy. · U.O. Reumatologia, Ospedale Niguarda Ca’ Granda, Milano Italy. · Istituto Dermopatico dell’Immacolata, Roma, Italy. ·J Biol Regul Homeost Agents · Pubmed #26403393.

ABSTRACT: Psoriatic arthritis is an inflammatory seronegative spondyloarthropathy that occurs in approximately 25% of patients with psoriasis and is a progressive and severely disabling disease. Most patients have had psoriasis for several years before the development of arthritis or develop the joint and skin condition simultaneously. Given the absence of specific diagnostic test for psoriatic arthritis, clinical findings remain the standard criteria for the diagnosis. Patients with psoriasis presenting to the dermatologist for management of their skin disease may have joint symptoms related or not to psoriatic arthritis and similarly arthritic patients presenting to a rheumatologist for the management of psoriatic arthritis may have skin lesions related or not to psoriasis. In this paper an expert panel of specialist belonging to the “Associazione Dermatologi Ospedalieri Italiani” (ADOI) and “Collegio dei Reumatologi Ospedalieri Italiani” (CROI) analysed the international literature and scientific recommendations and also investigated the Italian setting. It has been demonstrated in the literature that a multidisciplinary clinical setting may benefit patients with psoriatic arthritis from both diagnostic and therapeutic points of view. The comparative analysis of the Italian clinical records used by ADOI and CROI have highlighted some substantial differences. Collaboration between the dermatologist and rheumatologist allows for a more complete appreciation of the overall skin and musculoskeletal disease burden, and subsequently leads to a more comprehensive treatment approach.

7 Editorial Pharmacoeconomic burden in the treatment of psoriatic arthritis: from systematic reviews to real clinical practice studies. 2014

Lubrano, Ennio / Spadaro, Antonio. ·Dipartimento di Medicina Interna e Specialità Mediche - UOC di Reumatologia, "Sapienza" - Università di Roma, Azienda Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy. antonio.spadaro@uniroma1.it. ·BMC Musculoskelet Disord · Pubmed #24444003.

ABSTRACT: The economic assessment of treatment options in a chronic and severe disease like Psoriatic Arthritis (PsA) is crucial to estimate the burden of costs. In particular, the impact of new costly medications such as biologic agents have been studied to figure this important aspect of a multifaceted disease. In a previous observational, longitudinal multicentre cost evaluation study, the results showed that biologic agents are cost-effective. This study was obtained from the real clinical practice and encompassed PsA patients refractory to traditional treatments. Similar data were also obtained from reviews analysis of Randomized Controlled Trials (RCTs). Recently, Cawson et al. performed a systematic review, network meta-analysis and economic evaluation of biological therapy for the management of active PsA. The review was conducted to identify relevant, recently published studies and the new trial data were synthesized, via a Bayesian network meta-analysis (NMA), to estimate the relative efficacy of the TNF-α inhibitors in terms of Psoriatic Arthritis Response Criteria (PsARC) response, Health Assessment Questionnaire (HAQ) scores and Psoriasis Area and Severity Index (PASI). In particular the analysis showed that, on average, etanercept was the most cost-effective treatment and, at the National Institute for Health and Care Excellence willingness-to-pay threshold of between £20,000 to £30,000, etanercept is the preferred option. This study, as a systematic review, has been focused on main RCTs on active PsA treated by biological DMARDs and limitations to this analysis arise from a paucity of data on long-term follow up, as well as radiological progression and long-term safety. These interesting results reflected the important role of biologic agents in the management of PsA, highlighting their efficacy and cost-effectiveness. However, there are some unmet needs for pharmacoeconomic considerations based on prospective and/or on real clinical practice studies, as well as considering all the intriguing aspects of this challenging disease.

8 Review Psoriasis in pregnancy: case series and literature review of data concerning exposure during pregnancy to ustekinumab. 2019

Galluzzo, Marco / D'Adamio, Simone / Bianchi, Luca / Talamonti, Marina. ·a Division of Dermatology, Department of "Medicina dei Sistemi" , University of Rome "Tor Vergata" , Rome , Italy. ·J Dermatolog Treat · Pubmed #29676599.

ABSTRACT: Psoriasis tends to improve for approximately half of patients during pregnancy, but an equal number of patients report no change or worsening during this period, when lots of medications, like biologics, are not indicated. The aim of our study was to review data of patient that had been pregnant during ustekinumab treatment, analyzing data of our data set between September 2010 and February 2018. We found data of three patients that had been pregnant during ustekinumab treatment. All three patients successfully completed the pregnancy without complications. One of the three patients was pregnant even twice during treatment with ustekinumab, with also a successful birth of two perfectly healthy twins. Biologic agents approved for the treatment of moderate-to-severe psoriasis are currently classified as pregnancy category B, even if, particularly for ustekinumab, there are several case reports regarding exposure during pregnancy in humans related to a healthy pregnancy, both for women and children. Although further studies are required to find real indication of biological treatment in pregnant patients, according to our and to the reviewed experience, ustekinumab does not interfere with gestation.

9 Review Histopathology of the skin in rheumatic diseases. 2018

Chimenti, M S / Di Stefani, A / Conigliaro, P / Saggini, A / Urbani, S / Giunta, A / Esposito, M / Bianchi, L / Peris, K / Perricone, R. ·Rheumatology, Allergology and Clinical Immunology, Department of Medicina dei Sistemi, University of Rome Tor Vergata, Rome. maria.sole.chimenti@uniroma2.it. ·Reumatismo · Pubmed #30282444.

ABSTRACT: Rheumatological systemic autoimmune diseases, such as connective tissue diseases, rheumatoid arthritis or spondyloarthritis, are characterized by the presence of joint involvement associated with extra-articular manifestations. Among them, cutaneous diseases are often the most relevant and representative clinical manifestation, as in psoriatic arthritis, scleroderma or systemic lupus erythematosus. In this context, it is useful for rheumatologists to understand better skin diseases and their histopathological features. Evaluation of skin biopsy specimens can be helpful not only to confirm the diagnosis in both classic and clinically atypical variants, but also to improve further our knowledge of the pathogenetic mechanisms and the close link between skin and articular diseases. In this review, we discuss the clinical features, diagnostic evaluation and the histopathological features of skin manifestation of the most relevant rheumatological autoimmune diseases.

10 Review Commentary to the review article: Subedi S, Yu Q, Chen Z, Shi Y. Management of pediatric psoriasis with acitretin: A review. Dermatol Ther. 2018 Jan;31(1). 2018

Barygina, Victoria / Becatti, Matteo / Lotti, Torello / Taddei, Niccolo / Fiorillo, Claudia. ·Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy. · Department of Education Sciences, University of Studies Guglielmo Marconi, Rome, Italy. ·Dermatol Ther · Pubmed #30203455.

ABSTRACT: -- No abstract --

11 Review Dermatoscopy and Reflectance Confocal Microscopy Correlations in Nonmelanocytic Disorders. 2018

Lacarrubba, Francesco / Ardigò, Marco / Di Stefani, Alessandro / Verzì, Anna Elisa / Micali, Giuseppe. ·Dermatology Clinic, University of Catania, Via Santa Sofia 78, Catania 95123, Italy. Electronic address: francesco.lacarrubba@unict.it. · Department of Clinical Dermatology, San Gallicano Dermatological Institute, Rome, Italy. · Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy. · Dermatology Clinic, University of Catania, Via Santa Sofia 78, Catania 95123, Italy. ·Dermatol Clin · Pubmed #30201157.

ABSTRACT: Dermatoscopy and in vivo reflectance confocal microscopy are noninvasive techniques that provide a horizontal approach, with an en face view of the skin structures. Both techniques assist in the clinical diagnosis of a variety of inflammatory and infectious cutaneous disorders. In many cases, they have shown concordance. Their combined use represents, in several instances, a promising option to reach the final diagnosis without the need for invasive procedures.

12 Review Complementary and integrative therapies for psoriasis: Looking forward. 2018

Damevska, Katerina / França, Katlein / Lotti, Torello / Nikolovska, Suzana / Pollozhani, Nora. ·Clinic of Dermatology, Saints Cyril and Methodius University, Skopje, Macedonia. · Department of Dermatology & Cutaneous Surgery, Institute for Bioethics & Health Policy, Miami, Florida. · Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida. · University G. Marconi of Rome, Dermatology and Venereology, Rome, Italy. ·Dermatol Ther · Pubmed #30133906.

ABSTRACT: Despite the great advances in our understanding of disease pathogenesis and a rich variety of therapeutic options, including the availability of newer biologic agents, there is still no cure for psoriasis. Based on low levels of satisfaction in the treatment they receive and their overall care, it is not surprising that a substantial part of patients turn to complementary and alternative therapies. Integrative medicine is an exciting new approach to health care. The dermatologist should recognize this growing trend and become familiar with the current literature on integrative therapies for psoriasis. Several complementary therapies, those that have been found to be safe and effective, can be recommended as part of an integrative treatment plan.

13 Review Thyroid diseases and skin autoimmunity. 2018

Baldini, Enke / Odorisio, Teresa / Tuccilli, Chiara / Persechino, Severino / Sorrenti, Salvatore / Catania, Antonio / Pironi, Daniele / Carbotta, Giovanni / Giacomelli, Laura / Arcieri, Stefano / Vergine, Massimo / Monti, Massimo / Ulisse, Salvatore. ·Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy. · Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy. · NESMOS Department, "Sapienza" University of Rome, Rome, Italy. · Department of Surgical Sciences, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy. salvatore.ulisse@uniroma1.it. ·Rev Endocr Metab Disord · Pubmed #29948572.

ABSTRACT: The skin is the largest organ of the body, at the boundary with the outside environment. Primarily, it provides a physical and chemical barrier against external insults, but it can act also as immune organ because it contains a whole host of immune-competent cells of both the innate and the adaptive immune systems, which cooperate in eliminating invading pathogens following tissue injury. On the other hand, improper skin immune responses lead to autoimmune skin diseases (AISD), such as pemphigus, bullous pemphigoid, vitiligo, and alopecia. Although the interplay among genetic, epigenetic, and environmental factors has been shown to play a major role in AISD etiology and progression, the molecular mechanisms underlying disease development are far from being fully elucidated. In this context, epidemiological studies aimed at defining the association of different AISD with other autoimmune pathologies revealed possible shared molecular mechanism(s) responsible for disease progression. In particular, over the last decades, a number of reports have highlighted a significant association between thyroid diseases (TD), mainly autoimmune ones (AITD), and AISD. Here, we will recapitulate the epidemiology, clinical manifestations, and pathogenesis of the main AISD, and we will summarize the epidemiological evidence showing the associations with TD as well as possible molecular mechanism(s) underlying TD and AISD pathological manifestations.

14 Review Cutaneous and Mucosal Manifestations Associated with Celiac Disease. 2018

Rodrigo, Luis / Beteta-Gorriti, Valia / Alvarez, Nuria / Gómez de Castro, Celia / de Dios, Alvaro / Palacios, Laura / Santos-Juanes, Jorge. ·Gastroenterology Unit, Hospital Universitario Central de Asturias (HUCA), Avda. de Roma s/n, 33011 Oviedo, Asturias, Spain. lrrodrigo@uniovi.es. · Dermatology Unit, Hospital Universitario Central de Asturias (HUCA), Avda. de Roma s/n, 33011 Oviedo, Asturias, Spain. valita_bg@hotmail.com. · Gastroenterology Unit, Hospital Universitario Central de Asturias (HUCA), Avda. de Roma s/n, 33011 Oviedo, Asturias, Spain. nuriaalvarezh@gmail.com. · Dermatology Unit, Hospital Universitario Central de Asturias (HUCA), Avda. de Roma s/n, 33011 Oviedo, Asturias, Spain. celiagomez_88@hotmail.com. · Dermatology Unit, Hospital Universitario Central de Asturias (HUCA), Avda. de Roma s/n, 33011 Oviedo, Asturias, Spain. aldedivel@gmail.com. · Dermatology Unit, Hospital Universitario Central de Asturias (HUCA), Avda. de Roma s/n, 33011 Oviedo, Asturias, Spain. llaurinapalacios@hotmail.com. · Dermatology Unit, Hospital Universitario Central de Asturias (HUCA), Avda. de Roma s/n, 33011 Oviedo, Asturias, Spain. santosjjorge@uniovi.es. · Facultad de Medicina, Universidad de Oviedo, 33003 Oviedo, Asturias, Spain. santosjjorge@uniovi.es. ·Nutrients · Pubmed #29933630.

ABSTRACT: Celiac disease (CD) is an immune-mediated, gluten-induced enteropathy that affects predisposed individuals of all ages. Many patients with CD do not report gastrointestinal symptoms making it difficult to reach an early diagnosis. On the other hand, CD is related to a wide spectrum of extra-intestinal manifestations, with dermatitis herpetiformis (DH) being the best characterized. These associated conditions may be the clue to reaching the diagnosis of CD. Over the last few years, there have been multiple reports of the association between CD and several cutaneous manifestations that may improve with a gluten-free diet (GFD). The presence of some of these skin diseases, even in the absence of gastrointestinal symptoms, should give rise to an appropriate screening method for CD. The aim of this paper is to describe the different cutaneous manifestations that have been associated with CD and the possible mechanisms involved.

15 Review A safety evaluation of guselkumab for the treatment of psoriasis. 2018

Galluzzo, M / D'Adamio, S / Campione, E / Bianchi, L / Talamonti, M. ·a Dermatology, Department of "Medicina dei Sistemi" , University of Rome Tor Vergata , Rome , Italy. ·Expert Opin Drug Saf · Pubmed #29897790.

ABSTRACT: INTRODUCTION: Guselkumab is a fully human monoclonal IgG1λ antibody for the treatment of plaque psoriasis that inhibits interleukin (IL)-23p19 subunit, reducing the proliferation of type 17 helper T (Th-17) cells and thus production of Th-17-derived pro-inflammatory cytokines, especially IL-17 and IL-22. Areas covered: In the following article, the mechanism of action and mainly the efficacy and safety profile of guselkumab available from results of trials will be discussed. We summarized these data after a literature review including PubMed search, relating proceedings and abstracts from relevant international conferences, assessment reports from European and United States regulatory agencies and treatment guidelines up to April 2018. Expert opinion: The central role of IL-23 in psoriasis pathogenesis is supported by genetic links of IL-23 and IL-23R alleles to psoriasis susceptibility; early clinical trials have demonstrated that sufficient inhibition of IL-23p19 results in rapid resolution of the disease. Targeting IL-23, may be responsible for the high efficacy and durable responses of guselkumab, avoiding some adverse effects of IL-17A blockade, like mucocutaneous candida infections or triggering/worsening of inflammatory bowel disease, experienced with agents acting selectively against this molecule and that seem to be class related.

16 Review Efficacy and Safety Outcomes for Originator TNF Inhibitors and Biosimilars in Rheumatoid Arthritis and Psoriasis Trials: A Systematic Literature Review. 2018

Moots, Robert J / Curiale, Cinzia / Petersel, Danielle / Rolland, Catherine / Jones, Heather / Mysler, Eduardo. ·University of Liverpool, Liverpool, UK. R.J.Moots@liverpool.ac.uk. · Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, Clinical Sciences Centre, Aintree University Hospital, Longmoor Lane, Liverpool, L9 7AL, UK. R.J.Moots@liverpool.ac.uk. · Pfizer, Rome, Italy. · Pfizer, Collegeville, PA, USA. · Envision Pharma Group, Horsham, West Sussex, UK. · Organización Médica de Investigación, Buenos Aires, Argentina. ·BioDrugs · Pubmed #29790131.

ABSTRACT: OBJECTIVE: Regulatory approval of biosimilar versions of originator biotherapeutics requires that new biological products be highly similar to originator products, with no clinically meaningful differences in safety, purity, and potency. In some trials of biosimilars of tumor necrosis factor inhibitors for the treatment of rheumatoid arthritis (RA) and plaque psoriasis (PsO), pre-specified margins for efficacy and safety have been met, but differences in treatment responses between pivotal originator trials and biosimilar trials have been noted. The objective of this systematic review was to examine these differences. METHODS: Searches were conducted to identify comparative randomized clinical trials of approved or proposed biosimilars of adalimumab, etanercept, and infliximab. RESULTS: Of 83 publications identified, 16 publications were included for analysis (RA: originators, n = 5; biosimilars, n = 6; PsO: originators, n = 2; biosimilars, n = 3). American College of Rheumatology 20% response rates were higher among patients with RA receiving originator biologics and biosimilars in biosimilar trials than among patients receiving the originator biologics in pivotal trials. In etanercept studies in PsO, a difference was observed in Psoriasis Area and Severity Index 75% response rates between biosimilar and pivotal trials. Insufficient efficacy data were available from adalimumab and infliximab biosimilar studies in PsO to determine any differences in treatment responses between pivotal and biosimilar studies. CONCLUSIONS: Observed differences in treatment response rates between pivotal originator trials and trials of originator biologics and their respective biosimilars may be attributable to fundamental differences in study design and/or baseline patient characteristics, which require further analysis.

17 Review Role of the IL-23/IL-17 Axis in Psoriasis and Psoriatic Arthritis: The Clinical Importance of Its Divergence in Skin and Joints. 2018

Boutet, Marie-Astrid / Nerviani, Alessandra / Gallo Afflitto, Gabriele / Pitzalis, Costantino. ·Centre for Experimental Medicine & Rheumatology, William Harvey Research Institute and Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK. m.a.boutet@qmul.ac.uk. · Centre for Experimental Medicine & Rheumatology, William Harvey Research Institute and Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK. a.nerviani@qmul.ac.uk. · Unit of Allergology, Immunology & Rheumatology, Department of Medicine, Università campus Bio-Medico di Roma, 00128 Rome, Italy. gabgallo9@gmail.com. · Centre for Experimental Medicine & Rheumatology, William Harvey Research Institute and Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK. c.pitzalis@qmul.ac.uk. ·Int J Mol Sci · Pubmed #29425183.

ABSTRACT: Psoriasis is a chronic systemic inflammatory disease causing erythematosus and scaly skin plaques; up to 30% of patients with psoriasis develop Psoriatic Arthritis (PsA), which is characterised by inflammation and progressive damage of the peripheral joints and/or the spine and/or the entheses. The pathogenic mechanisms driving the skin disorder in psoriasis and the joint disease in PsA are sustained by the activation of inflammatory pathways that can be overlapping, but also, at least partially, distinct. Cytokines members of the IL-23/IL-17 family, critical in the development of autoimmunity, are abundantly expressed within the cutaneous lesions but also seem to be involved in chronic inflammation and damage of the synovium though, as it will be here discussed, not in all patients. In this review, we will focus on the state of the art of the molecular features of psoriatic skin and joints, focusing on the specific role of the IL-23/IL-17 pathway in each of these anatomical districts. We will then offer an overview of the approved and in-development biologics targeting this axis, emphasising how the availability of the "target" in the diseased tissues could provide a plausible explanation for the heterogeneous clinical efficacy of these drugs, thus opening future perspective of personalised therapies.

18 Review Interaction between microbiome and host genetics in psoriatic arthritis. 2018

Chimenti, Maria Sole / Perricone, Carlo / Novelli, Lucia / Caso, Francesco / Costa, Luisa / Bogdanos, Dimitrios / Conigliaro, Paola / Triggianese, Paola / Ciccacci, Cinzia / Borgiani, Paola / Perricone, Roberto. ·Rheumatology, Allergology and Clinical Immunology, Department of Medicina dei Sistemi, University of Rome Tor Vergata, Rome, Italy. · Rheumatology, Department of Internal Medicine, Sapienza University of Rome, Rome, Italy. Electronic address: carlo.perricone@uniroma1.it. · Rheumatology, Allergology and Clinical Immunology, Department of Medicina dei Sistemi, University of Rome Tor Vergata, Rome, Italy; Rheumatology, Department of Internal Medicine, Sapienza University of Rome, Rome, Italy. · Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy. · Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece. · Department of Biomedicine and Prevention, Section of Genetics, School of Medicine, University of Rome "Tor Vergata", Rome, Italy. ·Autoimmun Rev · Pubmed #29378263.

ABSTRACT: Psoriatic arthritis (PsA) is a chronic inflammatory joint disease, seen in combination with psoriasis. Both genetic and environmental factors are responsible for the development of PsA, however little is known about the different weight of these two distinctive components in the pathogenesis of the disease. Genomic variability in PsA is associated with the disease and/or some peculiar clinical phenotypes. Candidate genes involved are crucial in inflammation, immune system, and epithelial permeability. Moreover, the genesis and regulation of inflammation are influenced by the composition of the human intestinal microbiome that is able to modulate both mucosal and systemic immune system. It is possible that pro-inflammatory responses initiated in gut mucosa could contribute to the induction and progression of autoimmune conditions. Given such premises, the aim of this review is to summarize immune-mediated response and specific bacterial changes in the composition of fecal microbiota in PsA patients and to analyze the relationships between bacterial changes, immune system, and host genetic background.

19 Review Scanning the Immunopathogenesis of Psoriasis. 2018

Chiricozzi, Andrea / Romanelli, Paolo / Volpe, Elisabetta / Borsellino, Giovanna / Romanelli, Marco. ·Dermatology Department, University of Pisa, Via Roma 67, 56126 Pisa, Italy. andrea.chiricozzi@unipi.it. · Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1295 NW 14th St, Miami, FL 33125, USA. promanelli@med.miami.edu. · The Laboratory of Neuroimmunology, Fondazione Santa Lucia, Via del Fosso di Fiorano, 64, 00143 Rome, Italy. e.volpe@hsantalucia.it. · The Laboratory of Neuroimmunology, Fondazione Santa Lucia, Via del Fosso di Fiorano, 64, 00143 Rome, Italy. g.borsellino@hsantalucia.it. · Dermatology Department, University of Pisa, Via Roma 67, 56126 Pisa, Italy. ·Int J Mol Sci · Pubmed #29316717.

ABSTRACT: Psoriasis is a chronic inflammatory skin disease, the immunologic model of which has been profoundly revised following recent advances in the understanding of its pathophysiology. In the current model, a crosstalk between keratinocytes, neutrophils, mast cells, T cells, and dendritic cells is thought to create inflammatory and pro-proliferative circuits mediated by chemokines and cytokines. Various triggers, including recently identified autoantigens, Toll-like receptor agonists, chemerin, and thymic stromal lymphopoietin may activate the pathogenic cascade resulting in enhanced production of pro-inflammatory and proliferation-inducing mediators such as interleukin (IL)-17, tumor necrosis factor (TNF)-α, IL-23, IL-22, interferon (IFN)-α, and IFN-γ by immune cells. Among these key cytokines lie therapeutic targets for currently approved antipsoriatic therapies. This review aims to provide a comprehensive overview on the immune-mediated mechanisms characterizing the current pathogenic model of psoriasis.

20 Review Back to the future: a new topical approach for mild-to-moderate psoriasis. 2018

Girolomoni, Giampiero / Calzavara Pinton, Piergiacomo / Cristaudo, Antonio / Cicchetti, Americo. ·Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy - giampiero.girolomoni@univr.it. · Department of Clinical and Experimental Sciences, Section of Dermatology, University of Brescia, Brescia, Italy. · San Gallicano Dermatological Institute, IRCCS, Rome, Italy. · Postgraduate School of Health Economics and Management, Catholic University of the Sacred Heart, Rome, Italy. ·G Ital Dermatol Venereol · Pubmed #27982547.

ABSTRACT: Psoriasis is a chronic-relapsing skin disorder which requires long-term treatments. Therapeutic options for psoriasis include topical treatments, phototherapy and systemic therapy. However, those treatments, and particularly the topical drug therapies, may present some limitations, including poor efficacy/tolerability ratio and lack of adherence. Recently, the supersaturated aerosol foam formulation of the fixed combination calcipotriene plus betamethasone dipropionate (Cal/BD) has gained major attention because it overcomes some of the limitations associated with other topical treatments. This fixed-combination has increased efficacy compared with its individual components. Moreover, the alcohol-free aerosol foam formulation allows a higher penetration of the active ingredients into the skin, resulting in enhanced bioavailability and, consequently, in better clinical outcomes than other products with the same components. Given the short duration of therapy course and the fast onset of action, a reduced amount of Cal/BD foam formulation would be required for the treatment of psoriasis patients, resulting also in cost saving. Therefore this novel formulation could represent an alternative to other topical agents and a first-line therapy in the treatment of mild and mild-to-moderate psoriasis.

21 Review Integrins: Integrating the Biology and Therapy of Cell-cell Interactions. 2017

Pandolfi, Franco / Franza, Laura / Altamura, Simona / Mandolini, Claudia / Cianci, Rossella / Ansari, Aftab / Kurnick, James T. ·Institute of Internal Medicine, Catholic University, Rome, Italy. Electronic address: franco.pandolfi@unicatt.it. · Institute of Internal Medicine, Catholic University, Rome, Italy. · Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia. · CytoCure LLC, Beverly, Massachusetts; Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. ·Clin Ther · Pubmed #29203050.

ABSTRACT: PURPOSE: Although the role of integrins has been described in a variety of diseases, these roles seem to be distinct. To date, no study has attempted to provide links to the various pathways by which such integrins can be involved in these diverse disease settings. The purpose of this review was to address this gap in our knowledge with the hypothesis that there is, in fact, a common pathway by which integrins may function. METHODS: This article provides an in-depth perspective on the discovery, development, and design of therapeutics that modulate cellular function by targeting integrin:ligand interactions by reviewing the literature on this subject; the review included the most recent results of clinical and subclinical studies. A MEDLINE search was conducted for articles pertaining to the various issues related to integrins, and the most relevant articles are discussed (ie, not only those published in journals with a higher impact factor). FINDINGS: It seems that the ligation of the integrins with their cognate ligands plays a major role in translating membrane dialogue into biological function. In addition, they also seem to play a major regulatory role that can enhance or inhibit biological function depending on the context within which such receptor:ligand interactions occur and the organ and tissues at which interactions occurs and is manipulated. Those studies that used statistical analyses have been included where appropriate. IMPLICATIONS: Our findings show that anti-integrin treatment has the potential to become a valid coadjuvant in the treatment of several diseases including cancer, inflammatory diseases, HIv infection and cardiovascular diseases.

22 Review Switching Between Biological Treatments in Psoriatic Arthritis: A Review of the Evidence. 2017

Costa, Luisa / Perricone, Carlo / Chimenti, Maria Sole / Del Puente, Antonio / Caso, Paolo / Peluso, Rosario / Bottiglieri, Paolo / Scarpa, Raffaele / Caso, Francesco. ·Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, via S. Pansini 5, 80131, Naples, Italy. · Rheumatology, Department of Internal Medicine, Sapienza University of Rome, Rome, Italy. · Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", University of Rome "Tor Vergata", Rome, Italy. · Geriatric Unit, Faculty of Medicine and Psychology, S. Andrea Hospital, "Sapienza" University of Rome, Rome, Italy. · Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, via S. Pansini 5, 80131, Naples, Italy. rscarpa@unina.it. ·Drugs R D · Pubmed #29058302.

ABSTRACT: Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy. Therapy with anti-tumor necrosis factor (TNF)-α agents represents the first therapeutic choice for moderate and severe forms; however, PsA patients can experience anti-TNFα failure, lack of efficacy, or adverse events. Several evidences exist on the effectiveness of switching among different TNFα inhibitors, and we reviewed the published data on the effectiveness of anti-TNFα first-, second- and third-line. Most of the studies report that the main reason for switching to a second anti-TNFα agent is represented by lack of efficacy (primary or secondary) and, more rarely, adverse events. Switchers receiving their second anti-TNFα agent have considerably poorer responses compared with non-switchers. Survival of anti-TNFα treatment appears to be superior in PsA patients when compared with rheumatoid arthritis patients. Switching from anti-TNF agents to ustekinumab or secukinumab or apremilast can represent a valid alternative therapeutic strategy.

23 Review New insight into the pathogenesis of nail psoriasis and overview of treatment strategies. 2017

Ventura, Alessandra / Mazzeo, Mauro / Gaziano, Roberta / Galluzzo, Marco / Bianchi, Luca / Campione, Elena. ·Department of Dermatology, University of Rome "Tor Vergata", Rome, Italy. · Department of Experimental Medicine and Surgery, Rome, Italy. ·Drug Des Devel Ther · Pubmed #28919705.

ABSTRACT: Psoriasis is a chronic inflammatory disease affecting up to 3% of the general population. The prevalence of nail involvement in psoriasis patients varies between 15% and 79%. While the nails represent a small portion of the body surface area, psoriasis in these areas can have a disproportionate influence on a patient's physical and psychosocial activities. Differential diagnosis between an onychomycosis and a psoriatic nail could be challenging; nevertheless, coexistence of onychomycosis and nail psoriasis also occurs and both are common disorders in the general population. Nail psoriasis can be difficult to treat. Treatment of nail psoriasis should consider the body surface area of skin disease, psoriatic arthritis, severity of nail disease, and the impairment in the quality of life. All patients should be tested for onychomycosis before starting a therapy. This recommendation is underlined by the fact that nail psoriasis is mostly treated by immunosuppressive drugs, like steroids, methotrexate, or biologics, which may aggravate mycotic nail infections. Conventional systemic therapy, such as use of steroids, cyclosporine, methotrexate, and retinoid in the long term, can cause organ toxicities. Currently, use of apremilast and tofacitinib favors an early healing of nail psoriasis because they act directly on the pathogenic targets, distressing the inflammatory signals associated with the initiation and maintenance of the disease activity, and as with several conventional synthetic disease modifying antirheumatic drugs, they are characterized by the convenience of oral administration. The number of treatment options has increased considerably in recent years; however, given the heterogeneity of the disease, the therapy should be personalized to individual cases.

24 Review Small molecule therapy for managing moderate to severe psoriatic arthritis. 2017

Costa, Luisa / Del Puente, Antonio / Peluso, Rosario / Tasso, Marco / Caso, Paolo / Chimenti, Maria Sole / Sabbatino, Vincenzo / Girolimetto, Nicolò / Benigno, Carolina / Bertolini, Nicoletta / Del Puente, Aurora / Perricone, Roberto / Scarpa, Raffaele / Caso, Francesco. ·a Rheumatology Unit, Department of Clinical Medicine and Surgery , University Federico II , Naples , Italy. · b Geriatric Unit, Faculty of Medicine and Psychology , "Sapienza" University of Rome, S. Andrea, Hospital , Rome , Italy. · c Rheumatology, allergology and clinical immunology, Department of System Medicine , University of Rome Tor Vergata , Rome , Italy. · d Department of Medicine and Surgery , University of Milan "Bicocca" , Naples , Italy. ·Expert Opin Pharmacother · Pubmed #28891341.

ABSTRACT: INTRODUCTION: The majority of psoriatic arthritis (PsA) patients experience a good clinical response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and biologic therapies (bDMARDs). However, treatment failure with these drugs can represent a relevant clinical problem. Moreover, in daily clinical practice, the appropriate identification of patients eligible for these agents can be conditioned by numerous aspects, mainly represented by comorbidities, such as history of malignancies, chronic and recurrent infectious diseases. Areas covered: We searched in the PUBMED database and review published data on the efficacy and safety profile of the small molecules, inhibitor of phosphodiesterase 4, apremilast, and of JAK/STAT pathways, tofacitinib, in PsA. Moreover, we report data on the other JAK inhibitor, baricitinib, and the A(3) adenosine receptors agonist, CF101, emerging by studies conducted in psoriasis patients. Expert opinion: In Psoriatic Arthritis, apremilast appears promising for PsA and recent studies have shown a good efficacy and an acceptable safety profile. Data on tofacitinib in PsA are limited. Studies on the small molecules, baricitinib and CF101 are still incomplete and limited to trials conducted in Rheumatoid Arthritis and in psoriasis. Further studies on small molecules and on their underlining mechanisms are advocated in PsA.

25 Review Risk of Tuberculosis Reactivation in Patients with Rheumatoid Arthritis, Ankylosing Spondylitis, and Psoriatic Arthritis Receiving Non-Anti-TNF-Targeted Biologics. 2017

Cantini, Fabrizio / Nannini, Carlotta / Niccoli, Laura / Petrone, Linda / Ippolito, Giuseppe / Goletti, Delia. ·Department of Rheumatology, Hospital of Prato, Prato, Italy. · Translational Research Unit, Department of Epidemiology and Preclinical Research, National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy. · Scientific Direction, National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy. ·Mediators Inflamm · Pubmed #28659665.

ABSTRACT: Tuberculosis (TB) still represents an important issue for public health in underdeveloped countries, but the use of antitumor necrosis factor agents (anti-TNF) for the treatment of inflammatory rheumatic disorders has reopened the problem also in countries with low TB incidence, due to the increased risk of TB reactivation in subjects with latent tuberculosis infection (LTBI). Over the last 5 years, several non-anti-TNF-targeted biologics have been licensed for the treatment of rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. We reviewed the epidemiology of TB, the role of different cytokines and of the immune system cells involved in the immune response against TB infection, the methods to detect LTBI, and the risk of TB reactivation in patients exposed to non-anti-TNF-targeted biologics. Given the limited role exerted by the cytokines different from TNF, as expected, data from controlled trials, national registries of biologics, and postmarketing surveillance show that the risk of TB reactivation in patients receiving non-anti-TNF-targeted biologics is negligible, hence raising the question whether the screening procedures for LTBI would be necessary.

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