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15 pages, 2167 KiB

Open AccessArticle

Disease Control and Treatment Satisfaction in Patients with Chronic Spontaneous Urticaria in Japan

by Atsushi Fukunaga, Yuko Kishi, Kazuhiko Arima and Hiroyuki Fujita

J. Clin. Med. 2024, 13(10), 2967; https://doi.org/10.3390/jcm13102967 - 17 May 2024

Viewed by 533

Abstract

Background: Chronic spontaneous urticaria (CSU), characterized by the recurrence of pruritic hives and/or angioedema for >6 weeks with no identifiable trigger, has a negative impact on health-related quality of life (HRQoL). Methods: The objective of this web-based cross-sectional study was to evaluate disease [...] Read more.

Background: Chronic spontaneous urticaria (CSU), characterized by the recurrence of pruritic hives and/or angioedema for >6 weeks with no identifiable trigger, has a negative impact on health-related quality of life (HRQoL). Methods: The objective of this web-based cross-sectional study was to evaluate disease control, disease burden, and treatment satisfaction in Japanese adults with CSU using the Urticaria Control Test (UCT), HRQoL outcomes, and the Treatment Satisfaction Questionnaire for Medication–9 items (TSQM-9). Results: In total, 529 adults were included in the analysis (59.9% female), with a mean ± standard deviation (SD) in CSU duration of 13.2 ± 13.0 years. Based on UCT scores, two-thirds of patients had poor (score of 0–7; 23.6%) or insufficient (score of 8–11; 43.3%) symptom control, and one-third had good control (score of 12–16; 33.1%). Overall treatment satisfaction was not high, with mean ± SD TSQM-9 scores of 55.5 ± 17.6% for effectiveness, 68.2 ± 18.8% for convenience, and 59.2 ± 18.4% for global satisfaction. No apparent differences in TSQM-9 scores were observed between patients receiving different medications. HRQoL outcomes were worse among patients with poor/insufficient symptom control. Conclusions: Japanese adults with CSU have a high disease burden, and better treatment options are needed to increase treatment satisfaction. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician—Part II)

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13 pages, 915 KiB

Open AccessArticle

Prevalence and Characteristics of Itch and Pain in Patients Suffering from Chronic Hand Eczema

by Adam Zalewski, Piotr K. Krajewski and Jacek C. Szepietowski

J. Clin. Med. 2023, 12(13), 4198; https://doi.org/10.3390/jcm12134198 - 21 Jun 2023

Cited by 4 | Viewed by 1560

Abstract

Background: Hand eczema (HE) is a frequent chronic inflammatory dermatosis. Itch and pain are considered two of the most common and burdensome symptoms of the disease. Yet, the data related to these symptoms are still limited. The aim of this study was to [...] Read more.

Background: Hand eczema (HE) is a frequent chronic inflammatory dermatosis. Itch and pain are considered two of the most common and burdensome symptoms of the disease. Yet, the data related to these symptoms are still limited. The aim of this study was to evaluate characteristics of itch and pain in adults suffering from HE. Methods: The study group comprised 100 adult HE patients. An original questionnaire designed by the authors was used to survey the patients. It included questions regarding demographic characteristics such as the duration of the disease, exacerbation count, past diagnostics and treatment, as well as atopic predispositions. Additionally, the itch and pain intensity (numerical rating scale—NRS) during ‘3 days prior to the study’ and the ‘entire disease’ period was implemented. The clinical assessment of the disease severity was performed according to two specific measurement instruments: Investigator Global Assessment for Chronic Hand Eczema (IGA-CHE) scale and Hand Eczema Severity Index (HECSI). To assess patient quality of life (QoL), the DLQI tool was used and to determine the level of stigmatization and for its impact on patients’ life the 6-Item Stigmatization Scale (6-ISS) was employed. Results: Within the period of 3 days prior to the examination, itch was reported by 81.0% of patients (n = 81), whereas 53.0% (n = 53) of them experienced pain. Both symptoms were reported more frequently in females (itch: p = 0.022; pain: p = 0.033). When sexes were compared, females reached higher scores in both IGA-CHE and HECSI. Itch and pain intensity correlated positively with disease severity. The intensity of itch and pain significantly influences HE patients’ QoL. A positive correlation between the 6-ISS score and the intensity of itch in the ‘last 3 days’ period was revealed (r = 0.221; p = 0.027). Conclusions: Itch and pain are common symptoms in HE patients, significantly contributing to the feeling of stigmatization. Providing characteristics of itch and pain may improve HE management. Symptom-decreasing treatment would definitely have a positive influence on patients’ well-being. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician—Part II)

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15 pages, 1074 KiB

Open AccessArticle

Assessment of Frontal Hemispherical Lateralization in Plaque Psoriasis and Atopic Dermatitis

by Szabolcs Bozsányi, Natália Czurkó, Melinda Becske, Roland Kasek, Botond Keve Lázár, Mehdi Boostani, Fanni Adél Meznerics, Klára Farkas, Noémi Nóra Varga, Lili Gulyás, András Bánvölgyi, Bence Ágoston Fehér, Emese Fejes, Kende Lőrincz, Anikó Kovács, Hunor Gergely, Szabolcs Takács, Péter Holló, Norbert Kiss, Norbert Wikonkál and Imre Lázár Show full author list Hide full author list

J. Clin. Med. 2023, 12(13), 4194; https://doi.org/10.3390/jcm12134194 - 21 Jun 2023

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Abstract

Background: Each brain hemisphere plays a specialized role in cognitive and behavioral processes, known as hemispheric lateralization. In chronic skin diseases, such as plaque psoriasis (Pso) and atopic dermatitis (AD), the degree of lateralization between the frontal hemispheres may provide insight into specific [...] Read more.

Background: Each brain hemisphere plays a specialized role in cognitive and behavioral processes, known as hemispheric lateralization. In chronic skin diseases, such as plaque psoriasis (Pso) and atopic dermatitis (AD), the degree of lateralization between the frontal hemispheres may provide insight into specific connections between skin diseases and the psyche. This study aims to analyze the hemispherical lateralization, neurovegetative responses, and psychometric characteristics of patients with Pso and AD. Methods: The study included 46 patients with Pso, 56 patients with AD, and 29 healthy control (Ctrl) subjects. The participants underwent frontal electroencephalogram (EEG) measurement, heart rate variability (HRV) assessment, and psychological tests. Statistical analyses were performed using ANOVA, with Bonferroni correction applied for multiple comparisons. Results: This study shows a significant right-lateralized prefrontal activity in both AD patients (p < 0.001) and Pso patients (p = 0.045) compared with Ctrl, with no significant difference between the AD and Pso groups (p = 0.633). AD patients with right-hemispheric dominant prefrontal activation exhibited increased inhibition and avoidance markers, while Pso patients showed elevated sympathetic nervous system activity. Conclusion: Psychophysiological and psychometric data suggest a shared prevalence of right-hemispheric dominance in both AD and Pso patient groups. However, the findings indicate distinct psychodermatological mechanisms in AD and Pso. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician—Part II)

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15 pages, 1023 KiB

Open AccessArticle

Brodalumab for the Treatment of Moderate-to-Severe Psoriasis: An Expert Delphi Consensus Statement

by Maria Concetta Fargnoli, Federico Bardazzi, Luca Bianchi, Paolo Dapavo, Gabriella Fabbrocini, Paolo Gisondi, Giuseppe Micali, Anna Maria Offidani, Giovanni Pellacani, Nevena Skroza, Rosa Giuseppa Angileri, Martina Burlando, Anna Campanati, Carlo Giovanni Carrera, Andrea Chiricozzi, Andrea Conti, Clara De Simone, Vito Di Lernia, Enzo Errichetti, Marco Galluzzo, Claudio Guarneri, Claudia Lasagni, Serena Lembo, Francesco Loconsole, Matteo Megna, Maria Letizia Musumeci, Francesca Prignano, Antonio Giovanni Richetta, Emanuele Trovato, Marina Venturini, Ketty Peris and Piergiacomo Calzavara Pinton Show full author list Hide full author list

J. Clin. Med. 2023, 12(10), 3545; https://doi.org/10.3390/jcm12103545 - 18 May 2023

Cited by 3 | Viewed by 2027

Abstract

Brodalumab is a recombinant, fully human immunoglobulin IgG2 monoclonal antibody specifically targeted against interleukin-17RA that has been approved for the treatment of moderate-to-severe psoriasis in Europe. We developed a Delphi consensus document focused on brodalumab for the treatment of moderate-to-severe psoriasis. Based on [...] Read more.

Brodalumab is a recombinant, fully human immunoglobulin IgG2 monoclonal antibody specifically targeted against interleukin-17RA that has been approved for the treatment of moderate-to-severe psoriasis in Europe. We developed a Delphi consensus document focused on brodalumab for the treatment of moderate-to-severe psoriasis. Based on published literature and their clinical experience a steering committee drafted 17 statements covering 7 domains specific to the treatment of moderate-to-severe psoriasis with brodalumab. A panel of 32 Italian dermatologists indicated their level of agreement using a 5-point Likert scale (from 1 = “strongly disagree” to 5 = “strongly agree”) using an online modified Delphi method. After the first round of voting (32 participants), positive consensus was reached for 15/17 (88.2%) of the proposed statements. Following a face-to-face virtual meeting, the steering committee decided that 5 statements would form “main principles” and 10 statements formed the final list. After a second round of voting, consensus was reached in 4/5 (80%) of the main principles and 8/10 (80%) for consensus statements. The final list of 5 main principles and 10 consensus statements identify key indications specific to the use of brodalumab in the treatment of moderate-to-severe psoriasis in Italy. These statements aid dermatologists in the management of patients with moderate-to-severe psoriasis. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician—Part II)

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10 pages, 1320 KiB

Open AccessArticle

Long-Term Efficacy and Safety of Risankizumab for Moderate to Severe Psoriasis: A 2-Year Real-Life Retrospective Study

by Matteo Megna, Angelo Ruggiero, Teresa Battista, Laura Marano, Sara Cacciapuoti and Luca Potestio

J. Clin. Med. 2023, 12(9), 3233; https://doi.org/10.3390/jcm12093233 - 30 Apr 2023

Cited by 22 | Viewed by 1834

Abstract

Risankizumab is a humanized IgG monoclonal antibody inhibitor of IL23 and has been recently approved by the EMA and the FDA for the treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy. Its efficacy and safety have [...] Read more.

Risankizumab is a humanized IgG monoclonal antibody inhibitor of IL23 and has been recently approved by the EMA and the FDA for the treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy. Its efficacy and safety have been reported by clinical trials and real-life studies. However, even if long-term data from trials have already been reported (up to 172 weeks), data on long-term real-life experiences are still limited. The aim of our study was to investigate the long-term (2 years) efficacy and safety of risankizumab for psoriasis management in a real-life setting. A monocentric retrospective study was performed, enrolling 168 patients affected by moderate to severe psoriasis who were undergoing treatment with risankizumab. Psoriasis severity and safety outcomes were evaluated at each follow-up visit (week 16, week 28, week 52, week 88, week 104). A statistically significant reduction of psoriasis severity scores was reported from week 16 and was maintained up to week 104. Moreover, interesting results in terms of safety have been collected, without any serious adverse events registered. Our long-term real-life monocentric retrospective study confirmed the efficacy and safety of risankizumab up to 104 weeks of treatment. However, further studies are required to confirm our results and to increase available data to establish the best evidence-based biologic selection algorithm. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician—Part II)

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10 pages, 809 KiB

Open AccessEditor’s ChoiceArticle

The Eosinophil-to-Lymphocyte Ratio Acts as an Indicator for Improvement of Clinical Signs and Itch by Upadacitinib Treatment in Atopic Dermatitis

by Teppei Hagino, Hidehisa Saeki, Eita Fujimoto and Naoko Kanda

J. Clin. Med. 2023, 12(6), 2201; https://doi.org/10.3390/jcm12062201 - 12 Mar 2023

Cited by 11 | Viewed by 2070

Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin disease with severe itch. The eosinophil-to-lymphocyte ratio (ELR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) are reported to reflect itch or the severity of AD. We examined if these parameters may act [...] Read more.

Atopic dermatitis (AD) is a chronic inflammatory skin disease with severe itch. The eosinophil-to-lymphocyte ratio (ELR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) are reported to reflect itch or the severity of AD. We examined if these parameters may act as indicators for therapeutic effects of the Janus kinase 1 inhibitor upadacitinib for patients with AD in real-world clinical practice. Between August 2021 and September 2023, 65 Japanese patients (aged ≥ 12 years) with moderate to severe AD were treated with 15 mg/day of oral upadacitinib, plus twice daily topical corticosteroids. Before treatment, the baseline ELR, NLR, MLR, and PLR levels positively correlated with the eczema area and severity index (EASI), while the baseline NLR and PLR levels positively correlated with the peak pruritus-numerical rating scale (PP-NRS). After upadacitinib treatment, ELR and NLR remarkably decreased at week 4 and the reduced levels were maintained until week 24, in parallel with EASI and PP-NRS, while MLR and PLR transiently reduced at week 4, but returned to baseline levels after week 12. The percent reduction of ELR significantly correlated with the percent reductions of EASI and PP-NRS at weeks 4, 12, and 24 of upadacitinib treatment. ELR may act as an indicator for the improvement of clinical signs and itch by upadacitinib treatment in AD. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician—Part II)

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12 pages, 733 KiB

Open AccessArticle

Effects of Biologic Therapy on Laboratory Indicators of Cardiometabolic Diseases in Patients with Psoriasis

by Teppei Hagino, Hidehisa Saeki, Eita Fujimoto and Naoko Kanda

J. Clin. Med. 2023, 12(5), 1934; https://doi.org/10.3390/jcm12051934 - 1 Mar 2023

Cited by 7 | Viewed by 1843

Abstract

Psoriasis is associated with cardiometabolic and cardiovascular diseases. Biologic therapy targeting tumor necrosis factor (TNF)-α, interleukin (IL)-23, and IL-17 may improve not only psoriasis but also cardiometabolic diseases. We retrospectively evaluated whether biologic therapy improved various indicators of cardiometabolic disease. Between January 2010 [...] Read more.

Psoriasis is associated with cardiometabolic and cardiovascular diseases. Biologic therapy targeting tumor necrosis factor (TNF)-α, interleukin (IL)-23, and IL-17 may improve not only psoriasis but also cardiometabolic diseases. We retrospectively evaluated whether biologic therapy improved various indicators of cardiometabolic disease. Between January 2010 and September 2022, 165 patients with psoriasis were treated with biologics targeting TNF-α, IL-17, or IL-23. The patients’ body mass index; serum levels of HbA1c, total cholesterol, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol, triglyceride (TG), and uric acid (UA); and systolic and diastolic blood pressures were recorded at weeks 0, 12, and 52 of the treatment. Baseline psoriasis area and severity index (week 0) positively correlated with TG and UA levels but negatively correlated with HDL-C levels, which increased at week 12 of IFX treatment compared to those at week 0. UA levels decreased at week 12 after ADA treatment compared with week 0. HDL-C levels decreased 52 weeks after IXE treatment. In patients treated with TNF-α inhibitors, HDL-C levels increased at week 12, and UA levels decreased at week 52, compared to week 0. Thus, the results at two different time points (at weeks 12 and 52) were inconsistent. However, the results still indicated that TNF-α inhibitors may improve hyperuricemia and dyslipidemia. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician—Part II)

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Review

Jump to: Research

18 pages, 803 KiB

Open AccessReview

The Use of JAK/STAT Inhibitors in Chronic Inflammatory Disorders

by Giuseppina Caiazzo, Anna Caiazzo, Maddalena Napolitano, Matteo Megna, Luca Potestio, Luigi Fornaro, Melania Parisi, Maria Antonietta Luciano, Angelo Ruggiero, Anna Testa, Fabiana Castiglione, Cataldo Patruno, Maria Quaranta and Gabriella Fabbrocini

J. Clin. Med. 2023, 12(8), 2865; https://doi.org/10.3390/jcm12082865 - 14 Apr 2023

Cited by 9 | Viewed by 2551

Abstract

The Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway plays a critical role in orchestrating immune and inflammatory responses, and it is essential for a wide range of cellular processes, including differentiation, cell growth, and apoptosis. Over the years, this pathway [...] Read more.

The Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway plays a critical role in orchestrating immune and inflammatory responses, and it is essential for a wide range of cellular processes, including differentiation, cell growth, and apoptosis. Over the years, this pathway has been heavily investigated due to its key role in the pathogeneses of several chronic inflammatory conditions, e.g., psoriasis, atopic dermatitis (AD), and inflammatory bowel diseases (IBDs). Nevertheless, the impact of this pathway on the pathogenesis of inflammatory conditions remains unclear. This review describes the role of the JAK/STAT signaling pathway in the pathogenesis of inflammatory diseases such as psoriasis (Pso), psoriatic arthritis (PsA), AD, and IBD with a focus on ulcerative colitis (UC) and briefly resumes the use of JAK inhibitors in their clinical management. Full article

(This article belongs to the Special Issue Chronic Inflammatory Skin Diseases: An Update for Clinician—Part II)

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