Publications by authors named "A Pushpa-Rajah"
Background: Palmoplantar pustulosis (PPP) is a rare, debilitating, chronic inflammatory skin disease that affects the hands and feet. Clinical, immunological and genetic findings suggest a pathogenic role for interleukin (IL)-1.
Objectives: To determine whether anakinra (an IL-1 receptor antagonist) delivers therapeutic benefit in PPP.
Article Synopsis
- Variation in response to biologic therapy for inflammatory diseases, like psoriasis, is influenced by how much of the drug reaches the patient (drug exposure).
- Real-world data from a study with 491 patients receiving ustekinumab was analyzed to create a pharmacokinetic/pharmacodynamic (PK/PD) model, looking at different dosing strategies.
- The study identified a group of potential nonresponders and suggested that the model could be used in the future to personalize drug dosing through a monitoring system, aiming to enhance treatment effectiveness.
Importance: High-cost biologic therapies have transformed the management of immune-mediated inflammatory diseases. To optimize outcomes and reduce costs, dose adjustment informed by measurement of circulating drug levels has been shown to be effective in various settings. However, limited evidence exists for this approach with the interleukin 12 and interleukin 23 inhibitor ustekinumab.
View Article and Find Full Text PDFBiologics have transformed management of inflammatory diseases. To optimize outcomes and reduce costs, dose adjustment informed by circulating drug levels has been proposed. We aimed to determine the real-world clinical utility of therapeutic drug monitoring in psoriasis.
View Article and Find Full Text PDFObjective: To determine the effectiveness of a model osteoarthritis consultation, compared with usual care, on physical function and uptake of National Institute for Health and Care Excellence (NICE) osteoarthritis recommendations, in adults ≥45 years consulting with peripheral joint pain in UK general practice.
Method: Two-arm cluster-randomised controlled trial with baseline health survey. Eight general practices in England.