Publications by authors named "Clara DE Simone"

Psoriasis is a chronic immune-mediated disease that can be challenging to treat, especially in patients with severe disease or high body weight. Tildrakizumab is a monoclonal antibody which inhibits IL-23, approved for moderate-to-severe psoriasis with a standard 100 mg dose. A 200 mg dose may provide greater efficacy for patients over 90 kg or with high disease burden.

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(1) Background/Objectives: Nail psoriasis (NP) is a chronic and difficult-to-treat disease, which causes significant social stigma and impairs the patients' quality of life. Moreover, nail psoriasis is a true therapeutic challenge for clinicians. The presence of nail psoriasis can be part of a severe form of psoriasis and can have predictive value for the development of psoriatic arthritis.

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Background: Despite advancements in psoriasis treatment, a gap remains in aligning patient satisfaction with clinical outcomes. Our study aimed to evaluate which clinical and psychological factors may impact treatment satisfaction in psoriatic patients undergoing long-term biological therapies.

Methods: We performed an observational, cross-sectional, single-center study involving adult patients with moderate-to-severe psoriasis treated with biologics for at least 12 months.

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Article Synopsis
  • The text discusses cases of skin rashes, specifically eczema, linked to treatments with anti-IL17A and anti-IL17 receptor medications.
  • The patient in the case had previously been on an IL-17A inhibitor for two years without experiencing any eczematous reactions.
  • However, after starting treatment with bimekizumab, which targets both IL-17A and IL-17F, the patient developed skin eruptions.
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Bullous pemphigoid (BP) is an autoimmune bullous disease, typically affecting the elderly, characterized by the production of autoantibodies directed against structural components of the dermal-epidermal junction. An association between BP and psoriasis has been described several times, but the mechanisms underlying this association have yet to be clearly defined. The pathophysiological mechanism underlying psoriasis may be implicated in the pathogenesis of BP, as psoriasis precedes BP in most cases; in particular, a promoting role has been hypothesized by biologic therapies, which may induce a switch from a T helper 1 (T1)/T17-dominant cytokine milieu, typical of patients with psoriasis, to a T2-dominant one, typical of patients with BP.

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Introduction: This was an observational, retrospective, multicenter study, enrolling elderly patients (>65 years old) treated with ixekizumab with a diagnosis of psoriasis (PsO) and/or psoriatic arthritis (PsA) during the period 2020 to 2023.

Objectives: Efficacy of ixekizumab in elderly patients in the treatment of moderate to severe psoriasis.

Methods: We included 73 patients with psoriasis (32.

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Article Synopsis
  • Bullous pemphigoid (BP) is a rare autoimmune skin disorder, becoming more frequent with associations noted with certain diabetes medications called gliptins.
  • A study analyzed 30 idiopathic bullous pemphigoid (IBP) patients and 86 gliptin-associated BP (GABP) patients to explore genetic risk factors.
  • The research found a significant link between the HLA-DQB1*03:01 allele and both IBP and GABP, suggesting genetic markers that could indicate susceptibility to BP, particularly in individuals who have taken gliptins.
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: Psoriatic disease, a chronic immune-mediated systemic inflammatory condition, significantly impairs patients' quality of life. The advent of highly targeted biological therapies has transformed treatment strategies, emphasizing the importance of selecting the most effective and cost-efficient option. Secukinumab, an IL-17A inhibitor, has demonstrated efficacy and safety in treating moderate-to-severe plaque psoriasis (PsO).

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Article Synopsis
  • Novel biologics like tildrakizumab are being assessed for their effectiveness in treating psoriasis in challenging areas, focusing on patients with moderate-to-severe symptoms.
  • A study of 76 patients showed significant improvement in psoriasis severity scores after 16 weeks of treatment, highlighting the drug's potential benefits.
  • The findings suggest that tildrakizumab is effective and safe for managing difficult-to-treat psoriasis and related itching, with quick results.
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Introduction: Night shift work disrupts circadian rhythms and has been associated with immune system alterations and various health conditions. However, there is limited data regarding its impact on psoriasis. The aim of our study was to compare psoriasis severity and the hormonal and immunological profile in patients with a night shift work to those with a daytime occupation.

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Article Synopsis
  • The study assessed the long-term effectiveness of brodalumab in treating patients with moderate-to-severe psoriasis over a three-year period.
  • Out of 90 patients, 31.1% discontinued the treatment, while the drug demonstrated significant reduction in psoriasis severity with median PASI scores remaining low.
  • Factors influencing discontinuation included higher body mass index (BMI), worse baseline PASI scores, and the presence of psoriatic arthritis.
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Background: Alopecia areata (AA) is a non-scarring disorder characterized by hair loss that greatly affects patients' quality of life and has a chronic, recurring course. This disease is marked by an inflammatory process, mainly on an autoimmune basis primarily regulated by Janus kinase (JAK).

Research Design And Methods: We conducted a retrospective study evaluating the safety of JAKi in a real-world setting in 91 AA patients, with a specific focus on the assessment of infectious events.

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Article Synopsis
  • Genital psoriasis affects about 60% of psoriasis patients, presenting challenges in treatment, but IL-17 inhibitors like bimekizumab have shown promise for this difficult condition.
  • A 16-week study on 65 participants revealed that 98.4% achieved clear improvement in genital psoriasis, demonstrating both effective symptom relief and enhanced quality of life.
  • The results indicate bimekizumab could be a beneficial treatment for genital psoriasis, but further research with larger and longer studies is needed to confirm these findings.
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Interleukin-23 inhibitors, such as tildrakizumab, have emerged as safe and effective options for the management of psoriasis. Yet their efficacy in elderly patients (aged 65 years or more), particularly in those with difficult-to-treat areas involvement, remains insufficiently explored. We conducted this real-life retrospective multicentric observational study to assess the effectiveness of tildrakizumab in elderly patients with moderate-to-severe psoriasis, with involvement of difficult-to-treat areas.

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Background: Over the past few decades, advances in medical research and diagnostic tools have shed light on some aspects of pyoderma gangrenosum (PG). Nevertheless, the multifactorial etiology, pathogenesis, and optimal management strategies for PG need to be further investigated. To address these knowledge gaps and contribute to a better understanding of this complex dermatological disorder, we collected epidemiological, clinical, and therapeutic aspects of a case series of PG patients occurring in our department over the past 10 years.

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Introduction: Pustular psoriasis is considered a separate entity from plaque psoriasis and can be categorized as generalized pustular psoriasis (GPP), acrodermatitis continua of Hallopeau, or palmoplantar pustulosis (PPP). Current guidelines mostly include treatment options that have not been specifically developed for the treatment of pustular psoriasis. The majority of them does not have indication for the treatment of pustular psoriasis.

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A nationwide cross-sectional online survey was administered to dermatologists managing patients with moderate-to-severe plaque psoriasis across Italy to obtain real-world dermatologists' perspectives on the impact of psoriasis and its treatment on patients' daily lives and quality of life (QoL). A total of 91 dermatologists (aged 39.1 ± 11.

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Introduction: Patients with psoriasis who have failed multiple biologic drugs have been defined as "multi-failure," although there are no clear data on the characteristics, comorbidities, and best treatment strategies for this population. Nowadays, given the next generation and the number of biologics available, patients are considered multi-failure when ≥4 biologics fail to achieve a good response.

Methods: Demographic characteristics and efficacy of anti-interleukin drugs in multi-failure patients were compared to a cohort of general psoriatic patients treated with IL-23 or IL-17 inhibitors.

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Background: Data on the treatment of palmoplantar psoriasis (PP) are very limited as these patients are often excluded from clinical trials. Moreover, this form of psoriasis is often resistant to treatment, making its clinical management complex.

Methods: Primary endpoint was to evaluate the clinical and demographic characteristics and the drug survival of both biological and non-biological drugs in a population affected by PP.

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Baricitinib is a JAK1-2 inhibitor recently approved in Europe and Japan for the treatment of moderate-to-severe atopic dermatitis in adult patients at doses of 2 and 4 mg daily. The aim of this article is to discuss the safety profile of baricitinib in atopic dermatitis using data from clinical trials and the supporting literature, with a focus on infectious adverse events. An integrated analysis of safety data from eight clinical trials described infections as the most frequent treatment-emergent adverse events, mainly of mild-to-moderate severity, notably upper respiratory tract infections and herpes simplex exacerbations.

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Several comprehensive and updated guidelines are available on the management of psoriasis with systemic treatments. However, there is a lack of updates in recommendations and guidelines on topical treatments, particularly regarding the latest evidence and developments in treatment formulations. Consequently, a comprehensive literature review on this topic, considering the continuous evolution of knowledge and evaluation of the relevance of the available literature evidence, represents a current need to improve the topical management of psoriasis.

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Article Synopsis
  • Bimekizumab, a monoclonal antibody targeting Interleukin-17 A and F, is effective for moderate-to-severe plaque psoriasis, though real-world data is limited.
  • A retrospective study in 19 Italian hospitals assessed 237 patients treated with bimekizumab, measuring psoriasis severity at 4 and 16 weeks based on PASI scores.
  • Results showed significant improvements in skin clearance and quality of life, with 75.4% achieving clear skin by week 16, and side effects were minimal and manageable.
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