Publications by authors named "Giovanna Malara"

Article Synopsis
  • * Treatment methods for HS include a mix of medical therapies (like antibiotics and biologics) and surgical options, though many patients still experience high rates of recurrence and progression despite these treatments.
  • * A recent meeting of Italian HS experts focused on improving treatment strategies, emphasizing the importance of integrating biologic therapy with surgical options, and identifying ten key areas that need further exploration to optimize patient care.
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  • * A study involving 118 adults with moderate-to-severe AD found that over half experienced sleep issues, severe itching, and frequent flare-ups, affecting their daily functioning.
  • * Many patients reported significant disease impact on their lives, with around 37.3% indicating severe effects from AD, while one in four felt their current treatment was insufficient.
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Dimethyl fumarate (DMF) was recently approved by the European Medicines Agency for systemic treatment of moderateto- severe chronic plaque psoriasis. Appropriate management of DMF treatment is required to achieve optimal clinical benefits. 7 dermatology experts gathered online for 3 meetings to identify consensus on the use of DMF in patient selection, drug dosage/titration, side effects management, and follow-up, with the aim to provide guidance on the use of DMF for psoriasis in clinical dermatological practice based on literature data and expert opinion.

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Psoriasis is a chronic inflammatory disease which affects 29.5 million people worldwide and it can negatively impact quality of life, especially when it affects a special localization, such as nails, face, palms and soles, or intertriginous regions. Risankizumab is a humanized monoclonal antibody which targets the p19 subunit of interleukin-23 and it is currently licensed also as systemic therapy for moderate to severe plaque psoriasis.

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Purpose: Secukinumab is a fully human monoclonal antibody that inhibits interleukin (IL)-17A approved for the treatment of moderate to severe plaque psoriasis in adults and children. We compared the efficacy and safety of secukinumab in patients aged < 65 years (adult patients) versus patients aged ≥ 65 years (elderly patients) in a post-hoc analysis of the SUPREME study.

Patients And Methods: Patients with moderate to severe plaque psoriasis received subcutaneous secukinumab 300 mg per week for the first 5 weeks, then 300 mg per month.

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Article Synopsis
  • Guselkumab is a type of medicine that helps people with a skin condition called plaque psoriasis, especially those who didn't respond well to another treatment called ustekinumab.
  • A study with 233 patients showed that most improved significantly after using guselkumab over 104 weeks, with many experiencing a big reduction in their symptoms.
  • The treatment was safe, and even patients with other health issues had similar positive results as others in the study.
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Purpose: Psoriasis, a common systemic inflammatory disorder, presents with gender-related differences in the quality of life (QoL) and treatment outcomes. This post hoc analysis from the Phase 3b SUPREME study explored gender-related differences in patient characteristics and efficacy of secukinumab 300 mg on Psoriasis Area and Severity Index (PASI) 75/90/100 and impact on QoL using the Dermatology Life Quality Index (DLQI) in patients with moderate to severe psoriasis through week 24.

Patients And Methods: The proportion of patients achieving PASI 75/90/100 was computed using a nonresponder imputation approach.

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  • This study compared the effects of adalimumab originator and its biosimilar in patients with Hidradenitis Suppurativa (HS) across 14 Italian sites.
  • Researchers measured treatment ineffectiveness using the Hurley score and analyzed both non-switchers and switchers between the two medications.
  • Findings indicated that patients taking the biosimilar experienced greater treatment ineffectiveness compared to those on the originator, and switching treatments may increase the risk of ineffectiveness without guaranteeing positive results when switching back.
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  • Psoriasis requires a team approach for effective management, particularly involving dermatologists and rheumatologists for patients with both psoriasis and psoriatic arthritis.* -
  • A group of experts has developed recommendations on when it's essential for these specialists to collaborate, either together or sequentially, based on different healthcare settings.* -
  • The recommendations include organizing a joint care unit for dermatology and rheumatology, outlining a patient journey that can guide future healthcare strategies for diagnosing and treating psoriasis.*
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  • There is a lack of clinical trial data on the use of biologics for treating psoriasis in patients with a history of cancer, prompting this study on secukinumab treatment in such patients.
  • This observational study involved 42 adults with moderate-to-severe psoriasis, showing no tumor recurrence or progression, though three developed unrelated new malignancies during treatment.
  • Results indicated that a significant portion of participants achieved substantial improvements in psoriasis severity and quality of life after 48 weeks, supporting the safety and effectiveness of secukinumab for this patient group.
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Atopic dermatitis (AD) is a common inflammatory skin disease often associated with a significant impairment in the quality of life of affected patients. The Italian Society of Dermatology and Venereology (SIDeMaST) planned a national information campaign, providing direct access to 27 dermatologic centers dedicated to the management of AD. The aim of this study aimed was to outline critical aspects related to AD in the general population.

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Background: The management of paediatric atopic dermatitis (AD) is challenging, mostly relying on emollients and topical corticosteroids. Dupilumab, a fully human monoclonal antibody, has been recently approved for the treatment of children aged 6-11 years with moderate-to-severe AD not adequately controlled with topical therapies or when those therapies are not advisable.

Objectives: The aim of this study was to evaluate in real life the effectiveness and safety of dupilumab in the treatment of children aged from 6 to 11 years.

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This open-label multicentre trial evaluated the efficacy and safety of oral dimethyl fumarate (DMF) in patients with moderate-to-severe plaque psoriasis in real-life clinical practice over 52 weeks. Disease severity and improvement were assessed using the psoriasis area severity index (PASI), body surface area (BSA) affected, and Physician Global Assessment (PGA). Quality of life (QoL) was assessed using the Dermatology Life Quality Index (DLQI) questionnaire.

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Introduction: Psoriasis affects children with a considerable burden in early life. Treating pediatric psoriasis is challenging also because of the lack of updated specific guidelines. With the recent approval of several biologics for pediatric psoriasis and the ongoing COVID-19 pandemic, the management of young psoriatic patients is facing major changes.

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Background: The anti-inflammatory drug, thalidomide, is often administered off-label especially in dermatology patients with diseases refractory to different medications. The drug's mechanism of action is not well understood but clinical evidence suggests an immunomodulatory function. Although this drug is a useful tool for several dermatoses, there are associations between its use and neurotoxic and teratogenic side effects.

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Background: Chronic plaque psoriasis has been associated with metabolic comorbidities, including non-alcoholic fatty liver disease (NAFLD). A causal relationship between NAFLD and chronic kidney disease (CKD) is debated.

Objectives: To assess whether NAFLD is associated with impaired renal function in patients with psoriasis.

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Purpose: For patients with psoriasis, treatment adherence and persistence are fundamental if therapeutic goals are to be met. Patient Support Programs (PSPs) may be used as a support tool to assist patients and health care professionals optimize treatment and improve disease management.

Patients And Methods: In Italy, the PSP PSOLife CARE, which began on the 9th of February 2017 and is ongoing, aimed to support patients with psoriasis under therapy with secukinumab (Cosentyx).

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Introduction: Tildrakizumab is a monoclonal antibody that targets the p19 subunit of IL-23, a crucial cytokine for Th17 cells. Tildrakizumab has been assessed in several Phase I, II, and III clinical trials and is approved for treatment of adults with moderate to severe plaque psoriasis who are indicated for systemic therapy.

Areas Covered: The available evidence on the efficacy, safety, and use of tildrakizumab in special populations was evaluated by 14 experts who critically reviewed the current literature.

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Background: Dimethyl fumarate (DMF) is an oral systemic agent approved for the treatment of moderate-to-severe psoriasis vulgaris. It has a favourable tolerability profile, but it is associated with a high incidence of mild and reversible adverse events. The aim of the article is to describe a clinical experience aimed at increasing tolerability.

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Apremilast is an oral selective phosphodiesterase-4 inhibitor developed recently for psoriasis treatment. The aim of this study is to assess the real-life outcomes of use of apremilast in patients with psoriasis in everyday clinical practice. A total of 159 adult patients (90 males) with plaque psoriasis were included in the study.

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Article Synopsis
  • Guselkumab is a monoclonal antibody approved in the U.S. and EU for treating moderate-to-severe plaque psoriasis in adults, targeting the p19 subunit of interleukin 23.
  • Its efficacy and safety were proven in four Phase III trials, showing significant clinical response over three years, regardless of patient demographics, and effective even after other treatments failed.
  • In addition to treating plaque psoriasis, ongoing clinical development aims to explore its use for other inflammatory diseases, and it continues to demonstrate a favorable safety profile and improved quality of life for patients.
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Introduction: Treat-to-target strategies are used in several chronic diseases to improve outcomes. Treatment goals have also been suggested for psoriasis, but there is currently no consensus on targets, and guidance is needed to implement this strategy in clinical practice. The project 'Treat to Target Italia' was launched by a scientific board (SB) of 10 psoriasis experts to generate expert consensus recommendations.

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Atopic dermatitis is associated with a susceptibility to infection usually by Staphylococcus spp due to a decrease of AMPs and Th2 cytokines (eg, IL-17). We reported a rare E. faecalis skin contamination in AD patients due to a frequent contact with excrement.

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This study evaluated whether secukinumab treatment for patients with moderate to severe plaque psoriasis correlates with improvements in symptoms of anxiety and depression. SUPREME was a 24-week, phase IIIb, multicentre, prospective study conducted across 50 centres in Italy with an extension period of up to 72 weeks. Assessments used were: Psoriasis Area Sever-ity Index (PASI), Hospital Anxiety and Depression Scale (HADS) - Anxiety (HADS-A), and HADS - Depression (HADS-D) scores and Dermatology Quality Life Index (DLQI).

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