Exploring the Therapeutic Landscape: A Narrative Review on Topical and Oral Phosphodiesterase-4 Inhibitors in Dermatology.

Phosphodiesterase-4 (PDE4) is involved in the synthesis of inflammatory cytokines that mediate several chronic inflammatory disorders, including psoriasis and atopic dermatitis. In recent years, the therapeutic armamentarium in dermatology has expanded with the introduction of PDE4 inhibitors, both in oral and topical formulations. PDE4 inhibitors have gained increasing interest due to their remarkable safety record and ease of prescription, as evidenced by the recent influx of literature detailing its off-label uses.

Secukinumab for Treatment of Plaque Psoriasis in Real-World Clinical Practice in Spain: A Literature Review.

: Secukinumab was shown to be effective in treating moderate-to-severe plaque psoriasis in adults and pediatric patients ≥6 years. : A literature review was conducted to identify studies published in the preceding 5 years assessing the effectiveness and/or survival (safety in the second instance) associated with secukinumab treatment for moderate-to-severe plaque psoriasis with/without psoriatic arthritis (PsA) in real-world clinical practice in Spain. : 11 references were included, corresponding to seven studies (six retrospective and one prospective) (n = 1050).

A Narrative Review of the IL-18 and IL-37 Implications in the Pathogenesis of Atopic Dermatitis and Psoriasis: Prospective Treatment Targets.

Atopic dermatitis and psoriasis are prevalent inflammatory skin conditions that significantly impact the quality of life of patients, with diverse treatment options available. Despite advances in understanding their underlying mechanisms, recent research highlights the significance of interleukins IL-18 and IL-37, in Th1, Th2, and Th17 inflammatory responses, closely associated with the pathogenesis of psoriasis and atopic dermatitis. Hence, IL-18 and IL-37 could potentially become therapeutic targets.

Dupilumab treatment in paediatric atopic dermatitis (2-18 years): Spanish multicentre retrospective real-world study.

Background: Moderate-to-severe atopic dermatitis (AD) can be difficult to manage in paediatric patients, and there are few licensed treatments available for this age group. Dupilumab is approved for the treatment of AD in children older than 6 months.

Objectives: To assess the effectiveness and safety of dupilumab in a real-world cohort of paediatric patients with AD in Spain.

International Consensus Definition and Diagnostic Criteria for Generalized Pustular Psoriasis From the International Psoriasis Council.

Importance: Generalized pustular psoriasis (GPP) lacks internationally accepted definitions and diagnostic criteria, impeding timely diagnosis and treatment and hindering cross-regional clinical and epidemiological study comparisons.

Objective: To develop an international consensus definition and diagnostic criteria for GPP using the modified Delphi method.

Evidence Review: The rarity of GPP presents a challenge in acquiring comprehensive published clinical data necessary for developing standardized definition and criteria.

Choosing the right biologic treatment for moderate-to-severe plaque psoriasis: the impact of comorbidities.

Introduction: Psoriasis is a chronic inflammatory skin disease often associated with several comorbidities, such as psoriatic arthritis, inflammatory bowel disease, obesity, diabetes mellitus or cardiovascular diseases, infections, or cancer, among others. With the progressive aging of the population, a growing number of patients with psoriasis can be expected to present multiple comorbidities. Currently, there is a wide range of biological treatments available for moderate to severe psoriasis, including tumor necrosis alpha (TNF) inhibitors, IL12/23 inhibitor, IL17 inhibitors, and IL23 inhibitors.

Plastic waste in major orthopaedic surgical procedures: descriptive and sources of improvement.

Purpose: The healthcare industry is a significant contributor to single-use plastic waste, particularly in the operating room (OR). This study aims to assess the volume of plastic waste generated during total hip, knee, and shoulder arthroplasty in the OR and identify areas for improvement.

Method: A prospective transversal study at a tertiary hospital was conducted.

New and Emerging Oral/Topical Small-Molecule Treatments for Psoriasis.

The introduction of biologic therapies has led to dramatic improvements in the management of moderate-to-severe psoriasis. Even though the efficacy and safety of the newer biologic agents are difficult to match, oral administration is considered an important advantage by many patients. Current research is focused on the development of oral therapies with improved efficacy and safety compared with available alternatives, as exemplified by deucravacitinib, the first oral allosteric Tyk2 inhibitor approved for the treatment of moderate to severe psoriasis in adults.

Brodalumab Versus Guselkumab in Patients with Moderate-to-Severe Psoriasis with an Inadequate Response to Ustekinumab: A Randomized, Multicenter, Double-Blind Phase 4 Trial (COBRA).

Introduction: Despite improved treatment options for plaque psoriasis within the last decades, some patients still have an inadequate response to treatment. Direct clinical evaluation between therapies used after biologic failure could facilitate physicians' choice of treatment.

Methods: COBRA (NCT04533737) was a randomized (1:1), blinded (patient and assessor), 28-week, active-comparator trial conducted in Europe from December 2020 to December 2022.

Multi-Omics Approach to Improved Diagnosis and Treatment of Atopic Dermatitis and Psoriasis.

Psoriasis and atopic dermatitis fall within the category of cutaneous immune-mediated inflammatory diseases (IMIDs). The prevalence of IMIDs is increasing in industrialized societies, influenced by both environmental changes and a genetic predisposition. However, the exact immune factors driving these chronic, progressive diseases are not fully understood.

Genetic and Epigenetic Mechanisms of Psoriasis.

Psoriasis is a disease involving the innate and adaptative components of the immune system, and it is triggered by environmental factors in genetically susceptible individuals. However, its physiopathology is not fully understood yet. Recent technological advances, especially in genome and epigenome-wide studies, have provided a better understanding of the genetic and epigenetic mechanisms to determine the physiopathology of psoriasis and facilitate the development of new drugs.

Durability and long-term outcomes of biologic therapies in psoriasis.

Introduction: Significant advances in psoriasis treatment have taken place since the introduction of biologics. Tumor necrosis factor inhibitors were the first class of biologics approved and at that time greatly improved psoriasis treatment. However, newer biologics, directed to interleukin(IL)-23/IL-17 pathways central to psoriasis pathogenesis, have improved complete or nearly complete clearance rates and are characterized by an excellent safety profile.

Ixekizumab for the treatment of moderate-to-severe plaque psoriasis: the first septennium.

Ixekizumab is a humanized monoclonal antibody that specifically inhibits IL-17A. It has been approved for the treatment of adult and pediatric psoriasis, psoriatic arthritis and axial spondyloarthropathies by the US FDA and the EMA. Phase III trials, analyses and real-life data have reported its efficacy, effectiveness and safety.

Long-term safety and efficacy of risankizumab for the treatment of moderate-to-severe plaque psoriasis: Interim analysis of the LIMMitless open-label extension trial up to 5 years of follow-up.

Background: Psoriasis is a chronic, inflammatory skin disease often requiring long-term therapy.

Objective: To evaluate the long-term safety and efficacy of risankizumab in patients with psoriasis.

Methods: LIMMitless is an ongoing phase 3, open-label extension study evaluating the long-term safety and efficacy of continuous risankizumab 150 mg every 12 weeks for adults with moderate-to-severe plaque psoriasis following multiple phase 2/3 base studies.

Psoriasis: a focus on upcoming oral formulations.

Introduction: Targeted therapies have greatly improved the quality of life of patients with psoriasis. Despite the extensive list of treatments available, multiple new drugs are being developed, especially oral therapies with potential advantages as regards comfort of administration. However, the efficacy and safety of these new oral therapies need to be improved to match those of novel biologics.