Publications by authors named "Zenas Z N Yiu"
Background: The current management of psoriasis does not differentiate between young and old patients in selecting the safest and/or most effective biologic.
Objectives: To explore the effect of age at treatment initiation in response to biologics in patients with moderate-to-severe psoriasis in the UK and Eire.
Methods: Data from patients registering to the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR) from 2007-2024 on first course of Tumour Necrosis Factor (TNF), interleukin (IL) 12/13, IL-17 and IL-23 inhibitors (i) with at least 6 months' follow-up were included.
Background: The lack of evidence under routine clinical settings limited the widespread adoption of adalimumab biosimilars for psoriasis treatment.
Objective: This study compared the drug survival and safety of adalimumab biosimilars to Humira for psoriasis treatment.
Methods: We conducted a prevalent new-user cohort study using data from the French National Health Data System (SNDS), the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR), and the Spanish Registry of Systemic Therapy in Psoriasis (BIOBADADERM).
Article Synopsis
- The study compares the real-world effectiveness and safety of three treatments for atopic dermatitis: dupilumab, ciclosporin (CyA), and methotrexate (MTX), using data from the A-STAR register in the UK and Ireland.
- It involved 488 patients (adults and children) and measured treatment outcomes like the Eczema Area and Severity Index (EASI) and quality of life scales over 12 months.
- Results showed that dupilumab and CyA led to faster improvements in skin severity scores and overall patient outcomes compared to MTX, indicating dupilumab is an effective option in managing atopic dermatitis.
Article Synopsis
- - The study evaluates the efficacy and safety of the new biologic medication lebrikizumab for treating atopic dermatitis in comparison to other systemic treatments, using a systematic network meta-analysis of clinical trials.
- - Data was gathered from various medical databases, focusing on trials that assessed treatment effects for at least 8 weeks in patients with moderate to severe atopic dermatitis, with analysis conducted using random-effects Bayesian methods.
- - Key outcomes measured include the improvement in eczema severity (using scales like EASI and POEM), safety indicators such as serious adverse events, and the ability of participants to achieve significant improvements in their condition.
Genetically proxied IL-6 receptor inhibition is associated with increased risk of atopic dermatitis.
J Allergy Clin Immunol
September 2024
Background: Dermatitis has been reported after initiation of IL-6 receptor (IL-6R) inhibitors (IL-6Ri), while genetic association studies of atopic dermatitis (AD) have implicated IL-6R pathway signaling. However, causality remains unclear. As the indications for IL-6Ri expand, so do the clinical importance of determining whether there is mechanistic evidence linking it to AD.
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- Atopic dermatitis is a chronic skin condition, commonly seen in children, characterized by dry, itchy, and inflamed skin, often appearing before age 5 but can develop at any time.
- The study evaluates the clinical effectiveness and cost-effectiveness of three newer treatments—abrocitinib, tralokinumab, and upadacitinib—compared to traditional treatments like ciclosporin A and dupilumab for moderate-to-severe atopic dermatitis.
- A systematic review and network meta-analysis were conducted to analyze various treatment pathways and their outcomes, ultimately informing a new economic model for the NHS in England regarding treatment costs and effectiveness.
Importance: Biologics used for plaque psoriasis have been reported to be associated with an atopic dermatitis (AD) phenotype, or paradoxical eczema, in some patients. The risk factors for this are unknown.
Objective: To explore risk of paradoxical eczema by biologic class and identify factors associated with paradoxical eczema.
Article Synopsis
- The study investigates biologic therapy survival in patients with moderate-to-severe psoriasis, focusing on the impact of age at onset and HLA-C*06:02 status on treatment outcomes.
- Data from the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR) and the Biomarkers and Stratification To Optimize outcomes in Psoriasis (BSTOP) were analyzed to assess treatment effectiveness and safety.
- Findings reveal differences in biologic survival rates related to the patient's age at psoriasis onset and their HLA-C*06:02 genetic status, leading to insights that may inform individualized treatment approaches.
Objectives: Cardiovascular risk prediction tools developed for the general population often underperform for individuals with rheumatoid arthritis (RA), and their predictive accuracy are unclear for other inflammatory conditions that also have increased cardiovascular risk. We investigated performance of QRISK-3, Framingham Risk Score (FRS) and Reynolds Risk Score (RRS) in RA, psoriatic disease (psoriatic arthritis (PsA) and psoriasis) and ankylosing spondylitis (AS). We considered osteoarthritis as a non-inflammatory comparator.
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- A systematic review and network meta-analysis evaluated the efficacy of systemic treatments for atopic dermatitis, focusing on binary outcomes from randomized trials that lasted at least 8 weeks.
- The analysis included 83 trials with over 22,000 participants, comparing treatments based on their success rates in improving symptoms as measured by the Eczema Area and Severity Index (EASI) and Investigator Global Assessment (IGA).
- Results indicated that abrocitinib and upadacitinib had higher odds of achieving significant symptom improvement compared to dupilumab, while other treatments like baricitinib and tralokinumab showed lower odds of success.
Background: The risks of serious infections that lead to hospitalization and mortality in patients with psoriasis in Asia have not been comprehensively studied.
Objectives: We examined the incidence of serious infection and infection mortality in patients with psoriasis.
Methods: This population-based retrospective cohort study used the Taiwan National Health Insurance claims database from 2000 to 2017.
Article Synopsis
- Psoriasis is a long-lasting skin condition, and adalimumab is a treatment that used to be very expensive, but now cheaper versions called biosimilars are available after the original product's patent ran out.
- This study aims to compare how well the biosimilars work and how safe they are compared to the original adalimumab by looking at real patient data from different countries.
- The researchers will share their findings in scientific journals and at dermatology conferences by the end of 2023, following ethical guidelines.
Article Synopsis
- Recent clinical practice guidelines (CPGs) for managing urticaria were reviewed to assess their quality and identify gaps in treatment recommendations for chronic spontaneous urticaria.
- A total of 21 CPGs were analyzed, primarily from European and Asian countries, revealing that 81% scored poorly in critical appraisal domains such as applicability and stakeholder involvement.
- Most guidelines displayed potential biases, with 86% raising serious concerns about the involvement of experts and external review, and 95% failing to meet established trustworthiness standards in areas like updating procedures.
Article Synopsis
- Biosimilars can potentially lower costs for treating moderate-to-severe psoriasis, but their effectiveness and safety for this condition remain uncertain since they are often approved based on data from other diseases.
- The objective of the review was to analyze and compare the efficacy and safety of biosimilars versus their originator biologics specifically for psoriasis treatment.
- The review included 14 trials and 3 cohort studies, finding no significant differences in treatment outcomes or adverse events between biosimilars and originators, though some studies indicated a higher risk of adverse events in patients who switched to biosimilars.
Article Synopsis
- - This study investigates the real-world effectiveness and survival of methotrexate (MTX) and adalimumab (ADA) for treating moderate-to-severe psoriasis using data from the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR) involving 6,575 patients.
- - Results show that a significantly higher percentage of patients treated with ADA (77.4%) achieved an effective psoriasis score compared to those treated with MTX (37.4%), indicating that ADA is more effective than MTX.
- - Additionally, patients receiving MTX had a lower survival rate related to treatment ineffectiveness or adverse events at both 6 months and 1 year compared to those on ADA,
Uptake of tumour necrosis factor-alpha inhibitor biosimilars for psoriasis: a drug utilization study from the British Association of Dermatologists Biologic and Immunomodulators Register (BADBIR).
Br J Dermatol
July 2023
Article Synopsis
- - The research focuses on the uptake of Tumour necrosis factor-alpha inhibitors (TNFi) biosimilars for treating moderate-to-severe psoriasis in the UK and Ireland after the original biologics' patents expired, allowing for cheaper alternatives to become available.
- - Using data from the BADBIR registry, the study tracked the trend of patients switching from originator drugs (infliximab, etanercept, adalimumab) to biosimilars over time, and assessed factors influencing this switching and the initiation of biosimilars.
- - The results indicated that after three years, the switching rates to biosimilars varied notably, with a cumulative incidence reaching up to 66.6% for adalimumab and