tbuckley/cabot-search huggingface dataset:
P01 The efficacy of biological agents in the management of psoriasis in South Korea: a single centre study
Journal: British Journal of Dermatology (2024)

Abstract Biological agents (BAs) are increasingly becoming the primary treatment for psoriasis, with several BAs currently in use. Each agent operates with slight variations in mechanism and efficacy. The BAs utilized in our clinic include risankizumab (RM), secukinumab (SM), guselkumab (GM) and ustekinumab (UM). This study presents our findings from 12 weeks to 18 months of biologic treatment administered to psoriasis patients. The objective of this study was to determine which BA exhibits effectiveness and stability over an extended period, particularly in treating plaque psoriasis. From January 2018 to October 2023, we investigated a total of 163 cases of patients (RM 43 cases, SM 50 cases, GM 42 cases and UM 28 cases) who were treated with BAs over 18 months. Psoriasis area and severity index (PASI) scores were assessed at five intervals: initially, at 12–16 weeks post-initial BA administration, and then at 6/12/18 months. We analysed the PASI 100 rate (complete remission rate), the rate of switching to another BA, and the PASI 75/90/100 response rates according to the specific biologic agent. Our findings indicate that the PASI 75 ratio, commonly considered a treatment goal in psoriasis management, was largely achieved in patients treated with RM, SM, and GM, suggesting similar treatment effectiveness among these agents. However, the PASI 100 rate was notably higher in RM and GM compared with the other two BAs. UM exhibited the lowest PASI 100 rate and the highest rate of switching. Incorporating data from previous studies alongside our own, it is suggested that selectively blocking interleukin-23 (IL-23) via the inhibition of the p19 subunit rather than p40 leads to a more comprehensive inhibition of IL-23 activity.
Shared Mechanisms in Cancer and Cardiovascular Disease: S100A8/9 and the NLRP3 Inflammasome
Authors: Sophie Van Linthout
Journal: JACC CardioOncology (2024)

Inflammation and a dysregulated immune system are common denominators in cancer and cardiovascular disease (CVD). The Canakinumab Anti-Inflammatory Thrombosis Outcome Study (CANTOS) highlighted the convergence of interleukin (IL)-1β biology in cancer and CVD, and the potential of anti-IL-1β drugs for the treatment of both disease entities. Accumulating evidence further supports the role of the innate immunity members and IL-1β activators, S100A8/9 and the NLRP3 inflammasome, in both cancer and CVD. This review outlines the common involvement of S100A8/9 and the NLRP3 inflammasome, in cancer and CVD. Specifically, their time-, cell-, and context-dependent actions and hereto-related dichotomous role in different cancers and CVD are addressed, highlighting the need for further insights to allow tailored therapies.
2024 ACC Expert Consensus Decision Pathway on Strategies and Criteria for the Diagnosis and Management of Myocarditis
Authors: Mark H. Drazner, Biykem Bozkurt, Leslie T. Cooper, Niti R. Aggarwal, Cristina Basso, Nicole M. Bhave, Alida L.P. Caforio, Vanessa M. Ferreira, Bettina Heidecker, Amy R. Kontorovich, Pilar Martín, Gregory A. Roth, Jennifer E. Van Eyk
Journal: Journal of the American College of Cardiology (2024)
Cardiovascular Safety in Oncology Clinical Trials
Authors: Marc P Bonaca, Ninian N Lang, Alice Chen, Laleh Amiri-Kordestani, Leslie Lipka, Michal Zwiewka, Colette Strnadova, Sigrid Klaar, Susan Dent, Tijana Krnjeta Janicijevic, Joerg Herrmann, Ana Barac, Rudolf A de Boer, Anita Deswal, Morten Schou, Tomas G Neilan, Peter van der Meer, Javid Moslehi, Lavanya Kondapalli, Bonnie Ky, Teresa Lopez Fernandez, R Frank Cornell, Thomas W Flaig, Judith Hsia, Elad Sharon, Evandro de Azambuja, Jonathan Seltzer, James L Januzzi, Mark C Petrie
Journal: JACC CardioOncology (2024)

The development of novel treatments has improved cancer outcomes but may result in cardiovascular toxicities. Traditional approaches to clinical trial safety evaluation have limitations in their ability to detect signals of cardiovascular risk. Mechanisms to increase power and specificity to clarify cardiovascular safety are required. However, implications include increased costs and slower development. The Cardiovascular Safety Research Consortium facilitated stakeholder discussions with representation from academia, industry, and regulators. A think tank was assembled with the aim of providing recommendations for improved collection and reporting of cardiovascular safety signals in oncology trials. Two working groups were formed. The first focuses on incorporation of consensus definitions of cardiovascular disease into the Common Terminology Criteria for Adverse Events used in oncology trial reporting. The second group considers methods for ascertainment and adjudication of cardiovascular events in cancer trials. The overarching aim of this primer is to improve understanding of the potential cardiovascular toxicities of cancer therapies.
P83 Baseline characteristics of the BeNeBio cohort: dose reduction of the new generation biologics (IL-17 and IL-23 inhibitors) in psoriasis: a pragmatic, multicentre, randomized, controlled, non-inferiority study
Journal: British Journal of Dermatology (2024)

Abstract Biologics for psoriasis are highly effective but expensive. Dose reduction (DR) of the first-generation biologics has proven to be safe and (cost-)effective. However, data on DR of the newest biologics is scarce. This pragmatic non-inferiority study evaluates whether controlled DR of IL-17 and IL-23 inhibitors in psoriasis patients with low disease activity is non-inferior to usual care (UC). A total of 244 patients, receiving UC of IL-17/IL-23 inhibitors with psoriasis area and severity index (PASI) ≤5 for at least 6 months, and PASI and Dermatology Life Quality Index (DLQI) ≤5 at inclusion, were randomized 2:1 to DR (interval prolongation to 66 and 50% of UC) or UC. Outcomes: difference in cumulative incidence of persistent flares (PASI &amp;gt;5 for ≥3 months: primary) and proportion of patients with successful DR, course of PASI and DLQI, safety, costs, and pharmacokinetic profile (secondary). Two hundred and forty-four patients (100%) were included: 14% used secukinumab, 25% ixekizumab, 6% brodalumab, 1% bimekizumab, 30% guselkumab, 21% risankizumab and 3% tildrakizumab. The mean age was 51 years, mean body mass index (BMI) 27.5, 67% was male, 14% had concomitant psoriatic arthritis, median disease duration was 21 years [interquartile range (IQR) 20], 47% was biologic naive, and median psoriasis area and severity index (PASI) and DLQI were 0.0 (IQR 1.1 and 1.0, respectively). The baseline characteristics highlight a very low PASI and DLQI (both median 0) at inclusion while the threshold was PASI and DLQI ≤5, a relatively low mean BMI compared with general biologic cohorts, and a well-balanced proportion of biologic naivety vs. non-naivety.
P104 Bimekizumab treatment goals and satisfaction among patients with psoriasis in Europe: a real-world survey
Journal: British Journal of Dermatology (2024)

Abstract Bimekizumab (BKZ) is an IL-17A and IL-17F dual inhibitor biologic treatment approved by the European Medicines Agency for therapeutic use in patients with moderate-severe plaque psoriasis (PsO). While randomized clinical trials have established its efficacy and safety, real-world data on physician/patient treatment goals and satisfaction with BKZ in PsO management are scarce. We aimed to explore real-world expectations and satisfaction with BKZ among dermatologists and patients with PsO. Data were drawn from the Adelphi Real World PsO Disease Specific Programme™, a cross-sectional survey with elements of retrospective data collection of dermatologists and their consulting patients with PsO in France, Germany, Italy, Spain, and the United Kingdom conducted between January 2022 and August 2023. Dermatologists reported patient characteristics, treatment goals and satisfaction. Patients were invited to voluntarily self-complete a questionnaire covering their satisfaction and goals/expectations for treatment. Patients were split by duration of BKZ treatment [&amp;lt;4 months (8–124 days) and ≥4 months (125–730 days)]. Analyses were descriptive. Overall, 60 dermatologists provided data for a total of n = 274 patients with PsO who were receiving BKZ with known treatment duration (of which n = 97 patients also provided self-reported data). Patient characteristics are shown in Table 1. Of patients who had received BKZ for &amp;lt;4 months, 97% (n = 104/107) of dermatologists and 93% (n = 42/45) of patients were satisfied/very satisfied with treatment. Of patients who received BKZ for ≥4 months, 100% (n = 167/167) of dermatologists and patients (n = 48/48) were satisfied/very satisfied. The overall top three dermatologist- (n = 274) and patient-reported (n = 97) goals for BKZ treatment were: complete skin clearance (39%/28%, respectively), works quickly (20%/28%), and works long-term (17%/19%). For patients who received BKZ for &amp;lt;4 or ≥4 months with each stated goal, dermatologists reported BKZ achieved complete skin clearance in 68%/88% of patients, worked quickly in 89%/100%, and worked long term in 50%/86%, respectively. Patients with each stated goal self-reported complete skin clearance in 71%/84% of cases, worked quickly in 91%/100%, and worked long-term in 71%/78%, respectively. Overall, dermatologists and their patients with PsO receiving BKZ were highly satisfied regardless of treatment duration. Furthermore, physicians and patients expected BKZ to provide complete skin clearance and work quickly, which was achieved according to most respondents.Table 1Patient characteristicsPatientsn = 274Male, n (%)159 (58)Age, mean (SD)46.0 (14.6)PASI at current treatment initiation, mean (SD)n = 261, 14.0 (10.4)Years since PsO diagnosis, mean (SD)n = 176, 11.3 (10.8)Days on BKZ treatment, mean (SD)168.9 (114.9)SD, standard deviation.
P68 Safety in patients with latent tuberculosis who received concomitant anti-tuberculosis medications: analysis of 11 studies of guselkumab in psoriatic disease
Journal: British Journal of Dermatology (2024)

Abstract Treatments for psoriatic disease, including TNF inhibitors (TNFi), increase the risk of latent tuberculosis infection (LTBI) activation, and TB screening before initiating systemic therapy is recommended. Safety outcomes in LTBI+ patients with moderate-to-severe psoriasis (PsO) or active psoriatic arthritis (PsA) on guselkumab for up to 5 years were pooled from 11 Phase 2/3 studies (7 PsO, 4 PsA). Guselkumab was generally administered as 100 mg subcutaneous injections at Week (W)0, W4, then every 8 weeks (q8w) in PsO studies and W0, W4, then every 4 weeks (q4w) or q8w in PsA studies. Patients randomized to placebo crossed over to guselkumab at W16 (in PsO) or W24 (in PsA). Patients with active TB at screening were excluded. LTBI+ patients were eligible if appropriate LTBI treatment was initiated before/with the first study-drug administration or appropriate treatment was completed within 5 years. Safety was reported annually during the placebo-controlled period, and through the end of follow-up (PsO ≤5 years; PsA ≤2 years). LTBI+ patients were from Asia-Pacific − 10.0%(70/697), Western Europe − 7.3%(51/698), Eastern Europe − 7.3%(179/2453), and North America − 5.3%(74/1407). LTBI treatment initiated before [88.2% (330/374)], with [6.1% (23/374)], or after [5.6% (21/374)] first study drug dose [median −8.0 days (interquartile range, IQR, −20.0 to −2.0)]. LTBI treatments included isoniazid (82.1%), rifampicin (11.8%), and other medications (17.4%); 89.8% received monotherapy. No new-onset TB or LTBI activation was observed in any guselkumab-treated patient. Adverse events (AEs) and serious AEs rates were similar for guselkumab- and placebo-treated patients in LTBI+ and LTBI− groups during the placebo-controlled period; cumulative rates were comparable between guselkumab-treated LTBI+ and LTBI− patients through the end of follow-up. Through Year 1, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) elevations were more common in LTBI+ vs. LTBI− group; ≤2% of LTBI+ patients had Grade 3 elevations (no Grade 4) vs. 0.5% of LTBI− patients. From Years 1–5 [after ∼98% of LTBI+ patients completed prophylaxis (median 185 days, IQR 124–274)], the proportions of LTBI+ and LTBI− patients with elevated ALT/AST were similar. No cases of new-onset TB or LTBI activation were observed in up to 5 years of guselkumab treatment and safety was generally similar in LTBI+ and LTBI− patients. Consistent with the known safety of LTBI medications, ALT/AST elevations were more common in LTBI+ vs. LTBI− patients through Year 1; however, ALT/AST elevation rates were generally similar post-LTBI treatment. The absence of observed TB risk in guselkumab-treated patients suggests guselkumab may be a better treatment option than TNFi in high-risk patients, including those in TB-endemic regions.
P84 Digital voices: how influencers manifest psoriasis on social media
Journal: British Journal of Dermatology (2024)

Abstract Social media influencers have a powerful voice in healthcare communication. They share personal experience and treatment recommendations and advise others. Provided information can raise interest and discussion. The aim was to explore influencers who shared information about psoriasis on social media and reactions among people. On 9 June 2024, the first 1000 posts under the keyword ‘psoriasis’ were selected on Instagram platform to find out open-access accounts with a significant social media impact (more than 10 000 followers), who shares content related to psoriasis. Exclusion criteria were non-English accounts, commercial accounts and healthcare providers' accounts. Overall, 51 accounts were found and further analysis was made to define shared, most popular, and most discussed content. Popularity was assessed by ‘likes’ count under the posts and relevance by comments to posts. Content was divided into seven categories: psoriatic lesions, personal experience, motivational statements, advertisements, comorbidities (nail psoriasis, psoriatic arthritis, etc.), educational information, and treatment recommendations. According to categories most popular and most discussed posts were chosen from each account of the 51 included accounts. Fifty-one influencers with an average number of 41 607.8 ± 11 633.7 followers, 94.1 (48) were females and 5.8 (3) were males. All accounts had posts about psoriatic lesions, personal experience and motivational statements. Advertisements were performed in 45.1% (23), educational information in 23.5% (12), comorbidities in 3.9% (2) and treatment recommendations in 37.3% (19). The most popular and most discussed category was treatment recommendations with a mean number of 34 029.2 ± 9095.8 likes and 4418.5 ± 881.5 comments. Majority ‘likes’ (51 153) and comments (7442) received posts about scalp psoriasis mechanical plaque removal. The second most popular and most discussed was personal experience content with a mean number of 5909.7 ± 1057.9 likes and 679.5 ± 156.5 comments. The most unpopular and avoided content was an advertisement with a mean number of 357.1 ± 42.2 likes and 26.4 ± 5.6 comments. There was a mismatch between the frequently shared content by influencers and content people are genuinely interested in. The most interesting content among people was treatment recommendations, not psoriatic lesions clinical pictures or motivational statements, which were mostly shared by influencers. The reason for the identified mismatch could be due to extended waiting for dermatologist appointments, so people are searching for treatment options on social media and discussing them. Additionally, dermatologist appointments might not provide enough time to discuss all patient’s questions, and patients discuss them on social media platforms among people, who have the same problem and experience. However, mostly liked and commented content in the therapy recommendations category does not correspond to dermatologist’s paradigm of clinical practice.
P97 Drug survival rates and predictors of switching in psoriasis: a study of biologics and small molecules in the argentine population
Journal: British Journal of Dermatology (2024)

Abstract Several real-world drug survival studies of biologics and small molecules (B&amp;SM) have been published, but not in Argentina. The objectives of this study were to estimate the proportion of patients requiring switching B&amp;SM, identify factors associated with switching, and evaluate the drug survival rate by class of the first B&amp;SM. A retrospective cohort study was conducted on patients with psoriasis disease who consecutively attended the psoriasis clinic from 1 March 2022, to 29 February 2024. Patients treated with B&amp;SM were selected. The start date of the first B&amp;SM was considered the index date, with the end date being the switching date, death, or last visit. Drug survival rates were analysed using a Kaplan–Meier graph and log-rank test. Switching associated factors were examined through a Cox proportional hazards model, adjusting for age, sex, psoriasis onset time, obesity, diabetes, joint involvement, and worst psoriasis area and severity index (PASI) score.A total of 893 patients were evaluated, with 18.9% (169) receiving B&amp;SM; 64% (108) were men, with a mean age of 55 [standard deviation (SD) 16.3]. 74.6% (126) had psoriasis that started before age 40, and the mean worst PASI score was 18.8 (SD 11.2). Joint involvement was present in 30.8% (52), and among them, 17.3% (9) were diagnosed with psoriatic arthritis after biologic treatment initiation. Anti-TNF agents were prescribed in 50.3% of cases and antiIL-17 in 22.5% as the first biologic. Anti-TNF agents had a higher survival rate when used as the first biological (P = 0.0016). Switching B&amp;SM was needed in 37.9% (64) of cases, with 39% of failures occurring within the initial treatment year. The most common reason for change was secondary failure, with inter-class change accounting for 86% (55) of cases. The Cox proportional hazard model showed that joint involvement was linked to an increased risk of switching B&amp;SM [hazard ratio (HR) 2.12, 95% confidence interval (CI) 1.14–3.97; P = 0.017]. Additionally, each unit increase in PASI score raised the HR of switching by 1.03 (95% CI 1.00–1.05; P = 0.034). Finally, diabetes was associated with a heightened risk of switching (HR 1.49, 95% CI 1.09–2.06; P = 0.012). In our setting, joint involvement, high PASI score, and diabetes are predictors of switching B&amp;SM.
P30 Disease burden, treatment outcomes and new onset of cardiometabolic diseases and psoriatic arthritis with biologics and non-biologics in The Malaysian Psoriasis Registry patients: 10 years data
Journal: British Journal of Dermatology (2024)

Abstract Psoriasis (PsO) is a chronic autoimmune skin and joint inflammatory disease affecting ∼0.34% of people in Malaysia. PsO patients are at an increased risk of cardiometabolic diseases (CMDs) and psoriatic arthritis (PsA). Understanding how biologics and non-biologics impact CMDs and PsA development in PsO patients is crucial. This study aims to explore the disease burden, treatment outcomes, and new onset of CMDs and PsA with biologic and non-biologic systemic treatments in adult Malaysian PsO patients. This was a retrospective, cross-sectional study based on the Malaysian Psoriasis Registry (MPR) data (January 2013–December 2022) of adult PsO patients who had received non-biologic systemic treatment (acitretin, methotrexate, cyclosporine or combinations) or biologics [interleukin inhibitors (IL17i, IL12/23i and IL23i), tumour necrosis factor inhibitors (TNFi)] for at least 12 months. Descriptive analyses were performed on baseline characteristics, and treatment outcomes by treatment regimens at 12 and 24 months. The incidence rates of CMDs [ischemic heart disease (IHD), stroke, diabetes, hyperlipidaemia, hypertension, non-alcoholic fatty liver disease (NAFLD)] and PsA were compared by treatment regimens over 2 years. This analysis included 1721 PsO patients. At baseline, patients on biologics were younger (41 vs. &amp;gt;46 years), had earlier disease onset (26 vs. &amp;gt;29 years), more severe disease [psoriasis area and severity index (PASI) 20 vs. &amp;lt;15], and a higher rate of PsO family history (35 vs. &amp;lt;26%) than non-biologic patients. Biologic-treated patients experienced more pain, itch, and worse quality of life (QoL) than the non-biologics patients at baseline. More patients in the biologic group (especially IL17i) had less body surface area affected (&amp;lt;5% body surface area) at 12 and 24 months and better QoL [lower dermatology life quality index (DLQI)] at 12 months. At 24 months, QoL (DLQI) was similar for biologics and non-biologics, but the IL17i biologic group had the highest reduction in DLQI scores. At both time points, biologically treated patients had lower incidences of diabetes, hypertension, and hyperlipidaemia, and no newly reported IHD, stroke, depression, or NAFLD (at 12 months). Additionally, a lower PsA incidence was reported in biologic-treated patients at 12 months, with the IL17i group remaining PsA-free. At 24 months, the non-biologic cohort reported lower PsA incidence while the IL17i and TNFi biologic groups had no new PsA. PsO patients on biologics had better improvement in disease severity and lower risk of developing CMDs compared with non-biologics. Only IL17i-treated patients reported no new incidences of PsA over 2 years. Initiating biologic therapy (especially IL17i) early may enhance treatment outcomes and reduce the risk of new onset of CMDs and PsA in PsO patients.