Elderly psoriatic patients under biological therapies: an Italian experience.


Journal

Journal of the European Academy of Dermatology and Venereology : JEADV
ISSN: 1468-3083
Titre abrégé: J Eur Acad Dermatol Venereol
Pays: England
ID NLM: 9216037

Informations de publication

Date de publication:
Jan 2019
Historique:
received: 15 02 2018
accepted: 04 06 2018
pubmed: 16 6 2018
medline: 11 5 2019
entrez: 16 6 2018
Statut: ppublish

Résumé

The number of elderly patients with psoriasis is steadily increasing in the Western world; nevertheless, they are frequently excluded from biological clinical trials and described as a high-risk group for adverse events. Thus, there is lack of information concerning safety and effectiveness of available treatments for psoriasis in the elderly, particularly about new biological systemic drugs. Our aim was to describe our experience with all biological therapies currently used in the elderly (>65 years) psoriatic patients. A retrospective multicentric review of clinical records of all psoriatic patient aged 65 years or older actually receiving biological drugs (etanercept, adalimumab, infliximab, golimumab, certolizumab pegol, ustekinumab or secukinumab) was undertaken. Our study population included 266 elderly psoriatic patients actually receiving any biological therapy (adalimumab 31.2%, ustekinumab 28.9%, etanercept 20.3%, secukinumab 15%, infliximab 3%, golimumab 1% and certolizumab pegol 0.6%). The PASI score at the baseline (week 0) ranged from 4 to 54; mean ± SD, 16.5 ± 7.1, which changed after biological administration to 3.7 ± 8 at week 16, 1.6 ± 2.1 at week 28 and 1.2 ± 2.1 at week 52. Among 266 elderly psoriatic patients, 25 adverse events were reported during the observation period. The most frequent events were infections with 12 (48%) reports, followed by malignancies with four (16%) reports. To date, our study represents the widest experience on the use of biological drugs in elderly psoriatic patients. We found that all biologics for psoriasis showed a great efficacy also in elderly people, and the rate and the type of adverse effects were similar to the younger patients. In conclusion, the age alone should not limit our therapeutic options. Further observational study using multiple data sources is needed to evaluate long-term effectiveness and safety for elderly psoriatic patients.

Sections du résumé

BACKGROUND BACKGROUND
The number of elderly patients with psoriasis is steadily increasing in the Western world; nevertheless, they are frequently excluded from biological clinical trials and described as a high-risk group for adverse events. Thus, there is lack of information concerning safety and effectiveness of available treatments for psoriasis in the elderly, particularly about new biological systemic drugs.
OBJECTIVE OBJECTIVE
Our aim was to describe our experience with all biological therapies currently used in the elderly (>65 years) psoriatic patients.
METHODS METHODS
A retrospective multicentric review of clinical records of all psoriatic patient aged 65 years or older actually receiving biological drugs (etanercept, adalimumab, infliximab, golimumab, certolizumab pegol, ustekinumab or secukinumab) was undertaken.
RESULTS RESULTS
Our study population included 266 elderly psoriatic patients actually receiving any biological therapy (adalimumab 31.2%, ustekinumab 28.9%, etanercept 20.3%, secukinumab 15%, infliximab 3%, golimumab 1% and certolizumab pegol 0.6%). The PASI score at the baseline (week 0) ranged from 4 to 54; mean ± SD, 16.5 ± 7.1, which changed after biological administration to 3.7 ± 8 at week 16, 1.6 ± 2.1 at week 28 and 1.2 ± 2.1 at week 52. Among 266 elderly psoriatic patients, 25 adverse events were reported during the observation period. The most frequent events were infections with 12 (48%) reports, followed by malignancies with four (16%) reports.
CONCLUSIONS CONCLUSIONS
To date, our study represents the widest experience on the use of biological drugs in elderly psoriatic patients. We found that all biologics for psoriasis showed a great efficacy also in elderly people, and the rate and the type of adverse effects were similar to the younger patients. In conclusion, the age alone should not limit our therapeutic options. Further observational study using multiple data sources is needed to evaluate long-term effectiveness and safety for elderly psoriatic patients.

Identifiants

pubmed: 29906311
doi: 10.1111/jdv.15139
doi:

Substances chimiques

Antibodies, Monoclonal 0
Antibodies, Monoclonal, Humanized 0
Biological Products 0
Dermatologic Agents 0
golimumab 91X1KLU43E
Infliximab B72HH48FLU
secukinumab DLG4EML025
Ustekinumab FU77B4U5Z0
Adalimumab FYS6T7F842
Etanercept OP401G7OJC
Certolizumab Pegol UMD07X179E

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

143-146

Informations de copyright

© 2018 European Academy of Dermatology and Venereology.

Auteurs

F Ricceri (F)

Department of Surgery and Translational Medicine, Dermatology Unit, University of Florence, Florence, Italy.

F Bardazzi (F)

Department of Specialized, Clinical and Experimental Medicine, Division of Dermatology, University of Bologna, Bologna, Italy.

A Chiricozzi (A)

Dermatology Department, University of Pisa, Pisa, Italy.

P Dapavo (P)

Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy.

F Ferrara (F)

Department of Specialized, Clinical and Experimental Medicine, Division of Dermatology, University of Bologna, Bologna, Italy.

C Mugheddu (C)

Department of Medical Sciences and Public Health, Unit of Dermatology, University of Cagliari, Cagliari, Italy.

M Romanelli (M)

Dermatology Department, University of Pisa, Pisa, Italy.

F Rongioletti (F)

Department of Medical Sciences and Public Health, Unit of Dermatology, University of Cagliari, Cagliari, Italy.

F Prignano (F)

Department of Surgery and Translational Medicine, Dermatology Unit, University of Florence, Florence, Italy.

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Classifications MeSH