Adalimumab Dose Intensification in Recalcitrant Hidradenitis Suppurativa/Acne Inversa

Dermatology ◽  
2019 ◽  
Vol 236 (1) ◽  
pp. 25-30 ◽  
Author(s):  
Christos C. Zouboulis ◽  
Hendrik Hansen ◽  
Raffaele Dante Caposiena Caro ◽  
Giovanni Damiani ◽  
Isabelle Delorme ◽  
...  
Keyword(s):  
Hidradenitis Suppurativa ◽  
Life Quality ◽  
Case Series ◽  
Young Female ◽  
Acne Inversa ◽  
Physician Global Assessment ◽  
Dose Intensification ◽  
Score System ◽  
Short And Long Term

Background: Adalimumab is the only approved compound for the treatment of adult patients with moderate-to-severe hidradenitis suppurativa (HS) who did not respond to a systemic classical treatment. Despite its significant short- and long-term efficacy, a percentage of patients do not respond sufficiently. Moreover, some primary responders experience a response loss with time. Objective: To analyse the effectiveness of adalimumab dose intensification in HS patients. Methods: A case series of adalimumab 80 mg/week subcutaneously (s.c.) compassionate use in patients with HS, who did not respond sufficiently or in primary responders with progressive response loss to the registered adalimumab dose of 40 mg/week s.c. Patients were collected and evaluated retrospectively. Patients’ data were extracted from medical records. Results: The 14 patients collected were Caucasian with HS of Hurley stage II–III and moderate or severe International HS Severity Score System (IHS4) stage. Adalimumab dose intensification significantly improved IHS4 score, Pain Index, HS-Physician Global Assessment, pain, and Cardiff Dermatology Life Quality Index. Two young female patients with HS and Crohn’s disease developed psoriatic lesions during the treatment with adalimumab 80 mg/week s.c. Conclusion: An enhanced level of effectiveness was assessed in the majority of the HS patients treated with adalimumab dose intensification (80 mg/week s.c.). Larger studies are required to evaluate this observation.

Mechanical failure of the Mobi-C implant for artificial cervical disc replacement: report of 4 cases

2020 ◽  
Vol 33 (6) ◽  
pp. 727-733
Author(s):  
Jasmine A. T. DiCesare ◽  
Alexander M. Tucker ◽  
Irene Say ◽  
Kunal Patel ◽  
Todd H. Lanman ◽  
...  
Keyword(s):  
Cervical Spondylosis ◽  
Case Series ◽  
Dynamic Imaging ◽  
Disc Replacement ◽  
Cervical Disc ◽  
Artificial Disc ◽  
Younger Patients ◽  
Cervical Disc Replacement ◽  
Short And Long Term

Cervical spondylosis is one of the most commonly treated conditions in neurosurgery. Increasingly, cervical disc replacement (CDR) has become an alternative to traditional arthrodesis, particularly when treating younger patients. Thus, surgeons continue to gain a greater understanding of short- and long-term complications of arthroplasty. Here, the authors present a series of 4 patients initially treated with Mobi-C artificial disc implants who developed postoperative neck pain. Dynamic imaging revealed segmental kyphosis at the level of the implant. All implants were locked in the flexion position, and all patients required reoperation. This is the first reported case series of symptomatic segmental kyphosis after CDR.

Long-Term Follow-Up after Radiotherapy of Hidradenitis Suppurativa

Dermatology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Jurr Boer
Keyword(s):  
Total Dose ◽  
Hidradenitis Suppurativa ◽  
Early Stage ◽  
Case Reports ◽  
Case Series ◽  
Postal Survey ◽  
Long Term Follow Up ◽  
Late Treatment

<b><i>Background:</i></b> Patients with hidradenitis suppurativa (HS) are still often disappointed with the current treatments offered and there is a clear demand for more effective options. Since the late 1990s there has been a revival in the use of radiotherapy (RT) for different benign diseases, including HS. During the past 20 years one case series and some scattered case reports have described promising results of RT. <b><i>Objectives:</i></b> To evaluate the long-term efficacy of RT in early-stage HS. <b><i>Methods:</i></b> A postal survey-based long-term follow-up with simple factual questions of partly retrospective and partly contemporary characteristics was performed. Sixty-four patients (96 axillae), diagnosed with mild to moderate HS were irradiated with a orthovoltage unit with 100 kV, 3 mm Al or 200 kV, 0.5 Cu filtering, respectively. Four to six biweekly fractional doses ranging from 0.75 to 1 Gy up to a total dose of 6 Gy in one series, and in chronic cases followed by four daily fractions of 2 Gy up to a total dose of 14 Gy, were given. Late treatment toxicity and the rate of remission of the disease were evaluated. <b><i>Results:</i></b> The overall response rate of the survey was 64.1% with 40.6% (26/64) valid, complete questionnaires. In total, 40 axillae were irradiated in these 26 patients. After a median follow-up of 40 years (range 32–52) complete remission of the lesions occurred in 34 of the 40 sites (85%). None of the 26 patients with 40 irradiated sites reported adverse effects at the time of the survey. <b><i>Conclusions:</i></b> RT appears to be an effective treatment for early and mild HS in the majority of patients. In this case series, no side effects were reported after a median follow-up period of 40 years.

Long-term adalimumab efficacy in patients with moderate-to-severe hidradenitis suppurativa/acne inversa: 3-year results of a phase 3 open-label extension study

2019 ◽  
Vol 80 (1) ◽  
pp. 60-69.e2 ◽  
Author(s):  
Christos C. Zouboulis ◽  
Martin M. Okun ◽  
Errol P. Prens ◽  
Robert Gniadecki ◽  
Peter A. Foley ◽  
...  
Keyword(s):  
Hidradenitis Suppurativa ◽  
Extension Study ◽  
Acne Inversa ◽  
Open Label ◽  
Phase 3 ◽  
Open Label Extension

Intradiscal O2O3: Rationale, Injection Technique, Short- and Long-term Outcomes for the Treatment of Low Back Pain Due to Disc Herniation

2017 ◽  
Vol 68 (2) ◽  
pp. 171-177 ◽  
Author(s):  
Francesco Giurazza ◽  
Gianluigi Guarnieri ◽  
Kieran J. Murphy ◽  
Mario Muto
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Case Series ◽  
Radicular Pain ◽  
Motor Deficits ◽  
Injection Technique ◽  
Low Back ◽  
Long Term Outcomes ◽  
Short And Long Term

The management of low back pain should always start with a conservative approach; however, when it fails, intervention is required and at that moment the most appropriate choice remains unclear. Before invasive surgery, minimally invasive techniques can be adopted. In European trials and in a trans-Canadian clinical trial 03 ozone has been used successfully. In total over 50,000 patients have been treated safely. Ozone is a gas normally present in the atmosphere with potent oxidizing power; it has been used for percutaneous intradiscal injection combined with oxygen (O2O3) at very low concentrations for 15 years in Europe. The main indication is back pain with or without radicular pain but without motor deficits, which is refractory to 4-6 weeks of conservative therapies. Its mechanism of action on the disc is mechanical (volume reduction by subtle dehydration of the nucleus pulposis) and antinflammatory. The intradiscal ozone injection is performed with a thin needle (18-22 gauge) image guided by computed tomography or angiofluoroscopy and is usually complimented by periganglionic injection of corticosteroids and anesthetics. This combination gives immediate pain relief and allows time for the ozone to act. It is a cost-effective procedure that presents a very low complication rate (0.1%). The radicular pain is resolved before the back pain does, as is seen with microdiscectomy. Peer-reviewed publications of large randomized trials, case series, and meta analysis from large samples of patients have demonstrated the procedure to be safe and effective in the short and the long terms, with benefits recognized up to 10 years after treatment. We aim to review the principles of action of O2O3 and report the injection techniques, complications, and short- and long-term outcomes.

scholarly journals Short- and long-term outcomes after pancreaticoduodenectomy following total gastorectomy: Report of case series and literature review

2017 ◽  
Vol 30 ◽  
pp. 118-121 ◽  
Author(s):  
Satoshi Yokoyama ◽  
Kohei Ueno ◽  
Yasuhiro Higashide ◽  
Atsushi Noma ◽  
Yuko Okishio ◽  
...  
Keyword(s):  
Literature Review ◽  
Case Series ◽  
Long Term Outcomes ◽  
Short And Long Term

scholarly journals Clinical and Quality of Life Outcomes among Ixekizumab Treated Psoriasis Patients in a Real-World Setting

2021 ◽  
Vol 7 (3) ◽  
pp. 1-8
Author(s):  
William N Malatestinic ◽  
Keyword(s):  
Quality Of Life ◽  
Real World ◽  
Negative Impact ◽  
Life Quality ◽  
Well Being ◽  
Skin Condition ◽  
Physician Global Assessment ◽  
Significant Negative Impact

Introduction: Psoriasis is a chronic immune-mediated inflammatory skin condition that has a significant negative impact on the physical, emotional, and psychosocial well-being of those affected. This study aimed to assess the speed of onset and long-term clinical and quality of life (QOL) outcomes among Ixekizumab (IXE) treated plaque psoriasis patients. Method: A retrospective cohort study was conducted at a single US dermatology referral center. Medical charts were reviewed for adult psoriasis patients starting IXE (index date) between March 22, 2016, and February 28, 2018.Disease severity and QOL data were collected up to one-year pre-IXE initiation and up to 35 months post-IXE initiation. Static Physician Global Assessment (sPGA), Body Surface Area (BSA), and Dermatology Life Quality Index (DLQI) were summarized at 1-month post-index and at 3-month intervals. Logistic regressions were performed to evaluate the 1-month response in relation to long-term sPGA, BSA, and DLQI outcomes. Results: A total of 153 patients (median age at index: 47.7 years; 65.4% male; 93.5% Caucasian) were included in the study. Majority of patients (69%; n=106) were biologic-experienced prior to IXE initiation. At 1-month post-index 58.8% of patients achieved sPGA (0,1), 55.9% achieved DLQI (0,1), and 66.9% achieved BSA≤1%. Patients with sPGA (0,1) at 1-month post-index had greater odds of remaining sPGA (0,1) and BSA≤1% at 24-month (sPGA 0,1: OR=10.1; 95% CI: 2.1-47.9; BSA≤1%: OR=13.3; 95% CI: 2.2-80.2). Among patients who achieved sPGA (0,1) at 1-month post-index, the observed proportion of patients with sPGA (0,1), DLQI (0,1), and BSA≤1% remained largely the same for the 24-month follow-up. Conclusion: This real-world study demonstrated that the majority of patients initiating IXE achieved sPGA (0, 1), DLQI (0, 1) and BSA ≤1% targets within the first month of treatment and were able to maintain treatment response for up to 24 months independent of prior biologic exposure.

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