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  1. Article ; Online: Comment on 'Predicting treatment response in psoriasis using serum levels of adalimumab and etanercept: a single-centre, cohort study': reply from authors.

    Mahil, S K / Smith, C H

    The British journal of dermatology

    2013  Volume 169, Issue 5, Page(s) 1170–1171

    MeSH term(s) Anti-Inflammatory Agents/blood ; Antibodies, Monoclonal, Humanized/blood ; Female ; Humans ; Immunoglobulin G/blood ; Immunoglobulin G/therapeutic use ; Male ; Psoriasis/drug therapy ; Receptors, Tumor Necrosis Factor/blood ; Receptors, Tumor Necrosis Factor/therapeutic use
    Chemical Substances Anti-Inflammatory Agents ; Antibodies, Monoclonal, Humanized ; Immunoglobulin G ; Receptors, Tumor Necrosis Factor
    Language English
    Publishing date 2013-11
    Publishing country England
    Document type Comment ; Letter
    ZDB-ID 80076-4
    ISSN 1365-2133 ; 0007-0963
    ISSN (online) 1365-2133
    ISSN 0007-0963
    DOI 10.1111/bjd.12511
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Does weight loss reduce the severity and incidence of psoriasis or psoriatic arthritis? A Critically Appraised Topic.

    Mahil, S K / McSweeney, S M / Kloczko, E / McGowan, B / Barker, J N / Smith, C H

    The British journal of dermatology

    2019  Volume 181, Issue 5, Page(s) 946–953

    Abstract: Clinical question: Does weight loss reduce the severity and incidence of psoriasis or psoriatic arthritis (PsA) in obese individuals?: Background: Obesity presents a rising public health challenge and is more prevalent among individuals with ... ...

    Abstract Clinical question: Does weight loss reduce the severity and incidence of psoriasis or psoriatic arthritis (PsA) in obese individuals?
    Background: Obesity presents a rising public health challenge and is more prevalent among individuals with psoriasis or PsA than in the general population. Longitudinal population-based studies suggest a causal role for obesity in psoriasis and PsA onset and that obesity drives greater disease severity.
    Methods: We systematically reviewed evidence within the MEDLINE, Embase and CENTRAL databases and clinical trials registries examining lifestyle, pharmacological and surgical weight loss interventions in the treatment and prevention of psoriasis and PsA in obese individuals. Meta-analysis was conducted using random-effects models, followed by sensitivity analyses.
    Results: Of 176 full-text articles reviewed, 14 met the inclusion criteria. Meta-analysis of six randomized control trials (RCTs) confirmed that weight loss following lifestyle interventions (diet or physical activity) improves psoriasis compared with control [mean change in Psoriasis Area and Severity Index -2·59, 95% confidence interval (CI) -4·09 to -1·09; P < 0·001]. One RCT demonstrated a greater likelihood of achieving minimal PsA activity following diet-induced weight loss (odds ratio 4·20, 95% CI 1·82-9·66; P < 0·001). Three studies of pharmacological treatments reported conflicting results, and no RCTs of bariatric surgery were identified. Two cohort studies suggested that bariatric surgery, particularly gastric bypass, reduces the risk of developing psoriasis (hazard ratio 0·52, 95% CI 0·33-0·81; P < 0·01).
    Conclusions: These limited data indicate that weight loss can improve pre-existing psoriasis and PsA, and prevent the onset of psoriasis in obese individuals. Together with the National Institute for Health and Care Excellence obesity guidance, this informed a local obesity screening and management pathway, providing multidisciplinary weight loss interventions alongside conventional skin-focused care for patients with psoriasis.
    MeSH term(s) Arthritis, Psoriatic/diagnosis ; Arthritis, Psoriatic/epidemiology ; Arthritis, Psoriatic/etiology ; Arthritis, Psoriatic/therapy ; Bariatric Surgery ; Diet, Reducing ; Humans ; Incidence ; Life Style ; Obesity/complications ; Obesity/therapy ; Psoriasis/diagnosis ; Psoriasis/epidemiology ; Psoriasis/etiology ; Psoriasis/therapy ; Randomized Controlled Trials as Topic ; Severity of Illness Index ; Treatment Outcome ; Weight Loss
    Language English
    Publishing date 2019-05-02
    Publishing country England
    Document type Journal Article ; Meta-Analysis ; Systematic Review
    ZDB-ID 80076-4
    ISSN 1365-2133 ; 0007-0963
    ISSN (online) 1365-2133
    ISSN 0007-0963
    DOI 10.1111/bjd.17741
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: New blisters in a patient treated for Stevens-Johnson syndrome/toxic epidermal necrolysis.

    Mahil, S K / Martin, B / Creamer, D / Smith, C H

    Clinical and experimental dermatology

    2014  Volume 39, Issue 1, Page(s) 63–65

    MeSH term(s) Adult ; Diagnosis, Differential ; Edema/complications ; Female ; Humans ; Recurrence ; Skin Diseases, Vesiculobullous/etiology ; Stevens-Johnson Syndrome/complications
    Language English
    Publishing date 2014-01
    Publishing country England
    Document type Case Reports ; Letter
    ZDB-ID 195504-4
    ISSN 1365-2230 ; 0307-6938
    ISSN (online) 1365-2230
    ISSN 0307-6938
    DOI 10.1111/ced.12194
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Measles in a previously vaccinated human immunodeficiency virus-positive adult.

    Mahil, S K / Fleming, J / Robson, A / Sarkany, R

    Clinical and experimental dermatology

    2014  Volume 39, Issue 1, Page(s) 117–118

    MeSH term(s) AIDS-Related Opportunistic Infections/virology ; Adult ; HIV Infections/complications ; Humans ; Male ; Measles/diagnosis ; Measles/prevention & control ; Measles Vaccine
    Chemical Substances Measles Vaccine
    Language English
    Publishing date 2014-01
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 195504-4
    ISSN 1365-2230 ; 0307-6938
    ISSN (online) 1365-2230
    ISSN 0307-6938
    DOI 10.1111/ced.12238
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Clinical and epidemiological features of psoriasis exacerbations in children with SARS-CoV-2 infection.

    Skrek, S / Di Lernia, V / Beauchet, A / Bursztejn, A-C / Belloni Fortina, A / Lesiak, A / Thomas, J / Brzezinski, P / Topkarci, Z / Murashkin, N / Torres, T / Epishev, R / Chiriac, A / McPherson, T / Akinde, M / Maruani, A / Luna, P C / Vidaurri de la Cruz, H / Mallet, S /
    Leducq, S / Sergeant, M / Zitouni, J / Mahil, S K / Smith, C H / Flohr, C / Bachelez, H / Mahé, E

    Journal of the European Academy of Dermatology and Venereology : JEADV

    2023  Volume 37, Issue 10, Page(s) e1192–e1195

    MeSH term(s) Child ; Humans ; COVID-19/complications ; SARS-CoV-2 ; Tomography, X-Ray Computed ; Psoriasis/complications ; Psoriasis/epidemiology
    Language English
    Publishing date 2023-06-27
    Publishing country England
    Document type Letter
    ZDB-ID 1128828-0
    ISSN 1468-3083 ; 0926-9959
    ISSN (online) 1468-3083
    ISSN 0926-9959
    DOI 10.1111/jdv.19261
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Psoriasis treat to target: defining outcomes in psoriasis using data from a real-world, population-based cohort study (the British Association of Dermatologists Biologics and Immunomodulators Register, BADBIR).

    Mahil, S K / Wilson, N / Dand, N / Reynolds, N J / Griffiths, C E M / Emsley, R / Marsden, A / Evans, I / Warren, R B / Stocken, D / Barker, J N / Burden, A D / Smith, C H

    The British journal of dermatology

    2019  Volume 182, Issue 5, Page(s) 1158–1166

    Abstract: Background: The 'treat to target' paradigm improves outcomes and reduces costs in chronic disease management but is not yet established in psoriasis.: Objectives: To identify treatment targets in psoriasis using two common measures of disease ... ...

    Abstract Background: The 'treat to target' paradigm improves outcomes and reduces costs in chronic disease management but is not yet established in psoriasis.
    Objectives: To identify treatment targets in psoriasis using two common measures of disease activity: Psoriasis Area and Severity Index (PASI) and Physician's Global Assessment (PGA).
    Methods: Data from a multicentre longitudinal U.K. cohort of patients with psoriasis receiving systemic or biologic therapies (British Association of Dermatologists Biologics and Immunomodulators Register, BADBIR) were used to identify absolute PASI thresholds for 90% (PASI 90) and 75% (PASI 75) improvements in baseline disease activity, using receiver operating characteristic curves. The relationship between PGA (clear, almost clear, mild, moderate, moderate-severe, severe) and PASI (range 0-72) was described, and the concordance between absolute and relative definitions of response was determined. The same approach was used to establish treatment response and eligibility definitions based on PGA.
    Results: Data from 13 422 patients were available (58% male, 91% white ethnicity, mean age 44·9 years), including over 23 000 longitudinal PASI and PGA scores. An absolute PASI ≤ 2 was concordant with PASI 90 and an absolute PASI ≤ 4 was concordant with PASI 75 in 90% and 88% of cases, respectively. These findings were robust to subgroups of timing of assessment, baseline disease severity and treatment modality. PASI and PGA were strongly correlated (Spearman's rank correlation coefficient 0·92). The median PASI increased from 0 (interquartile range 0-0, range 0-23) to 19 (interquartile range 15-25, range 0-64) for PGA clear to severe, respectively. PGA clear/almost clear was concordant with PASI ≤ 2 in 90% of cases, and PGA moderate-severe severe was concordant with the National Institute for Health and Care Excellence PASI eligibility criteria for biologics in 81% of cases.
    Conclusions: An absolute PASI ≤ 2 and PGA clear/almost clear represent relevant disease end points to inform treat-to-target management strategies in psoriasis. What's already known about this topic? The most commonly used relative disease activity measure in psoriasis is ≥ 90% improvement in Psoriasis Area and Severity Index (PASI 90); however, it has several limitations including dependency on a baseline severity assessment. Defining an absolute target disease activity end point in psoriasis has the potential to improve patient outcomes and reduce costs, as demonstrated by treat-to-target approaches in other chronic diseases such as hypertension and diabetes. The Physician's Global Assessment (PGA) is a popular alternative measure of psoriasis severity in daily practice; however, its utility has not been formally assessed with respect to PASI. What does this study add? An absolute PASI ≤ 2 corresponds with PASI 90 response and is a relevant disease end point for treat-to-target approaches in psoriasis. There is a strong correlation between PASI and PGA. PGA moderate-severe/severe may serve as an alternative eligibility criterion for biologics to PASI-based definitions, and PGA clear/almost clear is an appropriate alternative absolute treatment end point. What are the clinical implications of this work? Absolute PASI ≤ 2 and PGA clear/almost clear represent relevant disease end points to inform treat-to-target management strategies in psoriasis.
    MeSH term(s) Adult ; Biological Products/therapeutic use ; Cohort Studies ; Dermatologists ; Ethnic Groups ; Female ; Humans ; Immunologic Factors ; Male ; Middle Aged ; Psoriasis/drug therapy ; Severity of Illness Index ; Treatment Outcome
    Chemical Substances Biological Products ; Immunologic Factors
    Language English
    Publishing date 2019-09-10
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80076-4
    ISSN 1365-2133 ; 0007-0963
    ISSN (online) 1365-2133
    ISSN 0007-0963
    DOI 10.1111/bjd.18333
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Comparing the efficacy and tolerability of biologic therapies in psoriasis: an updated network meta-analysis.

    Mahil, S K / Ezejimofor, M C / Exton, L S / Manounah, L / Burden, A D / Coates, L C / de Brito, M / McGuire, A / Murphy, R / Owen, C M / Parslew, R / Woolf, R T / Yiu, Z Z N / Uthman, O A / Mohd Mustapa, M F / Smith, C H

    The British journal of dermatology

    2020  Volume 183, Issue 4, Page(s) 638–649

    Abstract: Background: The rapid expansion of psoriasis biologics has led to an urgent need to understand their relative efficacy and tolerability to inform treatment decisions better and, specifically, to inform guideline development.: Objectives: To update a ... ...

    Abstract Background: The rapid expansion of psoriasis biologics has led to an urgent need to understand their relative efficacy and tolerability to inform treatment decisions better and, specifically, to inform guideline development.
    Objectives: To update a 2017 meta-analysis on the comparative efficacy and tolerability of biologic treatments for psoriasis.
    Methods: We searched the MEDLINE, PubMed, Embase and Cochrane databases for randomized controlled trials (RCTs), published up to 7 September 2018, of 11 licensed, NICE-approved biologics targeting tumour necrosis factor (adalimumab, etanercept, infliximab, certolizumab pegol), interleukin (IL)-12/IL-23p40 (ustekinumab), IL-17A (secukinumab, ixekizumab), IL-17RA (brodalumab) and IL-23p19 (guselkumab, tildrakizumab, risankizumab). A frequentist network meta-analysis ascertained direct or indirect evidence comparing biologics with one another, methotrexate or placebo. This was combined with hierarchical cluster analyses to consider efficacy (≥ 90% improvement in Psoriasis Area and Severity Index (PASI 90) or Physician's Global Assessment 0 or 1; PASI 75; Dermatology Life Quality Index improvement) and tolerability (drug withdrawal due to adverse events) outcomes at 10-16 weeks, followed by assessments of study quality, heterogeneity and inconsistency.
    Results: We identified 62 RCTs presenting data on direct comparisons (31 899 participants). All biologics were efficacious compared with placebo or methotrexate at 10-16 weeks. Hierarchical cluster analyses revealed that adalimumab, brodalumab, certolizumab pegol, guselkumab, risankizumab, secukinumab, tildrakizumab and ustekinumab were comparable with respect to high short-term efficacy and tolerability. Infliximab and ixekizumab clustered together, with high short-term efficacy but relatively lower tolerability than the other agents, although the number of drug withdrawal events across the network was low, so these findings should be treated with caution.
    Conclusions: Using our methodology we found that most biologics cluster together with respect to short-term efficacy and tolerability, and we did not identify any single agent as 'best'. These data need to be interpreted in the context of longer-term efficacy, effectiveness data, safety, posology and drug acquisition costs when making treatment decisions.
    MeSH term(s) Biological Therapy ; Humans ; Interleukin-12 ; Network Meta-Analysis ; Psoriasis/drug therapy ; Ustekinumab
    Chemical Substances Interleukin-12 (187348-17-0) ; Ustekinumab (FU77B4U5Z0)
    Language English
    Publishing date 2020-08-09
    Publishing country England
    Document type Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 80076-4
    ISSN 1365-2133 ; 0007-0963
    ISSN (online) 1365-2133
    ISSN 0007-0963
    DOI 10.1111/bjd.19325
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Predicting treatment response in psoriasis using serum levels of adalimumab and etanercept: a single-centre, cohort study.

    Mahil, S K / Arkir, Z / Richards, G / Lewis, C M / Barker, J N / Smith, C H

    The British journal of dermatology

    2013  Volume 169, Issue 2, Page(s) 306–313

    Abstract: Background: A substantial proportion of patients with psoriasis do not respond, or lose initial response to tumour necrosis factor-α antagonists. One possible mechanism relates to subtherapeutic drug levels due to an immunogenic antibody response.: ... ...

    Abstract Background: A substantial proportion of patients with psoriasis do not respond, or lose initial response to tumour necrosis factor-α antagonists. One possible mechanism relates to subtherapeutic drug levels due to an immunogenic antibody response.
    Objectives: To investigate the association between serum adalimumab and etanercept levels, antidrug antibody levels and clinical response in a cohort of patients with psoriasis using a commercially available enzyme-linked immunoassay.
    Methods: In a single-centre cohort of 56 adults with chronic plaque psoriasis initiated on adalimumab or etanercept monotherapy between 2009 and 2011, drug and antidrug antibody levels were measured at the patients' routine clinic reviews (4, 12 and 24 weeks of treatment and the last available observation). Patients' responses at 6 months were stratified into responders [75% reduction in Psoriasis Area and Severity Index from baseline (PASI 75) or Physician's Global Assessment score of 'clear' or 'nearly clear'] and nonresponders (failure to achieve PASI 50).
    Results: After 4 weeks, adalimumab levels were significantly higher in responders compared with nonresponders (P = 0·003) and these higher levels were sustained at 12 and 24 weeks. Anti adalimumab antibodies were detected in 25% of nonresponders (two of eight patients, average 22·5 weeks' follow-up) and none of the responders (n = 23, average 26·1 weeks' follow-up). There was no significant association between etanercept levels and clinical response at 4 weeks (P = 0·317) and no antietanercept antibodies were detected. Lack of serum trough levels may have resulted in underestimation of the prevalence of antidrug antibodies.
    Conclusions: Early adalimumab drug level monitoring at 4 weeks may be useful in predicting treatment response and potentially reduce drug exposure (and associated cost) with earlier review of treatment in those with low levels. No conclusions about the value of etanercept drug monitoring can be made due to the paucity of data. Larger studies are now required to assess the clinical utility and cost-effectiveness of these assays in personalizing therapy in psoriasis.
    MeSH term(s) Adalimumab ; Anti-Inflammatory Agents/blood ; Anti-Inflammatory Agents/therapeutic use ; Antibodies, Monoclonal, Humanized/blood ; Antibodies, Monoclonal, Humanized/therapeutic use ; Cohort Studies ; Enzyme-Linked Immunosorbent Assay ; Etanercept ; Female ; Humans ; Immunoglobulin G/blood ; Immunoglobulin G/therapeutic use ; Male ; Middle Aged ; Psoriasis/blood ; Psoriasis/drug therapy ; Receptors, Tumor Necrosis Factor/blood ; Receptors, Tumor Necrosis Factor/therapeutic use ; Treatment Outcome
    Chemical Substances Anti-Inflammatory Agents ; Antibodies, Monoclonal, Humanized ; Immunoglobulin G ; Receptors, Tumor Necrosis Factor ; Adalimumab (FYS6T7F842) ; Etanercept (OP401G7OJC)
    Language English
    Publishing date 2013-08
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80076-4
    ISSN 1365-2133 ; 0007-0963
    ISSN (online) 1365-2133
    ISSN 0007-0963
    DOI 10.1111/bjd.12341
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: A case of tuberculous lymphadenitis associated with subepidermal immunobullous disease.

    Alwan, W / Mahil, S K / Banerjee, P / Daramola, O / Giles, A / Hoque, S / Groves, R

    Clinical and experimental dermatology

    2015  Volume 40, Issue 8, Page(s) 946–948

    MeSH term(s) Adult ; Conjunctivitis/diagnosis ; Facial Dermatoses/diagnosis ; Hand Dermatoses/diagnosis ; Humans ; Male ; Mouth Diseases/diagnosis ; Skin Diseases, Vesiculobullous/diagnosis ; Tuberculosis, Lymph Node/diagnosis
    Language English
    Publishing date 2015-12
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 195504-4
    ISSN 1365-2230 ; 0307-6938
    ISSN (online) 1365-2230
    ISSN 0307-6938
    DOI 10.1111/ced.12624
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: British Association of Dermatologists guidelines for biologic therapy for psoriasis 2020: a rapid update.

    Smith, C H / Yiu, Z Z N / Bale, T / Burden, A D / Coates, L C / Edwards, W / MacMahon, E / Mahil, S K / McGuire, A / Murphy, R / Nelson-Piercy, C / Owen, C M / Parslew, R / Uthman, O A / Woolf, R T / Manounah, L / Ezejimofor, M C / Exton, L S / Mohd Mustapa, M F

    The British journal of dermatology

    2020  Volume 183, Issue 4, Page(s) 628–637

    MeSH term(s) Biological Therapy ; Dermatologists ; Humans ; Psoriasis/drug therapy
    Language English
    Publishing date 2020-07-21
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80076-4
    ISSN 1365-2133 ; 0007-0963
    ISSN (online) 1365-2133
    ISSN 0007-0963
    DOI 10.1111/bjd.19039
    Database MEDical Literature Analysis and Retrieval System OnLINE

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