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Article ; Online: Development of antidrug antibodies against adalimumab maps to variation within the HLA-DR peptide-binding groove.

Tsakok, Teresa / Saklatvala, Jake / Rispens, Theo / Loeff, Floris C / de Vries, Annick / Allen, Michael H / Barbosa, Ines A / Baudry, David / Dasandi, Tejus / Duckworth, Michael / Meynell, Freya / Russell, Alice / Chapman, Anna / McBride, Sandy / McKenna, Kevin / Perera, Gayathri / Ramsay, Helen / Ramesh, Raakhee / Sands, Kathleen /

Shipman, Alexa / Burden, A David / Griffiths, Christopher Em / Reynolds, Nick J / Warren, Richard B / Mahil, Satveer / Barker, Jonathan / Dand, Nick / Smith, Catherine / Simpson, Michael A

JCI insight

2023 Volume 8, Issue 4

Abstract: Targeted biologic therapies can elicit an undesirable host immune response characterized by the development of antidrug antibodies (ADA), an important cause of treatment failure. The most widely used biologic across immune-mediated diseases is adalimumab, ...

Abstract	Targeted biologic therapies can elicit an undesirable host immune response characterized by the development of antidrug antibodies (ADA), an important cause of treatment failure. The most widely used biologic across immune-mediated diseases is adalimumab, a tumor necrosis factor inhibitor. This study aimed to identify genetic variants that contribute to the development of ADA against adalimumab, thereby influencing treatment failure. In patients with psoriasis on their first course of adalimumab, in whom serum ADA had been evaluated 6-36 months after starting treatment, we observed a genome-wide association with ADA against adalimumab within the major histocompatibility complex (MHC). The association signal mapped to the presence of tryptophan at position 9 and lysine at position 71 of the HLA-DR peptide-binding groove, with both residues conferring protection against ADA. Underscoring their clinical relevance, these residues were also protective against treatment failure. Our findings highlight antigenic peptide presentation via MHC class II as a critical mechanism in the development of ADA against biologic therapies and downstream treatment response.
MeSH term(s)	Humans ; Adalimumab/therapeutic use ; Genome-Wide Association Study ; Antibodies ; Psoriasis ; HLA-DR Antigens
Chemical Substances	Adalimumab (FYS6T7F842) ; Antibodies ; HLA-DR Antigens
Language	English
Publishing date	2023-02-22
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2379-3708
ISSN (online)	2379-3708
DOI	10.1172/jci.insight.156643
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Article ; Online: The effect of methotrexate and targeted immunosuppression on humoral and cellular immune responses to the COVID-19 vaccine BNT162b2: a cohort study.

The Lancet. Rheumatology

2021 Volume 3, Issue 9, Page(s) e627–e637

Abstract: Background: Patients on therapeutic immunosuppressants for immune-mediated inflammatory diseases were excluded from COVID-19 vaccine trials. We therefore aimed to evaluate humoral and cellular immune responses to COVID-19 vaccine BNT162b2 (Pfizer- ... ...

Abstract	Background: Patients on therapeutic immunosuppressants for immune-mediated inflammatory diseases were excluded from COVID-19 vaccine trials. We therefore aimed to evaluate humoral and cellular immune responses to COVID-19 vaccine BNT162b2 (Pfizer-BioNTech) in patients taking methotrexate and commonly used targeted biological therapies, compared with healthy controls. Given the roll-out of extended interval vaccination programmes to maximise population coverage, we present findings after the first dose. Methods: In this cohort study, we recruited consecutive patients with a dermatologist-confirmed diagnosis of psoriasis who were receiving methotrexate or targeted biological monotherapy (tumour necrosis factor [TNF] inhibitors, interleukin [IL]-17 inhibitors, or IL-23 inhibitors) from a specialist psoriasis centre serving London and South East England. Consecutive volunteers without psoriasis and not receiving systemic immunosuppression who presented for vaccination at Guy's and St Thomas' NHS Foundation Trust (London, UK) were included as the healthy control cohort. All participants had to be eligible to receive the BNT162b2 vaccine. Immunogenicity was evaluated immediately before and on day 28 (±2 days) after vaccination. The primary outcomes were humoral immunity to the SARS-CoV-2 spike glycoprotein, defined as neutralising antibody responses to wild-type SARS-CoV-2, and spike-specific T-cell responses (including interferon-γ, IL-2, and IL-21) 28 days after vaccination. Findings: Between Jan 14 and April 4, 2021, 84 patients with psoriasis (17 on methotrexate, 27 on TNF inhibitors, 15 on IL-17 inhibitors, and 25 on IL-23 inhibitors) and 17 healthy controls were included. The study population had a median age of 43 years (IQR 31-52), with 56 (55%) males, 45 (45%) females, and 85 (84%) participants of White ethnicity. Seroconversion rates were lower in patients receiving immunosuppressants (60 [78%; 95% CI 67-87] of 77) than in controls (17 [100%; 80-100] of 17), with the lowest rate in those receiving methotrexate (seven [47%; 21-73] of 15). Neutralising activity against wild-type SARS-CoV-2 was significantly lower in patients receiving methotrexate (median 50% inhibitory dilution 129 [IQR 40-236]) than in controls (317 [213-487], p=0·0032), but was preserved in those receiving targeted biologics (269 [141-418]). Neutralising titres against the B.1.1.7 variant were similarly low in all participants. Cellular immune responses were induced in all groups, and were not attenuated in patients receiving methotrexate or targeted biologics compared with controls. Interpretation: Functional humoral immunity to a single dose of BNT162b2 is impaired by methotrexate but not by targeted biologics, whereas cellular responses are preserved. Seroconversion alone might not adequately reflect vaccine immunogenicity in individuals with immune-mediated inflammatory diseases receiving therapeutic immunosuppression. Real-world pharmacovigilance studies will determine how these findings reflect clinical effectiveness. Funding: UK National Institute for Health Research.
Language	English
Publishing date	2021-07-08
Publishing country	England
Document type	Journal Article
ISSN	2665-9913
ISSN (online)	2665-9913
DOI	10.1016/S2665-9913(21)00212-5
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Article ; Online: Humoral and cellular immunogenicity to a second dose of COVID-19 vaccine BNT162b2 in people receiving methotrexate or targeted immunosuppression: a longitudinal cohort study.

The Lancet. Rheumatology

2021 Volume 4, Issue 1, Page(s) e42–e52

Abstract: Background: COVID-19 vaccines have robust immunogenicity in the general population. However, data for individuals with immune-mediated inflammatory diseases who are taking immunosuppressants remains scarce. Our previously published cohort study showed ... ...

Abstract	Background: COVID-19 vaccines have robust immunogenicity in the general population. However, data for individuals with immune-mediated inflammatory diseases who are taking immunosuppressants remains scarce. Our previously published cohort study showed that methotrexate, but not targeted biologics, impaired functional humoral immunity to a single dose of COVID-19 vaccine BNT162b2 (Pfizer-BioNTech), whereas cellular responses were similar. Here, we aimed to assess immune responses following the second dose. Methods: In this longitudinal cohort study, we recruited individuals with psoriasis who were receiving methotrexate or targeted biological monotherapy (ie, tumour necrosis factor [TNF] inhibitors, interleukin [IL]-17 inhibitors, or IL-23 inhibitors) from a specialist psoriasis centre serving London and South-East England. The healthy control cohort were volunteers without psoriasis, not receiving immunosuppression. Immunogenicity was evaluated immediately before, on day 28 after the first BNT162b2 vaccination and on day 14 after the second dose (administered according to an extended interval regimen). Here, we report immune responses following the second dose. The primary outcomes were humoral immunity to the SARS-CoV-2 spike glycoprotein, defined as titres of total spike-specific IgG and of neutralising antibody to wild-type, alpha (B.1.1.7), and delta (B.1.617.2) SARS-CoV-2 variants, and cellular immunity defined as spike-specific T-cell responses (including numbers of cells producing interferon-γ, IL-2, IL-21). Findings: Between Jan 14 and April 4, 2021, 121 individuals were recruited, and data were available for 82 participants after the second vaccination. The study population included patients with psoriasis receiving methotrexate (n=14), TNF inhibitors (n=19), IL-17 inhibitors (n=14), IL-23 inhibitors (n=20), and 15 healthy controls, who had received both vaccine doses. The median age of the study population was 44 years (IQR 33-52), with 43 (52%) males and 71 (87%) participants of White ethnicity. All participants had detectable spike-specific antibodies following the second dose, and all groups (methotrexate, targeted biologics, and healthy controls) demonstrated similar neutralising antibody titres against wild-type, alpha, and delta variants. By contrast, a lower proportion of participants on methotrexate (eight [62%] of 13, 95% CI 32-86) and targeted biologics (37 [74%] of 50, 60-85; p=0·38) had detectable T-cell responses following the second vaccine dose, compared with controls (14 [100%] of 14, 77-100; p=0·022). There was no difference in the magnitude of T-cell responses between patients receiving methotrexate (median cytokine-secreting cells per 10 Interpretation: Functional humoral immunity (ie, neutralising antibody responses) at 14 days following a second dose of BNT162b2 was not impaired by methotrexate or targeted biologics. A proportion of patients on immunosuppression did not have detectable T-cell responses following the second dose. The longevity of vaccine-elicited antibody responses is unknown in this population. Funding: NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London; The Psoriasis Association.
Language	English
Publishing date	2021-11-09
Publishing country	England
Document type	Journal Article
ISSN	2665-9913
ISSN (online)	2665-9913
DOI	10.1016/S2665-9913(21)00333-7
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Article ; Online: Risk-mitigating behaviours in people with inflammatory skin and joint disease during the COVID-19 pandemic differ by treatment type: a cross-sectional patient survey.

Mahil, S K / Yates, M / Langan, S M / Yiu, Z Z N / Tsakok, T / Dand, N / Mason, K J / McAteer, H / Meynell, F / Coker, B / Vincent, A / Urmston, D / Vesty, A / Kelly, J / Lancelot, C / Moorhead, L / Bachelez, H / Bruce, I N / Capon, F /

Contreras, C R / Cope, A P / De La Cruz, C / Di Meglio, P / Gisondi, P / Hyrich, K / Jullien, D / Lambert, J / Marzo-Ortega, H / McInnes, I / Naldi, L / Norton, S / Puig, L / Sengupta, R / Spuls, P / Torres, T / Warren, R B / Waweru, H / Weinman, J / Griffiths, C E M / Barker, J N / Brown, M A / Galloway, J B / Smith, C H

The British journal of dermatology

2021 Volume 185, Issue 1, Page(s) 80–90

Abstract: Background: Registry data suggest that people with immune-mediated inflammatory diseases (IMIDs) receiving targeted systemic therapies have fewer adverse coronavirus disease 2019 (COVID-19) outcomes compared with patients receiving no systemic ... ...

Abstract	Background: Registry data suggest that people with immune-mediated inflammatory diseases (IMIDs) receiving targeted systemic therapies have fewer adverse coronavirus disease 2019 (COVID-19) outcomes compared with patients receiving no systemic treatments. Objectives: We used international patient survey data to explore the hypothesis that greater risk-mitigating behaviour in those receiving targeted therapies may account, at least in part, for this observation. Methods: Online surveys were completed by individuals with psoriasis (globally) or rheumatic and musculoskeletal diseases (RMDs) (UK only) between 4 May and 7 September 2020. We used multiple logistic regression to assess the association between treatment type and risk-mitigating behaviour, adjusting for clinical and demographic characteristics. We characterized international variation in a mixed-effects model. Results: Of 3720 participants (2869 psoriasis, 851 RMDs) from 74 countries, 2262 (60·8%) reported the most stringent risk-mitigating behaviour (classified here under the umbrella term 'shielding'). A greater proportion of those receiving targeted therapies (biologics and Janus Kinase inhibitors) reported shielding compared with those receiving no systemic therapy [adjusted odds ratio (OR) 1·63, 95% confidence interval (CI) 1·35-1·97]. The association between targeted therapy and shielding was preserved when standard systemic therapy was used as the reference group (OR 1·39, 95% CI 1·23-1·56). Shielding was associated with established risk factors for severe COVID-19 [male sex (OR 1·14, 95% CI 1·05-1·24), obesity (OR 1·37, 95% CI 1·23-1·54), comorbidity burden (OR 1·43, 95% CI 1·15-1·78)], a primary indication of RMDs (OR 1·37, 95% CI 1·27-1·48) and a positive anxiety or depression screen (OR 1·57, 95% CI 1·36-1·80). Modest differences in the proportion shielding were observed across nations. Conclusions: Greater risk-mitigating behaviour among people with IMIDs receiving targeted therapies may contribute to the reported lower risk of adverse COVID-19 outcomes. The behaviour variation across treatment groups, IMIDs and nations reinforces the need for clear evidence-based patient communication on risk-mitigation strategies and may help inform updated public health guidelines as the pandemic continues.
MeSH term(s)	COVID-19 ; Cross-Sectional Studies ; Humans ; Joint Diseases ; Male ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2021-03-09
Publishing country	England
Document type	Journal Article
ZDB-ID	80076-4
ISSN	1365-2133 ; 0007-0963
ISSN (online)	1365-2133
ISSN	0007-0963
DOI	10.1111/bjd.19755
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Article ; Online: Describing the burden of the COVID-19 pandemic in people with psoriasis: findings from a global cross-sectional study.

Mahil, S K / Yates, M / Yiu, Z Z N / Langan, S M / Tsakok, T / Dand, N / Mason, K J / McAteer, H / Meynell, F / Coker, B / Vincent, A / Urmston, D / Vesty, A / Kelly, J / Lancelot, C / Moorhead, L / Bachelez, H / Capon, F / Contreras, C R /

De La Cruz, C / Di Meglio, P / Gisondi, P / Jullien, D / Lambert, J / Naldi, L / Norton, S / Puig, L / Spuls, P / Torres, T / Warren, R B / Waweru, H / Weinman, J / Brown, M A / Galloway, J B / Griffiths, C M / Barker, J N / Smith, C H

Journal of the European Academy of Dermatology and Venereology : JEADV

2021 Volume 35, Issue 10, Page(s) e636–e640

MeSH term(s)	COVID-19 ; Cross-Sectional Studies ; Humans ; Pandemics ; Psoriasis/epidemiology ; SARS-CoV-2
Language	English
Publishing date	2021-08-19
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.17450
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Article ; Online: Nonadherence to systemic immune-modifying therapy in people with psoriasis during the COVID-19 pandemic: findings from a global cross-sectional survey.

Quirke-McFarlane, Sophia / Weinman, John / Cook, Emma S / Yiu, Zenas Z N / Dand, Nick / Langan, Sinead M / Bechman, Katie / Tsakok, Teresa / Mason, Kayleigh J / McAteer, Helen / Meynell, Freya / Coker, Bolaji / Vincent, Alexandra / Urmston, Dominic / Vesty, Amber / Kelly, Jade / Lancelot, Camille / Moorhead, Lucy / Barbosa, Ines A /

The British journal of dermatology

2023 Volume 188, Issue 5, Page(s) 610–617

Abstract: Background: Nonadherence to immune-modifying therapy is a complex behaviour which, before the COVID-19 pandemic, was shown to be associated with mental health disorders in people with immune-mediated diseases. The COVID-19 pandemic has led to a rise in ... ...

Abstract	Background: Nonadherence to immune-modifying therapy is a complex behaviour which, before the COVID-19 pandemic, was shown to be associated with mental health disorders in people with immune-mediated diseases. The COVID-19 pandemic has led to a rise in the global prevalence of anxiety and depression, and limited data exist on the association between mental health and nonadherence to immune-modifying therapy during the pandemic. Objectives: To assess the extent of and reasons underlying nonadherence to systemic immune-modifying therapy during the COVID-19 pandemic in individuals with psoriasis, and the association between mental health and nonadherence. Methods: Online self-report surveys (PsoProtectMe), including validated screens for anxiety and depression, were completed globally during the first year of the pandemic. We assessed the association between anxiety or depression and nonadherence to systemic immune-modifying therapy using binomial logistic regression, adjusting for potential cofounders (age, sex, ethnicity, comorbidity) and country of residence. Results: Of 3980 participants from 77 countries, 1611 (40.5%) were prescribed a systemic immune-modifying therapy. Of these, 408 (25.3%) reported nonadherence during the pandemic, most commonly due to concerns about their immunity. In the unadjusted model, a positive anxiety screen was associated with nonadherence to systemic immune-modifying therapy [odds ratio (OR) 1.37, 95% confidence interval (CI) 1.07-1.76]. Specifically, anxiety was associated with nonadherence to targeted therapy (OR 1.41, 95% CI 1.01-1.96) but not standard systemic therapy (OR 1.16, 95% CI 0.81-1.67). In the adjusted model, although the directions of the effects remained, anxiety was not significantly associated with nonadherence to overall systemic (OR 1.20, 95% CI 0.92-1.56) or targeted (OR 1.33, 95% CI 0.94-1.89) immune-modifying therapy. A positive depression screen was not strongly associated with nonadherence to systemic immune-modifying therapy in the unadjusted (OR 1.22, 95% CI 0.94-1.57) or adjusted models (OR 1.14, 95% CI 0.87-1.49). Conclusions: These data indicate substantial nonadherence to immune-modifying therapy in people with psoriasis during the pandemic, with attenuation of the association with mental health after adjusting for confounders. Future research in larger populations should further explore pandemic-specific drivers of treatment nonadherence. Clear communication of the reassuring findings from population-based research regarding immune-modifying therapy-associated adverse COVID-19 risks to people with psoriasis is essential, to optimize adherence and disease outcomes.
MeSH term(s)	Humans ; COVID-19/epidemiology ; Cross-Sectional Studies ; Pandemics ; Anxiety/epidemiology ; Anxiety/psychology ; Psoriasis/drug therapy ; Psoriasis/epidemiology ; Depression/epidemiology
Language	English
Publishing date	2023-02-10
Publishing country	England
Document type	Journal Article
ZDB-ID	80076-4
ISSN	1365-2133 ; 0007-0963
ISSN (online)	1365-2133
ISSN	0007-0963
DOI	10.1093/bjd/ljac144
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Article ; Online: Vaccine hesitancy and access to psoriasis care in the COVID-19 pandemic: findings from a global patient-reported cross-sectional survey.

Bechman, K / Cook, ES / Dand, N / Yiu, ZZN / Tsakok, T / Meynell, F / Coker, B / Vincent, A / Bachelez, H / Barbosa, I / Brown, MA / Capon, F / Contreras, CR / De La Cruz, C / Di Meglio, P / Gisondi, P / Jullien, D / Kelly, J / Lambert, J /

Lancelot, C / Langan, SM / Mason, KJ / McAteer, H / Moorhead, L / Naldi, L / Norton, S / Puig, L / Spuls, P / Torres, T / Urmston, D / Vesty, A / Warren, RB / Waweru, H / Weinman, J / Griffiths, CEM / Barker, JN / Smith, CH / Galloway, JB / Mahil, SK

medRxiv

Abstract: Background: COVID-19 vaccination is efficacious at protecting against severe COVID-19 outcomes in the general population. However, vaccine hesitancy (unwillingness for vaccination despite available vaccination services) threatens public health. ... ...

Abstract	Background: COVID-19 vaccination is efficacious at protecting against severe COVID-19 outcomes in the general population. However, vaccine hesitancy (unwillingness for vaccination despite available vaccination services) threatens public health. Individuals taking immunosuppression for psoriasis have been prioritised for COVID-19 vaccination, however there is a paucity of information on vaccine hesitancy in this population, including contributing factors. While global healthcare has been severely disrupted in the pandemic, the impact on access to psoriasis care and whether this may negatively influence vaccine uptake, is underexplored. Objectives: To explore organisational and individual factors associated with COVID-19 vaccine hesitancy in individuals with psoriasis. Methods: Individuals with psoriasis, identified through global patient organisations and social media, completed a cross-sectional self-reported online survey. The primary outcome was COVID-19 vaccine hesitancy. Logistic regression was used to examine the association between predictor variables (organisational and individual factors) and outcome. Results: Self-reported data from 802 individuals with psoriasis across 89 countries were available (65.6% female, median age 51 years [IQR 37-61], 43.7% taking systemic immunosuppression). Eight percent (n=63) reported vaccine hesitancy. Those reporting vaccine hesitancy were younger, more likely to be of non-white ethnicity, non-UK resident, have a lower BMI, not taking systemic immunosuppression and with shorter disease duration compared to those not reporting vaccine hesitancy. The commonest reasons for vaccine hesitancy were concerns regarding vaccine side-effects, that the vaccine is too new or that psoriasis may worsen post-vaccination. Forty percent (n=322) reported that their psoriasis care had been disrupted by the pandemic. These individuals were younger, of non-white ethnicity, with shorter duration and more severe psoriasis. Disruption to psoriasis care was associated with vaccine hesitancy (unadjusted OR 2.97 (95%CI 1.23-7.13), p=0.015), although not statistically significant in the adjusted model. Conclusion: A minority of individuals with psoriasis from our study reported COVID-19 vaccine hesitancy. Similar to general population trends, vaccine hesitancy in our psoriasis sample is most common in younger age and ethnic minority groups. Our data highlight patient concerns regarding COVID-19 vaccination, which are important to address during patient-clinician interactions to help optimise vaccine uptake and mitigate risks from the ongoing pandemic in individuals with psoriasis.
Keywords	covid19
Language	English
Publishing date	2022-01-23
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2022.01.20.22269546
Database	COVID19

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Article: Factors associated with hospitalization due to COVID-19 in patients with psoriasis: insights from a global registry

Mahil, S. / Dand, N. / Mason, K. / Yiu, Z. / Tsakok, T. / Meynell, F. / Coker, B. / McAteer, H. / Moorhead, L. / Mackenzie, T. / Calzavara Pinton, P. / Rivera, R. / Mahe, E. / Carugno, A. / Magnano, M. / Rech, G. / Balogh, E. / Feldman, S. / McMahon, D. /

Freeman, E. / Gisondi, P. / Puig, L. / Warren, R. / Di Meglio, P. / Langan, S. / Capon, F. / Griffiths, C. / Barker, J. / Smith, C.

British Journal of Dermatology

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #755045
Database	COVID19

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Article ; Online: Factors associated with adverse COVID-19 outcomes in patients with psoriasis

Mahil, SK / Dand, N / Mason, KJ / Yiu, ZZ / Tsakok, T / Meynell, F / Coker, B / McAteer, H / Moorhead, L / Mackenzie, T / Rossi, MT / Rivera, R / Mahe, E / Carugno, A / Magnano, M / Rech, G / Balogh, EA / Feldman, SR / De La Cruz, C /

Choon, SE / Naldi, L / Lambert, J / Spuls, P / Jullien, D / Bachelez, H / McMahon, DE / Freeman, EE / Gisondi, P / Puig, L / Warren, RB / Di Meglio, P / Langan, SM / Capon, F / Griffiths, CE / Barker, JN / Smith, CH

insights from a global registry-based study

2020

Abstract: BACKGROUND: The multi-morbid burden and use of systemic immunosuppressants in people with psoriasis may confer greater risk of adverse COVID-19 outcomes but data are limited. OBJECTIVE: Characterize the course of COVID-19 in psoriasis and identify ... ...

Abstract	BACKGROUND: The multi-morbid burden and use of systemic immunosuppressants in people with psoriasis may confer greater risk of adverse COVID-19 outcomes but data are limited. OBJECTIVE: Characterize the course of COVID-19 in psoriasis and identify factors associated with hospitalization. METHODS: Clinicians reported psoriasis patients with confirmed/suspected COVID-19 via an international registry, PsoProtect. Multiple logistic regression assessed the association between clinical/demographic characteristics and hospitalization. A separate patient-facing registry characterized risk-mitigating behaviours. RESULTS: Of 374 clinician-reported patients from 25 countries, 71% were receiving a biologic, 18% a non-biologic and 10% no systemic treatment for psoriasis. 348 (93%) fully recovered from COVID-19, 77 (21%) were hospitalized and nine (2%) died. Increased hospitalization risk was associated with older age (multivariable-adjusted OR 1.59 per 10 years, 95% CI 1.19-2.13), male sex (OR 2.51, 95% CI 1.23-5.12), non-white ethnicity (OR 3.15, 95% CI 1.24-8.03) and comorbid chronic lung disease (OR 3.87, 95% CI 1.52-9.83). Hospitalization was more frequent in patients using non-biologic systemic therapy than biologics (OR 2.84, 95% CI 1.31-6.18). No significant differences were found between biologic classes. Independent patient-reported data (n=1,626 across 48 countries) suggested lower levels of social isolation in individuals receiving non-biologic systemic therapy compared to biologics (OR 0.68, 95% CI 0.50-0.94). CONCLUSION: In this international moderate-severe psoriasis case series, biologics use was associated with lower risk of COVID-19-related hospitalization than non-biologic systemic therapies, however further investigation is warranted due to potential selection bias and unmeasured confounding. Established risk factors (being older, male, non-white ethnicity, comorbidities) were associated with higher hospitalization rates. CLINICAL IMPLICATIONS: We identify risk factors for COVID-19-related hospitalization in psoriasis patients, including older age, male sex, non-white ethnicity and comorbidities. Use of biologics was associated with lower hospitalization risk than non-biologic systemic therapies.
Keywords	RC705 Diseases of the respiratory system ; covid19
Subject code	610 ; 616
Language	English
Publishing date	2020-10-16
Publisher	Elsevier
Publishing country	uk
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Vaccine hesitancy and access to psoriasis care during the COVID-19 pandemic: findings from a global patient-reported cross-sectional survey.

Bechman, Katie / Cook, Emma S / Dand, Nick / Yiu, Zenas Z N / Tsakok, Teresa / Meynell, Freya / Coker, Bolaji / Vincent, Alexandra / Bachelez, Herve / Barbosa, Ines / Brown, Matthew A / Capon, Francesca / Contreras, Claudia R / De La Cruz, Claudia / Meglio, Paola Di / Gisondi, Paolo / Jullien, Denis / Kelly, Jade / Lambert, Jo /

The British journal of dermatology

2022 Volume 187, Issue 2, Page(s) 254–256

MeSH term(s)	COVID-19/prevention & control ; Cross-Sectional Studies ; Humans ; Pandemics ; Patient Reported Outcome Measures ; Psoriasis/drug therapy ; Vaccination ; Vaccination Hesitancy
Language	English
Publishing date	2022-05-03
Publishing country	England
Document type	Letter
ZDB-ID	80076-4
ISSN	1365-2133 ; 0007-0963
ISSN (online)	1365-2133
ISSN	0007-0963
DOI	10.1111/bjd.21042
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In stock of ZB MED Cologne/Königswinter

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Inter-library loan at ZB MED

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Inter-library loan at ZB MED

Full text online

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito