• Humans
• Methotrexate/therapeutic use
• Interleukin-17
• Tumor Necrosis Factor-alpha
• Psoriasis/drug therapy
• Cyclosporine
• Biological Factors/therapeutic use
• Biological Products/pharmacology
• Biological Products/therapeutic use
• Cytochrome P-450 Enzyme System
• Treatment Outcome
• Thalidomide/analogs & derivatives

• elderly
• fertility
• lactation
• paediatrics
• pregnancy
• psoriasis
• treatment

• Psoriasis
• biologics
• elderly
• geriatric
• small molecules
• treatment

• elderly
• fertility
• lactation
• pregnancy
• psoriasis
• therapy

• Aged
• Biological Products/adverse effects
• Cohort Studies
• Crohn Disease/chemically induced
• Crohn Disease/diagnosis
• Crohn Disease/drug therapy
• Humans
• Middle Aged
• Remission Induction
• Retrospective Studies
• Treatment Outcome
• Tumor Necrosis Factor-alpha
• Ustekinumab/adverse effects

• Biologic therapy
• Guidelines
• Guía
• Psoriasis
• Recomendaciones
• Recommendations
• Terapia biológica

• Humans
• Biological Factors/therapeutic use
• Dermatology
• Psoriasis/drug therapy
• Severity of Illness Index
• Venereology

The availability of biologic therapies in inflammatory bowel disease (IBD) is increasing significantly. This represents more options to treat patients, but also more difficulties in choosing the therapies, especially in the context of bio-naïve patients. Most evidence of safety and efficacy came from clinical trials comparing biologics with placebo, with a lack of head-to-head studies. Network meta-analysis of biologics and real-world studies have been developed to solve this problem. Despite the results of these studies, there are also other important factors to consider before choosing the biologic, such as patient preferences, comorbidities, genetics, and inflammatory markers. Given that resources are limited, another important aspect is the cost of biologic therapy, since biosimilars are widely available and have been demonstrated to be effective with a significant decrease in costs. In this review, we summarize the evidence comparing biologic therapy in both Crohn´s disease (CD) and ulcerative colitis (UC) in different clinical situations. We also briefly synthesize the evidence related to predictors of biologic response, as well as the biologic use in extraintestinal manifestations and the importance of the drug-related costs.

Elderly patients (aged ≥ 65 years) represent an increasing proportion of patients with psoriasis and 15% of these have moderate to severe disease. Biologics are being used frequently in this group of patients even though safety and efficacy data are limited. In addition, owing to anti‐interleukin (IL)‐23 therapies being a relatively recent option, no data have been reported about their use in elderly patients with psoriasis.

To evaluate and compare the safety and efficacy of guselkumab, risankizumab and tildrakizumab in real‐world practice in elderly patients.

This was a single‐centre retrospective study that enrolled patients aged ≥ 65 years with moderate to severe plaque psoriasis, treated with guselkumab, risankizumab or tildrakizumab. The length of the study for each group depended on the drug (44 weeks for risankisumab, 40 weeks for guselkumab and 28 weeks for tildrakizumab, owing to its more recent availability in Italy).

In total, 34 patients were enrolled (n = 20 on guselkumab; n = 8 on risankizumab; n = 6 on tildrakizumab). At Week 4, 29.4% reached 90% improvement in Psoriasis Area and Severity Index (PASI90) and 8.8% reached 100% improvement in PASI (PASI100); at Week 28, PASI90 and PASI100 was reached by 58.8% and 29.4%, respectively. At the final follow‐up (Week 40 or 44, depending on drug), data were available only for the risankizumab (Week 40) and guselkumab (Week 44) and groups, and showed that 71.4% of patients had reached PASI90 and 53.5% had reached PASI100. Four patients (11.7%) discontinued treatment. No significant differences were found between the three groups. The limitations of the study included its retrospective nature of the study, small sample size, and different numbers of patients and follow‐up duration for the different groups (highest for guselkumab, lowest for tildrakizumab).

The three anti‐IL‐23 therapies assessed are promising, safe and effective options in elderly patients, and there was no significant difference between them. However, more data are needed to confirm our results and to understand their role in the management of this group of patients.

• COVID-19
• Crohn’s disease
• elderly
• frailty
• inflammatory bowel disease
• phenotype
• treatment
• ulcerative colitis

• atopic dermatitis
• elderly
• observational studies
• psoriasis
• safety

The Third International Conference on Controversies in Vitamin D was held in Gubbio, Italy, September 10–13, 2019. The conference was held as a follow‐up to previous meetings held in 2017 and 2018 to address topics of controversy in vitamin D research. The specific topics were selected by the steering committee of the conference and based upon areas that remain controversial from the preceding conferences. Other topics were selected anew that reflect specific topics that have surfaced since the last international conference. Consensus was achieved after formal presentations and open discussions among experts. As will be detailed in this article, consensus was achieved with regard to the following: the importance and prevalence of nutritional rickets, amounts of vitamin D that are typically generated by sun exposure, worldwide prevalence of vitamin D deficiency, the importance of circulating concentrations of 25OHD as the best index of vitamin D stores, definitions and thresholds of vitamin D deficiency, and efficacy of vitamin D analogues in the treatment of psoriasis. Areas of uncertainly and controversy include the following: daily doses of vitamin D needed to maintain a normal level of 25OHD in the general population, recommendations for supplementation in patients with metabolic bone diseases, cutaneous production of vitamin D by UVB exposure, hepatic regulation of 25OHD metabolites, definition of vitamin D excess, vitamin D deficiency in acute illness, vitamin D requirements during reproduction, potential for a broad spectrum of cellular and organ activities under the influence of the vitamin D receptor, and potential links between vitamin D and major human diseases. With specific regard to the latter area, the proceedings of the conference led to recommendations for areas in need of further investigation through appropriately designed intervention trials. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.

• ENDOCRINE PATHWAYS
• METABOLIC BONE DISEASES
• NUTRITION
• OSTEOMALACIA
• RICKETS
• VITAMIN D
• VITAMIN D DEFICIENCY

Knowledge regarding differences in care for psoriatic patients is limited. The aim of this study was to investigate factors influencing prescription of systemic treatments for patients with psoriasis with a special focus on socioeconomic factors.

This was a non-interventional, cross-sectional study, conducted in 18 Italian University and/or hospital centers with psoriasis-specialized units. Questionnaires evaluating demographic and socioeconomic characteristics were administered to participants. Overall, 1880 consecutive patients affected by mild-to-severe psoriasis were recruited. Univariate and multivariable logistic regression analyses of systemic therapy prescription, with a special focus on biologics, accounting for the above mentioned characteristics were performed. Our analysis showed that all analyzed patients’ characteristics were significantly associated with biological therapy compared to non-biological systemic one. Particularly, women were less likely to receive biologics than men (OR = 0.66; 95% CI, 0.57–0.77). Elderly patients (≥65 years) and subjects with a BMI ≥30 had lower odds to receive biologics respect to adults (≥35–64 years) (OR = 0.33; 95% CI, 0.25–0.40), and subjects with BMI≥25<30 (OR = 0.64; 95% CI, 0.53–0.77), respectively. Northern and Southern patients were both less likely to receive biologics than Central patients (OR = 0.75; 95% CI, 0.63–0.89, and OR = 0.56; 95% CI,0.47–0.68, respectively). Lower economic profile and never reading books were both associated with decreased odds of receiving biological therapy.

This study shows that sex, age, comorbidities, and socioeconomic characteristics influence the prescription of systemic treatments in psoriasis, highlighting that there are still unmet needs influencing the therapeutic decision-making process that have to be addressed.

• Biologics
• elderly
• non-biological systemic therapies
• psoriasis
• safety profile

The number of elderly people with chronic inflammatory rheumatic diseases is increasing. This heterogeneous and comorbid population is at particular risk of cardiovascular, neoplastic, infectious and iatrogenic complications. The development of biotherapies has paved the way for innovative therapeutic strategies, which are associated with toxicities. In this review, we have focused on the scientific and therapeutic changes impacting the management of elderly patients affected by RA, SpA or PsA. A multidimensional health assessment resulting in an integrated therapeutic strategy was identified as a major research direction for improving the management of elderly patients.

• biotherapies
• efficacy
• elderly
• inflammatory rheumatism
• management
• safety

• IBD
• crohn's disease
• elderly
• ulcerative colitis

• Biological therapy
• Elderly
• Glucocorticoids
• Inflammatory bowel disease
• Outcomes
• Surgery

• Age Factors
• Aged
• Anti-Inflammatory Agents/administration & dosage
• Anti-Inflammatory Agents/adverse effects
• Biological Products/administration & dosage
• Biological Products/adverse effects
• Clinical Trials as Topic
• Colitis, Ulcerative/epidemiology
• Colitis, Ulcerative/therapy
• Comorbidity
• Crohn Disease/epidemiology
• Crohn Disease/therapy
• Drug Utilization/statistics & numerical data
• Evidence-Based Medicine/methods
• Evidence-Based Medicine/standards
• Evidence-Based Medicine/statistics & numerical data
• Gastroenterology/methods
• Gastroenterology/standards
• Gastroenterology/statistics & numerical data
• Glucocorticoids/administration & dosage
• Glucocorticoids/adverse effects
• Humans
• Patient Selection
• Practice Guidelines as Topic
• Prevalence
• Proctocolectomy, Restorative/adverse effects
• Proctocolectomy, Restorative/standards
• Proctocolectomy, Restorative/statistics & numerical data
• Treatment Outcome

• anti‐TNF
• inflammatory bowel disease
• ustekinumab
• vedolizumab

• Psoriasis
• TNF-alpha inhibitors
• anti-interleukin-12/23
• anti-interleukin-17
• anti-interleukin-23
• biologics
• dermatology life quality index (DLQI)
• health-related quality of life

• Dermatologist
• Environmental factors
• Nutrition
• Nutritionist
• Psoriasis
• Vitamin D

• Animals
• Dermatologists
• Humans
• Nutritional Physiological Phenomena
• Nutritionists
• Practice Patterns, Physicians'/statistics & numerical data
• Psoriasis/etiology
• Psoriasis/therapy
• Skin Physiological Phenomena/drug effects
• Vitamin D/administration & dosage
• Vitamin D/physiology
• Vitamin D Deficiency/complications

• Psoriasis
• elderly
• infliximab
• long-term