Determination of HLA-Cw6 status for secukinumab therapy is unnecessary, as it is highly effective regardless of HLA-Cw6 status.

INTRODUCTION: Heart failure (HF) is a complex syndrome in which effort limitation is associated with deterioration of peripheral musculature. Improving survival rates among these patients have led to the appearance of cases in which other pathologies are associated with HF, such as peripheral vascular insufficiency (PVI). The combination of these two pathologies is common, with significant repercussions for affected patients. OBJECTIVE: To compare functional limitations and quality of life between patients with HF in isolation or HF + PVI. METHOD: Twelve patients with HF+PVI were paired to 12 patients with HF in isolation. All had ejection fraction <40%. The following were conducted: 6 minute walk test (6MWT), chair test (CT), step test (ST), one repetition maximum test (1RM) and quality of life questionnaire. RESULTS: The results for the 6MWT (311±27 vs. 447±29), ST (49±3 vs. 81±10) and CT (17±1 vs. 21±1) were lower in the HF+PVI group than in the HF group (p<0.05). The HF+PVI group exhibited a reduction in the number of steps taken from the first to the second minute of the ST, in relation to the HF group. The HF group exhibited better HR recovery than the HF+PVI group (50±4 vs. 26±3; p<0.05). No differences were found in results for the Borg scale, the peripheral muscle strength test (1RM) or the questionnaires (p>0.05). CONCLUSIONS: The study participants who had mixed disease exhibited a greater degree of functional impairment than the group with HF, without reporting worsened quality of life.

Summary This study from Italy looked at the response of adults with moderate‐to‐severe psoriasis to secukinumab, a form of treatment known as a human monoclonal antibody, and in particular whether people with a specific gene called HLA‐Cw6 did better or worse. Individuals with this gene are 10 times more likely to develop psoriasis, and their psoriasis is more likely to start early in life and be more severe. Another human monoclonal antibody, ustekinumab, has been shown to produce a quicker and better response in people with the HLA‐Cw6 gene than without. The particular type of psoriasis under investigation in this study was the one where people have long‐lasting large, red, raised, flat areas of psoriasis with a silvery scale (chronic plaque psoriasis). The study confirmed a couple of things that were known already: for instance, that secukinumab is a very effective treatment that works quickly. Also, as one would expect, the group of patients with the HLA‐Cw6 gene were, on average, younger than the group without, and their psoriasis had started at a younger age. With regard to the HLA‐Cw6 gene itself, it was tested for in 431 of the 434 patients originally enrolled into the study. Thirty‐two patients dropped out. Of the remainder, the 227 patients with the HLA‐Cw6 gene did no better after 24 weeks’ secukinumab treatment than the 172 without it. In other words, secukinumab appeared to be equally effective in both groups, and there seems to be no reason to test for the gene before starting treatment.

Summary 这项来自意大利的研究调查了中度至重度银屑病成人对苏金单抗 (一种称为人单克隆抗体的治疗形式) 的治疗反应, 尤其是, 在存在称为 HLA‐Cw6 特定基因的人中的效果是更好还是更差。存在这种基因个体发生银屑病的风险增高 10 倍, 他们的银屑病更可能在生命早期开始, 并且更严重。另一种人单克隆抗体优特克单抗已被证实在有HLA‐Cw6 基因的患者中疗效比无此基因患者中更迅速且更有效。在此研究中接受研究的特定类型银屑病患者有着长期存在的大块、红色、高起、平伏银屑病区域, 上有银色鳞屑 (慢性斑块型银屑病)。这项研究证实了一些已知的事实: 如, 苏金单抗是一种起效迅速的极为有效治疗。另外, 如同预期, 存在 HLA‐Cw6 基因的患者组平均较无此基因患者年轻, 他们的银屑病开始年龄更早。就HLA‐Cw6 基因本身而言, 在最初入选此研究的 434 名患者中, 有 431 名接受了此基因的检测。32 名患者脱落。在其余患者中, 227 名有HLA‐Cw6 基因患者在 24 周苏金单抗治疗后的状况并不优于 172 名无此基因的患者。换而言之, 苏金单抗在两个组中似乎一样有效, 似乎没有理由在开始治疗前检测这一基因。