ORCID Profile
0000-0002-4847-8447
Current Organisations
St George Hospital
,
Bond University
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Publisher: Oxford University Press (OUP)
Date: 12-07-2023
DOI: 10.1093/CED/LLAD215
Abstract: Our case series findings indicate that tildrakizumab treatment in patients with hidradenitis suppurativa who previously received adalimumab demonstrated an initial improvement in disease activity within the first 6 months. However, this overall trend was not sustained beyond the 6-month mark. Nevertheless, it is noteworthy that patients who underwent long-term follow-up on tildrakizumab experienced ongoing disease activity but showed a reduction in Dermatology Life Quality Index scores.
Publisher: Frontiers Media SA
Date: 25-09-2023
Publisher: Wiley
Date: 15-06-2023
DOI: 10.1002/JVC2.182
Abstract: The use of biologic agents has significantly improved the quality of life for patients with chronic skin diseases, and many other autoinflammatory diseases, over the past two decades. Due to the immunosuppressive nature of biologic agents, patients on these treatments are at increased risk of infection. Compulsory serological testing and vaccine optimisation before commencing biologic therapy is not common practice, potentially leaving some of these patients exposed to vaccine‐preventable disease. Our real‐world data aims to assess if the use of biologic agents in patients with hidradenitis suppurativa and psoriasis leads to an accelerated loss of immunity to diseases commonly vaccinated against. We present 77 patients with psoriasis and hidradenitis who underwent serological testing before and after commencing biologic treatment. Statistical analysis, using the Z‐test for differences between two populations, was used to determine if a significant number of patients lost immunity after commencing biologic therapy for the treatment of their skin disease. A significant number of our patients lost immunity, especially to Hepatitis B ( p 0.001) and Diphtheria ( p 0.001), whilst being treated with a biologic agent. Whilst no control group was included in this real‐world study, our findings suggest that biologic agents may shorten the longevity of vaccine‐induced immunity and calls for future, larger‐scale, prospective studies. We recommend pre‐biologic serology testing and vaccine optimisation to reduce the risk of vaccine‐preventable illnesses and unnecessary treatment interruptions.
Publisher: Frontiers Media SA
Date: 14-03-2023
DOI: 10.3389/FMED.2023.1149742
Abstract: Pemphigus is a rare group of autoimmune mucocutaneous blistering conditions for which the mainstay of treatment is immunosuppression. This is usually achieved with high dose corticosteroids as well as steroid sparing agents. Rituximab is now recommended as a first line treatment for moderate to severe pemphigus vulgaris, the commonest form of pemphigus, alongside corticosteroids. During the early stages of the COVID-19 pandemic the use of rituximab was reduced in our department due to its long term irreversible B-cell suppression. During the COVID-19 pandemic careful pharmacological selection was undertaken for our pemphigus patients to balance the risks of immunosuppression. To demonstrate this, we report three pemphigus patients who required treatment for COVID-19 and assessment throughout the pandemic. To date there has been limited published data regarding the clinical outcomes of pemphigus patients who have developed COVID-19 infections following rituximab infusions, especially in those patients who have received COVID-19 vaccinations. Following careful personalized consideration, all three pemphigus patients presented received rituximab infusions since the start of the COVID-19 pandemic. These patients had also received COVID-19 vaccinations prior to becoming infected with COVID-19. Each patient had a mild COVID-19 infection after receiving rituximab. We advocate for all pemphigus patients to have a full course of COVID-19 vaccinations. Antibody response to COVID-19 vaccinations should ideally be confirmed by measuring pemphigus patient’s SARS-CoV-2 antibodies prior to receiving rituximab.
No related grants have been discovered for Corey Stone.