News in brief: Ustekinumab subsidised for kids with severe CPP; Skin imaging centre of excellence gets $2.5m funding; Covid chilblain mechanism revealed


12 Oct 2021

Ustekinumab subsidised for kids with severe chronic plaque psoriasis

Ustekinumab (Stelara) is now available on the PBS for the treatment of paediatric patients with severe chronic plaque psoriasis (CPP). The drug was recommended for listing by the PBAC at its March meeting on the basis that  that ustekinumab provides, for some patients, a significant improvement in efficacy over etanercept. “The PBAC considered that the strong consumer support for ustekinumab reflected an unmet clinicial need for a drug with an alternative mechanism of action to etanercept.” The PBAC also noted that although etanercept is currently available for the paediatric CPP population on the PBS, it has a TGA indication limited to 24 weeks’ treatment, as its safety profile depicts only short term use.

Skin imaging centre of excellence gets $2.5m funding

Professor Monika Janda and colleagues at the University of Queensland have been awarded $2.5 million in the latest round of NHMRC grants to fund a Centre of Research Excellence into skin imaging and precision diagnosis of skin cancers. The researchers say that in the absence of a national screening program for melanoma, the aim of the CRE is to identify how novel skin imaging technologies can be integrated into the pathway to improve early detection, and ultimately reduce the health and economic burden caused by melanoma skin cancer.

Covid chilblain mechanism revealed

The underlying mechanisms involved in “COVID toes” chilblain-like lesions have been elucidated in a French study published in the British Journal of Dermatology.

Researchers compared 50 participants with COVID toes and 13 with seasonal chilblains lesions that arose before the pandemic. They found that mechanisms behind both types involved type I interferon polarisation and a cytotoxic–natural killer gene signature.

Chilblain-like lesions were characterised by higher IgA tissue deposition and more significant transcriptomic activation of complement and angiogenesis factors compared with seasonal chilblains . We observed in CLL a systemic immune response associated with IgA antineutrophil cytoplasmic antibodies in 73% of patients, and elevated type I interferon blood signature in comparison with healthy controls.

And using blood biomarkers related to endothelial dysfunction and activation, and to angiogenesis or endothelial progenitor cell mobilisation, they confirmed endothelial dysfunction in chilblain-like lesions

“Our findings support an activation loop in the skin in chilblain-like lesions associated with endothelial alteration and immune infiltration of cytotoxic and type I IFN-polarised cells leading to clinical manifestations,” they concluded.

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