RICARDO ROMITI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/53 - Laboratório de Micologia, Hospital das Clínicas, Faculdade de Medicina
LIM/50 - Laboratório de Patologia das Moléstias Infecciosas, Hospital das Clínicas, Faculdade de Medicina
LIM/53 - Laboratório de Micologia, Hospital das Clínicas, Faculdade de Medicina
LIM/50 - Laboratório de Patologia das Moléstias Infecciosas, Hospital das Clínicas, Faculdade de Medicina
45 resultados
Resultados de Busca
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- Efficacy and safety of fixed-dose combination calcipotriol/betamethasone dipropionate foam for the treatment of psoriasis(2021) GOLD, L. Stein; PAUL, C.; ROMITI, R.The fixed-dose combination calcipotriol (Cal; 50 mu g/g) plus betamethasone dipropionate (BD; 0.5 mg/g) ointment and gel formulations have well-established efficacy profiles in the treatment of psoriasis vulgaris (chronic plaque psoriasis); this combination has been shown to produce favourable outcomes versus either monotherapy. To improve upon the efficacy and cosmetic acceptability of these treatments Cal/BD foam was developed, demonstrating superior efficacy in Phase II/III studies compared with either of its monocomponents, Cal/BD ointment, Cal/BD gel and various other therapies for the treatment of psoriasis. Multiple outcome measures were evaluated in the clinical studies, including physician's global assessment of disease severity and modified psoriasis area and severity index. Of note, 38-55% of patients across studies achieved a physician's global assessment of 'clear' or 'almost clear' after 4 weeks of Cal/BD treatment. This superior efficacy was not associated with an increased frequency or severity of adverse events, and there was no evidence for dysregulation of the hypothalamic-pituitary-adrenal axis or calcium homeostasis. Overall, Cal/BD foam was efficacious, with a good tolerability profile consistent with established Cal/BD formulations.
conferenceObject Patient perception and the importance of clear/almost clear skin as a treatment goal in moderate-to-severe plaque psoriasis: results of the 'Clear about Psoriasis' worldwide patient survey(2017) ARMSTRONG, A.; JARVIS, S.; BOEHNCKE, W-H; RAJAGOPALAN, M.; FERNANDEZ-PENAS, P.; ROMITI, R.; BEWLEY, A.; O'DONNELL, M.; HUNEAULT, L.; DEKKER, E.; SODHA, M.; WARREN, R. B.- Childhood-onset bullous systemic lupus erythematosus(2014) LOURENCO, D. M. R.; GOMES, R. Cunha; AIKAWA, N. E.; CAMPOS, L. M. A.; ROMITI, R.; SILVA, C. A.Bullous systemic lupus erythematosus has rarely been described in pediatric lupus population and the real prevalence of childhood-onset bullous systemic lupus erythematosus has not been reported. From January 1983 to November 2013, 303 childhood-onset SLE (c-SLE) patients were followed at the Pediatric Rheumatology Unit of the Childres Institute of Hospital das Clinicas da Faculdade de Medicina Universidade da Universidade de SAo Paulo, three of them (1%) diagnosed as childhood-onset bullous systemic lupus erythematosus. All three cases presented tense vesiculobullous lesions unassociated with lupus erythematosus lesions, with the median duration of 60 days (30-60). All patients fulfilled bullous systemic lupus erythematosus criteria. Two had nephritis and serositis and presented specific autoantibodies. The histological pattern demonstrated subepidermal blisters with neutrophils-predominant infiltrates within the upper dermis. Direct immunofluorescence (DIF) showed deposits of IgG and complement along the epidermal basement membrane, in the presence or absence of IgA and/or IgM. A positive indirect immunofluorescence on salt-split skin demonstrating dermal binding was observed in two cases. All of them had moderate/severe disease activity at diagnosis with median Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) of 18 (14-24). Two patients received dapsone and one with severe nephritis received immunosuppressive drugs. In conclusion, in the last 30 years the prevalence of bullous lupus in childhood-onset lupus population was low (1%) in our tertiary University Hospital. A diagnosis of SLE should always be considered in children with recurrent tense vesiculobullous lesions with or without systemic manifestations.
- Tofacitinib withdrawal and retreatment in moderate-to-severe chronic plaque psoriasis: a randomized controlled trial(2015) BISSONNETTE, R.; IVERSEN, L.; SOFEN, H.; GRIFFITHS, C. E. M.; FOLEY, P.; ROMITI, R.; BACHINSKY, M.; ROTTINGHAUS, S. T.; TAN, H.; PROULX, J.; VALDEZ, H.; GUPTA, P.; MALLBRIS, L.; WOLK, R.Background Tofacitinib is an oral Janus kinase inhibitor being investigated for the treatment of moderate-to-severe plaque psoriasis. Objectives To compare outcomes following tofacitinib withdrawal with outcomes of continuation. Methods In this phase 3 study (NCT01186744), patients received tofacitinib 5 mg (n = 331) or 10 mg (n = 335) twice daily for 24 weeks. The patients who achieved both >= 75% reduction in Psoriasis Area and Severity Index (PASI 75) score from baseline and Physician's Global Assessment (PGA) of 'clear' or 'almost clear' (PGA response) received a placebo (withdrawal) or the previous dose. At relapse (> 50% reduction in the PASI improvement during initial treatment) or week 40, the patients received the initial dose. Results Initial treatment: 33.5% and 55.2% achieved both PASI 75 and PGA responses with tofacitinib 5 and 10 mg twice daily, respectively, making them eligible for the treatment-withdrawal period. Withdrawal: 56.2%, 62.3%, 23.3% and 26.1% maintained PASI 75 responses with tofacitinib 5, 10 mg, placebo (5 mg) and placebo (10 mg) twice daily, respectively; 49.9%, 63.9%, 22.9% and 18.0% maintained PGA responses; and 92.3%, 93.0%, 32.8% and 42.9% did not relapse. Elevations in low-density lipoprotein-cholesterol levels following initial treatment (mean increase: 8.71 mg dL(-1) with 5 mg twice daily, 10.26 mg dL(-1) with 10 mg twice daily) were reversed upon withdrawal. Retreatment: 36.8% and 61.0% of patients who relapsed achieved PASI 75 responses with tofacitinib 5 or 10 mg after 16 weeks; 44.8% and 57.1% regained PGA responses. Conclusions Patients who received continuous treatment maintained a response more effectively when compared with placebo recipients. Safety profiles were comparable in both the continuous treatment group and retreatment group. Of those patients who relapsed, up to 60% recaptured a response with tofacitinib.
conferenceObject Biosimilars in psoriasis: clinical practice and regulatory perspectives in Latin America(2016) CRUZ, C. De la; CARVALHO, A.; LEON-DORANTES, G.; GARCIA, A. Londono; GONZALEZ, C.; MASKIN, M.; PODOSWA, N.; REDFERN, J.; VALENZUELA, F.; WALT, J. Van der; ROMITI, R.- Areata-Like Lupus as a Clinical Manifestation of Cutaneous Lupus Erythematosus(2022) MORAIS, K. L.; SECCHIN, P.; ANZAI, A.; VERUSSA, M. J. M. C.; MUNCK, A.; FECHINE, C. O. C.; VALENTE, N. Y. S.; ROMITI, R.Introduction: Lupus erythematosus (LE) is a chronic autoimmune disease that frequently causes hair loss and scalp lesions. Hair loss can be scarring and nonscarring, diffuse, or patchy. The nonscarring patchy alopecia is usually related to systemic LE (SLE) and may simulate alopecia areata (AA), reason why it is named areata-like lupus. Our case was diagnosed with areata-like lupus but did not meet criteria for SLE. Case Report: A 63-year-old woman presented with irregular nonscarring patchy alopecia in the temporal and frontoparietal scalp. Trichoscopy showed exclamation mark hairs, vellus hairs, and sparse yellow dots. Histology revealed epidermal vacuolar interface dermatitis, lymphohistiocytic infiltrate around the bulbs of anagen follicles, and eccrine glands. Direct immunofluorescence showed deposits of C3, IgA, and IgG in the basement membrane zone. Discussion: Patients with cutaneous LE can also manifest as nonscarring patchy alopecia that is clinically similar to AA, despite the absence of systemic manifestations. Areata-like lupus is secondary to the lupus autoimmune infiltrate that affects the skin including the hair follicles. Trichoscopy, histology, and direct immunofluorescence are important to differentiate this form of alopecia from AA, which is believed to have a higher incidence in lupus patients.
- Patient-dermatologist agreement in psoriasis severity, symptoms and satisfaction: results from a real-world multinational survey(2018) GRIFFITHS, C. E. M.; AUGUSTIN, M.; NALDI, L.; ROMITI, R.; GUEVARA-SANGINES, E.; HOWE, T.; PIETRI, G.; GILLOTEAU, I.; RICHARDSON, C.; TIAN, H.; JO, S. J.BackgroundPsoriasis is a chronic immune-mediated inflammatory disease, which often requires lifelong treatment. A strong partnership between the patient and healthcare practitioners should help to achieve effective treatment outcomes. ObjectiveTo assess concordance of views between patients with psoriasis and their treating dermatologists relative to psoriasis severity, presence of symptoms and satisfaction with disease control achieved. MethodsWe used data from the Growth from Knowledge (GfK) Disease Atlas real-world evidence program, a syndicated, retrospective, cross-sectional survey among dermatologists and their systemic therapy eligible patients with psoriasis, conducted across nine countries. Concordance was measured through patients and their dermatologist's identical answers to the same survey questions. Concordance was evaluated using percentage agreement between dermatologists and their patients, and Cohen's kappa () statistic. The level of concordance was defined as none' ( 0), none to slight' (0.01-0.20), fair' (0.21-0.40), moderate' (0.41-0.60), substantial' (0.61-0.80) and almost perfect' (>0.8). The analysis was conducted for the overall population and for each participating country. ResultsOverall, 524 dermatologists and 3821 patients with psoriasis were included in the survey. Concordance of patient and dermatologist perceptions of psoriasis severity was fair both at diagnosis, and at the time of the survey (61% agreement, = 0.326 and 55% agreement, = 0.370, respectively). Higher levels of concordance were reported when patients assessed their psoriasis as moderate-to-severe (using Investigator's Global Assessment/Physician's Global Assessment [IGA/PGA] 5-point scale of 3 or 4). Concordance regarding symptoms ranged from fair to moderate ( = 0.241-0.575). Satisfaction with psoriasis control was fair (39% agreement, = 0.213). Results showed different patterns of concordance across the participating countries although a low concordance was observed on the satisfaction with psoriasis control in all of them. ConclusionResults from this multinational real-world survey indicate different perceptions between patients with psoriasis and their dermatologist with respect to psoriasis severity, symptoms and disease control. Linked article: This article is commented on by P.V. Chernyshov, pp. 1404-1405 in this issue. To view this article visit
- Genital discoid lupus: a rare manifestation of cutaneous lupus erythematosus(2014) ROMITI, R.; ANZAI, A.; NICO, M. M.Cutaneous lupus erythematosus classically presents as sharply demarcated plaques with pigmentary changes and varying degrees of scarring typically affecting the face and scalp. Genital manifestations of lupus erythematosus have rarely been described in literature. Here we report two cases of discoid lupus erythematosus affecting the genital area. Both patients were equally affected by widespread discoid lesions on the head. Although rare, genital involvement of lupus erythematosus must be considered in the differential diagnosis of genital lesions.
- Quality-of-life impairment is not related to disease activity in lichen planopilaris and frontal fibrosing alopecia. Results of a preliminary cross-sectional study(2022) DOCHE, I.; ROMITI, R.; RIVITTI-MACHADO, M. C.; GORBATENKO-ROTH, K.; FREESE, R. L.; HORDINSKY, M. K.
- 3.41 - Skin Barrier, Microbiome and Psoriasis(2022) HIRAYAMA, A. L. S. da; FONSECA, D. C.; ROMITI, R.Psoriasis is an inflammatory skin disorder of multifactorial etiology related to dysregulation of innate and adaptive immune responses, genetic inheritance and environmental factors. Skin and gut share features and functions. Each one has a singular ecosystem that interacts with epithelial and immune responses. The association of psoriasis with inflammatory bowel disease is well-documented, as well as immune and correlated inflammatory pathways. Recent studies have shown differences in the microbiome of psoriasis suggesting that the influence of gut and skin microbiome can possibly be related with the pathophysiology, disease's course and even its prognosis and treatment response. © 2022 Elsevier Inc. All rights reserved.