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
52 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 52
- Evidence for neurogenic inflammation in lichen planopilaris and frontal fibrosing alopecia pathogenic mechanism(2020) DOCHE, Isabella; WILCOX, George L.; ERICSON, Marna; VALENTE, Neusa S.; ROMITI, Ricardo; MCADAMS, Brian. D.; HORDINSKY, Maria K.Lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) are lymphocytic scarring alopecias affecting primarily the scalp. Although both diseases may share some clinical and histopathological features, in the last decade, FFA has become an ""epidemic"" particularly in Europe, North and South America with unique clinical manifestations compared to LPP, thus, raising the idea that this disease may have a different pathogenesis. Symptoms such as scalp burning, pruritus or pain are usually present in both diseases, suggesting a possible role for nerves and neuropeptides in the pathogenesis of both diseases. Based on some previous studies, neuropeptides, such as substance P (SP) and calcitonin gene-related peptide (CGRP), have been associated with lipid metabolism and many chronic inflammatory disorders. In this study, we asked if these neuropeptides are associated with LPP and FFA scalp lesions. Alteration in the expression of SP and CGRP in affected and unaffected scalp skin from patients with both diseases was found with examination of sections using immunohistochemical techniques and confocal microscopy. We then quantitatively assessed and compared SP and CGRP expression from control, LPP and FFA scalp biopsies. Although LPP and FFA share similar histopathologic findings, opposite results were found in affected and unaffected scalp in the ELISA tests, suggesting that these diseases may have different pathogenic mechanisms. We also found presence of histopathological inflammation irrespective of evident clinical lesions, which raises the possibility that both diseases may be more generalized processes affecting the scalp.
- 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 Scalp neuropathy in dermatomyositis patients with recalcitrant scalp pruritus(2018) CIRINO, Pablo; WIPF, Angela; ROMITI, Ricardo; MCADAMS, Brian; FOSTER, Shawn; KENNEDY, William; HORDINSKY, MariaconferenceObject 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.- 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 Cross-Cultural Adaptation, Validation and Reliability Of The Brazilian Version Of The Psoriatic Arthritis Screening Evaluation Tool(2013) RANZA, Roberto; SCHAINBERG, Claudia G.; CARNEIRO, Sueli; MARTINS, Gladys; RODRIGUES, Jose Joaquim; CARNEIRO, Jamille; ROMITI, Ricardo; BARROS, Thiago B. M.; SAMPAIO, Ana Luiza; PEDREIRA, Amanda; COSTA, Carolina Z.; PINTO, Rogerio M. C.; HUSNI, M. Elaine; QURESHI, Abrar A.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.- 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
- Semantic and psychometric validation of the Brazilian Portuguese version (PASE-P) of the Psoriatic Arthritis Screening and Evaluation questionnaire(2018) COSTA, Carolina Zorzanelli; GOLDENSTEIN-SCHAINBERG, Claudia; CARNEIRO, Sueli; RODRIGUES, Jose Joaquim; ROMITI, Ricardo; BARROS, Thiago Bitar Martins; MARTINS, Gladys; CARNEIRO, Jamile; GRYNSZPAN, Rachel; SAMPAIO, Ana Luisa; MENDONCA, Tania Maria Silva; SILVA, Carlos Henrique Martins; QURESHI, Abrar A.; PINTO, Rogerio de Melo Costa; RANZA, RobertoPASE (Psoriatic Arthritis Screening and Evaluation) was developed in the English language to screen for inflammatory arthritis among patients with psoriasis. It is 15 item self administered questionnaire with a score from 15 to 75. A higher score indicates a greater risk for inflammatory joint disease. The purpose of this study was to translate, adapt and validate this questionnaire into Brazilian Portuguese (PASE-P). METHODS: 465 patients diagnosed with psoriasis (158 with psoriatic arthritis confirmed by a rheumatologist according to the CASPAR criteria and 307 without) were evaluated in dermatology clinics. We performed the analysis of semantic equivalence in eight steps. For psychometric equivalence, we evaluated the data quality, reliability, construct validity, well-known groups and discriminant characteristics of the items, as well as a ROC curve to determine optimal PASE-P cutoff points in case identification and their sensitivity / specificity. The final version presented excellent reproducibility (CCI = 0.97) and reliability (Cronbach's alpha> 0.9). A cut-off point of 25 distinguished between patients with and without psoriatic arthritis, with sensitivity of 69.5 and specificity of 86.8. PASE-P proved to be culturally valid and reliable to screen for psoriatic arthritis in Brazilian patients with psoriasis.
- 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.