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Fracture risk assessment in patients with chronic kidney disease (CKD) has been included in the CKD-MBD (''Chronic Kidney Disease-Mineral and Bone Disorders'') complex in international and national nephrology guidelines, suggesting for the first time the assessment of bone mineral density (BMD) if the results can influence therapeutic decision-making. However, there is very little information on actual clinical practice in this population. The main objective of the ERCOS (ERC-Osteoporosis) study is to describe the profile of patients with CKD G3-5D with osteoporosis (OP) and/or fragility fractures treated in specialized nephrology, rheumatology and internal medicine clinics in Spain. Fifteen centers participated and 162 patients (mostly women [71.2%] postmenopausal [98.3%]) with a median age of 77 years were included. Mean estimated glomerular filtration rate (eGFR) was 36 mL/min/1.73 m2 and 38% of the included patients were on dialysis. We highlight the high frequency of prevalent fragility fractures [37.7%), mainly vertebral (52.5%) and hip (24.6%)], the disproportionate history of patients with glomerular disease compared to purely nephrological series (corticosteroids) and undertreatment for fracture prevention, especially in nephrology consultations. This study is an immediate call to action with the dissemination of the new, more proactive, clinical guidelines, and underlines the need to standardize a coordinated and multidisciplinary care/therapeutic approach to these patients in an efficient way to avoid current discrepancies and therapeutic nihilism. Resumen: La valoración del riesgo de fractura del paciente con enfermedad renal crónica (ERC) ha sido incluida en el complejo CKD-MBD («Chronic Kidney Disease-Mineral and Bone Disorders») en guías nefrológicas internacionales y nacionales, sugiriéndose por primera vez la evaluación de la densidad mineral ósea (DMO) si los resultados pueden condicionar la toma de decisiones terapéuticas. Sin embargo, existe muy poca información en práctica clínica real en esta población. El objetivo principal del estudio ERCOS (ERC-Osteoporosis) es describir el perfil de los pacientes con ERC G 3-5 D con osteoporosis (OP) y/o fracturas por fragilidad atendidos en consultas especializadas de nefrología, reumatología y medicina interna en España. Participaron 15 centros y se incluyeron 162 pacientes (siendo en su mayoría mujeres [71,2%] postmenopáusicas [98,3%]) con una mediana de edad de 77 años. La mediana del filtrado glomerular estimado (FGe) fue de 36 mL/min/1,73m2 y 38% de pacientes incluidos estaban en diálisis. Destacamos la elevada frecuencia de fracturas por fragilidad prevalentes [37,7%), principalmente vertebrales (52,5%) y de cadera (24,6%)], el antecedente desproporcionado de pacientes con patología glomerular en comparación a series puramente nefrológicas (corticoides) y el infratratamiento para la prevención de fracturas, fundamentalmente en consultas nefrológicas. Este estudio supone una inmediata llamada a la acción con la difusión de las nuevas guías clínicas, más proactivas, y subraya la necesidad de homogeneizar el enfoque asistencial/terapéutico multidisciplinar coordinado de estos pacientes de un modo eficiente para evitar las actuales discrepancias y el nihilismo terapéutico.

Abstract Background There is limited evidence over the real‐life secukinumab survival in psoriatic patients, especially in the long‐term bio‐naïve subjects, and to date biological treatments have been assessed in patients with a chronic and recalcitrant psoriasis. It has been hypothesised that early intensive treatment with biological therapies could decrease pathogenic tissue resident memory (TRm) cells migration and potentially modify the natural course of psoriasis and related comorbidities. Objectives To analyze long‐term secukinumab efficacy, safety and survival, and its predictive factors for psoriasis treatment determining also whether early intervention may result in better outcomes for patients. Methods Bio‐naïve psoriatic patients under treatment with secukinumab (n = 128 patients) in a daily practice setting were analyzed in a retrospective multicentric study and followed up to 8 years. Drug survival rate, efficacy, posology and safety were reported. Results The overall secukinumab survival was 81.9% for an average treatment exposure of 147.9 weeks. The approved posology was the most commonly prescribed regimen (78.7%), and 17.7% could be optimized. An absolut‐PASI ≤3 was reached by 86.6%, 82.6% and 91.7% at the weeks 48,156 and 264, respectively. The incidence of arthritis or psoriasis related comorbidities was low. The response was not influenced by weight, age (>65), gender or the presence of arthritis. No severe adverse events were reported. Conclusions In our bio‐naïve series, the high efficacy and long‐term survival rates observed and the low prevalence of arthritis and comorbidities might suggest that early intervention could contribute to modify the course of the disease, but further studies are needed.