- Responsiveness of the EQ-5D-3L, DLQI, and DLQI-R for Patients With Psoriasis in the United States. [Letter]
- BJBr J Dermatol 2019 May 17
- Since psoriasis is associated with substantial impairment in health-related quality of life (HRQoL), this outcome has become an important endpoint in clinical trials and indicator of disease severity…
Since psoriasis is associated with substantial impairment in health-related quality of life (HRQoL), this outcome has become an important endpoint in clinical trials and indicator of disease severity in clinical practice. HRQoL can be measured using either generic instruments, such as the EuroQol 5-Dimension 3-Level (EQ-5D-3L), or dermatology-specific HRQoL instruments, such as the Dermatology Life Quality Index (DLQI). While generic HRQoL instruments are typically more extensively validated and allow for cross-disease comparisons, dermatology-specific instruments may have better responsiveness to change, which is important when evaluating the impact of treatment in clinical trials or routine practice. However, little is known about the relative responsiveness of generic versus disease-specific instruments for patients with psoriasis. This article is protected by copyright. All rights reserved.
- Secukinumab dosing optimization in patients with moderate to severe plaque psoriasis: Results from the randomised, open-label OPTIMISE study. [Journal Article]
- BJBr J Dermatol 2019 May 17
- CONCLUSIONS: Standard q4w dosing of secukinumab 300 mg is the optimal dosing regimen to achieve and maintain clear or almost clear skin. Subjects with body weight ≥90 kg not achieving PASI 90 at Week 24 may benefit from the q2w dosing regimen. This article is protected by copyright. All rights reserved.
- Drug Survival of Biological Therapies for Psoriasis Treatment in Germany and Associated Costs: A Retrospective Claims Database Analysis. [Journal Article]
- ATAdv Ther 2019 May 17
- CONCLUSIONS: Observed drug survival rates in this real-world setting were relatively low. In line with previous studies, ustekinumab had a higher persistence rate than other biologics.
- Risk of Developing Additional Immune-Mediated Manifestations: A Retrospective Matched Cohort Study. [Journal Article]
- ATAdv Ther 2019 May 17
- CONCLUSIONS: This study demonstrates that the risk of developing a second IMID is significantly higher for individuals who have already experienced a first IMID in a large and contemporary US claims database. Certain pairs of IMIDs co-occur more frequently than others. The risk of developing subsequent IMIDs may be an important consideration for clinicians when selecting treatment strategies.
- Psoriatic Arthritis: What is Happening at the Joint? [Review]
- RTRheumatol Ther 2019 May 17
- Psoriatic arthritis (PsA) is a heterogeneous and inflammatory disease with diverse clinical manifestations, including psoriasis, nail psoriasis, peripheral joint disease, axial joint disease, enthesi…
Psoriatic arthritis (PsA) is a heterogeneous and inflammatory disease with diverse clinical manifestations, including psoriasis, nail psoriasis, peripheral joint disease, axial joint disease, enthesitis, and dactylitis. Typically, this varied clinical presentation complicates the clinician's ability to distinguish PsA from other forms of arthritis. In the synovium of individuals with PsA, upregulation of the genes WNT3A, BMPR2, and TGFBR1 results in bone erosion and new bone formation, a pattern unique to the disease. Additionally, genes associated with angiogenesis and vascularization such as VEGF and TGFB1 facilitate inflammation and joint damage. Gross pathogenesis of PsA is driven by proinflammatory cytokines, and key cytokines affecting joint structures include tumor necrosis factor-α, interleukin (IL)-6, IL-17A, IL-21, IL-22, and IL-23. Early diagnosis is critical for providing treatment that prevents irreversible disease progression and function loss. This narrative review discusses differentiation of PsA from other forms of arthritis. Additionally, we detail the role of cytokines at the joint in mediating PsA pathogenesis.Funding: Novartis Pharmaceuticals Corporation.
- Th1, Th17, and Treg Responses are Differently Modulated by TNF-α Inhibitors and Methotrexate in Psoriasis Patients. [Journal Article]
- SRSci Rep 2019 May 17; 9(1):7526
- Psoriasis is a chronic, recurrent, immune-mediated, hyperproliferative inflammatory skin disease. The role of the adaptive immune system, particularly of Th1 and Th17 lymphocytes, has been regarded a…
Psoriasis is a chronic, recurrent, immune-mediated, hyperproliferative inflammatory skin disease. The role of the adaptive immune system, particularly of Th1 and Th17 lymphocytes, has been regarded as prominent in the immunopathogenesis of psoriasis, as well as decreased Tregs function. Immunobiological drugs were administered in therapeutic pulses and a few studies evaluate their effects on the immune repertoire. The aim of this study was to evaluate the adaptive immune profile of patients with severe psoriasis under immunobiological treatment in two time points. Thirty-two psoriasis patients and 10 control patients were evaluated. In the group of psoriasis patients, 10 patients were on anti-TNF and 14 patients on methotrexate treatment, while 8 individuals were not treated. IL-17, IFN-γ, TNF-α, IL-6, IL-2, and IL-10 were analyzed. CD4 T cell intracellular cytokines were analyzed. It was observed that stimulation could significantly increase the production of IL-17, IFN-γ, TNF-α, and IL-10 only before anti-TNF pulse therapy. The activation of Th1 and Treg cells after stimulation was significantly higher before anti-TNF pulse. Patients on methotrexate or anti-TNF therapy produced significantly lower levels of TNF-α, IL-10, and IL-6. Furthermore, these patients showed a significant decrease in the activated CD4+ T cells. The treatment with immunomodulator or methotrexate modulates the activation of CD4+ T cells, and anti-TNF treatment appears to have a modulating effect on the activation and production of Th1, Th17, and Treg cells.
- Patient-reported outcomes assessment tools for use in psoriasis in Spain: A systematic review. [Journal Article]
- ADActas Dermosifiliogr 2019 May 13
- CONCLUSIONS: We identified 5 specific instruments validated in Spain for scoring PROs in patients with psoriasis. The tools' psychometric properties vary, and it is essential to understand their strengths and weaknesses when selecting the right one for each situation. In use, these questionnaires are able to detect the high impact of psoriasis on patients' HRQoL. PROs provide useful information to complement routine clinical findings in psoriasis and may contribute to improving disease management.
- Treatments for Inverse Psoriasis: A Systematic Review. [Journal Article]
- JDJ Dermatolog Treat 2019 May 17; :1-23
- CONCLUSIONS: There is a paucity of high-quality studies on which to base treatment recommendations, especially with regard to the role of systemic and biologic therapies. Few studies, many of which are of low evidence quality, suggest that topical immunomodulators, vitamin D analogues, and mid-to-high-potency topical corticosteroids may be effective treatments, but more randomized controlled trials are needed.
- Vitis vinifera L. Leaf Extract Inhibits In Vitro Mediators of Inflammation and Oxidative Stress Involved in Inflammatory-Based Skin Diseases. [Journal Article]
- AAntioxidants (Basel) 2019 May 16; 8(5)
- Psoriasis is a chronic cutaneous condition characterized by the release of pro-inflammatory mediators and oxidative stress. The reduction of these factors is currently the most effective strategy to …
Psoriasis is a chronic cutaneous condition characterized by the release of pro-inflammatory mediators and oxidative stress. The reduction of these factors is currently the most effective strategy to inhibit the symptoms of pathology. Antioxidants from natural sources are increasingly used to improve skin conditions. Dried red leaves from grapevine (Vitis vinifera L., cv Teinturiers) showed anti-inflammatory and anti-bacterial activities, but their possible effects on keratinocytes have not been previously investigated. In this study we tested the ability of a water extract from grapevine leaves (VVWE) to inhibit inflammatory conditions in human keratinocytes (HaCaT cells), challenged with proinflammatory (tumor necrosis factor-α (TNF-α) or lipopolysaccharide (LPS)) or prooxidant (ultraviolet B radiation (UVB) or H2O2) mediators. VVWE inhibited interleukin-8 (IL-8) secretion induced by proinflammatory stimuli, acting on the IL-8 promoter activity, but the effect was lower when prooxidant mediators were used. The effect was partly explained by the reduction of nuclear factor-κB (NF-κB)-driven transcription and nuclear translocation. Furthermore, vascular endothelial growth factor (VEGF) secretion, a regulator of angiogenesis, was inhibited by VVWE, but not matrix metalloproteinase-9 (MMP-9), a protease involved in matrix remodeling. VVWE, assayed on Franz diffusion cell system, showed a marked reduction of High Performance Liquid Chromatography (HPLC)-identified compounds. Pure molecules individually failed to reduce TNF-α-induced IL-8 release, suggesting synergistic effects or the presence of other bioactive compounds still unknown.
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- Total glucosides of paeony for the treatment of psoriasis: A systematic review and meta-analysis of randomized controlled trials. [Review]
- PPhytomedicine 2019 Apr 25; 62:152940
- CONCLUSIONS: TGP can be used to treat psoriasis with reduced adverse reactions and recurrence rates. However, the mechanism of TGP in psoriasis treatment requires to be evaluated further in high-quality, large-sample, and rigorous clinical studies.