Neue Studien: Europe PMChttps://www.psoriasis-news.de/articles.html/1_articles/page/13/?d=1Neue Studien: Europe PMCdeBiologics for treatment of paediatric plaque psoriasis: A systematic review and network meta-analysis.https://www.psoriasis-news.de/articles.html/1_articles/biologics-for-treatment-of-paediatric-plaque-psoriasis-a-systematic-review-and-network-meta-analysis-r292/Background and objectiveAs biologic therapy is increasingly being utilized in the treatment of paediatric psoriasis, we aim to perform a systematic review and network meta-analysis to compare the efficacy and safety of available biologic treatments for moderate to severe paediatric plaque psoriasis.

Methods

Relevant randomized controlled trials (RCTs) were searched for in PubMed, Embase, Cochrane CENTRAL and clinicaltrials.gov. We performed a fixed-effects frequentist network meta-analysis (NMA) with the surface under the cumulative ranking curve (SUCRA) calculated for and mean ranking calculated. The main outcomes of interest were a ≥75% improvement in PASI score (PASI75), ≥90% improvement in PASI score (PASI90), 100% improvement in PASI score (PASI100), CDLQI score of 0/1 (CDLQI 0/1) at weeks 12-16 and safety outcomes at 12-20 weeks. Point probabilities of response were also calculated, presented as absolute risk differences per 1000 patients with their 95% CIs compared to placebo.

Results

Seven RCTs comprising 1016 psoriasis patients were included. Compared to placebo, all biologic therapies exhibited a significantly higher PASI90 and PASI75 response. Based on the SUCRA, Ixekizumab ranked highest in achieving the PASI100 (SUCRA: 0.9, Mean Rank: 1.8) response. Secukinumab high dose ranked the best for PASI90 (SUCRA: 0.8, Mean Rank: 3.0). For the CDLQI 0/1 (SUCRA: 0.8, Mean Rank: 2.2) response and the PASI75 (SUCRA: 0.9, Mean Rank: 2.2) response, standard dose Ustekinumab exhibited superior performance.

Conclusion

All biologic agents (not including non-biologic comparators methotrexate and FAEs) were significantly superior to placebo, with no significant difference between individual biologic therapies, for the treatment of moderate-to-severe paediatric plaque psoriasis. Ixekizumab and Secukinumab demonstrated a trend towards a higher PASI90 response, while Ustekinumab showed a trend towards increased CDLQI and PASI75 responses. These findings highlight the need for better-powered trials in this population to determine the optimal treatment modality.

Prospero number

CRD42023476983.

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]]>292Sun, 19 Oct 2025 16:05:15 +0000Psoriatic arthritis risk in psoriasis patients receiving anti-IL-23 vs anti-IL-17: comparison of drug classes and individual agents.https://www.psoriasis-news.de/articles.html/1_articles/psoriatic-arthritis-risk-in-psoriasis-patients-receiving-anti-il-23-vs-anti-il-17-comparison-of-drug-classes-and-individual-agents-r289/ObjectivesBiologic therapies for skin psoriasis (PsO) have been linked to a lower risk of developing psoriatic arthritis (PsA), but their efficacy across different mechanisms of action remains to be fully explored. This study aimed to compare PsA risk in PsO patients prescribed interleukin-23 inhibitors (IL23i) vs interleukin-17 inhibitors (IL17i).

Methods

This retrospective cohort study utilized the TriNetX database to categorize adult PsO patients into two cohorts: those newly prescribed IL23i (without IL17i exposure) and those newly prescribed IL17i (without IL23i exposure). Patients with a history of PsA or previous use of anti-tumor necrosis factor-α or anti-interleukin-12/23 agents were excluded. A total of 5,490 patients, matched 1:1 by propensity scores, were analyzed for PsA risk using hazard ratios (HR) from Cox regression.

Results

The 5-year cumulative incidence of PsA was significantly lower in IL23i users compared with IL17i users (11.68% vs 19.94%; p <0.001). IL23i treatment was associated with a reduced PsA risk (HR 0.475, 95% CI 0.382-0.590). This reduced risk persisted across various subgroups defined by age, sex, race, PsO subtypes, obesity, and elevated inflammatory markers. Similar results were observed in individual drug comparisons, with lower risks for guselkumab vs secukinumab (0.480, 0.358-0.645) and ixekizumab (0.698, 0.509-0.956), risankizumab vs secukinumab (0.433, 0.306-0.612) and ixekizumab (0.504, 0.347-0.732), and tildrakizumab vs secukinumab (0.339, 0.131-0.875). The comparison of tildrakizumab vs ixekizumab (0.451, 0.171-1.191) also suggested a lower risk but was not statistically significant.

Conclusions

PsO patients treated with IL23i had a lower subsequent PsA risk compared with those treated with IL17i.

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]]>289Sun, 19 Oct 2025 14:34:58 +0000Integrated Microbiome and metabolome analysis reveals Microbial-Metabolic interactions in psoriasis pathogenesis.https://www.psoriasis-news.de/articles.html/1_articles/integrated-microbiome-and-metabolome-analysis-reveals-microbial-metabolic-interactions-in-psoriasis-pathogenesis-r288/BackgroundPsoriasis is a chronic inflammatory skin disorder with unclear etiology. The roles of skin microbiome and metabolic dysregulation in psoriasis pathogenesis are not yet fully understood.

Methods

We conducted an integrated microbiome and untargeted metabolomic analyses on skin samples from 29 patients with psoriasis and 31 healthy controls. The skin microbiota was characterized using 16 S rRNA gene sequencing, and untargeted metabolomic profiling was performed using LC-MS/MS. Multivariate statistical analyses were used to identify differential microbes and metabolites, followed by correlation analyses to explore microbe-metabolite interactions.

Results

Psoriatic lesions exhibited significantly higher skin microbial alpha diversity compared to healthy controls. Principal component analysis revealed distinct microbial community structures between the two groups. At the genus level, Corynebacterium and Staphylococcus were significantly enriched in psoriatic lesions, while Cutibacterium was notably reduced. Metabolomic analysis identified 63 differential metabolites, with 39 upregulated and 24 downregulated in psoriatic lesions. These metabolites were primarily involved in lipid metabolism (particularly phospholipids and sphingolipids), amino acid metabolism, and inflammatory mediator pathways. Correlation analysis revealed significant associations between microbial alterations and metabolic dysregulation. Cutibacterium abundance was negatively correlated with inflammatory lipids and positively correlated with antioxidant metabolites, whereas Staphylococcus and Corynebacterium exhibited the opposite pattern. Notably, the abundance of Propionibacteriaceae strongly correlated with glutathione levels (r = 0.821, P < 0.001), indicating a potential role of microbiome-mediated oxidative stress in psoriasis.

Conclusions

This study highlights significant alterations in both the skin microbiome and metabolome in patients with psoriasis, revealing complex microbe-metabolite interaction networks. The findings suggest that microbial dysbiosis, particularly the decreased abundance of Cutibacterium and the increased abundance of Staphylococcus/Corynebacterium, may contribute to psoriasis pathogenesis by modulating lipid metabolism, inflammatory pathways, and oxidative stress responses.

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]]>288Sun, 19 Oct 2025 14:34:58 +0000Cross-cultural adaptation and preliminary diagnostic performance assessment of the psoriasis epidemiology screening tool (PEST) questionnaire in Spanish.https://www.psoriasis-news.de/articles.html/1_articles/cross-cultural-adaptation-and-preliminary-diagnostic-performance-assessment-of-the-psoriasis-epidemiology-screening-tool-pest-questionnaire-in-spanish-r287/ObjectivesTo perform the cross-cultural adaptation of the Psoriasis Epidemiology Screening Tool (PEST) questionnaire into Spanish (PEST-S) and conduct a preliminary exploratory assessment of its discriminative ability to identify psoriatic arthritis (PsA) among patients with psoriasis (Ps), osteoarthritis (OA), or both.

Methods

The PEST questionnaire was translated and culturally adapted into Spanish following international guidelines. A cross-sectional study was conducted including adult patients with PsA, Ps, OA, and Ps+OA. The PEST-S was administered to all participants. PsA diagnosis was confirmed using CASPAR criteria. Diagnostic performance was evaluated using sensitivity, specificity, likelihood ratios, area under the ROC curve (AUC), and Cohen's kappa coefficient. Comparisons of individual PEST-S items were performed across diagnostic groups.

Results

A total of 124 patients were included: 32 with PsA, 31 with Ps, 33 with Ps+OA, and 28 with OA. The questionnaire required less than one min to complete. PEST-S scores ≥3 yielded a sensitivity of 100%, specificity of 94.2%, LR+ of 17.2, and LR- of 0. The AUC was 0.97 (95% CI: 0.95-0.99). Agreement between PEST-S and CASPAR classification was 93.2% (κ = 0.838). A statistically significant difference was found in the responses to all five PEST-S items between patients with PsA and those in the other diagnostic groups (p< 0.05).

Conclusion

The Spanish version of the PEST questionnaire (PEST-S) demonstrated excellent diagnostic performance in distinguishing PsA from Ps and OA in a Spanish-speaking population. These findings support its clinical utility and justify further validation in a screening context among patients with psoriasis without prior rheumatologic evaluation.

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]]>287Sun, 19 Oct 2025 14:34:58 +0000Understanding Enthesitis in Psoriatic Disease: Insights and Implications.https://www.psoriasis-news.de/articles.html/1_articles/understanding-enthesitis-in-psoriatic-disease-insights-and-implications-r286/Weiterlesen

]]>286Sun, 19 Oct 2025 14:34:58 +0000Genetic proxies of GLP1R expression in whole blood are associated with lower risk of psoriasis and psoriatic arthritishttps://www.psoriasis-news.de/articles.html/1_articles/genetic-proxies-of-glp1r-expression-in-whole-blood-are-associated-with-lower-risk-of-psoriasis-and-psoriatic-arthritis-r285/Weiterlesen

]]>285Sun, 19 Oct 2025 14:34:58 +0000Prevalence of Psoriatic Arthritis in Patients with Moderate-to-Severe Psoriasis in the Era of Biologics and Small Molecule Therapieshttps://www.psoriasis-news.de/articles.html/1_articles/prevalence-of-psoriatic-arthritis-in-patients-with-moderate-to-severe-psoriasis-in-the-era-of-biologics-and-small-molecule-therapies-r284/Objectives: To estimate the prevalence of psoriatic arthritis (PsA) and associated fac-tors in patients with moderate-to-severe psoriasis.

Methods:

Retrospective, single-center study of a cohort of psoriasis patients in stand-ard follow-up in a dermatology department from July 2008 to January 2024. Patients ≥18 years with moderate-to-severe psoriasis were included and classified into 3 groups according to the treatment received: group 1, biologics or small molecules with or without conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs); group 2, only csDMARDS; and group 3, non-pharmacological treatments. Demographic and clinical variables were collected. The prevalence of PsA was estimated with its 95% confidence interval (CI). The cumulative incidence of PsA was analyzed across groups, and logistic regression models were built.

Results:

The study population comprised 308 patients (67.2%, 22.7%, 10% in groups 1, 2, and 3, respectively). Dif-ferences between the groups were observed in severity of psoriasis, weight, smoking status, and dyslipidemia (p< 0.05). The prevalence of PsA was 11.7% (95% CI, 8.1-15.3), with most patients in group 1. This group had a high-er risk of PsA following diagnosis of psoriasis or initiation of treatment. Belonging to groups 2 and 3 had a smaller effect than belonging to group 1 in the development of PsA; nail involvement and obstructive sleep apnea (OSA) were associated with development of PsA (p< 0.05).

Conclusions:

The prevalence estimate was lower than previous estimates, probably owing to the increased use of biologics. Not requiring biologics for disease control had less effect on development of PsA. Nail involvement and OSA were associated with PsA.

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]]>284Sun, 19 Oct 2025 14:34:58 +0000Incidence and Predictors of Secondary Failure to Biologic Therapy in Patients With Psoriatic Arthritis.https://www.psoriasis-news.de/articles.html/1_articles/incidence-and-predictors-of-secondary-failure-to-biologic-therapy-in-patients-with-psoriatic-arthritis-r283/ObjectiveSecondary failure to biologic disease-modifying antirheumatic drugs (bDMARDs) is challenging and contributes to the complexity of managing psoriatic arthritis (PsA). We aimed to define the frequency and incidence of this phenomenon in PsA and identify the risk factors for its occurrence.

Methods

We retrieved data on patients with PsA from our single-center, specialized-care, prospective observational cohort who initiated and remained on bDMARDs for ≥ 1 year after clinic enrollment between 2000 and 2023. We defined response to therapy at the 1-year visit (baseline) as achievement of ≥ 40% reduction in the swollen joint count (SJC) and either ≥ 50% reduction in Psoriasis Area and Severity Index (PASI) or PASI ≤ 2. We defined secondary failure as the inability to maintain response criteria or as the clinician's judgment of loss of effectiveness. To examine factors associated with secondary failure, we fitted Cox regression models.

Results

Of 482 patients included in the study, 264 (54.8%) were responders at 1 year. Of these, 94 (35.6%) developed secondary failure at a median of 1.6 (IQR 0.7-3.8) years from response. In the multivariable model, higher SJC (hazard ratio [HR] 1.39, 95% CI 1.05-1.84) and PASI (HR 1.14, 95% CI 1.01-1.29) at baseline were associated with secondary failure. Tumor necrosis factor inhibitors (TNFi) vs other bDMARD use (HR 0.39, 95% CI 0.18-0.88), initiation as first-line bDMARD (HR 0.48, 95% CI 0.25-0.91), and treatment initiation during more recent calendar years (HR 0.34, 95% CI 0.12-0.98) were associated with less secondary failure.

Conclusion

Secondary failure to bDMARD is common in PsA and may be influenced by both disease- and therapy-related factors.

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]]>283Sun, 19 Oct 2025 14:34:58 +0000Integrated Single-Cell RNA Sequencing and Proteome-Wide Mendelian Randomization Identifies Therapeutic Targets for Psoriasis and Associated Complications.https://www.psoriasis-news.de/articles.html/1_articles/integrated-single-cell-rna-sequencing-and-proteome-wide-mendelian-randomization-identifies-therapeutic-targets-for-psoriasis-and-associated-complications-r282/BackgroundTo identify new targets for protein-based treatments in psoriasis and evaluate the possible negative impacts of these druggable proteins.

Methods

We carried out an extensive analysis of the entire set of proteins in the blood (proteome-wide) to determine if there are causal links between certain blood proteins and the likelihood of developing psoriasis. The proteins were selected from the UK Biobank Pharma Proteomics Project (UKBPPP) database, which includes genetic data for 2,940 different blood proteins. We obtained the cis-expression quantitative trait locus (cis-eQTL) of druggable genes from eQTLGen Consortium as exposure and the genome-wide association study (GWAS) of psoriasis.

Results

Our research discovered a strong genetic link between plasma APOF, ATP6V1G2, IFNLR1, CRELD1, PRSS8, and TNF proteins and a higher chance of having psoriasis. These proteins share genetic variations associated with psoriasis (PPH3+PPH4>0.8). The ROC curves derived from these protein quantity trait loci (pQTLs) demonstrate that they can distinguish between individuals with psoriasis and those without. The druggable gene analysis showed that simvastatin is related to TNF based on the Drug SIGnatures DataBase webtool.

Conclusion

Our study has explored the causal relationships between six blood proteins and psoriasis, offering a detailed insight into potential therapeutic targets. Among them, simvastatin might have an effect on psoriasis via TNF.

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]]>282Sun, 19 Oct 2025 14:34:58 +0000Letter to the Editor Regarding "Ixekizumab Retention Rate and Predictors of Treatment Persistence in Psoriatic Arthritis: Results of an Italian Multicenter Study".https://www.psoriasis-news.de/articles.html/1_articles/letter-to-the-editor-regarding-ixekizumab-retention-rate-and-predictors-of-treatment-persistence-in-psoriatic-arthritis-results-of-an-italian-multicenter-study-r281/No abstract supplied.

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]]>281Sun, 19 Oct 2025 14:34:58 +0000Association of BMI, BMR, BSA, and body weight with psoriasis severity and treatment response: evidence from a real-world cohort.https://www.psoriasis-news.de/articles.html/1_articles/association-of-bmi-bmr-bsa-and-body-weight-with-psoriasis-severity-and-treatment-response-evidence-from-a-real-world-cohort-r280/BackgroundAlthough biologic and systemic therapies have advanced psoriasis management, real-world evidence guiding individualized treatment remains limited. In particular, the influence of body size and metabolic parameters on disease severity and treatment response is underexplored.

Objective

To investigate the associations of body mass index (BMI), basal metabolic rate (BMR), body surface area (BSA), and body weight with baseline psoriasis severity and therapeutic response across different treatment modalities.

Methods

This multicenter, prospective study included 1955 patients from the Shanghai Psoriasis Effectiveness Evaluation CoHort (SPEECH) and 1663 patients for longitudinal follow-up. Multivariable regression models were used to examine the associations between body size/metabolic parameters and the baseline psoriasis area and severity index (PASI) scores, as well as PASI-based treatment responses at Week 12 and Week 20. Stratified analyses by treatment type and receiver operating characteristic curve analysis were conducted to assess predictive performance.

Results

All four parameters were positively associated with baseline PASI scores (FDR-adjusted P < 0.05). Prospectively, elevated BMI, BMR, BSA, and body weight were significantly associated with reduced likelihood of achieving PASI 75/90/100, and lower percentage reduction in PASI score at both time points. These associations were particularly pronounced in patients receiving biologic therapies. In the ustekinumab subgroup, body composition showed enhanced predictive accuracy for high-level PASI responses.

Conclusion

Elevated BMI, BSA, body weight, and BMR are associated with more severe psoriasis and diminished treatment efficacy, especially those treated with biologics. These findings underscore the need for personalized dosing strategies in biologic therapy, especially for fixed-dose agents like ustekinumab.

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]]>280Sun, 19 Oct 2025 14:34:58 +0000Nail manifestations reflecting abnormalities of bone and soft tissues in interphalangeal joints affected by psoriatic arthritis.https://www.psoriasis-news.de/articles.html/1_articles/nail-manifestations-reflecting-abnormalities-of-bone-and-soft-tissues-in-interphalangeal-joints-affected-by-psoriatic-arthritis-r279/IntroductionPsoriatic arthritis (PsA) presents various imaging abnormalities in joints and diverse nail changes, but the link between nail and joint findings remains unclear. This study aimed to gain a better understanding of the relationships between nail manifestations and abnormal articular architectures by investigating the associations between nail abnormalities and articular findings in PsA-affected interphalangeal joints.

Methods

A total of 106 nails adjacent to PsA-affected distal interphalangeal joints were examined in 29 patients who underwent comprehensive systemic evaluation and imaging for the diagnosis and treatment of PsA. Imaging studies, including X-ray, magnetic resonance imaging, and iodine-enhanced dual-energy computed tomography, were conducted to examine the acral joints.

Results

Nail manifestations were observed in 81 among 106 fingers or toes (76.4%). Pitting, the most common nail finding (75/106, 70.8%), was observed in isolation on 22/75 nails (29.3%), while other nail manifestations were observed in isolation on ≤ 3/50 nails (6.0%). Among the 81 examined nail lesions, 49 (61.3%) preceded the onset of articular symptoms in the adjacent interphalangeal joints, 9 (11.2%) followed the joint symptoms, and 23 (28.8%) occurred simultaneously. Articular bone findings, such as bone erosion and bone proliferation, were positively associated with subungual hyperkeratosis, leukonychia, crumbling, and/or transverse grooves. In contrast, soft tissue findings, including tenosynovitis, synovitis, and periarthritis, were negatively associated with onycholysis, subungual hyperkeratosis, leukonychia, and/or pitting.

Conclusion

The study suggests that nail manifestations may be positively associated with bone abnormalities and negatively associated with soft tissue inflammation in PsA. Nail examinations may help estimate articular conditions. Key points • More than 60% of nail manifestations precede the onset of articular symptoms in the adjacent interphalangeal joints. • Nail manifestations may be positively associated with bone abnormalities and negatively with soft tissue inflammation in PsA. • Nail examination may aid in estimating articular status, prompting appropriate evaluation and early treatment for the affected joints.

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]]>279Wed, 15 Oct 2025 07:49:02 +0000KDM6B inhibition modulates monocyte activation and alleviates IMQ-psoriasis skin inflammationhttps://www.psoriasis-news.de/articles.html/1_articles/kdm6b-inhibition-modulates-monocyte-activation-and-alleviates-imq-psoriasis-skin-inflammation-r278/Weiterlesen

]]>278Wed, 15 Oct 2025 07:49:02 +0000Single cell transcriptomics of human psoriasis and epidermal specific Ube2l3 deficient mice highlight CXCL16/CXCR6 involvement in psoriasis development.https://www.psoriasis-news.de/articles.html/1_articles/single-cell-transcriptomics-of-human-psoriasis-and-epidermal-specific-ube2l3-deficient-mice-highlight-cxcl16cxcr6-involvement-in-psoriasis-development-r277/+ Vγ2+ γδT cells in mouse while CXCR6+ CD8+ T cells in human. CXCL16 is the only chemokine that binds to and stimulates CXCR6. Ube2l3 reduction in keratinocytes activates IL-1β and then promotes CXCL16 expression through STAT3 signaling. Up-regulated CXCL16 in keratinocytes and cDC2/mDC then attracts Vγ2+ γδT17 or CD8+ T cells to secrete IL-17A and form a positive feedback loop in keratinocytes supporting psoriatic lesions. Thus, UBE2L3 is a keratinocyte-intrinsic suppressor of epidermal IL-17 production in Vγ2+ γδT cells in mouse and CD8+ T cells in human through the CXCL16/CXCR6 signaling pathway in psoriasis.

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]]>277Wed, 15 Oct 2025 07:49:02 +0000Prolactin links psychological stress to psoriasis via a fibroblast-chemokine pathwayhttps://www.psoriasis-news.de/articles.html/1_articles/prolactin-links-psychological-stress-to-psoriasis-via-a-fibroblast-chemokine-pathway-r276/Weiterlesen

]]>276Wed, 15 Oct 2025 07:49:02 +0000Correction to "Safety and Effectiveness of Ixekizumab in Japanese Patients with Psoriasis Vulgaris, Psoriatic Arthritis, Generalized Pustular Psoriasis, and Erythrodermic Psoriasis: Post-marketing Surveillance".https://www.psoriasis-news.de/articles.html/1_articles/correction-to-safety-and-effectiveness-of-ixekizumab-in-japanese-patients-with-psoriasis-vulgaris-psoriatic-arthritis-generalized-pustular-psoriasis-and-erythrodermic-psoriasis-post-marketing-surveillance-r275/No abstract supplied.

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]]>275Wed, 15 Oct 2025 07:49:02 +0000Dose reduction and discontinuation of conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs) for people with rheumatoid arthritis or psoriatic arthritis in remission or low disease activity.https://www.psoriasis-news.de/articles.html/1_articles/dose-reduction-and-discontinuation-of-conventional-synthetic-disease-modifying-anti-rheumatic-drugs-dmards-for-people-with-rheumatoid-arthritis-or-psoriatic-arthritis-in-remission-or-low-disease-activity-r274/ObjectivesThis is a protocol for a Cochrane Review (intervention). The objectives are as follows: To investigate the benefits and harms of dose reduction and discontinuation of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) in adults with rheumatoid arthritis or psoriatic arthritis, who have been in sustained remission or low disease activity. This is a common review protocol, outlining the approach for two separate Cochrane reviews for people with rheumatoid arthritis or psoriatic arthritis. Dose reduction or discontinuation of csDMARDs in adults with rheumatoid arthritis, who have been in sustained remission or low disease activity Dose reduction or discontinuation of csDMARDs in adults with psoriatic arthritis, who have been in sustained remission or low disease activity.

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]]>274Tue, 14 Oct 2025 14:46:53 +0000PLAN-psoriasis: protocol for a randomised controlled feasibility trial comparing patient-led 'as-needed' treatment and therapeutic drug monitoring-guided treatment to continuous treatment for adults with clear or almost clear skin on risankizumab monotherhttps://www.psoriasis-news.de/articles.html/1_articles/plan-psoriasis-protocol-for-a-randomised-controlled-feasibility-trial-comparing-patient-led-as-needed-treatment-and-therapeutic-drug-monitoring-guided-treatment-to-continuous-treatment-for-adults-with-clear-or-almost-clear-skin-on-risankizumab-monotherapy-r273/IntroductionTargeted biologic therapies have transformed outcomes for individuals with psoriasis, a common immune-mediated inflammatory skin disease. The widespread use of these highly effective treatments has led to a growing number of individuals with clear or nearly clear skin remaining on continuous, long-term treatment. Personalised strategies to minimise drug exposure may sustain long-term disease control while reducing treatment burden, associated risks and healthcare costs. This study aims to evaluate the feasibility of a definitive pragmatic effectiveness trial of two personalised dose minimisation strategies compared with continuous treatment (standard care) in adults with well-controlled psoriasis receiving the exemplar biologic risankizumab.

Methods and analysis

This is a multicentre, assessor-blind, parallel group, open-label randomised controlled feasibility trial in the UK, evaluating two personalised biologic dose minimisation strategies for psoriasis. 90 adults with both physician-assessed and patient-assessed clear or nearly clear skin on risankizumab monotherapy for ≥12 months will be randomised in a 1:1:1 ratio to (1) patient-led 'as-needed' treatment, where risankizumab is administered at the first sign of self-assessed psoriasis recurrence, (2) therapeutic drug monitoring-guided treatment, with personalised dosing intervals determined using a pharmacokinetic model or (3) continuous treatment as per standard care, for 12 months. Participants will be invited to submit self-reported outcomes and self-taken photographs every 3 months using a bespoke remote monitoring system (mySkin app) and will attend an in-person assessment at 12 months. They may also request additional patient-initiated follow-up appointments during the trial if needed. The primary outcome is the practicality and acceptability of the two personalised biologic dose minimisation strategies, assessed as a composite measure including recruitment and retention rates, adherence to the assigned strategies and acceptability to both patients and clinicians. The feasibility of collecting healthcare cost and resource utilisation data will also be evaluated to inform a future cost-effectiveness analysis. A nested qualitative study, involving semistructured interviews with patients and clinicians, will explore perspectives on the personalised biologic dose minimisation strategies. These findings will inform the design of a future definitive trial.

Ethics and dissemination

This study received ethical approval from the Seasonal Research Ethics Committee (reference 24/LO/0089). Results will be disseminated through scientific conferences, peer-reviewed publications and patient/public engagement events. Lay summaries and infographics will be codeveloped with patient partners to ensure the findings are accessible for the wider public.

Trial registration number

ISRCTN17922845.

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]]>273Tue, 14 Oct 2025 14:46:53 +0000The risk of cardiovascular events following treatment for psoriatic arthritis with a biological agent.https://www.psoriasis-news.de/articles.html/1_articles/the-risk-of-cardiovascular-events-following-treatment-for-psoriatic-arthritis-with-a-biological-agent-r272/ObjectivesPsoriatic arthritis (PsA) increases cardiovascular disease risk. Emerging evidence suggests biologic Disease-Modifying Antirheumatic Drugs (DMARDs) may offer protective effects, though their advantage over conventional therapy remains under investigation.

Methods

A retrospective cohort study was conducted using the Chang Gung Memorial Research Database in Taiwan. Patients with PsA were identified from 2001 to 2022. The study included 2,383 patients who had used at least one disease-modifying antirheumatic drugs (DMARDs), divided into two groups: 1,190 on bDMARDs and 1,193 on conventional DMARDs (cDMARDs). The primary outcome was defined as a major adverse cardiovascular event (MACE), including stroke, myocardial infarction, cardiovascular mortality or coronary revascularization. Potential confounding was mitigated using inverse probability of treatment weighting.

Results

The average follow-up period was 5.1 years for the bDMARD group and 5.0 years for the cDMARD group. The incidence of MACE was 0.34 and 0.55 events per 100 person-years in the bDMARDs and cDMARDs groups, respectively. All-cause mortality occurred at rates of 0.73 and 1.86 per 100 person-years in the bDMARDs and cDMARDs groups, respectively. The results showed that the bDMARDs group had lower risks of MACE (hazard ratio [HR]: 0.65; 95% confidence interval [CI]: 0.43-0.96), all-cause mortality (HR: 0.44; 95% CI: 0.35-0.57) and cardiovascular mortality (HR: 0.54; 95% CI: 0.32-0.92), but a higher incidence of infection-related admission (subdistribution HR: 1.45; 95% CI: 1.18-1.78).

Conclusions

bDMARDs may reduce cardiovascular events and mortality in PsA, but infection risks warrant close monitoring. Further research is needed to refine treatment strategies.

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]]>272Tue, 14 Oct 2025 14:46:53 +0000RETRACTION: Mendelian Randomization Analysis of Psoriasis and Psoriatic Arthritis Associated With Risks of Ulcerative Colitis.https://www.psoriasis-news.de/articles.html/1_articles/retraction-mendelian-randomization-analysis-of-psoriasis-and-psoriatic-arthritis-associated-with-risks-of-ulcerative-colitis-r271/No abstract supplied.

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]]>271Tue, 14 Oct 2025 14:46:53 +0000Cardiovascular Risk in Autoimmune Diseases: Mechanisms, Management, and Emerging Evidencehttps://www.psoriasis-news.de/articles.html/1_articles/cardiovascular-risk-in-autoimmune-diseases-mechanisms-management-and-emerging-evidence-r270/No abstract supplied.

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]]>270Tue, 14 Oct 2025 14:46:53 +0000What drives patient cost variability in psoriasis care: a single centre study.https://www.psoriasis-news.de/articles.html/1_articles/what-drives-patient-cost-variability-in-psoriasis-care-a-single-centre-study-r268/BackgroundPsoriasis a chronic inflammatory skin disease, poses a substantial economic burden on healthcare systems globally. This study examines psoriasis consultations from the provider's perspective within a dermatology department, aiming to generate detailed cost data to support value-based care. Specifically, it investigates the drivers of consultation-level cost variability, explores opportunities for efficiency, and also estimates one-year treatment costs to inform the development of bundled payment models. The goal is to highlight the importance of patient cost transparency and improving cost structures in chronic disease settings.

Methods

Using Time-Driven Activity-Based Costing (TD-ABC), treatment costs associated with nurses, doctors, and total visits for 127 patients with mild and moderate forms of psoriasis were measured. Financial data was collected in collaboration with the hospital's financial department. During consultations, nurses and physicians recorded time and patient-related information. Additional or missing details were retrieved from patient medical files. Descriptive analyses assessed mean costs and variability by patient and disease characteristics.

Independent variables

therapy type, patient status (new vs. returning), comorbidities, and treatment changes, were stratified to compare cost differences across groups.

Results

Mean consultation costs were €55, with a minimum and maximum of €25 and €110. New patients incurred 40% higher costs than returning ones, mainly due to longer interactions with nurses and physicians. Key cost drivers for a total consultation included patient status, personality traits, nurse experience, and therapy switches. Physician consultations were particularly impacted by treatment changes and patient engagement levels. Annual treatment costs varied substantially by medication type: topical treatments averaged €325 per year, systemic treatments €1,353, and biological therapies €11,920, highlighting the significant impact of medication choice on overall expenses.

Conclusions

This study highlighted substantial variability in consultation and yearly treatment costs for psoriasis patients. These findings emphasized the critical need for detailed cost data to optimise departmental workflows, support efficient resource allocation, and inform the design of equitable bundled payment models. Improving cost transparency was shown to strengthen clinical and financial decision-making. Future research was recommended to explore the cost implications of comorbidities and to extend benchmarking efforts across dermatology settings to guide system-wide improvements in care delivery and sustainability.

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]]>268Tue, 14 Oct 2025 14:32:50 +0000Dual-responsive gelatin-based amphiphilic celastrol prodrug polymer nanoassemblies for psoriasis treatment.https://www.psoriasis-news.de/articles.html/1_articles/dual-responsive-gelatin-based-amphiphilic-celastrol-prodrug-polymer-nanoassemblies-for-psoriasis-treatment-r267/Weiterlesen

]]>267Tue, 14 Oct 2025 14:32:50 +0000Serum SCCA as a biomarker for assessing severity and monitoring treatment response in psoriasis.https://www.psoriasis-news.de/articles.html/1_articles/serum-scca-as-a-biomarker-for-assessing-severity-and-monitoring-treatment-response-in-psoriasis-r266/BackgroundWhile clinical examination remains the diagnostic cornerstone for psoriasis, there is a relative lack of objective, quantitative biomarkers to complement clinical assessment for tracking disease severity and monitoring therapeutic response. We evaluated serum SCCA's utility in identifying psoriasis and assessing its severity across demographic (gender, age) and clinical (comorbidity) subgroups, and its association with therapeutic responses.

Methods

A total of 181 adult (≥18 years old) patients with newly diagnosed psoriasis were included in the disease group; 385 patients with other skin-related diseases and 658 healthy adults were included as controls. Patients diagnosed with tumors or renal failure were excluded. Serum SCCA was determined using Roche Cobas e 801 analyzer (Roche, Basel, Switzerland). Dynamic analysis was performed to evaluate the significance of serum SCCA in monitoring psoriasis treatment response.

Results

Serum SCCA levels in psoriasis patients were mainly affected by gender and concomitant diseases. Notably, SCCA demonstrated high diagnostic accuracy (AUC: 0.89-0.90) in patients with comorbidities, with sex-specific cutoffs. The cutoff value of serum SCCA for identifying severe psoriasis was 2.64 ng/mL with an AUC greater than 0.9 and an NPV over 95 %. Serum SCCA levels were significantly correlated with the psoriasis area and severity index (PASI) and body surface area (BSA) both before and after treatment. The median decrease rate of serum SCCA was close to 50 % at >5 days post-treatment and 60 % at >10 days post-treatment.

Conclusions

Serum SCCA shows promise as a reliable, complementary biomarker for the severity assessment and treatment monitoring of psoriasis. Its application for identification purposes should be stratified by sex and comorbidities.

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]]>266Tue, 14 Oct 2025 14:32:50 +0000Response to Chen et al.'s "Risk of major adverse cardiovascular events and venous thromboembolic events between patients with psoriasis or psoriatic arthritis on tumor necrosis factor inhibitors, interleukin 17 inhibitors, interleukin 12/23 inhibitors, anhttps://www.psoriasis-news.de/articles.html/1_articles/response-to-chen-et-als-risk-of-major-adverse-cardiovascular-events-and-venous-thromboembolic-events-between-patients-with-psoriasis-or-psoriatic-arthritis-on-tumor-necrosis-factor-inhibitors-interleukin-17-inhibitors-interleukin-1223-inhibitors-and-inter-r265/No abstract supplied.

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