Neue Studien: Europe PMChttps://www.psoriasis-news.de/articles.html/1_articles/page/16/?d=1Neue Studien: Europe PMCdeLetter 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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]]>265Tue, 14 Oct 2025 14:32:50 +0000Psoriatic Arthritis Linked to Pembrolizumab in a Lung Cancer Patient: From Oncologist to Rheumatologisthttps://www.psoriasis-news.de/articles.html/1_articles/psoriatic-arthritis-linked-to-pembrolizumab-in-a-lung-cancer-patient-from-oncologist-to-rheumatologist-r264/No abstract supplied.

Weiterlesen

]]>264Tue, 14 Oct 2025 14:32:50 +0000Cuproptosis Facilitates Chronic Skin Inflammation by Regulating the α-Ketoglutarate/H3K4me3/Ferritin Heavy Chain 1 Signaling Pathway-Mediated Ferroptosis.https://www.psoriasis-news.de/articles.html/1_articles/cuproptosis-facilitates-chronic-skin-inflammation-by-regulating-the-%CE%B1-ketoglutarateh3k4me3ferritin-heavy-chain-1-signaling-pathway-mediated-ferroptosis-r263/Weiterlesen

]]>263Tue, 14 Oct 2025 14:32:50 +0000A Trial of Coach-Supported, Smartphone-Delivered Cognitive Behavioral Therapy for Psoriasis With Comorbid Depressionhttps://www.psoriasis-news.de/articles.html/1_articles/a-trial-of-coach-supported-smartphone-delivered-cognitive-behavioral-therapy-for-psoriasis-with-comorbid-depression-r262/No abstract supplied.

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]]>262Tue, 14 Oct 2025 14:32:50 +0000Psoriasis and the risk of 26 cancers: pooled population-based cohort studies from Denmark, England, Israel, and Taiwan.https://www.psoriasis-news.de/articles.html/1_articles/psoriasis-and-the-risk-of-26-cancers-pooled-population-based-cohort-studies-from-denmark-england-israel-and-taiwan-r261/BackgroundPsoriasis is a chronic inflammatory skin disease, and the risk of developing cancer has been postulated due to the presence of several plausible underlying mechanisms. Understanding the association between psoriasis and cancer is imperative to the provision of optimal psoriasis care.

Objectives

To examine the risk of developing cancer in individuals with psoriasis.

Methods

Population-based cohort studies were conducted in Denmark, England, Israel, and Taiwan through the use of linked electronic health records. Individuals aged at least 18 years of age with a diagnosis of psoriasis in the country-specific study period were matched to up to 6 comparators with no record of psoriasis prior to index date. Country-specific hazard ratios for the risk of cancer development overall and for 26 site-specific cancers between individuals with and without psoriasis were calculated through Cox regression. Country-specific estimates were pooled using random effects modelling.

Results

We included 702,022 individuals with psoriasis and 4,185,342 matched comparators. In models implicitly controlled for age, sex and calendar time by matching, there was a small association between psoriasis and cancer overall (pooled HR [pHR]:1.08;95%CI, 1.04-1.13; I2= 92.4%). Adjustment for potential confounding factors resulted in a slight attenuation of risk (pHR:1.05; 95%CI, 1.01-1.09; I2=81.2%). When restricted to those with moderate-to-severe psoriasis, the risk of cancer overall was slightly higher (pHR:1.16;95%CI, 1.04-1.28; I2=92.8%) and confounder adjusted models (pHR: 1.09;95%CI, 1.03-1.15; I2=60.6%). Associations with psoriasis were present for oral cavity (pHR: 1.29; 95%CI, 1.12-1.47; I2=55.4%), pharynx (pHR:1.30;95%CI, 1.07-1.58; I2=58.4%), oesophagus (pHR:1.17;95%CI, 1.03-1.33; I2=56.6%), liver (pHR:1.53;95%CI, 1.33-1.77; I2=75.1%), pancreas (pHR:1.09;95%CI, 1.02-1.17; I2=0.0%), kidney (pHR:1.19;95%CI, 1.11-1.27; I2=0.0%), bladder (pHR: 1.13; 95%CI, 1.06-1.20; I2=28.7%), and keratinocyte cancers (pHR:1.37;95%CI, 1.16-1.63; I2=97.5%), Hodgkin lymphoma (pHR:1.56;95%CI, 1.16-2.11; I2=69.7%), non-Hodgkin lymphoma (pHR:1.16;95%CI, 1.07-1.26; I2=35.5%) and leukaemia (pHR:1.18; 95%CI, 1.08-1.29; I2=41.9%). Site-specific associations generally persisted, with slight risk exacerbations and additional associations for lung and ovarian cancers, when limited to people with moderate-to-severe psoriasis.

Conclusion

Psoriasis was associated with an increased risk of developing 14 of 26 investigated site-specific cancers, including cancers with poor prognosis, such as liver, lung, and oesophageal cancer. Our findings can be used to reinforce cancer prevention strategies in psoriasis care.

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]]>261Tue, 14 Oct 2025 14:32:50 +0000A Trial of Coach-Supported, Smartphone-Delivered Cognitive Behavioral Therapy for Psoriasis With Comorbid Depression.https://www.psoriasis-news.de/articles.html/1_articles/a-trial-of-coach-supported-smartphone-delivered-cognitive-behavioral-therapy-for-psoriasis-with-comorbid-depression-r260/BackgroundPsoriasis is associated with increased risk of depression. Although cognitive behavioral therapy (CBT) is an evidence-based treatment, access remains limited.

Objectives

To evaluate the feasibility, acceptability, and preliminary efficacy of a smartphone-delivered, coach-led CBT program for depression among individuals with psoriasis.

Methods

This single-arm, 8-week pilot study (Mindset trial, NCT06216691) enrolled adults with psoriasis and at least mild depressive symptoms (PHQ-9 ≥5). Participants engaged in a smartphone-based CBT program guided by bachelor's-level lay coaches. Primary outcomes were feasibility as evaluated by module completion and acceptability as evaluated by the Client Satisfaction Questionnaire-8 (CSQ-8]) and User Version of the Mobile Application Rating Scale (uMARS). Secondary outcomes included changes in the Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), Appearance Anxiety Inventory, Skindex-16, and Psoriasis Symptom Inventory.

Results

Of 30 participants, 63.3% completed ≥4/8 modules and 43.3% completed ≥6/8 modules. Mean CSQ-8 and uMARS scores were 27.2 (SD 4.5) and 4.0 (SD 0.7), respectively, supporting high satisfaction. Statistically and clinically significant improvements were observed in PHQ-9 (mean change -4.4; Cohen's d = 0.92), GAD-7 (-2.8; d = 0.63), and Skindex-16 symptoms (5.0; d = 0.78), emotions (10.0; d = 0.95), and functioning (6.4; Cohen's d = 0.71) subscales as well as the Psoriasis Symptom Inventory (3.1; d = 0.43).

Conclusions

This study supports the feasibility, acceptability, and preliminary efficacy of smartphone-delivered CBT for individuals with psoriasis and depressive symptoms. Given the scalability of this model, future randomized trials are warranted to assess broader effectiveness in dermatology care settings.

Weiterlesen

]]>260Tue, 14 Oct 2025 14:32:50 +0000Toward precision in psoriatic arthritis: addressing the challenge of difficult-to-treat disease.https://www.psoriasis-news.de/articles.html/1_articles/toward-precision-in-psoriatic-arthritis-addressing-the-challenge-of-difficult-to-treat-disease-r259/IntroductionDifficult-to-treat psoriatic arthritis (D2T-PsA) is increasingly recognized as a complex clinical entity characterized by persistent disease burden despite multiple targeted therapies. Its identification is essential to improve patient outcomes and to guide the development of new therapeutic strategies.

Areas covered

In this perspective article, we discuss the evolving concept of D2T-PsA, including its epidemiology, clinical characterization, and underlying pathophysiological mechanisms. We highlight the role of gender differences, psychosocial comorbidities, and central sensitization in shaping disease persistence and patient-reported impact. We also examine the limitations of current disease activity indices (DAPSA, PsAID, PASDAS) in capturing heterogeneity and the need for multidimensional frameworks. A structured literature search was conducted in PubMed/MEDLINE and Scopus databases (January 2020-June 2025), restricted to English-language publications, using combinations of the terms psoriatic arthritis, difficult-to-treat, refractory, and difficult-to-manage. Additional references were identified from conference abstracts and relevant bibliographies.

Expert opinion

Recognizing D2T-PsA as a distinct, multifactorial entity is critical to advancing personalized medicine. Future directions will involve harmonizing EULAR and GRAPPA frameworks, integrating biomarker discovery, digital tools, and adaptive trial designs, and embedding patient perspectives. This multidimensional approach is expected to transform treatment from empirical cycling toward precision care in psoriatic arthritis.

Weiterlesen

]]>259Tue, 14 Oct 2025 14:32:50 +0000Efficacy and safety of gut microbiota-targeted therapy in patients with psoriasis: a systematic review and meta-analysis of randomized controlled trials.https://www.psoriasis-news.de/articles.html/1_articles/efficacy-and-safety-of-gut-microbiota-targeted-therapy-in-patients-with-psoriasis-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials-r254/No abstract supplied.

Weiterlesen

]]>254Fri, 10 Oct 2025 06:15:28 +0000Preterm birth in women with psoriatic arthritis: what are the risks and risk factors? A collaborative cohort study from Sweden, Denmark and Norway.https://www.psoriasis-news.de/articles.html/1_articles/preterm-birth-in-women-with-psoriatic-arthritis-what-are-the-risks-and-risk-factors-a-collaborative-cohort-study-from-sweden-denmark-and-norway-r253/ObjectiveTo estimate risk and to identify risk factors for preterm birth in pregnant women with psoriatic arthritis (PsA) in relation to maternal characteristics, treatment and disease activity, both before and during pregnancy.

Methods

We linked clinical rheumatology registers to medical birth registers in Sweden, Denmark and Norway and identified PsA pregnancies and control pregnancies 2006-2021, matched 1:10 on age, parity, country and birth year. Adjusted ORs (aORs) for preterm birth in PsA pregnancies vs control pregnancies were calculated overall and stratified by maternal characteristics, antirheumatic treatment and disease load (9 months before and during pregnancy).

Results

We observed 54 preterm births among 688 PsA pregnancies (7.8%) versus 312 among 6880 control pregnancies (4.5%); aOR, 95% CI: 1.80, 1.29 to 2.51. The risk estimate was largely unaffected by parity, smoking and body mass index. PsA pregnancies exposed to a combination of biologic and conventional synthetic disease-modifying antirheumatic drugs (DMARDs) and/or glucocorticoids during pregnancy had a markedly increased risk of preterm birth compared with control pregnancies (4.44, 2.07 to 9.50), whereas exposure to biological DMARD (bDMARD) monotherapy (primarily tumour necrosis factor inhibitors) had not (0.73, 0.22 to 2.42). High disease load before pregnancy was associated with increased risk. The proportion of preterm birth was higher in those stopping bDMARD during the first trimester (21%) opposed to those continuing past the first trimester (10%) based on few events.

Conclusion

We identified an 80% increased risk of preterm birth in PsA pregnancies compared with control pregnancies. Antirheumatic combination therapy during and high disease load before pregnancy constituted risk factors. Discontinuing bDMARD treatment in early pregnancy further increased the risk. Our findings support that a subgroup of PsA pregnancies should be considered high-risk pregnancies.

Weiterlesen

]]>253Fri, 10 Oct 2025 06:15:28 +0000Cost-effectiveness of deucravacitinib versus apremilast of moderate-to-severe plaque psoriasis in China.https://www.psoriasis-news.de/articles.html/1_articles/cost-effectiveness-of-deucravacitinib-versus-apremilast-of-moderate-to-severe-plaque-psoriasis-in-china-r252/ObjectivesThe study aimed to assess the cost-effectiveness of deucravacitinib versus apremilast for treating moderate-to-severe plaque psoriasis from the Chinese healthcare system's perspective.

Methods

The treatment efficacy of deucravacitinib was compared with apremilast using response rates derived from the head-to-head phase 3 clinical trials, POETYK PSO-1 and PSO-2. A decision-tree (first 24-week)/ Markov model (later period) was constructed to estimate the incremental cost per quality-adjusted life-year (QALY) gained over a lifetime horizon. The efficacy inputs were based on randomized controlled trials, while adverse event rates, discontinuation probabilities, costs, and utility data were obtained from relevant literature and Chinese sources. A 5% annual discount rate was used for the analysis of outcomes and costs. Model outcomes were characterized by quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio (ICER). One-way sensitivity analysis and probability sensitivity analysis (PSA) were performed to examine the robustness of the results.

Results

According to the assumed lifetime horizon and model, the ICER of deucravacitinib 6 mg once daily compared with apremilast 30 mg twice daily was 140,047 CNY per QALY. Deucravacitinib was more cost-effective than apremilast at the willingness-to-pay (WTP) threshold of 287,247 CNY per QALY. In the One-way sensitivity analysis, the cost of deucravacitinib was identified as the parameter exerting the greatest impact on the base-case results. The results of PSA showed the probability of deucravacitinib being cost-effective was 99.4%.

Conclusion

At the WTP threshold of 287,247 CNY, deucravacitinib 6 mg once daily was a cost-effective treatment strategy for moderate-to-severe plaque psoriasis compared with apremilast 30 mg twice daily from the Chinese healthcare system perspective over a lifetime horizon.

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