- 178 Aufrufe
Neue Studien
Although the data on psoriasis epidemiology included in the Global Psoriasis Atlas (GPA) provide valuable information on psoriasis prevalence worldwide, the GPA database is still incomplete. Therefore, the aim of the study was to assess the prevalence, incidence, and mortality rates of psoriasis and its types in Poland based on the data registered by the National Health Fund (NHF).Methods
The study included psoriasis patients registered at least twice in the Polish NHF database between 2010 and 2023.Results
At the end of 2023, 639,662 living psoriasis patients had been registered in the Polish NHF database, which constituted 1.70% of the Polish general population. The percentage of female psoriasis patients was found to be higher (54.95%) than male patients (45.05%). Of all the Polish NHF-registered psoriasis patients, plaque psoriasis affected 95.66%, pustular psoriasis 3.05%, psoriatic arthritis 7.20%, and guttate psoriasis 0.27%. In comparison to the general Polish population, psoriasis prevalence was observed to be lower in children (0.84%). The all-cause mortality rate among psoriasis patients was found to be higher in comparison to the general Polish population, with a higher mortality rate noted in male psoriasis patients.Conclusions
The NHF database we studied suggests a direct relationship between the prevalence, incidence, and all-cause mortality rates in psoriasis and patients' age and sex. However, the study also revealed a decrease in mortality rates and a slow increase in the prevalence of psoriasis in the Polish population, which calls for further studies.Weiterlesen
- 206 Aufrufe
Metabolic dysfunction-associated steatotic liver disease (MASLD) is more prevalent in patients with psoriasis compared to healthy individuals. Interleukin (IL)-17 and IL-23 inhibitors may have beneficial effects on MASLD by reducing systemic inflammation and improving metabolic parameters.Objectives
To assess the effect of IL-17 and IL-23 inhibitors on MASLD and liver fibrosis in patients with psoriasis.Design
We performed a systematic review that followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.Data sources and methods
A literature search was conducted across four databases: MEDLINE, Embase, Web of Science, and Cochrane Central Register of Controlled Trials, from database inception to September 27, 2024. Observational studies and clinical trials that reported the presence of MASLD and/or liver fibrosis in patients with psoriasis/psoriatic arthritis treated with IL-17 or IL-23 inhibitors were included. The Newcastle Ottawa Scale (NOS) was used for risk of bias assessment in cohort studies, the Revised Cochrane Risk of Bias Tool (RoB2.0) in randomized controlled trials, and the Risk of Bias in non-randomized studies-of Interventions (ROBINS-I v.2) tool in non-randomized trials.Results
Fourteen studies were included: four clinical trials, five retrospective cohort studies, three prospective cohort studies, and two post hoc studies. Two cohort studies and one clinical trial showed a low risk of bias. Both post hoc studies had a high risk of bias. Eleven studies assessed the effect of IL-17 inhibitors on MASLD or liver fibrosis; six reported a neutral effect, while five demonstrated improvements in liver tests. Three studies evaluated IL-23 inhibitors; one showed neutral effects, another reported improvement in fibrosis-4 index (FIB-4) scores at 6 months, and the third was still in the recruitment phase.Conclusion
IL-17 and IL-23 inhibitors may provide beneficial effects on MASLD and liver fibrosis in patients with psoriasis. Larger, well-designed studies are needed to confirm these findings.Trial registration
PROSPERO CRD42024599350.Weiterlesen
- 184 Aufrufe
Psoriasis is a systemic immune disease associated with the development of various cancers. However, the causal nature of this association remains unclear. This study aims to systematically investigate the potential causal relationship between psoriasis and 32 types of cancer.Methods
We utilized data from two large genomic databases, the UK Biobank and FinnGen, to extract GWAS summary statistics for 32 cancer types as outcomes and psoriasis-related data as exposures. Mendelian randomization (MR) analysis was performed to assess the causal effects of psoriasis on cancer risk. Sensitivity analyses, including heterogeneity and horizontal pleiotropy tests, were conducted to ensure robustness. Additionally, meta-analysis and FDR correction were applied to enhance the reliability of the results.Results
Our findings revealed significant causal relationships between psoriasis and four cancer types: Psoriasis was associated with an increased risk of laryngeal cancer (OR = 1.15, 95% CI: 1.05-1.26). Psoriasis exhibited a protective effect against oral cavity and pharyngeal cancer (OR: 0.91; 95% CI: 0.86-0.97), prostate cancer (OR: 0.97; 95% CI: 0.95-0.99), and malignant non-melanoma cancer (OR: 0.89; 95% CI: 0.82-0.96).Conclusion
Psoriasis may exert bidirectional effects on the development of specific cancers through distinct mechanisms. Specifically, psoriasis may increase the risk of laryngeal cancer while reducing the risk of oral cavity and pharyngeal cancer, prostate cancer, and malignant non-melanoma cancer. These findings provide new insights into the causal relationship between psoriasis and cancer and could inform prevention and treatment strategies for these diseases.Weiterlesen
- 148 Aufrufe
In recent years, the prevalence of uveitis among patients with psoriasis has shown a noticeable upward trend. Previous studies have investigated the immunological mechanisms underlying the potential connection between psoriasis and uveitis, but systematic studies exploring their bidirectional relationship is absent. This study aims to systematically evaluate the bidirectional association between psoriasis and uveitis to provide evidence.Methods
We thoroughly searched PubMed, Embase, and the Cochrane Library for relevant observational studies published from the inception of these databases up to Mar 11th, 2024. Our systematic review was based on priori protocol pre-registered in PROSPERO (No. CRD42024522464). Risk and bias assessments were analyzed using STATA 16.0.Results
We analyzed the results from 7 studies involving 81,775,820 subjects. The results showed that the incidence of uveitis was higher in patients with psoriasis compared to patients without psoriasis (OR = 1.16, 95% CI: 1.11-1.21). At the same time, patients with uveitis showed heightened susceptibility to psoriasis (OR = 1.52, 95% CI: 1.34-1.70, I2: 90.6%, P < 0.01). The subgroup analysis found that uveitis affects the severity and type of psoriasis.Conclusions
The current systematic review and meta-analysis found a bidirectional association between psoriasis and uveitis. Notably, patients with severe psoriasis and psoriasis with joint symptoms should be informed about their increased risk to developing uveitis.Weiterlesen
- 132 Aufrufe
Psoriatic Arthritis (PsA), an immune mediated inflammatory arthritis, affects a quarter of patients with cutaneous psoriasis, usually after psoriasis onset. Early diagnosis of PsA is challenging. A biomarker-based diagnostic test may facilitate early diagnosis.Objectives
We aimed to determine whether specific clinical features or genetic and protein markers, alone or in combination, can distinguish patients with PsA from those with psoriasis without PsA (PsC).Methods
Patients with PsA and PsC were identified from a database of patients with psoriatic disease. Detailed demographic and clinical information were collected at time of assessment. Single-nucleotide polymorphisms (SNPs) of 19 "PsA weighted" genes were genotyped. Serum samples were used to assess 15 protein markers by ELISA. Association between clinical, genetic and protein markers and PsA were determined, and models were developed to discriminate PsA from PsC using machine learning algorithms.Results
Demographic and clinical information had low predictive value in distinguishing PsA from PsC (AUC - 0.607, P < .01). SNP and protein panels also had low value in discriminating PsA from PsC (AUC - 0.691, P < .001 and AUC - 0.694, P < .001, respectively). Combining protein, SNPs and clinical features provided better discriminatory value (best performing model: Random Forest, AUC - 0.733, P < .001).Conclusion
Combining previously identified clinical, genetic and protein markers have a fair ability to differentiate PsA from PsC. Further studies are required for identifying better diagnostic signatures.Weiterlesen
- 141 Aufrufe