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Mastzellen spielen eine größere Rolle bei Schuppenflechte, als viele denken: Sie bilden in den betroffenen Hautstellen die Entzündungsstoffe IL17A, IL17F und RORC[5]. Vor einer Therapie sind sie besonders aktiv. Auch nach erfolgreicher Behandlung, zum Beispiel mit Antikörpern oder UVB-Licht, bleiben viele dieser Mastzellen erhalten – dann aber eher in einer „ruhigen“ Variante, die trotzdem weiter IL-17A ausschüttet[5]. Auffällig: Je mehr dieser Mastzellen nach der Therapie übrigbleiben, desto schneller kehrt die Schuppenflechte zurück. Mastzellen und T-Zellen arbeiten dabei eng zusammen und steuern das Entzündungsgeschehen über die sogenannte IL-23/IL-17-Achse[5]. Originaltitel: Mast cells express IL17A, IL17F and RORC in lesional psoriatic skin, are activated before therapy and persist in high numbers in a resting state with IL-17A positivity after treatment. Link zur Quelle

In dieser Studie wird untersucht, wie wirksam und sicher Zasocitinib (TAK-279) bei Erwachsenen mit aktiver Psoriasis-Arthritis ist. Besonderes Augenmerk liegt darauf, ob die Patientinnen und Patienten zuvor bereits biologische Medikamente erhalten haben oder nicht. Die Teilnehmenden werden nach dem Zufallsprinzip entweder mit Zasocitinib in unterschiedlichen Dosierungen oder einem Placebo behandelt. Ziel ist es herauszufinden, wie viele der Behandelten nach 16 Wochen eine spürbare Verbesserung ihrer Gelenkbeschwerden (ACR20-Ansprechen) erreichen. Zusätzlich werden weitere Aspekte wie Hautbeteiligung, Lebensqualität und Fatigue bewertet. Zasocitinib ist ein sogenannter TYK2-Inhibitor – das heißt, er blockiert gezielt das Enzym Tyrosin-Kinase 2 im Körper. Dieses Enzym spielt eine wichtige Rolle bei Entzündungsprozessen des Immunsystems, die für Erkrankungen wie Psoriasis-Arthritis typisch sind. Durch die Hemmung von TYK2 kann Zasocitinib dazu beitragen, Entzündungen zu verringern und Symptome sowohl an den Gelenken als auch an der Haut zu lindern. Das Medikament wird als Tablette eingenommen. Originaltitel: A Multi-Center, Randomized, Double-Blind, and Placebo-Controlled Phase 3 Study to Evaluate the Efficacy and Safety of Zasocitinib (TAK-279) in Subjects with Active Psoriatic Arthritis Stratified by Prior Biologic Use (LATITUDE-PsA-3002) Erkrankung: Aktive Psoriasis-Arthritis Phase: III Firma: Takeda Development Center Americas Inc. Art der Verabreichung: Tablette https://euclinicaltrials.eu/search-for-clinical-trials/?lang=en&EUCT=2024-513112-99-00

Ein Forschungsteam hat ein KI-Tool entwickelt, das mithilfe künstlicher Intelligenz ganz automatisch den Schweregrad von Nagel-Psoriasis bewertet[2][5]. Das System nutzt Fotos und den sogenannten „modified Nail Psoriasis Severity Index“ (mNAPSI) und liefert dabei ähnlich zuverlässige Ergebnisse wie Experten[3][5]. So geht die Einschätzung schneller und objektiver als bei der üblichen Begutachtung per Hand. Die Technik könnte die Behandlung von Nagel-Psoriasis in Zukunft einfacher und genauer machen[5]. Originaltitel: Corrigendum: Advancement and independent validation of a deep learning-based tool for automated scoring of nail psoriasis severity using the modified nail psoriasis severity index. Link zur Quelle

Bimekizumab wirkt bei mittelschwerer bis schwerer Plaque-Psoriasis anhaltend gut. Nach drei Jahren hatten rund 69 % der Patientinnen und Patienten komplett erscheinungsfreie Haut, egal ob sie von Anfang an Bimekizumab bekamen oder nach einem Jahr von Secukinumab wechselten. Häufigste Nebenwirkungen waren Nasen-Rachen-Entzündung, Mundsoor und Infekte der oberen Atemwege. Schwerwiegende Nebenwirkungen wie schwere Infektionen oder Entzündungen des Darms traten über die drei Jahre nicht häufiger auf. Bimekizumab blieb insgesamt gut verträglich[2][3][5]. Originaltitel: Bimekizumab efficacy and safety through 3 years in patients with moderate-to-severe plaque psoriasis: long-term results from the BE RADIANT phase IIIb trial open-label extension period. Link zur Quelle

Methotrexat (MTX) ist ein wichtiges Medikament bei Psoriasis und Psoriasis arthritis, aber wie sicher ist es wirklich? Ein großes Team hat jetzt über 130.000 Berichte zu Nebenwirkungen aus den Jahren 2004 bis 2024 ausgewertet. Meistens meldeten Frauen Probleme, vor allem Erwachsene zwischen 18 und 65 Jahren. Die häufigsten Beschwerden betrafen das Immunsystem, die Muskeln, Gelenke und das Blut. Am meisten wurde über allgemeine Probleme und Reaktionen an der Injektionsstelle berichtet. Schwere Folgen wie Krankenhausaufenthalte oder sogar Todesfälle kamen vor, aber am häufigsten waren sonstige ernste Vorfälle. Die Ergebnisse zeigen: Nebenwirkungen sind möglich, aber es gibt klare Muster, wer und was besonders betroffen ist. Das hilft, Methotrexat noch sicherer einzusetzen[1][3]. Originaltitel: Adverse drug reactions related to methotrexate: a real-world pharmacovigilance study using the FAERS database from 2004 to 2024 Link zur Quelle

Eine neue große Auswertung hat sich angeschaut, wie oft bei Menschen mit Psoriasis, die sogenannte Interleukin-Hemmer bekommen, entzündliche Darmerkrankungen (IBD) neu auftreten. Von 12.185 Patientinnen und Patienten, die so behandelt wurden, entwickelten 22 eine neue IBD. Unter 4.372 Kontrollpersonen trat nur ein einziger Fall auf. Das ergibt eine Rate von etwa 2,4 Fällen pro 1.000 Patienten pro Jahr[1]. Vor allem der Einsatz von IL-17-Hemmern steht im Verdacht, das Risiko leicht zu erhöhen, obwohl andere Studien das Risiko als niedrig einstufen und keinen klaren Unterschied zu unbehandelten Psoriasis-Patienten sehen[2][3][4][5]. Fazit: Das Risiko für eine neue IBD bei Therapie mit Interleukin-Hemmern ist insgesamt sehr gering, bleibt aber besonders bei IL-17-Hemmern ein Thema, das Ärztinnen und Ärzte im Blick behalten sollten[1][3][4]. Originaltitel: Risk of new-onset inflammatory bowel disease in psoriasis patients treated with five different interleukin inhibitors: a systmatic review and meta-analysis Link zur Quelle

Rund 280.000 Menschen in Deutschland leben mit Multiple Sklerose (MS). Ungefähr 5 % davon haben zusätzlich eine chronisch-entzündliche Krankheit wie Psoriasis, Rheuma oder chronisch-entzündliche Darmerkrankungen. TNFα-Blocker sollten bei MS vermieden werden, da sie die MS verschlechtern können. Bei leichter MS mit Psoriasis hilft Dimethylfumarat, bei MS und Rheuma sind Azathioprin oder Leflunomid/Teriflunomid sinnvoll. Bei stärkerer Krankheitsaktivität kommen Anti-CD20-Antikörper infrage. Bei MS und Darmerkrankungen ist Azathioprin eine Option, bei schwerer Colitis auch Ozanimod. Die Behandlung sollte immer individuell und mit mehreren Fachärzten abgestimmt werden[1]. Originaltitel: Treatment Options for the Comorbidity of Multiple Sclerosis With Other Chronic Inflammatory Diseases. Link zur Quelle

In der KEEPsAKE 2-Studie wird untersucht, wie wirksam und sicher Risankizumab bei Erwachsenen mit aktiver Psoriasis-Arthritis ist – einer chronisch-entzündlichen Erkrankung, die sowohl die Gelenke als auch die Haut betrifft. Besonders im Fokus stehen Patientinnen und Patienten, bei denen bisherige biologische Therapien oder klassische Medikamente nicht ausreichend gewirkt haben oder nicht vertragen wurden. Die Studie vergleicht Risankizumab mit einem Placebo: Ziel ist es herauszufinden, wie viele Teilnehmende nach 24 Wochen eine spürbare Verbesserung ihrer Gelenkbeschwerden erreichen (gemessen am sogenannten ACR20-Ansprechen). Zusätzlich werden Verbesserungen bei Lebensqualität, Müdigkeit sowie Hautsymptomen erfasst. Risankizumab ist ein sogenannter monoklonaler Antikörper. Er richtet sich gezielt gegen einen Botenstoff des Immunsystems (Interleukin-23), der eine zentrale Rolle bei Entzündungsprozessen spielt. Durch diese gezielte Blockade kann Risankizumab Entzündungen hemmen und so Beschwerden wie Schmerzen, Schwellungen und Bewegungseinschränkungen lindern – ohne das gesamte Immunsystem zu unterdrücken. Originaltitel: A Phase 3, Randomized, Double-Blind Study Comparing Risankizumab to Placebo in Subjects with Active Psoriatic Arthritis Including Those Who Have a History of Inadequate Response or Intolerance to Biologic Therapy(ies) (KEEPsAKE 2) Erkrankung: Psoriasis-Arthritis Phase: III Firma: AbbVie Deutschland GmbH & Co. KG Art der Verabreichung: Injektion (Lösung zur Injektion) https://euclinicaltrials.eu/search-for-clinical-trials/?lang=en&EUCT=2023-505477-33-00

No abstract supplied.Weiterlesen

No abstract supplied.Weiterlesen

ObjectiveTo describe the psoriatic phenotype associated with psoriatic arthritis (PsA).MethodsBased on the previously published 4-item Psoriatic Arthritis Uncluttered Screening Evaluation (PURE-4) validation study, this work aims to describe the sociodemographic and clinical characteristics, as well as the PURE-4 questionnaire outcomes, of patients with psoriasis (PsO) who completed the study. It compares those diagnosed with PsA during the study to those with PsO only. The variables compared were age, sex, time since diagnosis of PsO, PsO location, PsO treatment, Psoriasis Area and Severity Index (PASI), and Dermatology Life Quality Index (DLQI).ResultsThe study included 253 patients with PsO, from whom 46 developed PsA (28 [60.9%] male; mean age 48.9 [11.1] years) during the study. At baseline, patients who developed PsA had more involvement of PsO in the neck (13% vs 3.4%, P < 0.01), knees (71.4% vs 50%, P = 0.02), hands (40% vs 17.7%, P < 0.01), and feet (22.9% vs 9.8%, P = 0.03) as well as high-impact areas. PASI (8.7 [SD 5.6] vs 6.8 [SD 5.0], P = 0.03) and DLQI (9.9 [SD 6.9] vs 7.6 [SD 6.7], P = 0.09) values were higher among patients with PsA. Peripheral joint pain with swelling (item 4) was the most prevalent item of PURE-4 among patients with PsA, ranging from 67.6% (vs 47.1%; P = 0.03) in Assessment I to 91.7% (vs 45.4%; P < 0.01) in Assessment II.ConclusionGreater PsO involvement in neck, knees, hands, and feet as well as in high-impact areas of patients who developed PsA provides additional information on the arthritogenic phenotype of PsO in our study population compared to locations generally linked to arthritis risk, such as the nails or scalp.Weiterlesen

The aim of this study was to translate and culturally validate the Psoriatic Arthritis Quality of Life Questionnaire (PsAQoL) into Turkish and to evaluate its reliability and validity in patients with psoriatic arthritis (PsA). A total of 162 PsA patients diagnosed according to CASPAR criteria were recruited from two rheumatology clinics. The PsAQoL was translated and culturally adapted into Turkish using a standardized forward-backward translation method. Internal consistency was assessed using Cronbach's alpha. Construct validity was evaluated by correlating PsAQoL scores with quality of life (SF-36), functional (HAQ), emotional (HADS), and clinical disease activity indices (DAPSA, BASDAI, DAS28). The Turkish version of the PsAQoL was found to be clear, concise, and well understood by patients. The average time to complete the questionnaire was 3.3 ± 0.9 min. Internal consistency was good (Cronbach's α = 0.930). Strong correlations were found with SF-36 physical (r = - 0.744) and mental components (r = - 0.731), indicating convergent validity. Moderate correlations were observed with HAQ (r = 0.533), VAS pain (r = 0.408), HADS-Anxiety (r = 0.535), and HADS-Depression (r = 0.517), while correlations with unrelated clinical parameters such as age and PASI were weak or insignificant, indicating divergent validity. No floor or ceiling effects were detected, and there were no missing responses. The Turkish version of the PsAQoL is a valid, reliable, and practical tool for assessing disease-specific quality of life in PsA. Its ease of use and psychometric strength support its application in both clinical practice and researchs.Weiterlesen

IntroductionPsoriasis is a chronic, systemic inflammatory disease with significant physical and psychosocial burden. Advances in understanding the pathogenesis of psoriasis, particularly the role of interleukin (IL)23/Th17 axis, have led to the development of selective drugs targeting these cytokines. Among these, IL23 inhibitors (guselkumab, risankizumab, and tildrakizumab), represent the most recent class of biologic drugs approved for the management of moderate-to-severe plaque psoriasis. Since their approval, real-life data on the use of anti-IL23 have confirmed their high efficacy, durability, and favorable safety profile.Areas coveredThis narrative review summarizes real-world data on the effectiveness, also in difficult-to-treat areas, safety, and drug survival of IL23 inhibitors in psoriasis.Expert opinionReal-world evidence consistently confirms the strong efficacy, favorable safety profile, and long-term treatment durability of IL23 inhibitors across various patient subgroups, including those with comorbidities, prior biologic failures, and the involvement of difficult-to-treat areas. IL23 inhibitors have become key components of the therapeutic arsenal in psoriasis, and their performance in real-world settings continues to support their widespread adoption in clinical practice.Weiterlesen

BackgroundPsoriasis is frequently associated with metabolic syndrome and an increased cardiovascular risk. Tildrakizumab, an IL-23 inhibitor, may affect metabolic parameters in addition to improving skin severity.Aim of the studyTo evaluate the impact of increasing tildrakizumab dosage on lipid and glucose levels in psoriasis patients with metabolic syndrome who showed a partial response to the standard 100 mg dose.Materials and methodsTwenty-five patients with psoriasis and metabolic syndrome were enrolled in a 52-week prospective study. After 16 weeks of treatment with 100 mg tildrakizumab, patients with an absolute PASI >2 were switched to 200 mg. Total cholesterol, LDL, and glucose were measured at baseline, week 16, week 40, alongside PASI and DLQI.ResultsAt baseline, mean total cholesterol, LDL, and glucose were 190.7, 120.1, and 99.4 mg/dL, respectively. The 100 mg dose did not result in significant metabolic changes at week 16. However, switching to 200 mg tildrakizumab led to significant reductions at week 40 in total cholesterol (178.3 mg/dL), LDL (110.1 mg/dL), and glucose (87.2 mg/dL) (all p < 0.05). Significant improvements in PASI (1.2) and DLQI (0.2) were also observed (p < 0.05).ConclusionsIncreasing the tildrakizumab dose to 200 mg in partial responders with metabolic syndrome significantly improved both skin severity and metabolic profiles, lowering cholesterol, LDL, and glucose. These findings suggest a possible dose-dependent effect of tildrakizumab on metabolic parameters through enhanced IL-23 inhibition.Weiterlesen

No abstract supplied.Weiterlesen

BackgroundAlthough IL-17 inhibitors like Secukinumab and Ixekizumab have shown significant efficacy in psoriasis, the impact of early intervention with biologics to modify the disease course and achieve long-term remission remains unclear.ObjectivesTo examine the potential of early intervention with IL-17 inhibitors for disease modification in psoriasis.MethodsWe conducted a multicenter retrospective cohort study on moderate-to-severe plaque psoriasis patients who received at least 4 weeks of treatment with Secukinumab or Ixekizumab between April 2019 and April 2023, taking the relapse rate one year after cessation of treatment as the primary endpoint.ResultsAmong 400 patients who discontinued treatment after achieving PASI90, the median relapse time was 3.29 months(approximately 14 weeks). Of 141 patients who discontinued treatment after achieving PASI90 for over a year, 24 (88.89%) in the ultra-short disease duration(USDD, psoriasis duration ≤ 1 year) group and 33 (82.5%) in the short disease duration(SDD, psoriasis duration ≤ 2 year) group achieved one year of drug-free remission.LimitationsThe potential impact of early intervention on comorbidity development was not addressed in this study.ConclusionEarly intervention with IL-17 inhibitors leads to faster responses and may promote disease modification in psoriasis.Weiterlesen

Psoriasis is a chronic autoimmune disease of the skin manifested by keratinocyte hyperproliferation, immune dysregulation, and chronic inflammation that result in scaly plaques. Conventional interventions such as corticosteroids, immunosuppressants, and biologics offer symptomatic relief but are limited by side effects and incomplete remission. Psoriasis pathogenesis is complex and entails numerous immune cells (dendritic cells, Th1, Th17, Th22, Tregs, macrophages, NK cells) and molecular pathways (IL-17, IL-22, IL-23, TNF-α, NF-κB). Gene therapy suppresses cytokine production, modulates immune activation, and normalizes keratinocyte turnover to achieve sustained control of disease. Gene therapy is a promising option by modulating inflammatory circuits at the molecular level. Methods such as CRISPR-Cas9, RNA interference (RNAi), and antisense oligonucleotides (ASOs) target major psoriasis-related cytokines (IL-17, IL-22, IL-23, TNF-α) and transcription factors (NF-κB), inhibiting inflammation and abnormal keratinocyte proliferation. With ongoing research, gene-based therapies in combination with biologics and nanotechnology-based drug delivery provide a personalized and efficient option for the treatment of psoriasis. This review discusses conventional and innovative gene therapies, which have been found to hit specific cellular and molecular targets to combat psoriasis therapy.Weiterlesen

Psoriasis, the most common inflammatory skin disease, is marked by excessive proliferation of keratinocytes and infiltration of immune cells into the epidermis. Current treatments, particularly biologics targeting the IL‑23/IL‑17 axis, demonstrate excellent efficacy, but issues of recurrence and side effects persist. Therefore, it is essential to identify safer and more effective alternatives. Lobetyolin (LBT), a key component of polyacetylenes in Codonopsis pilosula, exhibits potent antioxidant and antitumor properties, yet its potential for treating psoriasis remains unexplored. In the present study, it was found that topical treatment with LBT significantly inhibits psoriasis in mice and maintains skin homeostasis during disease progression by regulating genes associated with keratinocyte proliferation and differentiation, enhancing the PPAR signaling pathway, and upregulating genes and metabolites involved in linoleic acid metabolism. Additionally, LBT suppressed gene expression linked to cytokine activity as well as the Il17, Tnf and MAPK signaling pathways in IMQ‑treated dendritic cells (DCs). These findings underscored LBT's efficacy in reducing IMQ‑induced psoriasis‑like skin inflammation by preserving skin homeostasis and inhibiting inflammatory cytokines in DCs. The present results suggested that topically applied LBT could serve as a promising drug candidate for psoriasis treatment or as an adjunct to biologic therapies to prevent disease relapse.Weiterlesen

Psoriasis is a chronic, multifactorial, inflammatory skin disease, increasingly recognized as a systemic disorder influenced by the gut-skin axis, which is a dynamic bidirectional communication between intestinal microbiome and cutaneous immune response. This narrative review explores the understanding of the gut-skin axis with the latest evidence on how gut dysbiosis occurs in psoriasis, characterized by reduced microbial diversity and its shifts, and how it contributes to pathogenesis and exacerbation of psoriasis. Notably, recent scientific literature evidence suggests that the alteration of gut microbiome in psoriasis includes a decreased level of beneficial species like Faecalibacterium prausnitzii and a rise in the level of proinflammatory bacterial species like Prevotella copri. Mechanistic insights reveal that gut-derived metabolites, impaired barrier functions, and immune signaling, particularly involving IL-23 and Th17 cells, play a pivotal role in this axis, linking intestinal health to cutaneous manifestations. Both animal and human trials underscore the therapeutic potential of interventions targeting the gut microbiota, including prebiotics, probiotics, dietary modifications, and FMT, demonstrating some promising but variable effects on disease severity and systemic inflammation. Despite these advances, translating the gut-skin axis into clinical practice presents a notable challenge due to limited scientific evidence, a lack of standardised microbiome profiling, and the absence of universally accepted biomarkers to monitor and stratify therapeutic outcomes. These limitations hinder the development of personalised care approaches and the integration of the gut-skin axis as a promising frontier in many autoimmune diseases, where the gut-skin axis and the intestinal microbiome play a crucial role.Weiterlesen

ObjectiveResidual confounding effects and disease severity are attributed to controversial results in studies of psoriatic disease (PsD) and mortality. We aimed to evaluate the risk of mortality in patients with incident PsD, compared to matched controls from the population.MethodsWe used the nationwide, population-based insurance claim datasets in Taiwan from 2010 to 2018. Incident cases of PsD were identified by International Classification of Diseases (ICD) codes. A nonexposed cohort was established through propensity score matching (PSM). Deaths were identified via the National Mortality Database. We evaluated the risk of all-cause mortality in PsD compared to the PSM nonexposed individuals using Cox regression. The mortality risk was evaluated in patients with more severe disease stratified by systemic therapy use and having psoriatic arthritis (PsA).ResultsThere were 108,642 patients with incident PsD (40.2% women) and an equal number of PSM non-PsD individuals. Compared to the age- and sex-matched controls, there was a higher risk of mortality among patients with PsD (adjusted hazard ratio [aHR] 1.73, 95% CI 1.68-1.77, P < 0.001). After PSM, we found an attenuated but persistent higher risk of mortality in PsD compared to controls (aHR 1.20, 95% CI 1.16-1.24). There was a trend of higher mortality in patients exposed to biologic therapies, but not for PsA.ConclusionThere was an increased risk of all-cause mortality in individuals with PsD compared to individuals without PsD before and after both PSM and adjustment for comorbidities. The risk of mortality was higher in patients with psoriasis but not in patients with PsA as compared to controls.Weiterlesen

ObjectiveTo describe the psoriatic phenotype associated with psoriatic arthritis (PsA) METHODS: Based on the previously published PURE 4 validation study, this work aims to describe the sociodemographic and clinical characteristics, as well as the PURE-4 questionnaire outcomes, of psoriasis patients who completed the study. It compares those diagnosed with PsA during the study to those with only psoriasis . The variables compared were age, gender, time since diagnosis of psoriasis, psoriasis location, psoriasis treatment, Psoriasis Area and Severity Index (PASI), and Dermatology Life Quality Index (DLQI).ResultsThe study included 253 psoriasis patients, from whom 46 developed PsA (28 [60.9%] male; mean age 48.9 [11.1]) during the study. At baseline, patients who developed PsA had more involvement of psoriasis in the neck (13.0% vs. 3.4%, p<0.01), knees (71.4% vs. 50.0%, p=0.02), hands (40.0% vs. 17.7%, p<0.01), and feet (22.9% vs. 9.8%, p=0.03) as well as high impact areas. PASI (8.7 [5.6] vs. 6.8 [5.0], p=0.03) and DLQI (9.9 [6.9] vs. 7.6 [6.7], p=0.09) values were higher among patients with PsA. Peripheral joint pain with swelling (item 4) was the most prevalent item of PURE-4 among patients with PsA, ranging from 67.6% in Assessment I to 91.7% in Assessment II (91.7% vs. 45.4%, p<0.01).ConclusionGreater psoriasis involvement in neck, knees, hands, and feet as well as high impact areas of patients who developed PsA suggests additional information on arthritogenic phenotype of psoriasis in our study population compared to locations generally linked to arthritis risk (nail or scalp).Weiterlesen

AimOnly limited data is available on the benefit of brodalumab 210 mg, an IL-17 receptor A antagonist, on patient-reported outcomes (PROs) in different psoriasis severity groups under real-world-evidence (RWE) conditions.MethodsLIBERO, a prospective, multicenter, 12- and 52-weeks (W) non-interventional study on brodalumab in adult patients with plaque-type psoriasis assessed its short- and long-term impact on PROs in mild, moderate and severe psoriasis defined by Psoriasis Area Severity Index (PASI).Results200 (31.3%) patients with severe (PASI ≥ 20), 263 (41.2%) with moderate (PASI = 10-19) and 168 (26.3%) with mild (PASI < 10) psoriasis were analyzed. In all severity groups a rapid and sustained reduction of mean(m) PASI was observed as of W2. 76.7, 84.9 and 82.0% of patients assessed their psoriasis as being clear/almost clear in mild, moderate and severe subgroups and mean Dermatological Life Quality Index improved from 11.2, 14.3 and 17.1 to 3.2, 2.9 and 3.8. 73.7% of patients rated brodalumab as being quite/very beneficial (Patient Benefit Index, PBI) and were quite/very satisfied with the treatment (TSQM-9). Regaining disease control and reducing physical impairment achieved highest PBI-scores.ConclusionLIBERO confirms the benefit of brodalumab on PROs including rapid and complete clearance of skin lesions, quality of life and individual patient benefits - irrespective of their disease severity.Weiterlesen

BackgroundPsoriasis is a chronic inflammatory disease associated with abnormalities in the immune system. Microsomal prostaglandin E synthase-1 (mPGES-1), a terminal enzyme for prostaglandin (PG) E2 biosynthesis, is highly expressed in the skin of psoriasis patients. However, the detailed role of mPGES-1 in psoriasis remains unclear. In the present study, we aimed to investigate the role of mPGES-1 in psoriasis-like skin inflammation induced by imiquimod (IMQ), a well-established model of psoriasis.MethodsPsoriasis was induced in mPGES-1-deficient (mPGES-1-/-) and wild-type (WT) mice by administering IMQ for 6 days. Psoriasis was evaluated based on the scores of the macroscopic symptoms, including skin scaling, thickness, and redness, and on the histological features. The skin expression of mPGES-1 was determined by real-time polymerase chain reaction and Western blotting. The impact of mPGES-1 deficiency on T-cell immunity was determined by flow cytometry and γδ T-cell depletion in vivo with anti-T-cell receptor (TCR) γδ antibody.ResultsThe inflamed skin of mPGES-1-/- mice showed severe symptoms after the administration of IMQ. Histological analysis further showed significant exacerbation of psoriasis in mPGES-1-/- mice. In WT mice, the mPGES-1 expression was highly induced at both mRNA and protein levels in the skin, and PGE2 increased significantly after IMQ administration, while the PGE2 production was largely abolished in mPGES-1-/- mice. These data indicate that mPGES-1 is the main enzyme responsible for PGE2 production in the skin. Furthermore, the lack of mPGES-1 increased the numbers of IL-17A-producing γδ T cells in the skin with IMQ-induced psoriasis, and γδ T-cell depletion resulted in a reduction of the facilitated psoriasis symptoms under the condition of mPGES-1 deficiency.ConclusionsOur study results demonstrate that mPGES-1 is the main enzyme responsible for skin PGE2 production, and that mPGES-1 deficiency facilitates the development of psoriasis by affecting the development of T-cell-mediated immunity. Therefore, mPGES-1 might impact both skin inflammation and T-cell-mediated immunity associated with psoriasis.Weiterlesen

Patients with autoimmune diseases are susceptible to developing a second autoimmune disorder. Psoriasis, a common autoimmune disease, frequently occurs alongside other autoimmune conditions in some individuals. We report the case of a young female patient diagnosed with plaque psoriasis, initially treated with secukinumab, and achieved complete skin clearance at 12 weeks. However, she experienced a decline in the efficacy of secukinumab, with recurrence of symptoms and subsequent development of chronic spontaneous urticaria (CSU) and was switched to treatment with deucravacitinib, an oral, selective, allosteric tyrosine kinase 2 inhibitor. The use of deucravacitinib resulted in a favorable therapeutic outcome, effectively managing both psoriasis and CSU 12 weeks after treatment. This case highlights the potential of deucravacitinib as a novel monotherapy for patients with both psoriasis and CSU.Weiterlesen

Entzündliche Hautkrankheiten wie Psoriasis sind weltweit eine große Belastung. In China gibt es besonders viele neue Fälle, die Zahl der Betroffenen ist dort deutlich höher als in den USA. Vor allem Pilz- und bakterielle Infektionen spielen eine große Rolle[5]. In den USA ist die Belastung im Vergleich etwas niedriger, aber auch dort leben viele Menschen mit entzündlichen Hautkrankheiten[1]. Hautkrankheiten zählen weltweit zu den häufigsten chronischen Krankheiten. Sie verursachen viele Jahre, in denen Menschen mit Einschränkungen leben müssen und beeinflussen Lebensqualität und Alltag stark[4][5]. Jede Region braucht eigene Strategien, um Betroffenen besser zu helfen. Originaltitel: Burden of Inflammatory Skin Diseases Based on GBD Data: China vs USA. Link zur Quelle