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No abstract supplied.Weiterlesen

No abstract supplied.Weiterlesen

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.MethodsA 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.ResultsSerum 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.ConclusionsSerum 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.Weiterlesen

Celastrol(CE) has been investigated for its prophylactic and anti-inflammatory effects in various inflammatory and autoimmune diseases like psoriasis. However, poor water solubility, low bioavailability, and high toxicity, have limited its application The objective of this study is to design and synthesize a gelatin-based CE prodrug polymer which can self-assemble into nanoparticles, encapsulating CE to improve its aqueous solubility. Two gelatin derivatives with opposite charges were synthesized through a condensation reaction. CE prodrug nanoparticles were formed by coupling CE to these two gelatin derivatives using dynamic chemical bonding: C-S bonds and borate bonds. The resulting nanoparticles(G-C-G) had an average particle size of approximately 147.15 ± 8.25 nm, and a drug loading capacity (DL) of 1.52 ± 0.25%. The transdermal penetration of nanoparticles (G-C-G) was found to be improved compared to free CE in vitro. In a mouse model of psoriasis, nanoparticles G-C-G resulted in a reduction of erythema, scaly epidermal symptoms, spleen weight, and cytokine levels, including IL-17 and IL-23, indicating high therapeutic potential for psoriasis. In conclusion, CE prodrug nanoparticles (G-C-G) increase the water solubility and skin permeability of free CE, making it a potential therapeutic agent for psoriasis.Weiterlesen

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.MethodsUsing 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 variablestherapy type, patient status (new vs. returning), comorbidities, and treatment changes, were stratified to compare cost differences across groups.ResultsMean 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.ConclusionsThis 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.Weiterlesen

Forschende sind optimistisch: Eine dauerhafte Heilung der Psoriasis könnte bald möglich sein. Bisher wirken Antikörper-Therapien sehr gut, sie stoppen die Entzündung fast komplett. Das Problem ist, dass man diese Mittel lebenslang nehmen muss. Setzt man sie ab, kehrt die Schuppenflechte oft schnell zurück[1]. Es gibt aber Ausnahmen: Manche Menschen bleiben auch nach dem Absetzen jahrelang beschwerdefrei. Forschende hoffen, mit neuen Methoden genau das für viele zu erreichen. Besonders spannend ist, dass man gezielt Zellen beeinflussen kann, die sich das „Kranksein“ merken. Wird dieses Gedächtnis gelöscht, könnte die Haut gesund bleiben, auch ohne ständige Medikamente[1]. In den nächsten zehn Jahren könnte aus dieser Forschung tatsächlich eine richtige Heilung entstehen, meinen Expertinnen und Experten[1]. Originaltitel: A psoriasis cure could be in touching distance Link zur Quelle

In der INSPIRE 1-Studie wird untersucht, wie wirksam und sicher Tildrakizumab bei Erwachsenen mit aktiver Psoriasis-Arthritis ist, die bereits mit Anti-TNF-Medikamenten behandelt wurden, aber weiterhin Beschwerden haben. Die Studie ist eine große, internationale Phase-III-Studie, bei der die Teilnehmenden entweder Tildrakizumab oder ein Placebo als Injektion erhalten. Ziel ist es, nach 24 Wochen zu prüfen, wie viele Patientinnen und Patienten eine spürbare Verbesserung ihrer Gelenkbeschwerden erreichen (ACR20-Response). Die bisherigen Ergebnisse zeigen, dass Tildrakizumab die Symptome der Psoriasis-Arthritis im Vergleich zum Placebo deutlich verbessert und dabei ein bekanntes, gutes Sicherheitsprofil aufweist. Tildrakizumab ist ein sogenannter monoklonaler Antikörper, der gezielt den Botenstoff Interleukin-23 (IL-23) blockiert. IL-23 spielt eine wichtige Rolle bei Entzündungsprozessen im Körper, insbesondere bei Autoimmunerkrankungen wie Psoriasis und Psoriasis-Arthritis. Durch die Hemmung von IL-23 kann Tildrakizumab die Entzündung und die damit verbundenen Beschwerden wie Gelenkschmerzen und Hautveränderungen lindern. Das Medikament wird bereits zur Behandlung der Schuppenflechte (Plaque-Psoriasis) eingesetzt und wird als Fertigspritze unter die Haut gespritzt. Originaltitel: A Phase III, Randomized, Double-Blind, Placebo-Controlled Study to Demonstrate the Efficacy and Safety of Tildrakizumab in Anti-TNF Experienced Subjects with Active Psoriatic Arthritis I (INSPIRE 1) Erkrankung: Psoriasis-Arthritis Phase: III Firma: Sun Pharmaceutical Industries Limited Art der Verabreichung: Injektion (Fertigspritze, subkutan) https://euclinicaltrials.eu/search-for-clinical-trials/?lang=en&EUCT=2023-507415-35-00

## Kontinuierliche Behandlung mit Biologika Bei der Behandlung von Psoriasis wird eine kontinuierliche Therapie mit Biologika empfohlen. Diese Medikamente sind bei der Behandlung der Schuppenflechte sehr wirksam, da sie direkt auf das Immunsystem eingreifen und Entzündungen reduzieren[1][2]. Beliebte Biologika sind IL-17- (z.B. Ixekizumab, Secukinumab) und IL-23-Inhibitoren (z.B. Guselkumab, Risankizumab), die eine schnelle Symptomlinderung bieten[3]. ## Unterbrechungen in der Behandlung In der Praxis kommt es jedoch häufig zu Unterbrechungen der Behandlung. Diese können verschiedene Gründe haben und sind nicht immer medizinisch bedingt. Solche Unterbrechungen können zu schnellen Rezidiven der Psoriasis führen, was die Behandlung erschwert[3]. Es ist wichtig, dass Patienten mit ihrem Arzt besprechen, wie sie ihre Behandlung am besten fortsetzen können. ## Optimierung der Behandlung Um die Behandlung zu optimieren, ist es entscheidend, die richtigen Biologika für den individuellen Patienten auszuwählen. Neuere Studien zeigen, dass eine Anpassung der Therapie an die spezifischen Bedürfnisse des Patienten zu besseren Ergebnissen führt[2][5]. Originaltitel: Optimierung von Biologika bei chronischer Plaque‐Psoriasis: Einblicke zu nichtmedizinischen Unterbrechungen von IL‐17‐, IL‐12/23‐ und IL‐23‐Inhibitoren Link zur Quelle

Biologische Therapien bei Psoriasis haben bestimmte anatomische Unterschiede in der verbleibenden Krankheitsaktivität, die als residueller PASI-Wert bezeichnet wird. Eine Studie hat gezeigt, dass trotz erfolgreicher Behandlung mit biologischen Medikamenten bei 228 von 1000 Patienten nach 24 bis 28 Wochen noch Hauterkrankungen verblieben sind. Die unteren Gliedmaßen waren am häufigsten betroffen (44,3%). Es wurden Unterschiede in der Häufigkeit und dem Ort der verbleibenden Erscheinungen zwischen verschiedenen biologischen Medikamenten beobachtet. Secukinumab hatte den höchsten und Risankizumab den niedrigsten Anteil an Patienten mit verbleibender Krankheitsaktivität an den unteren Gliedmaßen. Dies führte häufig zu Behandlungswechseln oder -unterbrechungen. Originaltitel: Biologic treatments for psoriasis have different anatomical specificities in residual PASI. Link zur Quelle

Menschen mit Psoriasis, Akne, Neurodermitis oder Nesselsucht haben oft Probleme beim Schlafen. Wenn du schlecht schläfst oder oft nachts wach wirst, kann das deine Hautkrankheit verschlimmern. Es gibt Hinweise darauf, dass bestimmte Schlafgewohnheiten direkt mit diesen Krankheiten zusammenhängen. Schlechter Schlaf stört zum Beispiel deine innere Uhr und beeinflusst, wie gut die Haut Entzündungen bekämpft. Das betrifft wichtige Immunzellen, die nachts besonders aktiv sind. Wenn du zu wenig schläfst, produziert dein Körper mehr Stoffe, die Entzündungen fördern. Dadurch kann der Juckreiz stärker werden, was wiederum deinen Schlaf weiter stört. Kinder mit Hauterkrankungen leiden häufiger unter Schlafstörungen, Müdigkeit und sogar psychischen Belastungen wie Depressionen. Mädchen sind besonders oft betroffen. Es ist sinnvoll, dass du als Patient auf guten Schlaf achtest und bei Problemen deinen Arzt darauf ansprichst. Originaltitel: Association between sleep traits and inflammatory skin diseases Link zur Quelle

GLP-1-Rezeptor-Agonisten wie Ozempic oder Trulicity helfen nicht nur beim Abnehmen und beim Senken des Blutzuckers, sondern haben auch Auswirkungen auf die Haut. Häufig gibt es an der Einstichstelle Rötungen, Juckreiz oder Schwellungen, manchmal entstehen sogar Quaddeln oder richtige Allergien[1][4]. Sehr selten können ernsthafte Hauterkrankungen wie Bullöses Pemphigoid auftreten[1][2]. Einige Menschen berichten über komische Hautgefühle wie Kribbeln oder Brennen – das passiert bei oraler Einnahme häufiger[1][6]. Weil viele mit den Medikamenten schnell Gewicht verlieren, kann es zu Haarausfall kommen (Telogen Effluvium) oder das Gesicht wirkt eingefallen, der sogenannte „Ozempic Face“[5]. Interessant: Es gibt Hinweise, dass GLP-1-Rezeptor-Agonisten Entzündungen lindern und sogar bei Wundheilung oder bei Schuppenflechte helfen könnten, hier ist aber noch viel Forschung nötig[1][3]. Bei Hautproblemen oder ungewöhnlichen Reaktionen solltest du immer deinen Arzt oder deine Ärztin ansprechen. Originaltitel: Dermatologic Implications of Glucagon-Like Peptide-1 Receptor Agonist Medications Link zur Quelle

Menschen mit Psoriasis haben laut einer dänischen Studie ein erhöhtes Risiko, eine akute oder chronische Bauchspeicheldrüsenentzündung (Pankreatitis) zu bekommen. Das Risiko steigt, je schwerer die Schuppenflechte ist. Die Forscher vermuten, dass Entzündungen, wie sie bei Psoriasis vorkommen, eine Rolle spielen könnten. Trotzdem ist Pankreatitis insgesamt selten. Es gibt Hinweise, dass Medikamente wie Methotrexat das Risiko senken könnten[1][5][6]. Fachleute empfehlen, mögliche Symptome wie starke Oberbauchschmerzen oder unerklärliche Übelkeit ernst zu nehmen und früh zum Arzt zu gehen. Originaltitel: Risk of acute and chronic pancreatitis in patients with psoriasis: A Danish nationwide cohort study Link zur Quelle

Frauen mit Psoriasis-Arthritis (**PsA**) haben laut einer großen Studie aus Skandinavien ein deutlich höheres Risiko für eine Frühgeburt als Frauen ohne PsA. Bei etwa 8 von 100 PsA-Schwangerschaften kam das Baby zu früh zur Welt, bei Frauen ohne PsA waren es nur 5 von 100[8]. Das Risiko für eine Frühgeburt steigt besonders dann, wenn die Mutter während der Schwangerschaft eine Kombination aus verschiedenen Antirheumatika und/oder Kortison einnimmt. Auch eine hohe Krankheitsaktivität vor der Schwangerschaft erhöht das Risiko. Wer biologische Medikamente (bDMARDs) früh in der Schwangerschaft absetzt, riskiert ebenfalls häufiger eine Frühgeburt: Bei ihnen lag die Rate bei 21 Prozent, während es bei Frauen, die weiterbehandelt wurden, nur 10 Prozent waren[8]. Andere Faktoren wie Rauchen, Übergewicht oder wie oft eine Frau bereits entbunden hat, spielten in dieser Studie nur eine geringe Rolle. Die Ergebnisse zeigen: Manche Schwangerschaften bei PsA gelten als Hochrisikoschwangerschaft und sollten eng begleitet werden[8]. Originaltitel: Preterm birth in women with psoriatic arthritis: what are the risks and risk factors? A collaborative cohort study from Sweden, Denmark and Norway Link zur Quelle

Dr. Google gibt nicht immer richtige Infos und viele Menschen mit Hautproblemen schauen inzwischen lieber auf Social Media nach Rat[8]. Es gibt aber immer noch wenige Hautärzte, die sich aktiv mit eigenen Beiträgen dort zeigen[1]. Wenn sie es tun, können sie eine große Zielgruppe erreichen und Patienten besser aufklären. Sie klären über neue Behandlungen auf und geben Tipps, die vorher nur Fachleute kannten[1]. Das Problem: Es gibt auch viel Unsinn im Netz. Nicht jede Influencerin ist wirklich Expertin, obwohl sie Tipps zur Hautpflege gibt[5]. Für Menschen mit Schuppenflechte oder Psoriasis-Arthritis ist das gefährlich. Falsche Infos können nämlich dazu führen, dass man seine Haut nicht richtig behandelt oder Hoffnungen auf Wunder-Methoden hat, die nicht funktionieren[2]. Dermatologen auf Social Media können helfen, das zu verhindern. Sie können die wichtigsten Themen ehrlich und verständlich erklären. So finden sich auch Patienten mit seltenen Hautkrankheiten schneller in einer Community, die versteht, was sie wirklich brauchen[1]. Social Media kann aber auch Nachteile haben. Hautärzte stecken viel Zeit in ihre Accounts und müssen aufpassen, dass sie nie die Grenzen zur Werbung oder zu Freundschaften mit Patienten verwischen. Außerdem ist es schwer, alle Hautthemen gleich viel Aufmerksamkeit zu geben. Die meisten Menschen klicken lieber auf Beiträge zu Pickeln oder Falten als auf Schuppenflechte[3]. Trotzdem lohnt es sich, wenn Fachleute online aktiv sind. Sie können so Vertrauen schaffen, Falschinformationen entgegentreten und mit Betroffenen auf Augenhöhe reden[1][2]. Wer als Patient auf Social Media unterwegs ist, sollte genau hinschauen: Wer schreibt das? Gibt derjenige offen an, ob er einen Facharzt-Titel hat? Oder steht vielleicht doch Beauty statt Medizin im Vordergrund? Hautärzte sind auch gefragt, sich stärker online zu engagieren, damit richtige Infos auf TikTok, Instagram und Co. ankommen[1]. Originaltitel: Integrating social media into modern dermatology – a cross‐sectional study Link zur Quelle

## Schlechter Schlaf erhöht Psoriasis-Risiko Eine große Studie aus Großbritannien hat untersucht, ob schlechter Schlaf das Risiko für Psoriasis erhöht. Die Forscher haben dafür Daten von über 500.000 Menschen ausgewertet[4]. Die Wissenschaftler schauten sich verschiedene Schlaf-Faktoren an: Wann jemand am liebsten schläft, wie lange er schläft, ob er Schlafprobleme hat, ob er schnarcht und ob er tagsüber müde ist. Aus diesen Faktoren bildeten sie Gruppen mit gutem und schlechtem Schlafmuster. Das Ergebnis: Menschen mit schlechten Schlafgewohnheiten bekommen häufiger Psoriasis. Das gilt besonders für Frauen[4]. Die Forscher berücksichtigten dabei auch die genetische Veranlagung der Teilnehmer. ## Was bedeutet das für Betroffene? Die Verbindung zwischen Schlaf und Psoriasis funktioniert in beide Richtungen. Schlechter Schlaf kann Psoriasis auslösen oder verschlimmern[1]. Umgekehrt stört Psoriasis oft den Schlaf, vor allem wenn sie stark juckt oder schmerzt[1]. Besonders Menschen mit Psoriasis-Arthritis haben häufig Schlafprobleme. Sie schlafen schlechter als Menschen mit Psoriasis ohne Gelenkbeteiligung[1]. Auch Schlafapnoe spielt eine Rolle. Menschen mit Psoriasis haben ein erhöhtes Risiko für Schlafapnoe[2]. Je schwerer die Psoriasis ist, desto höher ist dieses Risiko[2]. Originaltitel: Associations of sleep pattern and genetic risk with late-onset psoriasis: A large prospective cohort study Link zur Quelle

Viele Menschen setzen heute auf **ätherische Öle** als natürliche Alternative zu künstlichen Stoffen in Hautpflegeprodukten. Studien zeigen: Teebaumöl hilft gut gegen Akne, Lavendel und Rosmarin wirken entzündungshemmend und können sogar gegen Hautalterung helfen. Auch Extrakte aus Kamille oder Hanf verbessern die Hautgesundheit[2][3]. Wichtig ist aber: Die Qualität und Anwendung ist oft sehr unterschiedlich, manchmal gibt es zu wenig große Studien. Bei manchen Ölen wie Lavendel, Pfefferminze oder Teebaumöl kann es außerdem zu Hautreizungen kommen. Die meisten Menschen vertragen ätherische Öle gut, doch Allergien oder Hautreaktionen sind möglich. Deshalb sollte man neue Produkte erst an einer kleinen Hautstelle testen und nicht zu viel auf einmal auftragen[2][4]. Mehr Forschung ist nötig, bevor Ärzte ätherische Öle eindeutig empfehlen können. Wer sie nutzt, achtet am besten auf gute Qualität und vernünftige Anwendung. Originaltitel: Frontiers | Evaluating efficacy, safety, and innovation in skin care applications of essential oils: a systematic review Link zur Quelle

Skin infiltration by neutrophils is a hallmark of the chronic inflammatory skin disease psoriasis, yet the mechanisms underlying neutrophil recruitment and positioning in chronically inflamed skin remain poorly understood. In this study, we demonstrate the significant impact of a total genetic deficiency of secretory leukocyte protease inhibitor (SLPI) on neutrophil migration in mouse skin. Without SLPI, neutrophils displayed an unconventional migratory pattern, characterized by altered interactions with vessel walls and reduced efficiency in extravasating from blood vessels into skin tissue during the early stages of experimental psoriasis. This was associated with changes in tissue motility, positioning neutrophils farther from the skin entry vessels and closer to the skin surface. Neutrophil diapedesis was partially dependent on SLPI within the neutrophils themselves. The impact of SLPI on neutrophil movement was further supported by the increased migration of human neutrophils in the presence of neutrophil-penetrant recombinant SLPI. Additionally, our data suggest that neutrophils with varying capacities for vessel wall interaction are released from the bone marrow into circulation in an SLPI-dependent manner. These findings establish a role for SLPI in regulating the spatiotemporal infiltration of neutrophils into the skin in psoriasis, highlighting its relevance to psoriasis pathophysiology.Weiterlesen

Psoriasis is a complex inflammatory autoimmune skin illness that causes epidermal keratinocyte hyperproliferation and dedifferentiation. In a previous study we did in the lab, we found that treating human keratinocytes (HaCaT) with PUVA increased the expression of hsa-miR-718 compared to control. In this study, an imiquimod (IMQ)-induced mouse model and HaCaT were used to look at how overexpressing miR-718 could help treat psoriasis and its causes. To gain more understanding, the in vivo study used the JAK1/3 inhibitor tofacitinib. We observed that miR-718 overexpression leads to the inhibition of JAK-STAT signalling, as evidenced by the reduced expression of STAT1, JAK proteins, and their phosphorylated forms, both in vitro and in vivo. Luciferase assay demonstrated the direct inhibition of STAT1 due to miR-718 overexpression. Additionally, in vitro experiments showed downregulation of STAT2 and STAT3. Inhibition of basal miR-718 in HaCaT overactivates JAK-STAT signalling proteins. In psoriatic mice, ectopic miR-718 reduces NF-kB, a key mediator of inflammation. IHC shows lower acanthosis and parakeratosis in IMQ-induced psoriatic mice. In the skin of mice that had been miR-718 transfected, there was less VEGF, MMP7 and MMP9. Understanding how miR-718 improves psoriasis not only provides new information but also inspires hope for its potential use as a psoriasis treatment.Weiterlesen

BackgroundPsoriasis is a chronic, immune-mediated inflammatory dermatosis associated with an elevated risk of cardiovascular disease (CVD) due to systemic inflammation and metabolic dysregulation. Phenotypic age acceleration (PhenoAge-accel) quantifies accelerated biological aging by comparing an individual's predicted 'phenotypic age' (based on immune/inflammatory markers and chronological age) to their actual age. Notably, both the onset and progression of psoriasis exhibit strong associations with biological aging process. The aim of this study was to investigate their combined effect on the risk of all-cause and CVD mortality.MethodsThis study included 11,443 participants from the National Health and Nutrition Examination Survey (NHANES) conducted during 2003-2006 and 2009-2010. Weighted multivariable logistic regression models were used to evaluate the association between PhenoAge-accel and psoriasis risk. PhenoAge-accel ≥ 0 was defined as PhenoAge-accel+. Furthermore, participants were stratified into four groups: psoriasis-/PhenoAge-accel-, psoriasis+/PhenoAge-accel-, psoriasis-/PhenoAge-accel+, and psoriasis+/PhenoAge-accel+. The Cox proportional hazards models were employed to investigate the joint effects of psoriasis and PhenoAge-accel on all-cause and CVD mortality risk.ResultsAt baseline, 312 participants were diagnosed with psoriasis. After adjusting for covariates, compared to those with PhenoAge-accel < 0, the odds ratios (95% CI) for psoriasis in the PhenoAge-accel ≥ 0 group was 1.83 (1.36-2.45). During a median follow-up of 10.91 years (interquartile range: 9.83-14.75), 1059 deaths event occurred, including 306 caused by CVD. In the multivariable-adjusted model, compared with the reference group, the hazard ratios and 95% CIs for all-cause mortality in the psoriasis-/PhenoAge-accel+, psoriasis+/PhenoAge-accel-, and psoriasis+/PhenoAge-accel+ groups were 1.80 (1.54-2.10), 0.96 (0.56-1.65), and 2.70 (1.66-4.39), respectively. A similar trend was observed for CVD mortality.ConclusionsPhenoAge-accel is positively associated with psoriasis risk. Furthermore, the coexistence of psoriasis and PhenoAge-accel are significantly associated with an increased risk of all-cause and CVD mortality.Weiterlesen

BackgroundEpidemiological studies have revealed a close association between psoriasis and non-alcoholic fatty liver disease (NAFLD), but the causal relationship and underlying mechanisms remain unclear.Materials and methodsIn this study, we used genome-wide association study (GWAS) data from the MRC Integrative Epidemiology Unit (MRC-IEU) to investigate the causal relationship between psoriasis and NAFLD, as well as potential mediators. Two-sample and two-step MR analyses were conducted, followed by bulk and single-cell transcriptomic analyses to validate our MR findings. In vivo validation was performed using Enzyme-Linked Immunosorbent Assay (Sample of patients (n=10)), immunohistochemistry, and liver bulk transcriptomic analysis.ResultsThe two-sample MR analysis revealed that genetically predicted psoriasis significantly increased the risk of NAFLD (OR = 1.07, 95% CI = 1.03-1.12, p = 0.001). Mediation analysis suggested that psoriasis was associated with elevated plasma Interleukin-1 receptor antagonist protein (IL-1RA) levels (OR = 1.02, 95% CI = 1.00-1.05, p = 0.031), which in turn raised the risk of NAFLD (OR = 1.15, 95% CI = 1.04-1.27, p = 0.006). In vivo experiments demonstrated elevated IL-1RA levels in the skin and plasma of psoriasis patients. Similarly, imiquimod (IMQ)-induced psoriasis mouse models exhibited increased IL-1RA levels in plasma and liver, accompanied by liver inflammation. MR and colocalization analysis indicated a positive correlation between IL-1RA, apolipoprotein B, and cholesterol.ConclusionOur study demonstrates that genetically predicted psoriasis increases the risk of NAFLD, and plasma IL-1RA may serve as a potential mediator between psoriasis and NAFLD.Weiterlesen

IntroductionPatient demographics, disease characteristics, and treatment history can impact the efficacy of biologic treatments in patients with psoriasis. Understanding the efficacy of biologics, such as bimekizumab, across diverse patient subgroups is important for optimising treatment outcomes. Here, we assess whether high overall clinical responses observed in bimekizumab-treated patients with moderate to severe plaque psoriasis are consistent across subgroups, both versus comparators and with long-term treatment.MethodsData were analysed post hoc from the BE SURE, BE VIVID, and BE READY phase 3 trials, their open-label extension (OLE) BE BRIGHT, and the BE RADIANT phase 3b trial. Patients received either bimekizumab or adalimumab to week 24 (BE SURE), bimekizumab or ustekinumab to week 52 (BE VIVID), and bimekizumab or secukinumab to week 48 (BE RADIANT). In the 3-year pooled analysis (all trials), included patients received bimekizumab continuously from baseline into the OLE. Subgroups of patients with moderate to severe plaque psoriasis were defined by age, sex, weight, disease duration, disease severity, nail involvement (modified Nail Psoriasis Severity Index > 0), and prior biologic exposure, at baseline. The proportions of patients achieving complete skin clearance (PASI 100; 100% improvement from baseline in Psoriasis Area and Severity Index) in each subgroup are reported alongside 95% confidence intervals (CI). Modified non-responder imputation (mNRI) was used for missing data.ResultsFollowing comparator-controlled periods, the proportion of bimekizumab-treated patients who achieved PASI 100 was consistent across subgroups and numerically greater versus patients who received adalimumab (to week 24), ustekinumab (to week 52), and secukinumab (to week 48) in all subgroups. Among patients who received bimekizumab continuously for 3 years (N = 1107), PASI 100 response rates remained consistent across age (68.6% [40 to < 65 years]-73.7% [≥ 65 years]), sex (69.6% [male]-71.4% [female]), weight (63.4% [≥ 103.9 kg]-75.5% [< 74.3 kg]), disease duration (65.5% [≤ 5 years]-71.1% [> 20 years]), disease severity (67.7% [PASI 12 to < 15]-71.1% [PASI ≥ 20]), nail involvement (69.1% [yes]/71.3% [no]), and prior biologic exposure (71.7% [yes]/69.1% [no]; prior anti-TNF exposure 67.6% [yes]/70.6% [no]) subgroups; 95% CIs overlapped in all instances, indicating no meaningful differences between subgroups.ConclusionBimekizumab demonstrated consistently high long-term efficacy in patients with psoriasis across diverse subgroups. Higher rates of PASI 100 were achieved with bimekizumab versus adalimumab, ustekinumab, and secukinumab, across all subgroups. These results highlight bimekizumab as an effective treatment for a broad range of people living with psoriasis.Trial registrationNCT03412747, NCT03370133, NCT03410992, NCT03598790, NCT03536884.Weiterlesen

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.MethodsA 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.ResultsSerum 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.ConclusionsSerum 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.Weiterlesen

PurposeThis study aimed to investigate the risk of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAVs) among patients with psoriasis in a large population.Patients and methodsIn this population-based study using the collaborative electronic health record research network, the risk of developing AAVs (ie, eosinophilic granulomatosis with polyangiitis (EGPA), granulomatosis with polyangiitis (GPA), and microscopic polyangiitis (MPA)) was analyzed in a cohort of patients diagnosed with psoriasis between 2006 and 2024. Non-psoriasis controls were selected in a 1:1 ratio using propensity score matching. Patients who were diagnosed with AAVs before the index date were excluded. Univariate Cox proportional hazard model and subgroup analyses were used to estimate the hazard ratio (HR) with a 95% confidence interval (CI) for developing AAVs. The Kaplan-Meier method was used to plot the cumulative incidence curves. The risk of AAVs in psoriatic patients treated with biological agents was explored.ResultsAfter matching, 436,201 patients were included in each cohort. There were 281 incident cases of AAV during follow-up in the psoriasis cohort and 122 incident cases of AAV in the non-psoriasis cohort. The risk of developing AAVs in the psoriasis cohort was significantly higher than in the non-psoriasis cohort (HRs (95% CI) for AAVs, EGPA, and GPA were 2.01 (1.63 to 2.49), 1.84 (1.11 to 3.06), and 2.11 (1.65 to 2.71), respectively. Compared with psoriasis patients who did not receive biologics, those treated with biologics showed no statistically significant increase in AAVs risk (HR 1.31, 95% CI 0.65 to 2.66).ConclusionPatients with psoriasis have a higher risk of AAVs development. Treatment with biologic agents is not associated with an elevated risk of AAVs.Weiterlesen

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.MethodsThe 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.ResultsAccording 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%.ConclusionAt 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.Weiterlesen

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.MethodsWe 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).ResultsWe 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.ConclusionWe 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