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Psoriasis involving the genital region (GenPsO) is associated with impaired quality of life (QoL), including sexual burden and avoidance of sexual intercourse. There is limited data on the effectiveness of risankizumab in GenPsO on patients' QoL and sexual impairment. GPS-Best, a nested cohort non-interventional study within the German Psoriasis registry PsoBest, aims to evaluate the effectiveness of risankizumab in GenPsO and its impact on QoL and sexual impairment. This interim analysis involves 52 patients who completed week 16 of the 52-week GPS-Best study. Patient questionnaires, including the Genital Psoriasis Symptoms Scale (GPSS) and Genital Psoriasis Sexual Impact Scale (GPSIS), were evaluated in patients with plaque psoriasis and a static physician's global assessment of genitalia ≥ 3 at baseline. The results demonstrated a significant reduction in the GPSS total score from a median [IQR] of 42.0 [36.0-57.0] at baseline to 3.0 [0-9.0] at week 16 (p < 0.001). In the GPSIS avoidance and impact subscale, more patients reported 'never' avoiding sexual activity at week 16 compared to baseline (46.8% vs. 10.5%) and 78.9% reported 'no or very low' impact compared to 18.5% at baseline, respectively. These findings indicate risankizumab significantly reduces patient-reported GenPsO symptoms over a 16-week period and increases sexual QoL.Weiterlesen

BackgroundConventional systemic agents remain the cornerstone treatment for psoriasis because of their availability and cost-effectiveness. However, few studies have compared the effectiveness and drug persistence of these agents in Asian populations.ObjectivesTo evaluate the effectiveness and drug persistence of methotrexate, cyclosporine, and acitretin, and to identify factors associated with these outcomes.MethodsWe reviewed data from 338 psoriasis patients treated with methotrexate, cyclosporine, or acitretin.ResultsOut of 473 treatment courses, 239 (50.5%) involved methotrexate, 123 (26%) involved acitretin, and 111 (23.5%) involved cyclosporine. After 1 year, the proportion of patients who achieved absolute Psoriasis Area and Severity Index (PASI) ≤ 2 was greater with methotrexate (30.6%) and cyclosporine (22.2%) than with acitretin (9.5%). For absolute PASI ≤ 4, methotrexate (57%) and cyclosporine (47.2%) showed greater effectiveness than did acitretin (34.9%), with a significant difference only between methotrexate and acitretin (P = .017). The effectiveness findings were consistent in both the 1- and 3-year analyses. Multivariate analysis revealed that a high baseline PASI score significantly reduced the effectiveness of both methotrexate and cyclosporine. For methotrexate, a high body mass index was also associated with reduced effectiveness, whereas for acitretin, scalp involvement and male sex were key factors. Methotrexate demonstrated the longest drug survival at 1 year. Higher ages at psoriasis onset and systemic treatment-naive status were correlated with longer drug survival. Conversely, a higher body mass index and psychiatric comorbidities were linked to shorter survival.LimitationsMethotrexate is typically the first-line systemic therapy in Thailand, which may underestimate the true efficacy of cyclosporine and acitretin when used subsequently.ConclusionMethotrexate was more effective and persistent than were cyclosporine and acitretin in a real-world setting.Weiterlesen

ObjectivesSternoclavicular joint (SCJ) involvement in psoriatic arthritis (PsA) is poorly characterized. We aimed to assess its prevalence and clinical associations in a longitudinal PsA cohort.MethodsWe retrospectively analyzed prospectively collected data from the Gladman Krembil Psoriatic Arthritis Program. Patients with SCJ involvement (tender and/or swollen SCJ) were identified, and their demographic, clinical, laboratory, and treatment details were retrieved. Univariable and multivariable generalized estimating equation models were used to assess associations with clinically swollen SCJ. Results are reported as odds ratios (OR) with 95% confidence intervals (CI).ResultsAmong 1,737 patients, 182 (10.5%) had SCJ involvement, including 36 (2.1%) with clinically swollen SCJs ever over follow-up. SCJ involvement was present at enrolment into the cohort (baseline) in 33.1% of affected individuals. The mean age was 41.4 ± 12 years, and 42% were male. In univariable analyses, SCJ involvement was significantly associated with higher swollen joint count (SJC) (OR 1.142, 95% CI 1.08-1.16), dactylitis (4.51, 2.02-10.05), and enthesitis (6.74, 3.45-13.15). No significant associations were observed with sex, disease duration, axial and nail disease, PASI, pustular psoriasis, or HLA markers. In multivariable analysis, SCJ swelling remained associated with higher SJC (1.08, 1.03-1.14), enthesitis (4.54, 1.98-10.45), dactylitis (4.54, 1.98-10.45) and lower biologic or targeted synthetic DMARD use (0.30, 0.10-0.88).ConclusionSCJ involvement is an underrecognized but clinically meaningful manifestation of PsA, associated with greater disease burden and enthesitis, often requiring escalation to advanced therapies.Weiterlesen

Psoriasis is a chronic skin disease mediated by Th1 and Th17 immune responses and is classified as a systemic inflammatory disorder. Notably, psoriasis is an independent risk factor for myocardial infarction, stroke, and cardiovascular mortality, particularly in severe disease. However, the cellular mechanisms linking psoriasis to cardiovascular disease have not yet been identified. To address this gap, we investigated systemic markers of inflammasome signaling and innate immune activation in patients with psoriasis. Whole blood was collected from 43 patients, including active psoriasis (mild-to-moderate disease) without clinical manifestations of atherosclerosis, inactive psoriasis (minimal disease activity), patients receiving anti-TNF-α therapy, and 19 BMI-matched healthy controls. Multiparametric spectral flow cytometry was performed to profile inflammasome signaling, and mass spectrometry-based proteomics was used to obtain unbiased phenotyping of circulating immune cells. Classical monocytes from patients with active psoriasis exhibited heightened NLRP3 protein expression and caspase-1 activity upon brief physiological stimulation, responses absent in inactive psoriasis and healthy controls. Mechanistically, active psoriasis demonstrated elevated plasma ATP and increased monocyte expression of P2X7R, a potent NLRP3 activator. TNF-α was identified as a key cytokine, selectively upregulating both P2X7R and NLRP3. Baseline proteomics revealed enriched pathways for monocyte extravasation and cell adhesion, suggesting a pro-thrombotic state. Stimulation increased proteins linked to ROS and mitochondrial stress. Monocytes from active psoriasis exhibited increased baseline activation and, upon stimulation, enhanced monocyte-platelet aggregation, both of which were attenuated by inhibition of mitochondrial ROS. Importantly, anti-TNF therapy normalized ATP levels, P2X7R expression, inflammasome responsiveness, monocyte activation, and monocyte-platelet interactions, supporting the restoration of systemic immune homeostasis. In patients with mild-to-moderate psoriasis, we demonstrate persistent systemic stress, resulting in inflammasome hyperreactivity and increased monocyte-platelet aggregation in response to minor perturbations in cellular homeostasis. Notably, TNF-α blockade restores these effects, providing mechanistic insight into how anti-TNF therapy reduces systemic inflammation and cardiovascular risk.Weiterlesen

No abstract supplied.Weiterlesen

Background: /Objectives: Plaque psoriasis is a chronic immune-mediated inflammatory disease affecting approximately 3% of the global population and resulting in a significant deterioration in quality of life. Systemic therapy with monoclonal antibodies (mAbs) targeting TNF-α, IL-23, and IL-17 improves clinical outcomes and patients’ quality of life. Treatment strategies commonly include different mAbs and different sequencings approaches between agents, which are well-established in clinical practice. In contrast, evidence supporting the switch from intravenous to subcutaneous administration of the same mAb remains limited. Herein, we report data from a retrospective case series of patients with plaque psoriasis treated with intravenous infliximab (IV-IFX; Anti TNF-α) and transitioned to subcutaneous infliximab (SC-IFX) to compare clinical and patient-reported outcomes across routes. Methods: 11 plaque psoriasis patients were retrospectively analyzed. The scores of Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI) and Physician Global Assessment (PGA) were assessed during IV-IFX and after switching to SC-IFX. To evaluate patients’ satisfaction, the Score of Treatment Satisfaction Questionnaire Medication-9 (TSQM-9) was evaluated. Both Student’s t-test and ANOVA were used to assess statistically significant differences between the two routes of administration (p&lt;0.05). Results: scores for PASI, DLQI and PGA were lower with SC-IFX compared to IV-IFX, indicating improved disease control and quality of life after the switch. PASI and DLQI improved in 81% and 100% of patients treated with SC-IFX, respectively. TSQM-9 total scores increased significantly by 24% (P&lt;0.001). In particular, the questions addressing the “convenience” of treatment, revealed a marked advantage for the SC-IFX formulation (p&lt;0.001). No treatment-emergent adverse events were registered. Conclusions: In this retrospective case series, switching from IV-IFX to SC-IFX appeared to be safe and to maintain or improve clinical response and enhanced treatment satisfaction. Thus, these findings highlight the potential of SC-IFX as a viable maintenance option for patients with plaque psoriasis previously treated with IV-IFX.Weiterlesen

BackgroundAlthough testing for latent tuberculosis (TB) infection has been standard practice for psoriasis patients being treated with IL-17 or IL-23 inhibitors, evidence for this practice is weak.ObjectivesTo review evidence on safety of IL-17 and IL-23 inhibitors in the setting of latent TB infection, and to provide a new Joint Position Statement on this topic.MethodsExperts from the National Psoriasis Foundation (NPF) and the International Psoriasis Council (IPC) reviewed evidence regarding progression of latent TB infection to active disease in psoriasis patients receiving IL-17 or IL-23 blockers. A Joint Position Statement was formulated and approved to provide updated guidance to clinicians.Results87.5% of the members from the NPF Medical Board and IPC approved a new Joint Position Statement regarding psoriasis patients being treated with IL-17 or IL-23 inhibitors, stating that testing for latent TB infection is not required.LimitationsThis position statement allows for exceptions where continued testing for latent TB infection could be considered, including for patients on concomitant immunosuppressive therapy and for those living in TB endemic areas.ConclusionPsoriasis experts reached consensus that routine testing for latent TB infection is not required in psoriasis patients being treated with IL-17 or IL-23 inhibitors.Weiterlesen

No abstract supplied.Weiterlesen

Psoriatic arthritis (PsA) is a chronic, immune-mediated inflammatory arthritis associated with psoriasis, affecting joints, entheses, and the axial skeleton. While primary care providers and dermatologists frequently encounter psoriasis (PsO), early recognition of PsA remains critical to preventing irreversible joint damage. This paper is written to provide a comprehensive overview of PsA, beginning with a clinical case that highlights diagnostic and therapeutic challenges. In this review, the epidemiology of PsA will be discussed, emphasizing its prevalence and risk factors among patients with PsO. The discussion extends to the underlying pathogenesis, focusing on genetic predisposition, environmental triggers, and key cytokines, including TNF-α, IL-17, and IL-23, that have become targets for advanced therapeutics. The clinical features of PsA are explored in detail, including peripheral and axial arthritis, enthesitis, dactylitis, and extra-articular manifestations. Diagnostic approaches are discussed, with a focus on the Classification Criteria for Psoriatic Arthritis (CASPAR) and Moll & Wright criteria. Additionally, we examine screening tools designed to facilitate early detection in dermatology clinics. Diagnostic modalities, including imaging and serologic markers, are reviewed. Finally, we explore the evolving landscape of PsA treatment, spanning conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), biologic agents (bDMARDs), and targeted synthetic DMARDs (tsDMARDs). Given the increasing availability of cytokine-targeted therapies, an interdisciplinary approach between dermatologists and rheumatologists is essential for optimizing outcomes in PsA patients. Patients with PsA are cared for by rheumatologists, dermatologists, and primary care providers who help manage the comorbidities associated with PsA. By bridging primary care, dermatology, and rheumatology in the care of PsA, this paper aims to enhance understanding of PsA for facilitating early identification and timely intervention for improved patient care.Weiterlesen

## Gute Nachricht für Menschen mit Genitalpsoriasis Ein Medikament namens Risankizumab hilft Menschen mit Psoriasis im Genitalbereich deutlich besser zu leben. Das zeigt eine neue Studie aus Deutschland mit 52 Patienten.[1][3] Die Studie untersuchte, wie sehr die Psoriasis die Sexualität der Betroffenen einschränkt. Das ist wichtig, weil Genitalpsoriasis oft zu Scham und Vermeidung führt. **Das Ergebnis nach 16 Wochen ist beeindruckend:** Die Symptome sanken drastisch. Von den Patienten, die anfangs Geschlechtsverkehr mieden, taten das nach 16 Wochen fast die Hälfte nicht mehr. Etwa 79 Prozent berichteten, dass die Psoriasis nur noch wenig oder gar keine Auswirkungen auf ihr Leben hat. **Warum ist das wichtig?** Menschen mit Genitalpsoriasis leiden oft nicht nur unter Juckreiz oder Rötungen. Sie leiden vor allem psychisch. Viele trauen sich nicht, ihre Partner zu berühren. Sie fühlen sich unwohl. Risankizumab scheint genau diese Last zu nehmen. **Was kommt als Nächstes?** Die Studie läuft noch bis Woche 52. Forscher erwarten weitere positive Ergebnisse. Und auch andere Studien zeigen ähnliches: Bei etwa 70 Prozent der Patienten verbesserte sich die sexuelle Aktivität deutlich.[1] Für viele Menschen mit Genitalpsoriasis könnte dieses Medikament endlich eine echte Lösung sein. Originaltitel: Reduction of impairment of sexual activity in patients with genital psoriasis treated with risankizumab: interim results of a real-world study. Link zur Quelle

Noninvasive imaging of skin diseases is highly valued in both dermatological research and practice. Reflectance confocal microscopy (RCM) is primarily applied to assess melanocytic lesions because of its high resolution, whereas optical coherence tomography (OCT) is particularly used for non-melanocytic skin tumors owing to its greater penetration depth. Line-field confocal optical coherence tomography (LC-OCT) combines the techniques of reflectance confocal microscopy (RCM) and optical coherence tomography (OCT), enabling visualization of the skin down to the superficial dermis while simultaneously providing cellular resolution. The visualization of the skin changes can be done horizontally, vertically, in 3D mode or as a video in real time. The evaluation of the measurement can be supported by artificial intelligence if required. The field of application of LC-OCT includes both melanocytic and non-melanocytic lesions. In addition, preliminary studies show great potential in the diagnosis and therapy control of inflammatory and infectious skin diseases. Nevertheless, RCM and OCT still have their place in special cases such as tumors requiring a particularly high resolution or penetration depth > 500 µm.Weiterlesen

No abstract supplied.Weiterlesen

IntroductionDelays remain in patients receiving effective treatment strategies that have potential to clear their skin of psoriasis, improve their quality of life (QoL) and change the psoriatic disease course, which, if uncontrolled, can irreversibly alter an individual's life course (i.e. cumulative life course impairment [CLCI]). This study explored current international awareness and consideration of the potential impact of psoriasis over the life course within clinical assessments and decisions about its management.MethodsCross-sectional surveys collated insights from people with psoriasis and healthcare professionals (HCPs) treating psoriasis (dermatologists and primary care physicians [PCPs]) across 29 countries.ResultsData were collected from 487 people with psoriasis, 574 dermatologists and 618 PCPs. Despite people with psoriasis highlighting a range of daily activities that are 'very frequently' or 'always' affected by their psoriasis, 37% were never or rarely asked by their HCPs how the disease affects their life. Fewer than half of people with psoriasis had a high understanding of the potential future impact of psoriasis (or CLCI-contributing factors), and 44% were unaware that clear/almost clear skin is now a realistic treatment target. Almost half of HCPs considered psoriasis to be of early onset when it presented at ≤ 15 years of age. Despite HCP awareness of the impact of psoriasis on QoL, many of the contributing factors to CLCI were not addressed routinely in clinical practice nor considered when deciding on treatment; 40% of dermatologists set treatment goals (such as clear skin/almost clear skin/target Dermatology Life Quality Index [DLQI]) sometimes, less frequently, or not at all.ConclusionsMisalignment exists in the experience of people living with psoriasis versus its assessment in clinical practice. Support is needed for assessment and monitoring of elements that may contribute to CLCI in clinical practice worldwide, to guide early psoriasis treatment decision-making to mitigate the risk for CLCI. Infographic available for this article. INFOGRAPHIC.Weiterlesen

No abstract supplied.Weiterlesen

No abstract supplied.Weiterlesen

Sternoclavicular joint (SCJ) involvement in psoriatic arthritis (PsA) is poorly characterized. We aimed to assess its prevalence and clinical associations in a longitudinal PsA cohort. We retrospectively analyzed prospectively collected data from the Gladman Krembil Psoriatic Arthritis Program. Patients with SCJ involvement (tender and/or swollen SCJ) were identified, and their demographic, clinical, laboratory, and treatment details were retrieved. Univariable and multivariable generalized estimating equation models were used to assess associations with clinically swollen SCJ. Results are reported as odds ratios (OR) with 95% confidence intervals (CI). Among 1,737 patients, 182 (10.5%) had SCJ involvement, including 36 (2.1%) with clinically swollen SCJs ever over follow-up. SCJ involvement was present at enrolment into the cohort (baseline) in 33.1% of affected individuals. The mean age was 41.4 ± 12 years, and 42% were male. In univariable analyses, SCJ involvement was significantly associated with higher swollen joint count (SJC) (OR 1.142, 95% CI 1.08-1.16), dactylitis (4.51, 2.02-10.05), and enthesitis (6.74, 3.45-13.15). No significant associations were observed with sex, disease duration, axial and nail disease, PASI, pustular psoriasis, or HLA markers. In multivariable analysis, SCJ swelling remained associated with higher SJC (1.08, 1.03-1.14), enthesitis (4.54, 1.98-10.45), dactylitis (4.54, 1.98-10.45) and lower biologic or targeted synthetic DMARD use (0.30, 0.10-0.88). SCJ involvement is an underrecognized but clinically meaningful manifestation of PsA, associated with greater disease burden and enthesitis, often requiring escalation to advanced therapies.Weiterlesen

Psoriasis is a systemic immune‑mediated skin disease, typically considered to be incurable. Identification of meaningful biomarkers has been a notable challenge in psoriasis prevention and management. The present study aimed to determine the signature genes driving psoriasis and their underlying mechanism. Microarray datasets of psoriasis were obtained from the Gene Expression Omnibus database, and the differentially expressed genes (DEGs) were identified using the 'limma' R package. Gene Set Enrichment Analysis (GSEA) was performed using the 'clusterProfiler' R tool. Functional and pathway enrichment of DEGs were analyzed using a bioinformatics website (Wei Sheng Xin). Furthermore, the present study applied least absolute shrinkage and selection operator regression, random forest and support vector machine‑recursive feature elimination techniques to pinpoint signature genes driving psoriasis. Subsequently, CIBERSORT was used to determine whether psoriasis‑infiltrating immune cells had a strong connection with signature genes. Immunohistochemistry (IHC) was used to demonstrate the expression of TGM1 in human psoriasis samples. Cell transfection was employed to verify the function of TGM1. The top 163 significant DEGs were identified from the GSE30999 dataset, and Kyoto Encyclopedia of Genes and Genomes analysis illustrated that these genes were mostly involved in 'viral protein interaction with cytokine and cytokine receptor', as well as the 'IL‑17 signaling pathway'. The present study screened transglutaminase 1 (TGM1) as a signature gene by combining three machine learning algorithms. Through single‑gene GSEA, the present study further revealed that TGM1 was associated with 'GF‑RTK‑PI3K signaling pathway' and 'cytokine‑JAK‑STAT signaling pathway', providing valuable insights into the underlying mechanism of psoriasis. Additionally, the present study validated TGM1 expression in the GSE53552 and GSE13355 datasets, and demonstrated its elevated expression in lesional psoriatic skin using IHC. Finally, TGM1 overexpression was demonstrated to increase the expression levels of inflammatory factors and keratinocyte differentiation markers, whereas knockdown decreased their expression, especially IL‑1β, S100A8, S100A9 and K1. Together, these findings suggest that TGM1 could be a promising therapeutic target for psoriasis, highlighting its potential application in psoriasis therapy.Weiterlesen

Atherosclerosis is now considered to reflect systemic inflammation involving the elevation of multiple proinflammatory cytokines, sharing common underlying pathophysiological mechanisms with psoriasis. There has been increasing interest in whether anti-inflammatory treatment of psoriasis can prevent or halt the progression of atherosclerosis. Here, we conducted a cross-sectional observational clinical study in psoriasis patients with at least one traditional cardiovascular risk factor, such as diabetes, hypertension, or dyslipidemia, and who were being treated with systemic anti-inflammatory drugs. To assess CAD risk, we performed coronary computed tomography angiography (CCTA). We assessed 27 psoriasis patients (14 males/13 females), whose median PASI score was 0 [range, 0-2.3] at the time of CCTA. They had sustained well-controlled psoriasis for a median of 44 months [range, 1-144]. Coronary plaques of varying degrees were detected in 20 patients (74%) by CCTA. Four patients were diagnosed with silent myocardial ischemia (SMI) by invasive coronary angiography (CAG), revealing severe coronary stenosis in major arteries. The severity of coronary plaque burden was significantly associated with male sex, hypertension, and carotid ultrasound abnormalities. Furthermore, notably, we detected a significant positive correlation between the duration of biologic treatment and calcified plaque burden among patients treated with biologic agents for over 6 months. Our study highlights the importance of tight disease control and screening for CAD even in well-controlled psoriasis patients. Further accumulation of studies may lead to better management of CAD risks in this population.Weiterlesen

Psoriasis is a prevalent chronic inflammatory skin disease that significantly reduces patients' quality of life. Current treatments have limited efficacy and severe side effects, necessitating the development of new drugs. Notopterygii rhizoma et radix (Qiang Huo, QH), a Traditional Chinese Medicine (TCM) herb commonly studied for psoriasis patterns and treatment, requires further clarifications of its pharmacological mechanism. This study first verified the therapeutic effects of QH on Imiquimod (IMQ)-induced psoriasis-like mice and LPS-induced keratinocyte (HaCaT) model. Our study showed QH significantly alleviated skin symptoms, improved pathological changes, inhibited HaCaT proliferation, and reduced inflammation. Network pharmacology was then applied to explore QH's potential mechanism, revealing its main effects on phosphoinositide-3 kinase/protein kinase-B/mammalian target of rapamycin (PI3K/Akt/mTOR), Erbb, and interleukin-17 (IL-17) signaling pathways. Further experiments using IMQ-induced mice and LPS-induced HaCaT model confirmed QH's effects on the PI3K/Akt/mTOR pathway. Notably, this is the first study to demonstrate that QH exerts anti-psoriatic effects via modulation of the PI3K/Akt/mTOR pathway, highlighting its multi-compound, multi-target pharmacological nature. QH relieves psoriasis severity in a "multi-compound and multi-target" manner, providing insight into the application of QH in psoriasis treatment. These findings present mechanistic insights into QH's therapeutic potential and suggest it as a promising multi-target alternative to conventional treatments for psoriasis.Weiterlesen

No abstract supplied.Weiterlesen

Interleukin-23 (IL-23) plays a pivotal role in the intricate interplay between the skin, gut, and joints, contributing significantly to the pathogenesis of various inflammatory diseases including psoriasis, psoriatic arthritis (PsA), inflammatory bowel disease (IBD) and Behcet's disease. In recent years, several IL-23 inhibitors have been granted approval for the treatment of psoriasis, PsA and IBD. As up to one-third of patients diagnosed with psoriasis may go on to develop PsA and given the strong immunogenetic pathway incrimination of the IL-23 pathway in both psoriasis and PsA, dermatological lead therapy for psoriasis may therefore delay the development of PsA. Furthermore, patients with psoriasis or PsA are associated with increased risk of developing IBD. There is also evidence for psoriasis-directed therapy preventing IBD in keeping with the known pivotal role of IL-23 in both intestinal homeostasis and in the pathogenesis of IBD, including ulcerative colitis and Crohn's disease. This review discusses the multifaceted roles of IL-23 in regulating immune response and maintaining tissue homeostasis within the skin-gut-joint axis. In particular, the use of IL-23 inhibitors in trials in patients with psoriasis, IBD and PsA patients will also be discussed in relation to reverse translational immunology insights around inflammation in these domains.Weiterlesen

# Frühe Biologika bei Psoriasis-Arthritis: Schneller Start aber gleicher Ziel Eine neue Studie verglich zwei Behandlungswege bei Psoriasis-Arthritis. Forscher wollten wissen ob ein starker Start besser ist. Die eine Gruppe bekam sofort Secukinumab. Das ist ein modernes Biologikum gegen Entzündungen. Die andere Gruppe begann mit Standardmedikamenten. Bei dieser Gruppe kamen stärkere Mittel erst später dazu. Nach einem Jahr zeigte sich etwas Überraschendes. Beide Gruppen hatten ähnliche Ergebnisse. Etwa die Hälfte der Patienten in beiden Gruppen verbesserte sich um 50 Prozent. Das nennt man ACR50 und ist ein wichtiges Ziel bei der Behandlung. Aber es gab einen Unterschied. Die Secukinumab-Gruppe fühlte sich schon nach drei Monaten besser. Sie brauchte auch weniger Medikamentenwechsel während der Therapie. Die Studienleiter sagen: Beide Wege führen zum Ziel. Ein intensiver Start hilft nur schneller. Langfristig sind die Ergebnisse aber gleich gut. Für Betroffene bedeutet das Entlastung. Wer zunächst mit milderen Medikamenten beginnt kann später immer noch umsteigen. Wer aber schnell Linderung braucht könnte sofort mit Biologika starten. Wichtig bleibt: Regelmäßige Kontrollen sind nötig. So kann die Therapie bei Bedarf angepasst werden. Die gute Nachricht ist klar. Egal welcher Weg gewählt wird. Mit der richtigen Behandlung lassen sich die Ziele erreichen. Das gibt Hoffnung für alle Betroffenen. Quelle: STAMP-Studie im Lancet Rheumatology November 2025 Originaltitel: Intensive biological DMARD-first strategy versus standard step-up care in psoriatic arthritis (STAMP): 1-year results from a multicentre, open-label, randomised controlled trial comparing two treat-to-target strategies Link zur Quelle

# Psoriasis kann dein ganzes Leben prägen Psoriasis ist mehr als nur Hautprobleme. Die Krankheit kann dein Leben lang beeinflussen. Das nennt man kumulative Lebensbeeinträchtigung oder CLCI. CLCI bedeutet dass sich die Auswirkungen von Psoriasis über die Jahre häufen. Sie betreffen deine Gesundheit dein Selbstwertgefühl und dein tägliches Leben. Eine große Studie hat 487 Betroffene und über 1000 Ärzte aus 29 Ländern befragt. Viele Patienten gaben an dass Psoriasis oft ihr tägliches Leben stört. Doch 37 Prozent wurden selten oder nie gefragt wie die Krankheit sie beeinträchtigt. Fast die Hälfte wusste nicht dass klare Haut heute ein realistisches Behandlungsziel ist. Ärzte erkennen zwar dass Psoriasis die Lebensqualität mindert. Doch viele CLCI-Faktoren werden im Alltag nicht beachtet. 40 Prozent der Hautärzte setzen klare Behandlungsziele nicht regelmäßig. Fast die Hälfte der Ärzte hält Psoriasis erst für früh beginnend wenn sie vor dem 15. Lebensjahr auftritt. CLCI entsteht durch verschiedene Faktoren. Dazu gehören früher Krankheitsbeginn starke Schmerzen oder Juckreiz. Auch psychische Belastungen wie Depressionen spielen eine Rolle. Wichtig sind aber auch Bewältigungsstrategien. Soziale Unterstützung und gute Information helfen dabei die Auswirkungen zu verringern. Die Studie zeigt eine große Lücke zwischen Patientenerfahrungen und ärztlicher Praxis. Ärzte müssen mehr über die langfristigen Folgen aufgeklärt werden. Betroffene sollten aktiv über ihre Lebenssituation sprechen. Klare Haut ist heute möglich. Frühzeitige Behandlung kann spätere Probleme verhindern. Du bist nicht allein mit deiner Psoriasis. Sprich offen mit deinem Arzt über alle Auswirkungen. Frage nach klaren Behandlungszielen. Suche dir Unterstützung bei Selbsthilfegruppen. Deine Zukunft ist es wert. Originaltitel: Is Cumulative Life Course Impairment Considered in Psoriasis Management? A Multinational Survey of People with Psoriasis and Healthcare Professionals Link zur Quelle

Viele Menschen mit Psoriasis leiden nicht nur an Hautproblemen, sondern auch an Einschränkungen im Alltag. Diese können sich im Laufe des Lebens häufen – das nennt man Cumulative Life Course Impairment (CLCI). CLCI bedeutet, dass die Krankheit langfristig das Leben beeinflusst, zum Beispiel bei Freundschaften, im Job oder bei der Stimmung. Eine große internationale Umfrage zeigt: Viele Ärztinnen und Ärzte sprechen selten mit ihren Patienten darüber, wie stark die Psoriasis deren Leben beeinträchtigt. Fast die Hälfte der Betroffenen weiß nicht, dass heute oft fast klare Haut möglich ist. Auch Behandlungsziele wie klare Haut oder ein besseres Lebensgefühl werden nicht immer besprochen. Die gute Nachricht: Frühzeitige und gezielte Therapie kann das Risiko für CLCI verringern. Doch dafür braucht es mehr Aufklärung und ein besseres Gespräch zwischen Patienten und Ärzten. Originaltitel: Is Cumulative Life Course Impairment Considered in Psoriasis Management? A Multinational Survey of People with Psoriasis and Healthcare Professionals. Link zur Quelle

## Spritze statt Pille? Neue Studie zu Methotrexat bei Psoriasis Du nimmst Methotrexat gegen Psoriasis? Dann interessiert dich vielleicht diese neue Studie. Forscher haben zehn Studien verglichen. Sie wollten wissen: Ist Methotrexat als Spritze unter die Haut besser als als Pille? Die Ergebnisse sind klar. Die Spritzenform überzeugt bei stärkeren Verbesserungen. Bei 75 Prozent weniger Hautproblemen (PASI75) war sie fast sechsmal erfolgreicher. Bei 90 Prozent weniger Problemen (PASI90) war sie dreimal wirksamer. Die Pille war nur leicht besser bei geringeren Verbesserungen (PASI50). Wichtig für dich: Die Spritze verträgt man oft besser. Es gab weniger Nebenwirkungen. Weniger Menschen brachen die Behandlung ab. Das ist ein großer Vorteil im Alltag. Warum ist das so? Die Spritze gelangt zuverlässiger in den Körper. Bei der Pille kommt bei hohen Dosen weniger an. Experten sprechen von besserer Bioverfügbarkeit. Das bedeutet: Der Wirkstoff wirkt effektiver. Natürlich hat die Spritze einen Haken. Du musst sie selbst setzen. Für manche ist das unangenehm. Aber viele berichten: Nach der ersten Gewöhnung geht es gut. Moderne Spritzen sind winzig und schmerzarm. Die Studie bestätigt europäische Empfehlungen. Sie raten schon länger zur Spritze bei Psoriasis. Ärzte in Deutschland und Europa setzen sie daher oft als erste Wahl ein. Fazit: Bei mittelschwerer bis schwerer Psoriasis lohnt die Spritze oft. Sie wirkt stärker und verträgt sich besser. Sprich mit deinem Arzt darüber. Vielleicht ist sie auch für dich die bessere Option. Deine Haut wird es dir danken! Originaltitel: Comparative efficacy and safety of oral versus subcutaneous methotrexate in the treatment of psoriasis: a systematic review, pairwise and network meta-analysis with CINeMA and GRADE assessment Link zur Quelle