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BackgroundPsoriasis is a non-communicable inflammatory skin disease that affects approximately 2%-3% of the world's population. Given its high impact on quality of life and the fact that a subset of patients exhibits suboptimal or secondary loss of response to current treatments, identifying new therapeutic strategies is crucial. Proliferation-associated protein 2G4 (PA2G4) is a transcription factor that has been exclusively studied in cancer research, where it promotes cell growth and enhances tumourigenesis by inhibiting apoptosis. However, its role in inflammatory skin diseases remains largely unknown.ObjectivesThis study focused on the pathophysiological and immunological functions of PA2G4 in psoriasis and evaluated its potential as a therapeutic target.MethodsBulk, single-cell, and spatial RNA sequencing combined with immunohistochemistry were used to assess PA2G4 expression in psoriatic skin compared with that in non-lesional controls. Functional studies were performed in primary human keratinocytes and reconstructed human epidermis (RHE) models using the CRISPR/Cas9-mediated knockout (KO) of PA2G4 and pharmacological inhibition of PA2G4 with the small-molecule WS6. The regulatory effects of PA2G4 on cellular processes, such as proliferation, differentiation, and survival, were investigated using RNA-seq, western blot analysis, scratch assays, and annexin V staining.ResultsPA2G4 was highly abundant in psoriasis, and its expression was predominantly restricted to basal proliferating keratinocytes. Its gene expression is positively correlated with psoriasis severity, the degree of acanthosis, neutrophil infiltration, and genes which are upregulated in psoriasis. PA2G4 KO in primary human keratinocytes activated differentiation pathways while suppressing proliferation pathways, resulting in the downregulation of proliferation- and inflammation-related genes (e.g. MKI67, IL20, VEGFA, and HIF1A) and the upregulation of differentiation and cell adhesion markers (e.g. KRT6C, LCE2C, and DSG4). Functionally, the PA2G4 KO reduced keratinocyte proliferation in scratch assays, attenuated interleukin-22-induced acanthosis in RHE models, and promoted keratinocyte death. Pharmacological inhibition of PA2G4 using the small-molecule inhibitor WS6 similarly downregulated genes associated with proliferation and cell survival.ConclusionsPA2G4 could promote keratinocyte hyperproliferation and survival in psoriasis, thereby critically influencing epidermal homeostasis. Therefore, inhibition of PA2G4 may represent a new treatment option for psoriasis.Weiterlesen

Erythrodermic psoriasis(EP) is a rare, life-threatening variant affecting 75%-90% of the body surface area. Characterized by widespread erythema and potential systemic symptoms like fever and lymphadenopathy, it severely impairs patient quality of life. The pathogenesis of erythrodermic psoriasis is not fully understood. It is a multifactorial, multistep process suspected to result from an abnormal immune response induced by both genetic and environmental factors. Key contributors to erythrodermic psoriasis onset include specific gene polymorphisms, altered expression of adhesion molecules, dysregulated cytokine activity, and abnormal activation of T cell subsets. Additionally, imbalances in the skin microbiota and external factors, such as infections and medications, play important roles in disease onset and progression. Distinct from prior reviews that primarily emphasize clinical features and treatment, this review integrates recent mechanistic advances across genetic, immune, environmental, and microbiome domains to provide an updated, systems-level framework for understanding erythrodermic psoriasis and to highlight potential therapeutic implications.Weiterlesen

BackgroundPsoriasis, a chronic inflammatory skin disease affecting 2-3% of the global population, is driven by dysregulated immune responses. Despite advancements in biologic therapies, treatment challenges persist due to high recurrence rates. This study aimed to identify immune-related hub genes and elucidate their clinical implications in psoriasis pathogenesis and therapy.MethodsMultiple microarray datasets from psoriasis patients (GSE30999, GSE106992, GSE14905, GSE78097, and GSE117468) were obtained to identify immune-key genes by differential gene analysis and Weighted Gene Co-expression Network Analysis (WGCNA). Subsequently, immune-related hub genes were identified using the Least Absolute Shrinkage and Selection Operator (LASSO) algorithm and Protein-Protein Interaction (PPI) networks, with further validation through Gene Set Enrichment Analysis (GSEA) and Receiver Operating Characteristic (ROC) curves to assess exploratory within-sample discrimination. Pearson correlation analysis evaluated the relationship between hub genes, skin lesion severity, and treatment outcomes. The study also conducted immune infiltration by using the Cell-type Identification by Estimating Relative Subsets Of RNA Transcripts (CIBERSORT) algorithm and identified potential therapeutic targets by the Drug-Gene Interaction Database (DGIdb).ResultsThirty-one immune-related key genes were identified, and six hub genes (CLEC7A, CXCL1, IRF1, S100A12, S100A8, S100A9) were validated as central players in immune signaling pathways. These genes exhibited within-sample discrimination (AUC > 0.9) and correlated with disease severity and biological therapy efficacy. Immune infiltration analysis revealed increased activated memory CD4+ T cells and M1 macrophages in lesional skin, which was strongly associated with hub gene expression. Additionally, drug-gene interaction analysis identified potential therapeutic agents targeting these genes.ConclusionThis study identified six immune-related hub genes that were closely linked to the severity of psoriasis, the effectiveness of biological treatments, and infiltrated activated memory CD4+ T cells and M1 macrophages. Our findings elucidate a novel immune-related hub gene network in psoriasis and provide potential targets for the development and application of biologics.Weiterlesen

The introduction of biosimilars for moderate-to-severe psoriasis treatment has demonstrated comparable efficacy and safety to originator biologics, with the potential to improve cost-effectiveness. We explored the potential for biosimilars to improve access to biologics for psoriasis, especially in low-and-middle-income countries where costs often limit access to originators. The analysis was based on a systematic review conducted as part of the submission process to include adalimumab and ustekinumab in the World Health Organization Essential Medicines List for psoriasis. Among 17 studies included in the systematic review, we focused on those that provided data evaluating the cost and/or cost-effectiveness of biosimilars versus originators in the treatment of psoriasis. Two studies met the inclusion criteria. The first was a cohort-based Markov model which showed that biosimilar adalimumab was cost-effective compared with originator adalimumab for moderate-to-severe psoriasis. The second, using a cost-per-responder model, found that adalimumab biosimilar had the lowest cost-per psoriasis area and severity index (PASI) complete clearance (PASI100) responder among the anti-tumor necrosis factor therapies. Biosimilars have a key role in reducing costs and expanding treatment availability for psoriasis patients. Further health economic studies, focusing on psoriasis, are required to demonstrate how biosimilars can improve access to biologics in this condition.Weiterlesen

Background and objectivesEvidence-based recommendations for the treatment of patients with psoriatic disease (PsO) and a prior history of malignancy are limited. This study aimed to compare the incidence of newly diagnosed neoplasms among patients with PsO and a previous malignancy receiving treatment with conventional systemic therapies, apremilast, or biologic agents.Patients and methodsRetrospective observational study using TriNetX. PsO patients (ICD10:L40) with a previous diagnosis of cancer (ICD10:C00-D49) less than 5 years prior to systemic therapy initiation were selected. Outcomes evaluated included new documentation of neoplasms and all-cause mortality.ResultsPatients under biologic therapy had a significantly lower new neoplasm documentation rate and all-cause mortality compared to classical agents (HR 0.857 and HR 0.705, respectively) and apremilast (HR 0.782 and HR 0.803, respectively) at 3 years follow-up. Only TNFi exhibited a significantly lower new neoplasm rate (HR 0.867, p < 0.0001) compared to classical agents; however, all biologic agents significantly decreased mortality. IL-23i was the only biologic therapy to significantly lower cancer recurrence risk (RR 0.878) compared to TNFi, with no differences in all-cause mortality.ConclusionsBiologic therapy for PsO may represent a safe treatment option in patients with a history of malignancy, compared with conventional systemic therapies or apremilast. Among biologic agents, IL-23 inhibitors appear to be associated with the most favorable safety profile.Weiterlesen

# Biosimilars' Role in Expanding Global Access to Psoriasis Treatment Biosimilars are **highly effective and safe alternatives** to originator biologic drugs for psoriasis, offering substantial cost reductions and improved access to treatments that were previously unaffordable for many patients.[2][3] ## How Biosimilars Improve Access Biosimilars are FDA-approved biologic products that are very similar to existing reference biologics, with no clinically meaningful differences in safety or efficacy.[5] By using reverse engineering after patent expiration, they cost significantly less than originators. Real-world data shows adalimumab, etanercept, and infliximab biosimilars reduced treatment costs to approximately €500–€1,000 per patient response, compared to €1,800–€1,900 for originator drugs.[3] Within the US Department of Veterans Affairs system, biosimilars provided substantial cost savings in 2023 and continue to expand access within public healthcare systems globally.[2] ## Clinical Evidence Numerous randomized controlled trials and real-world studies confirm that switching patients from originator biologics to biosimilars maintains efficacy and safety.[1][3] Patients with moderate-to-severe plaque psoriasis who responded to originator infliximab showed no significant loss of response or additional adverse events when switched to the biosimilar CT-P13.[3] Multiple biosimilars are now approved or in development for TNF inhibitors, adalimumab, etanercept, infliximab, and ustekinumab.[3][7] ## Remaining Barriers Despite these benefits, significant obstacles persist. Patent protections have limited US biosimilar availability.[1] Physicians often lack familiarity with biosimilars, and patients report concerns about efficacy when switching treatments.[4] Additionally, absent patient support programs and inconsistent physician communication about biosimilar switches raise concerns about trust and pharmacovigilance.[4] Education for both providers and patients is essential to increase biosimilar adoption and fully realize their potential to democratize access to biologic therapy. Originaltitel: The role of biosimilars in enhancing global access to psoriasis treatment - PubMed Link zur Quelle

# Zusammenfassung der MED-PSO Studie Die Studie untersuchte, wie sich schwer zu behandelnde Schuppenflechte-Flecken von klassischen unterscheiden – insbesondere welche Gene aktiviert sind, wie das Immunsystem reagiert und welche Moleküle eine Rolle spielen. Das Hauptziel war zu verstehen, warum manche Patienten schlecht auf die bisherige Therapie ansprechen, und zu testen, wie effektiv ein neues Medikament gegen diese schweren Fälle wirkt. ## Die untersuchte Substanz Das Medikament **Deucravacitinib** (Handelsname: Sotyktu) gehört zur Klasse der sogenannten TYK2-Inhibitoren. TYK2 ist ein Protein in deinen Immunzellen, das Entzündungsreaktionen auslöst – genau wie das Gaspedal beim Auto. Wenn man dieses Protein blockiert, wird die überaktive Immunreaktion bei Schuppenflechte gebremst. Der Körper produziert dann weniger Entzündungsstoffe, die die typischen roten, schuppigen Stellen der Schuppenflechte verursachen. Die Studie testete eine Tablette mit 6 mg Wirkstoff, die täglich genommen wurde, über einen Zeitraum von 16 Wochen. --- Originaltitel: A Mono-Center, Prospective Biomarker Study to investigate the differences in the inflammatory gene expression signature, the distribution of immune cells, psoriasis-driving factors and signaling molecules between classic and hard-to-treat psoriasis plaques and the effects of TYK2 blockade with deucravacitinib – MED-PSO Erkrankung: Mittelschwere bis schwere Plaque-Psoriasis (Schuppenflechte) Phase: Phase IV (Therapeutische Anwendung) Firma: Charité Universitätsmedizin Berlin Art der Verabreichung: Tablette (filmüberzogene Tablette) https://euclinicaltrials.eu/search-for-clinical-trials/?lang=en&EUCT=2023-508948-22-00

**Hoffnung für seltene Psoriasis-Form** Eine seltene und schwere Psoriasis-Form lässt sich besser behandeln als bisher gedacht. Forscher aus Bayern untersuchten 29 Patienten. Die meisten erhielten biologische Medikamente. Bei allen Patienten verbesserte sich die Erkrankung deutlich. Die Messwerte der Schwere sanken stark. Besonders wirksam sind Medikamente gegen die Botenstoffe IL-17 und IL-23. Einige Patienten wurden sogar ganz gesund. Ältere Medikamente verursachten mehr Nebenwirkungen. Ärzte fordern nun klare Behandlungsrichtlinien. Originaltitel: Systemic Treatment and Outcome in Erythrodermic Psoriasis: A Retrospective Multicenter Study. Link zur Quelle

Biosimilars demonstrate **comparable efficacy and safety to originator biologics** for moderate-to-severe psoriasis while offering substantially lower costs, creating significant potential to expand treatment access in low- and middle-income countries where price barriers currently restrict patients' access to effective treatments.[1][2][5] **Clinical Equivalence Confirmed** A systematic review of 14 randomized clinical trials and 3 cohort studies found no clinically or statistically significant differences in efficacy and safety between biosimilars and their originator products for psoriasis treatment.[5] Specific comparisons—including biosimilar MSB11022 (adalimumab) and CT-P13 (infliximab)—showed similar reductions in Psoriasis Area and Severity Index scores and comparable adverse event rates.[1] Twenty-four biosimilars derived from 4 reference products are now approved for psoriasis treatment in the United States.[6] **Addressing Access Barriers** Although biologic therapies have significantly improved psoriasis outcomes, their high costs have limited access and created healthcare inequalities, particularly in resource-limited regions.[2] Biosimilars promise to improve patient access to these proven effective treatments while maintaining improved health outcomes and reducing overall treatment costs.[2] **Important Considerations and Limitations** Evidence quality varies across settings. Most clinical evidence derives from randomized controlled trials; high-quality real-world effectiveness data across diverse healthcare systems remains limited.[5] Biosimilars can receive regulatory approval for psoriasis based on extrapolated evidence from other diseases rather than direct psoriasis trials.[5] Long-term safety and immunogenicity data are limited compared to originators due to their shorter market presence.[1] Additionally, patent protections continue to restrict biosimilar availability in some regions.[3] While switching from originator to biosimilar appears safe based on available evidence, careful patient monitoring during transitions remains important.[2] Originaltitel: The role of biosimilars in enhancing global access to psoriasis treatment Link zur Quelle

I notice that while your query references a specific cross-sectional survey on patient attitudes toward digital health interventions in dermatology, the full study details aren't included in the search results provided. However, I can share what the search results reveal about **dermatological patients' attitudes toward digital health interventions**: ## Patient Acceptance and Interest Patients generally show **positive attitudes and interest in digital health tools**, though their actual adoption remains limited[1]. Only a small minority of patients (6%) had prior experience with digital health interventions before participating in studies[1]. Importantly, patients reported being **dependent on their dermatologists' acceptance** of these tools—meaning they're more likely to use digital solutions if their physicians recommend them[1]. ## Key Barriers and Facilitators The main obstacle is **lack of digital competence**: inadequate digital health literacy affects a significant portion of patients, ranging from 22% in Norway to 58% in Germany[1]. Additionally, patients exhibit **hesitancy toward AI-based diagnoses without dermatologist involvement**—84% of patients prefer a dermatologist's diagnosis over AI alone[4]. Trust remains crucial: patients strongly prefer receiving dermatology information directly from their dermatologists (99%), with 78% reporting high satisfaction with physician-provided information[5]. ## Practical Implications For these findings to translate into better care, digital health tools must be **user-friendly and adapted to varying skill levels**[1]. Data privacy transparency is essential, and successful implementation requires dermatologists' active endorsement and integration into existing workflows[1]. To provide more detailed analysis of the specific study you're referencing, please share the complete study text or clarify which results you'd like me to focus on. Originaltitel: Attitudes of dermatological patients towards digital health interventions: a cross‐sectional survey and cluster analysis Link zur Quelle

**Spurenelemente und deine Gelenkschmerzen** Forscher haben etwas Neues herausgefunden. Menschen mit Psoriasis-Arthritis haben oft zu wenig von bestimmten Stoffen im Blut. Diese Stoffe heißen Spurenelemente. Die wichtigsten sind Selen, Kupfer und Zink. Dein Körper braucht sie wirklich. Eine neue Studie hat 160 Patienten untersucht.[1] Die Forscher verglichen Menschen mit Psoriasis-Arthritis mit gesunden Menschen. Das Ergebnis war eindeutig. Allen Patienten fehlten diese wichtigen Spurenelemente. Das Interessante: Wenn die Entzündungswerte steigen, sinken die Selen-Werte besonders.[1] Das ist kein Zufall. Vielleicht könnte Selen-Behandlung dir helfen. Sie könnte deine Entzündung besser kontrollieren. Die gute Nachricht: Ärzte wissen das jetzt. Bald könnten personalisierte Behandlungen mit diesen Stoffen dir Erleichterung bringen.[1] Sprich mit deinem Arzt darüber. Originaltitel: Trace Element Deficiency in Axial Spondyloarthritis and Psoriatic Arthritis in Relation to Markers of Inflammation and Remission. Link zur Quelle

Psoriasis is a relapsing autoimmune disease exacerbated by aberrant interleukin (IL)-17 A activity. Majoon Ushba, a unani polyherbal formulation implicated in clinical cases of psoriasis lacks immunopharmacological validation. The study aims to investigate the pre-clinical efficacy of Majoon Ushba and its therapeutic role in mitigating IL-17A-induced keratinocytes ferroptosis via ablation of JAK-2/STAT-3 pathway. HaCaT cells were stimulated with IL-17A to assess the activation of the JAK-2-STAT-3 pathway. The STAT-3 inhibitor, S3I-201, was used to confirm the role of the STAT-3 axis in keratinocyte ferroptosis. Majoon Ushba pretreatment was assessed to determine its efficacy in alleviating keratinocyte ferroptosis. An imiquimod (IMQ)-induced psoriasis mouse model was used to evaluate the pre-clinical efficacy of Majoon Ushba. Furthermore, prior high-performance liquid chromatography (HPLC) profiling was leveraged for in-silico docking analysis to identify the binding affinities of key phytoconstituents with IL-17RA and STAT-3. Majoon Ushba alleviated the IL-17A/JAK-2-STAT-3 axis, improved GPX4 expression, and regulated lipid peroxidation. Subsequently, Majoon Ushba also reversed the expression of pathogenic mediators and led to a reduction in serum cytokine levels of IL-17A, IL-23, and IFN-γ. An in-silico docking analysis suggested favorable binding affinities for key phytoconstituents of Majoon Ushba against IL-17RA and STAT-3. Aligned with pre-clinical and in vitro results, the computational findings offer initial evidence that the polyherbal formulation may influence the IL-17A/JAK-2-STAT-3 signaling pathway. In conclusion, our preliminary findings reveal a plausible mechanistic basis for the anti-psoriatic efficacy of Majoon Ushba, warranting larger clinical trials in psoriasis patient cohorts.Weiterlesen

ObjectivesThere is very limited data regarding atlantoaxial instability (AAI) in patients with psoriatic arthritis (axPsA). In this study, we aimed to contribute to the existing literature on this topic.MethodsAdult patients were included in this single-center study who were classified as PsA by the 'CASPAR' criteria and evaluated as having axial involvement according to the 'Calin' criteria. Those with inflammatory or non-inflammatory diseases that could affect the spine were excluded. Electronic patient files were reviewed retrospectively. Lateral neutral/full extension/full flexion and open-mouth anteroposterior cervical radiographs were evaluated by three rheumatologists blinded to the patients. Patients were compared in two groups as AAI-positive and AAI-negative.ResultsA total of 100 patients with a mean age of 48.8 years and a mean PsA duration of 7.4 years, 57% of whom were female, were included in the study. A total of 20 AAI lesions were detected in 18% patients; subaxial subluxation was detected in eight, anterior atlantoaxial subluxation (AAS) in seven, posterior AAS in three, lateral AAS in one, and vertical subluxation in one case. In the group with AAI, the presence of psoriasis (Ps) (p = 0.037), scalp psoriasis (p < 0.001), and the use of targeted therapy for Ps and PsA (p < 0.001, p < 0.001) were significantly higher than in the AAI-negative group.ConclusionGiven that Ps and PsA patients on targeted therapy may reflect cases with higher disease activity and inadequate response to conventional treatments, it may be appropriate to consider closer monitoring for AAI in these patients. Key Points • Atlantoaxial instability is present in approximately one-fifth of patients with axial psoriatic arthritis. • The most common instability lesion is subaxial subluxation, accounting for 40% of all lesions. • The presence of psoriasis, scalp psoriasis, and the use of targeted therapies for psoriatic arthritis or psoriasis are significantly more frequent in the group with atlantoaxial instability. These factors may be useful for cervical spine monitoring in patients with axial psoriatic arthritis. • The use of targeted therapies for psoriatic arthritis or psoriasis may indirectly indicate an association between high disease activity and atlantoaxial instability.Weiterlesen

This study collected and analyzed clinical data of psoriasis patients to develop and validate a psoriasis relapse risk prediction model. It aims to support early relapse risk assessment in clinical practice and inform the design of preventive interventions. To develop and validate a risk prediction model for psoriasis relapse. A convenience sampling method was used to select 504 psoriasis patients admitted to a tertiary hospital in China between January 2022 and December 2024, including 353 cases in the training set and 151 cases in the testing set. Independent risk factors for psoriasis relapse were identified through univariate analysis and logistic regression analysis to develop a prediction model. A nomogram and SHAP summary plot were generated for model visualization, and the model's goodness of fit and discriminative ability were evaluated. The 1-year relapse rate of psoriasis patients after treatment was 66.67%. Logistic regression identified six independent risk factors for psoriasis relapse: BMI, diabetes, biologic use, smoking, upper respiratory tract infection (URTI), and non-standard medication, all of which were incorporated into the model. The area under the ROC curve (AUC) values for the training and testing sets were 0.767 [95% CI 0.715-0.818] and 0.704 [95% CI 0.620-0.789], respectively. The model showed moderate discrimination and good calibration. Decision curve analysis (DCA) confirmed clinically meaningful net benefit in both training and test sets. The predictive model for psoriasis relapse risk established in this study demonstrated only moderate predictive performance. This model can serve as a preliminary exploratory tool, providing a certain degree of quantitative reference for assessing the risk of psoriasis relapse; however, rigorous external validation in independent multicenter cohorts is still required before clinical application.Weiterlesen

BackgroundLifestyle factors have the potential to enhance well-being and quality of life (QoL). This study aimed to identify lifestyle patterns among UK-based adults with psoriasis and examine associations with QoL.MethodsThis was a cross-sectional analysis of the 'Asking People with Psoriasis about Lifestyle and Eating' (APPLE) study (n=353). QoL, Body Mass Index (BMI), and physical activity were assessed using the Dermatology Life Quality Index (DLQI), self-reported weight and height, and the International Physical Activity Questionnaire.ResultsParticipant demography was: 82% female; mean (SD) age of 41 (13) years; and BMI of 27 (7) kg/m2. When fully adjusted for age, sex, smoking, and alcohol use, compared to individuals in the highest BMI tertile (35 (5) kg/m2), those in the lowest tertile (21 (2) kg/m2) reported a 71% reduced likelihood of QoL impairments (Odds Ratio (OR) = 0.29; 95% CI 0.14-0.59, adjusted P<0.01). Dairy-free, gluten-free, and pescatarian diets were more frequently adopted in individuals reporting healthy BMIs (≈24 kg/m2, adjusted P<0.05). Higher levels of physical activity (2932 (1509) Metabolic Equivalent of Task Minutes per week), and adequate sleep duration (7 (0) hours/day) were associated with lower odds of QoL impairments, although attenuated by multiple testing. Participants affected by embarrassment or self-consciousness related to their psoriasis engaged in less vigorous-intensity and walking activities compared to those who were less affected (adjusted P<0.05).ConclusionsAssessing weight status and physical activity in individuals reporting high DLQI scores may help identify modifiable behaviours contributing to poorer QoL and thereby shape interventions.Weiterlesen

BackgroundPsoriasis is a chronic, immune-mediated skin disorder that causes physical, psychological, and social burdens. There is a growing need to better characterize the distinct clinical features and specific treatment needs of elderly patients with psoriasis, which remains an important area for further research to optimize care in this population.ObjectiveTo investigate the clinical characteristics, comorbidities, and treatment preferences of elderly patients with psoriasis vulgaris.MethodsPatients with psoriasis vulgaris were included in this retrospective study. Data on demographics, disease characteristics, including age at diagnosis, body surface area (BSA), Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), comorbidities, and treatment needs were collected. Patients at the visit over 60 years of age were defined as elderly patients. Patients who were diagnosed before 40 years of age were defined as early-onset psoriasis (EOP), and patients who were diagnosed over 40 years of age were defined as late-onset psoriasis (LOP). Continuous variables were compared using t-tests or Mann-Whitney U-tests, categorical variables using Chi-square or Fisher's exact tests. Spearman correlation was used for association analysis. Statistical significance was set at P<0.05.ResultsA total of 375 patients were included, comprising 70 (18.67%) elderly and 305 (81.33%) non-elderly patients. The elderly group had a significantly higher proportion of LOP (87.14% vs 48.76%, P<0.05). A higher percentage of elderly patients had moderate-to-severe (27.14% vs 20.98%, P<0.05) and severe (1.43% vs 0.66%, P<0.05) disease. Comorbidities were more prevalent in the elderly, including cardiovascular disease (12.86% vs 3.93%, P<0.05) and diabetes (12.86% vs. 1.31%, P<0.05). Despite this, elderly patients reported lower DLQI scores (median 2.00 vs. 3.00, P<0.05). Regarding treatment needs, elderly patients were less likely to prioritize reducing treatment costs (10.00% vs 20.98%, P<0.05) and preventing disease recurrence (30.00% vs 44.26%, P<0.05) compared to non-elderly patients. Within the elderly cohort, EOP patients exhibited more severe disease (median BSA: 3.00 vs 2.00; median PASI: 3.30 vs 0.80, P<0.05), a higher rate of familial psoriasis (33.33% vs 4.92%, P<0.05), and a greater demand for reducing treatment costs (33.3% vs 6.56%, P<0.05) compared to LOP patients.ConclusionElderly patients with psoriasis present a distinct clinical profile characterized by a high prevalence of late-onset disease, a significant comorbidity burden, and differing treatment priorities focused less on cost and recurrence. Despite the increased clinical severity, their perceived quality-of-life impact is lower. Besides, they report higher dissatisfaction linked to unmet needs in itch relief, drug safety, and long-term control. Within the elderly cohort, early-onset patients had more severe disease, stronger familial predisposition, and greater cost-related concerns. The findings highlight the necessity for age-specific, multidimensional management strategies for this population.Weiterlesen

IntroductionThis study analyzed the mechanisms of action of Andrographis paniculata (AP), a medicinal plant with diverse pharmacological properties, on psoriasis.Materials and methodsThe active components of AP and their corresponding targets were identified. These targets were subsequently intersected with differentially expressed genes (DEGs) and immune-related genes associated with psoriasis. The resulting gene set was subjected to functional enrichment analysis and immune infiltration analysis. The scRNA-seq data were analyzed to delineate the single-cell landscape in psoriasis and cell type-specific expression of genes of interest. Further, the molecular docking and experimental verification were performed for validation.ResultsActive components of AP and their targets were predicted. Cross-referencing these targets with psoriasis DEGs revealed 2 feature genes (AR and ITGAL), both exhibiting strong diagnostic potential. The two genes were associated with differentially enriched pathways and immune cell infiltration. Further, scRNA-seq analysis identified 10 cell subclusters. Notably, AR was expressed in reticular fibroblasts of healthy controls, while ITGAL was expressed in T cells of psoriasis samples. Molecular docking confirmed a stable binding interaction between Dehydroandrographolide and AR. In vitro validation using an M5 cytokine-induced keratinocyte model demonstrated that Dehydroandrographolide exerted potent anti-inflammatory and antiproliferative effects. Furthermore, it significantly modulated the protein expression levels of both genes.DiscussionCombining in-silico and in-vitro analyses, this study identified AR and ITGAL as potential key mediators and validated the efficacy of the active component of AP, Dehydroandrographolide, against psoriasis.ConclusionCollectively, the study demonstrated that AP had the potential anti-psoriasis effects.Weiterlesen

To compare the efficacy and safety of different ustekinumab biosimilars for treating moderate-to-severe plaque psoriasis (PP), providing an evidence-based basis for clinical medication. We systematically searched randomized controlled trials on ustekinumab biosimilars for treating moderate-to-severe PP in adults from Embase, PubMed, Cochrane Library, and Web of Science. Stata 18.0 was utilized for data analysis. Nine studies were included, involving 4293 moderate-to-severe PP patients. 1) Ustekinumab biosimilars and the reference listed drug (RLD) ustekinumab-RP had no significant difference in the psoriasis area and severity index (PASI) improvement (P > 0.05), and the biosimilar CT-P43 was most effective in improving PASI at different time points. 2) For the dermatology life quality index, Bmab1200, AVT04 and CT-P43, had statistically significant differences from the RLD (P < 0.05). 3) The biosimilar CT-P43 was most effective in improving the Physician Global Assessment score, with the highest SUCRA value (99.8%). 4) The reduction of the body surface area and the treatment-emergent adverse event rate had no statistically significant difference from the RLD (P > 0.05). 5) The biosimilar CT-P43 and Bmab1200 demonstrated a lower probability of generating anti-drug antibodies, showing statistically significant differences from other biosimilars (P < 0.05). Ustekinumab biosimilars demonstrate comparable efficacy and safety to ustekinumab-RP for treating moderate-to-severe PP in adults. The biosimilar CT-P43 is more effective in improving short-term PASI. Due to limitations in the number and quality of included studies, more high-quality studies are required to validate these findings.Weiterlesen

Originaltitel: Difficult to treat disease in psoriatic arthritis- is it different from axial spondyloarthritis? Link zur Quelle

Originaltitel: Using causal machine learning and real world data to improve dose response decision making for secukinumab in psoriatic arthritis. Link zur Quelle

# Psoriasis arthritis verbindet Haut- und Gelenkerkrankung Wissenschaftler haben eine spannende Entdeckung gemacht. Sie zeigt, dass Psoriasis arthritis wie eine Brücke zwischen zwei Krankheiten funktioniert. Auf der einen Seite steht die Gelenkerkrankung Rheumatoide Arthritis. Auf der anderen Seite steht die Hauterkrankung Psoriasis. Die Forscher untersuchten spezielle Blutzellen namens Monozyten. Sie schauten sich an, wie diese Zellen bei Psoriasis arthritis arbeiten. Dabei fanden sie etwas Besonderes. Psoriasis arthritis hat nämlich Merkmale von beiden Krankheiten gleichzeitig. Die Wissenschaftler entdeckten auch gemeinsame Entzündungsmuster. Diese treten bei allen drei Erkrankungen auf. Besonders interessant ist: Bei Psoriasis arthritis wirken zwei verschiedene Entzündungsprogramme gleichzeitig. Das eine wirkt wie bei der Gelenkerkrankung. Das andere wirkt wie bei der Hauterkrankung. Was bedeutet das für dich? Diese neuen Erkenntnisse helfen Ärzten besser zu verstehen, was in deinem Körper passiert. Sie könnten künftig auch bessere Vorhersagen machen. Das bedeutet: Deine Behandlung könnte später noch gezielter auf dich abgestimmt werden. Originaltitel: Psoriatic arthritis monocyte DNA methylomes bridge joint and skin inflammatory pathways across rheumatoid arthritis and psoriasis. Link zur Quelle

# Neue Daten zeigen: So häufig ist Psoriasis wirklich Forscher haben untersucht, wie oft Psoriasis und andere Erkrankungen bei Menschen ab 50 Jahren in Deutschland auftreten. Dafür nutzen sie Daten von Millionen versicherten Personen. Das Ergebnis ist interessant für Menschen mit Psoriasis. Bei Männern ab 50 treten pro 100.000 Menschen zwischen 268 und 430 Fälle von Psoriasis auf. Bei Frauen sind es 230 bis 412 Fälle. Das bedeutet: Männer erkranken etwas häufiger an Psoriasis als Frauen. Die genaue Häufigkeit hängt vom Alter ab. Die Forscher wollten vor allem herausfinden, welche Nebenwirkungen nach einer Impfung normal sind. Deshalb brauchten sie diese genauen Zahlen. Sie zeigen, wie oft Psoriasis und ähnliche Erkrankungen ohne Impfung auftreten würden. Die Studie nutzte echte Krankenkassendaten. Das macht die Ergebnisse sehr zuverlässig. Ärzte können diese Werte jetzt besser einschätzen, ob eine Erkrankung durch eine Impfung verursacht wurde. Für Patienten bedeutet das: Es wird sicherer nachvollziehbar, ob eine Impfung wirklich schuld an einer neuen Diagnose war. Originaltitel: Sex- and age-specific background incidence rates for various medical events in the German population aged ≥ 50 years using a nationwide monitoring system of claims data. Link zur Quelle

No abstract supplied.Weiterlesen

Lipoxygenases peroxidise polyunsaturated fatty acids, resulting in oxylipins, which may act pro- or anti-inflammatory. Arachidonate 15-lipoxygenase type B was shown to play a role in the resolution of keratinocyte inflammation and is upregulated in psoriasis. Its murine ortholog, arachidonate 8-lipoxygenase (Alox8), differs in regiospecificity in that it adds molecular oxygen to the 8th and not 15th carbon of arachidonic acid. This study aimed to determine if Alox8 plays a role in the resolution of murine imiquimod-induced psoriasis. Alox8 knockout (KO) mice, which are not commercially available, were generated with a functional KO targeting the enzyme's active site. Untargeted Lipidomics revealed changes in the skin lipidome from both imiquimod-induced psoriasis as well as between wild-type and KO mice. Furthermore, LC-MS/MS revealed a functional KO with reductions in Alox8-specific oxylipins. Lipid peroxidation marker 4-hydroxynonenal was elevated in the epidermis of wild-type mice from imiquimod treatment, however, it was significantly reduced in Alox8 KO mice. Alox8 KO mice exhibited a thickened epidermis, resulting from reduced DNA damage and increased proliferation. Moreover, immune cell infiltration was enhanced in Alox8 KO mice, including a higher abundance of γδ T cells. Elevated cytokine levels of interleukin-17 and -22, accompanied by keratinocyte-produced C-X-C motif chemokine ligand 1, were detected in the skin of Alox8 KO mice. Additionally, cyclooxygenase 2 expression and prostaglandin E2 levels were enhanced in Alox8 KO mice. These data demonstrate an exacerbated and prolonged inflammatory psoriasis phenotype in Alox8 KO mice, implying that Alox8 aids in the resolution of murine psoriasis.Weiterlesen

# Alter kein Hindernis für Secukinumab-Therapie Die gute Nachricht: Das Alter spielt bei der Wirksamkeit von Secukinumab keine wesentliche Rolle.[1] In dieser großen Analyse von über 1400 Patienten zeigte das Medikament bei jüngeren und älteren Patienten ähnlich gute Ergebnisse bei der Verbesserung der Symptome.[1] ## Das bedeutet für Euer tägliches Leben Die Hauptziele der Therapie – weniger Schmerzen, bessere Beweglichkeit, geringere Entzündung – werden in beiden Altersgruppen gleich gut erreicht.[1] Daher sollte Euer Alter kein Grund sein, auf diese moderne Therapie zu verzichten. Kleine Unterschiede zeigten sich nur bei Nebenpunkten: Ältere Patienten verzeichneten etwas weniger Verbesserung bei der Lebensqualität und in Entzündungsmarkern.[1] Diese Unterschiede sind aber gering und ändern nichts an der grundsätzlich guten Wirksamkeit. **Fazit:** Wenn Euer Arzt Secukinumab empfiehlt, ist Euer Alter kein Grund, die Therapie abzulehnen. Die Studie zeigt: Auch mit 40+ profitiert Ihr von dieser Behandlung.[1] Originaltitel: No major effect of age ( 40 vs. ≥ 40 years) on response to secukinumab in patients with axSpA: a post hoc analysis of six phase 3 trials - Arthritis Research & Therapy Link zur Quelle