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## Übergewicht und Psoriasis-Arthritis gemeinsam denken Die Übersichtsarbeit zeigt: Viele von Euch mit Psoriasis-Arthritis haben Übergewicht.[4][8] Das erhöht das Risiko für PsA und verstärkt die Entzündung im Körper.[4][9] Betroffene mit hohem Gewicht haben oft mehr Schmerzen, mehr geschwollene Gelenke und eine schlechtere Lebensqualität.[3][8] Übergewicht geht häufig mit Bluthochdruck, Diabetes und Herzkrankheiten zusammen.[4][9][15] Wichtig: Ein höheres Gewicht kann die Wirkung von Medikamenten mindern.[4][5][16] Es wird dann schwerer, eine niedrige Krankheitsaktivität zu erreichen.[4][6] Die Studien zeigen aber auch: Wenn Ihr Gewicht verliert, bessern sich Gelenkentzündung und Begleiterkrankungen.[3][4][7] Für Euren Alltag bedeutet das: Sprecht mit Eurem Behandlungsteam offen über Gewicht und Ernährung.[2][13] Lasst Herz, Blutdruck, Zucker und Blutfette regelmäßig kontrollieren.[4][9][15] Eine kalorienarme Ernährung und sanfte, gelenkschonende Bewegung können ein wichtiger Teil Eurer Behandlung sein.[7][13] Holt Euch bei Bedarf Unterstützung durch Ernährungsberatung und psychologische Hilfe.[1][14] Originaltitel: Psoriatic arthritis and obesity: a review of clinical burden and considerations for comprehensive care - PubMed Link zur Quelle

IntroductionSwitching biologics for psoriasis is common; however, data on switching to alternative treatments after failure of IL-23 inhibitors are limited.MethodsA retrospective analysis was conducted to extract efficacy and drug survival data from the BIOREP registry from January 2015 to June 2025. The analysis included all patients with psoriasis who were switched from an IL-23 inhibitor to an IL-17 inhibitor during this period and had at least one follow-up visit recorded.ResultsA total of 102 patients were switched from an IL-23 inhibitor to an IL-17 inhibitor, with 92 (90.2%) of these switches occurring due to insufficient efficacy. In these 92 patients, PASI-75 was achieved in 82.6% after 3 months and in 73.5% after 12 months. Absolute PASI ≤ 1 was achieved by 66.3% of patients after 3 months and 52.9% after 12 months. Patients treated with bimekizumab had the highest probability of meeting both efficacy parameters, particularly an absolute PASI ≤ 1 after 3 months. The overall survival probability was 79.5% after 12 months and 68.1% after 24 months.ConclusionFor patients with an inadequate response to IL-23 inhibitors, switching to IL-17 inhibitors offers adequate efficacy in reaching current therapeutic goals during the first year of treatment.Weiterlesen

BackgroundIn childhood, moderate-to-severe psoriasis often requires systemic treatments such as acitretin, methotrexate, or cyclosporine. This study aimed to explore the feasibility of discontinuing systemic therapy in pediatric patients who achieve remission when receiving these treatments and to identify predictors of sustained remission.MethodsThe ACMe cohort study was a retrospective, multicenter, international, real-world study involving children and adolescents with moderate-to-severe psoriasis treated with acitretin, methotrexate, or cyclosporine. Patients who achieved remission and stopped their systemic treatment were monitored for up to 6 months to evaluate the need for further systemic treatment.ResultsOf the 433 patients analyzed, 79 (18.2%) discontinued systemic treatment due to remission. Of these, 70 (88.6%) remained off systemic treatment for at least 6 months. Factors predictive of discontinuation due to remission included younger age (9.0 ± 3.5 vs. 10.5 ± 4.1 years, p < 0.001); lower baseline psoriasis severity (PGA: 3.0 ± 0.7 vs. 3.3 ± 0.8; and PASI: 9.3 ± 4.8 vs. 11.1 ± 6.8, p < 0.04); and the presence of non-palmoplantar forms of psoriasis (palmoplantar psoriasis: 5 (6.3%) vs. 58 (16.4%), p = 0.02). No factors were identified that predicted sustained remission at 6 months.ConclusionsThese promising results suggest that systemic treatment discontinuation during clinical remission is feasible for pediatric patients with moderate-to-severe psoriasis and is associated with a low risk of early relapse. Prospective studies with long-term follow-up are needed to confirm the durability of remission and to better define criteria for selecting candidates for treatment discontinuation.Weiterlesen

**Was zeigt die Studie?** Die Studie ordnet **genitale und inverse Psoriasis** als eigenen Typ der Psoriasis ein, mit typischen Beschwerden und besonderen Merkmalen.[3] Das erklärt, warum die Erkrankung in Hautfalten und im Intimbereich anders aussieht, stärker nässt und sich oft schmerzhafter oder empfindlicher anfühlt.[1][2][3] Auch Therapien wirken dort nicht immer so gut wie an anderen Hautstellen.[3][6] Für Euch bedeutet das: Ärztinnen und Ärzte nehmen diese Form zunehmend als eigenes Problem ernst. Es wird mehr gezielt geforscht, welche Medikamente und Cremes an Genitalien und in Hautfalten am besten helfen.[3][4][5] Damit wächst die Chance auf besser passende Behandlungen und auf Empfehlungen, die Eure Lebensqualität und Sexualität stärker berücksichtigen.[3][5][7] Im Alltag hilft es, offen über Beschwerden zu sprechen, auch über Schmerzen beim Sex oder Schamgefühle.[3][7] Nutzt eher **milde, nicht zu fettige Pflege**, haltet Hautfalten möglichst trocken und vermeidet starke Reibung, zum Beispiel mit Gleitmittel beim Geschlechtsverkehr.[1][2][7] Originaltitel: Clinical and genetic characterization of genital and inverse psoriasis as a distinct psoriasis endotype Link zur Quelle

Die Studie zeigt: Mit Hilfe von CRISPR und Künstlicher Intelligenz lassen sich unerwartete Angriffspunkte für Medikamente gegen Psoriasis direkt in menschlichen Hautzellen finden. Erste Salben im Tiermodell wirkten ähnlich stark wie eine etablierte Biologika‑Therapie.[3] ### Was bedeutet das für Euch? Für Euch heißt das: Es gibt neue Ideen, wie man Entzündung in der Haut sehr gezielt bremsen könnte. Die Forschenden fanden dabei auch ein Ziel, das bisher kaum beachtet wurde, zum Beispiel den Oxytocin‑Rezeptor. Das Besondere: Die Wirkstoffe wurden als Gel auf die Haut der Mäuse gegeben und wirkten ähnlich gut wie eine Spritzentherapie mit Biologika.[3] In Zukunft könnten solche lokalen Therapien helfen, mit weniger Einfluss auf das ganze Immunsystem auszukommen. Wichtig: Das ist frühe Forschung. Bisher wurden nur Tiermodelle getestet. Für Euch ändert sich im Alltag noch nichts. Aber die Studie liefert Bausteine, damit später neue Salben oder Cremes entwickelt werden können, die gezielt in Hautzellen ansetzen. Originaltitel: Surprising drug targets for psoriasis emerge from comprehensive CRISPR study of human skin cells Link zur Quelle

## Neue Ziele für zukünftige Psoriasis-Behandlungen Die Forschenden haben Hautzellen mit einer Gen-Schere behandelt und von einer KI auswerten lassen.[1][9] So fanden sie Gene, die das IL‑17‑Signal in den Hautzellen steuern, besonders den Oxytocin‑Rezeptor und einen Stoffwechselweg für Leukotriene.[1][9] Salben mit Wirkstoffen gegen diese Ziele konnten bei Mäusen die Schuppenflechte deutlich mindern, ähnlich stark wie eine gespritzte IL‑17‑Therapie.[1] Für Euch bedeutet das: Die Ergebnisse zeigen neue Ansätze für **künftige** Behandlungen direkt an der Haut. Solche Salben könnten eines Tages Entzündung und gestörte Hautbarriere zugleich bessern und dabei den ganzen Körper weniger belasten.[1] Noch ist das aber Forschung an Mäusen und im Labor, nicht an Menschen.[1][8] Für den Alltag heute ändert sich nichts an den empfohlenen Therapien und der Wichtigkeit guter Hautpflege. Die Studie bestätigt aber, wie zentral Eure Hautbarriere ist. Sanfte Pflege, Feuchtigkeit und Schutz der Haut bleiben ein wichtiger Teil Eurer Behandlung. Originaltitel: AI-guided CRISPR screening reveals therapeutic targets in psoriasis - Nature Communications Link zur Quelle

Wie oft Menschen mit entzündlichem Rheuma im Krankenhaus landen, hat sich in Deutschland deutlich verändert. Für Rheumatoide Arthritis ging die Zahl der Klinikaufenthalte seit 2010 spürbar zurück. Kinder mit kindlicher Arthritis mussten sogar deutlich seltener ins Krankenhaus. Bei Psoriasis Arthritis stiegen die Klinikfälle dagegen leicht an. Morbus Bechterew blieb fast unverändert. 2020 brachen die Zahlen für alle Gruppen ein, wohl wegen der Corona Pandemie. Trotz besserer Medikamente brauchen viele weiter Operationen. Bei Rheuma werden oft Hüften und Knie ersetzt, bei Morbus Bechterew eher an der Wirbelsäule operiert. Darum ist ein gutes Team aus Rheumatologie und Orthopädie wichtig. Originaltitel: Changing Patterns of Hospitalisation and Orthopaedic Procedure Profiles in Major Inflammatory Rheumatic Diseases in Germany: a Nationwide Analysis of Hospital Discharge Data. Link zur Quelle

Wie schwer deine Psoriasis ist, entscheidet oft über die Therapie[1]. Ärzte nutzen dafür den PASI, einen Punktwert für Ausbreitung und Stärke der Plaques[1]. Diesen Wert zu schätzen ist gar nicht so leicht und braucht Übung[1]. Eine Studie hat nun Medizinstudierende mit VR-Brille oder klassischem Vortrag trainiert[1]. Die Gruppe mit VR hat die Schwere der Psoriasis genauer eingeschätzt und war zufriedener mit der Lerneinheit[1]. Das ist gut für dich, denn besser geschulte Ärzte können passende Therapien schneller finden[1]. Vielleicht läuft dein nächster Arztbesuch also mit Hilfe von VR im Hintergrund[1]. Originaltitel: Psoriasis Area and Severity Index Training via Virtual Reality Application: New Way of Effective Teaching. Link zur Quelle

Wenn Gelenke bei axialer Spondyloarthritis oder Psoriasis Arthritis Probleme machen sollen Ärzte klar sehen wie aktiv die Entzündung ist. Eine internationale Forschergruppe hat verschiedene Tests verglichen und festgestellt dass zusammengesetzte Werte besser sind als nur die Zahl der geschwollenen Gelenke. Besonders gut schnitt der DAPSA44 ab. Er fasst Gelenkschmerzen geschwollene Gelenke und Einschätzung durch Patienten zu einem Wert zusammen. Fachleute empfahlen DAPSA44 fast einstimmig als Standard für Studien. Das kann helfen neue Therapien genauer zu prüfen und zu vergleichen. Originaltitel: Instrument selection for the assessment of peripheral arthritis in axial and peripheral spondyloarthritis: an ASAS project. Link zur Quelle

Trial number: 2023-503766-24-00 Overall trial status: Ongoing, recruiting Trial title: A Phase 3b/4 Multi-center, Randomized, Open-label, Long-term Safety Study of Deucravacitinib in Comparison to Ustekinumab in Participants with Moderate-to-Severe Plaque Psoriasis (PRAGMATYK) Medical conditions: Moderate to Severe Plaque Psoriasis Status in each country: Romania:Ongoing, recruiting, Bulgaria:Ongoing, recruiting, Germany:Ongoing, recruiting, Spain:Ongoing, recruiting, Czechia:Ongoing, recruiting, France:Ongoing, recruiting, Hungary:Ongoing, recruiting, Italy:Ongoing, recruiting, Sweden:Authorised, recruitment pending, Poland:Authorised, recruitment pending, Denmark:Authorised, recruitment pending, Belgium:Authorised, recruiting Trial phase: Phase III and phase IV (Integrated) Therapeutic Areas: Diseases [C] - Immune System Diseases [C20] Primary end point: Composite cardiovascular endpoint defined as: adjudicated 3-point MACE (non-fatal MI, non-fatal stroke, and cardiovascular death) plus coronary revascularization Secondary end point: Adjudicated events of: Non-fatal MI, non-fatal stroke, cardiovascular death, coronary revascularization, 3-point MACE (non-fatal MI, nonfatal stroke, and cardiovascular death), PE, DVT, the composite of all VTE events of PE, DVT and retinal vein occlusion, arterial thromboembolic events (including retinal artery occlusion), HF requiring hospitalization or urgent care visit, malignancy excluding NMSC, NMSC, and opportunistic infections including TB and complicated herpes zoster, SAEs, all-cause mortality, and AEs leading to permanent treatment discontinuation, Laboratory tests: complete metabolic panel, including liver function test and fasting lipid panel at baseline and every 26 weeks thereafter Age of participants: 18-64 years, 65+ years Gender of participants: Female, Male Trial region: In both EEA and non-EEA Planned number of participants: 1289 Sponsor: Bristol-Myers Squibb Services Unlimited Company Sponsor type: Pharmaceutical company Trial product: USTEKINUMAB, USTEKINUMAB, deucravacitinib Results posted: No Overall decision date: 19/01/2026 Countries decision date: ES: 26/01/2026, PL: 26/01/2026, DE: 20/01/2026, RO: 26/01/2026, DK: 02/02/2026, BE: 02/02/2026, FR: 02/02/2026, IT: 02/02/2026, CZ: 16/02/2026, BG: 22/01/2026, SE: 02/02/2026, HU: 23/01/2026 Last updated date: 20/04/2026View the full article

Trial number: 2024-511166-36-00 Overall trial status: Authorised, recruiting Trial title: An Extension Study in Patients with Moderate to Severe Plaque Psoriasis to Evaluate the Long-term Safety, Efficacy and Durability of Response to ESK-001 (ONWARD3) Medical conditions: Moderate to Severe Plaque Psoriasis Status in each country: Belgium:Ended, France:Ongoing, recruitment ended, Portugal:Ongoing, recruitment ended, Germany:Ongoing, recruitment ended, Czechia:Ongoing, recruitment ended, Spain:Ongoing, recruitment ended, Latvia:Ongoing, recruitment ended, Romania:Ended, Estonia:Ongoing, recruitment ended, Bulgaria:Ongoing, recruitment ended, Poland:Ongoing, recruitment ended, Hungary:Ongoing, recruitment ended, Austria:Ended Trial phase: Therapeutic confirmatory (Phase III) Therapeutic Areas: Diseases [C] - Skin and Connective Tissue Diseases [C17] Primary end point: Incidence and severity of treatment-emergent adverse events and serious adverse events Secondary end point: Long-term efficacy endpoints: * Achievement of ≥75%, ≥90%, and ≥100% reductions in PASI after 24, 48, 72, 96 weeks of overall ESK-001 treatment * Achievement of sPGA-0, sPGA-0/1 and ssPGA after 24, 48, 72, 96 weeks of overall ESK-001 treatment * Mean change from baseline in PASI %BSA, Clinical response endpoints: * Following ESK-001 withdrawal, loss of response in: PASI-75 sPGA-0/1 PASI-90 PASI-100 and median time to loss of response in PASI-75 and sPGA0/1. * After achievement of a response at Week 24 in parent study, maintenance of the response in the following at Weeks 24 and 48 in LTE: PASI-75, PASI-90, and PASI-100 sPGA-0 and sPGA-0/1, Clinical response endpoints (continued): * Lack of response at Week 24 in parent study followed by an achievement of response in the following at Weeks 24 and 48 in LTE: PASI-75, PASI-90, and PASI-100 sPGA-0 and sPGA-0/1, Quality of life endpoints: * Achievement of the following after 24, 48, 72, 96 weeks of overall ESK-001 treatment: DLQI-0/1 Change from baseline in DLQI, PSSD, NRS (Pruritus, Joint Pain, and Joint Disease Activity), SF-36 * After achievement of a response at Week 24 in parent study, maintenance of the response in the following at Weeks 24 and 48 in LTE: DLQI-0/1 4 point improvement in DLQI PSSD-0 Age of participants: 18-64 years, 65+ years Gender of participants: Female, Male Trial region: In both EEA and non-EEA Planned number of participants: 931 Sponsor: Alumis Inc. Sponsor type: Pharmaceutical company Trial product: ESK-001 placebo / Pharmaceutical Form: Film-coated tablet / Route of administration: Oral use / Maximum duration of treatment: 24 weeks, ESK-001 Results posted: No Overall decision date: 29/04/2025 Countries decision date: AT: 06/05/2025, BE: 29/04/2025, RO: 06/05/2025, EE: 06/05/2025, PT: 02/05/2025, FR: 29/04/2025, LV: 30/04/2025, ES: 30/04/2025, CZ: 30/04/2025, PL: 05/05/2025, HU: 05/05/2025, DE: 30/04/2025, BG: 08/05/2025 Last updated date: 09/07/2026Den kompletten Artikel zeigen

Trial number: 2023-503766-24-00 Overall trial status: Ongoing, recruiting Trial title: A Phase 3b/4 Multi-center, Randomized, Open-label, Long-term Safety Study of Deucravacitinib in Comparison to Ustekinumab in Participants with Moderate-to-Severe Plaque Psoriasis (PRAGMATYK) Medical conditions: Moderate to Severe Plaque Psoriasis Status in each country: Romania:Ongoing, recruiting, Bulgaria:Ongoing, recruiting, Germany:Ongoing, recruiting, Spain:Ongoing, recruiting, Czechia:Ongoing, recruiting, France:Ongoing, recruiting, Hungary:Ongoing, recruiting, Italy:Ongoing, recruiting, Sweden:Authorised, recruitment pending, Poland:Authorised, recruitment pending, Denmark:Authorised, recruitment pending, Belgium:Authorised, recruiting Trial phase: Phase III and phase IV (Integrated) Therapeutic Areas: Diseases [C] - Immune System Diseases [C20] Primary end point: Composite cardiovascular endpoint defined as: adjudicated 3-point MACE (non-fatal MI, non-fatal stroke, and cardiovascular death) plus coronary revascularization Secondary end point: Adjudicated events of: Non-fatal MI, non-fatal stroke, cardiovascular death, coronary revascularization, 3-point MACE (non-fatal MI, nonfatal stroke, and cardiovascular death), PE, DVT, the composite of all VTE events of PE, DVT and retinal vein occlusion, arterial thromboembolic events (including retinal artery occlusion), HF requiring hospitalization or urgent care visit, malignancy excluding NMSC, NMSC, and opportunistic infections including TB and complicated herpes zoster, SAEs, all-cause mortality, and AEs leading to permanent treatment discontinuation, Laboratory tests: complete metabolic panel, including liver function test and fasting lipid panel at baseline and every 26 weeks thereafter Age of participants: 18-64 years, 65+ years Gender of participants: Female, Male Trial region: In both EEA and non-EEA Planned number of participants: 1289 Sponsor: Bristol-Myers Squibb Services Unlimited Company Sponsor type: Pharmaceutical company Trial product: USTEKINUMAB, USTEKINUMAB, deucravacitinib Results posted: No Overall decision date: 19/01/2026 Countries decision date: ES: 26/01/2026, PL: 26/01/2026, DE: 20/01/2026, RO: 26/01/2026, DK: 02/02/2026, BE: 02/02/2026, FR: 02/02/2026, IT: 02/02/2026, CZ: 16/02/2026, BG: 22/01/2026, SE: 02/02/2026, HU: 23/01/2026 Last updated date: 20/04/2026Den kompletten Artikel zeigen

Bei einer speziellen Form von Schuppenflechte mit Ekzem Anteilen wirkt Deucravitinib wohl schwächer. In einer kleinen Studie bekamen 38 Menschen mit Psoriasis das Mittel. 19 hatten die klassische Form, 19 die ekzematisierte Form. Bei der klassischen Psoriasis hielt die Therapie im Schnitt 21 Monate, bei der ekzematisierten nur 6 Monate. Mehr Menschen mit klassischer Psoriasis spürten eine deutliche Besserung. In der Gruppe mit Ekzem Anteilen traten öfter Rückfälle auf. Die Daten stammen aus zwei Unikliniken in Deutschland. Die Forschenden wollen nun prüfen wie sich dieser Unterschied erklären lässt. Originaltitel: Eczematous component in psoriasis is possibly a negative prognostic factor for deucravacitinib treatment outcome. Link zur Quelle

Wer Psoriasis oder andere entzündliche Hautkrankheiten hat, kennt Juckreiz oft als schlimmstes Symptom. Eine Studie mit 522 Erwachsenen zeigt, dass nicht nur der Schweregrad der Haut zählt. Besonders wichtig sind, wie stark der Juckreiz ist und wie lange er am Tag anhält. Viele Betroffene kratzen sich häufig und schlafen schlecht. All das zusammen verschlechtert die Lebensqualität deutlich. Die Forschenden folgern, dass gute Behandlung nicht nur die Haut beruhigen soll. Sie muss auch den Juckreiz lindern und den Schlaf verbessern. Originaltitel: Itch, Scratching, and Sleep Mediate the Association between Disease Severity and Quality of Life in Pruritic Dermatoses: A Cross-Sectional Study. Link zur Quelle

Trial number: 2023-507039-39-00 Overall trial status: Authorised, recruiting Trial title: A Phase 3 Multicenter, Randomized, Double-blind, Placebo-controlled and Deucravacitinib Active Comparator-controlled Study to Evaluate the Efficacy and Safety of JNJ-77242113 for the Treatment of Participants With Moderate to Severe Plaque Psoriasis Medical conditions: Moderate to Severe Plaque Psoriasis Status in each country: Italy:Not authorised, Germany:Ongoing, recruitment ended, Romania:Ongoing, recruitment ended, Spain:Ongoing, recruitment ended, Poland:Ongoing, recruitment ended, Hungary:Ongoing, recruitment ended Trial phase: Therapeutic confirmatory (Phase III) Therapeutic Areas: Diseases [C] - Immune System Diseases [C20] Primary end point: IGA score of 0 or 1 and a ≥2-grade improvement from baseline at Week 16., PASI 90 at Week 16. Secondary end point: N/A Age of participants: 65+ years, 18-64 years Gender of participants: Female, Male Trial region: In both EEA and non-EEA Planned number of participants: 342 Sponsor: Janssen - Cilag International Sponsor type: Pharmaceutical company Trial product: JNJ-77242113, DEUCRAVACITINIB, Film-Coated Tablet without Deucravacitinib, Film-Coated Tablet without JNJ-77242113 Results posted: No Overall decision date: 19/03/2024 Countries decision date: IT: 21/03/2024, RO: 21/03/2024, DE: 20/03/2024, HU: 04/04/2024, PL: 25/03/2024, ES: 21/03/2024 Last updated date: 06/07/2026Den kompletten Artikel zeigen

Trial number: 2024-512496-12-00 Overall trial status: Ongoing, recruitment ended Trial title: A Phase 3, Multicenter, Open-Label Study to Evaluate the Long-term Safety, Tolerability, and Efficacy of TAK-279 in Subjects with Moderate-to-Severe Plaque Psoriasis Medical conditions: Moderate to Severe Plaque Psoriasis Status in each country: Czechia:Ongoing, recruitment ended, Spain:Ongoing, recruitment ended, Latvia:Ongoing, recruitment ended, Poland:Ongoing, recruitment ended, Italy:Ongoing, recruitment ended, Hungary:Ongoing, recruitment ended, Bulgaria:Ongoing, recruitment ended, Germany:Ongoing, recruitment ended, France:Ongoing, recruitment ended Trial phase: Therapeutic confirmatory (Phase III) Therapeutic Areas: Diseases [C] - Skin and Connective Tissue Diseases [C17] Primary end point: Incidence of treatment-emergent adverses events (TEAEs), Incidence of serious adverse events (SAEs) Secondary end point: Over the duration of the study: ≥75% improvement in Psoriasis Area and Severity Index (PASI-75), Over the duration of the study: Static Physician Global Assessment (sPGA) of clear (0) or almost clear (1) with a ≥2-point decrease from baseline Age of participants: 65+ years, 18-64 years Gender of participants: Female, Male Trial region: In both EEA and non-EEA Planned number of participants: 839 Sponsor: Takeda Development Center Americas Inc. Sponsor type: Pharmaceutical company Trial product: ZASOCITINIB Results posted: No Overall decision date: 16/01/2025 Countries decision date: HU: 17/01/2025, IT: 17/01/2025, DE: 20/01/2025, FR: 28/07/2025, ES: 20/01/2025, LV: 16/01/2025, BG: 21/01/2025, CZ: 17/01/2025, PL: 21/01/2025 Last updated date: 29/05/2026Den kompletten Artikel zeigen

Trial number: 2024-511166-36-00 Overall trial status: Authorised, recruiting Trial title: An Extension Study in Patients with Moderate to Severe Plaque Psoriasis to Evaluate the Long-term Safety, Efficacy and Durability of Response to ESK-001 (ONWARD3) Medical conditions: Moderate to Severe Plaque Psoriasis Status in each country: Belgium:Ended, France:Ongoing, recruitment ended, Portugal:Ongoing, recruitment ended, Germany:Ongoing, recruitment ended, Czechia:Ongoing, recruitment ended, Spain:Ongoing, recruitment ended, Latvia:Ongoing, recruitment ended, Romania:Ended, Estonia:Ongoing, recruitment ended, Bulgaria:Ongoing, recruitment ended, Poland:Ongoing, recruitment ended, Hungary:Ongoing, recruitment ended, Austria:Ended Trial phase: Therapeutic confirmatory (Phase III) Therapeutic Areas: Diseases [C] - Skin and Connective Tissue Diseases [C17] Primary end point: Incidence and severity of treatment-emergent adverse events and serious adverse events Secondary end point: Long-term efficacy endpoints: * Achievement of ≥75%, ≥90%, and ≥100% reductions in PASI after 24, 48, 72, 96 weeks of overall ESK-001 treatment * Achievement of sPGA-0, sPGA-0/1 and ssPGA after 24, 48, 72, 96 weeks of overall ESK-001 treatment * Mean change from baseline in PASI %BSA, Clinical response endpoints: * Following ESK-001 withdrawal, loss of response in: PASI-75 sPGA-0/1 PASI-90 PASI-100 and median time to loss of response in PASI-75 and sPGA0/1. * After achievement of a response at Week 24 in parent study, maintenance of the response in the following at Weeks 24 and 48 in LTE: PASI-75, PASI-90, and PASI-100 sPGA-0 and sPGA-0/1, Clinical response endpoints (continued): * Lack of response at Week 24 in parent study followed by an achievement of response in the following at Weeks 24 and 48 in LTE: PASI-75, PASI-90, and PASI-100 sPGA-0 and sPGA-0/1, Quality of life endpoints: * Achievement of the following after 24, 48, 72, 96 weeks of overall ESK-001 treatment: DLQI-0/1 Change from baseline in DLQI, PSSD, NRS (Pruritus, Joint Pain, and Joint Disease Activity), SF-36 * After achievement of a response at Week 24 in parent study, maintenance of the response in the following at Weeks 24 and 48 in LTE: DLQI-0/1 4 point improvement in DLQI PSSD-0 Age of participants: 18-64 years, 65+ years Gender of participants: Female, Male Trial region: In both EEA and non-EEA Planned number of participants: 931 Sponsor: Alumis Inc. Sponsor type: Pharmaceutical company Trial product: ESK-001 placebo / Pharmaceutical Form: Film-coated tablet / Route of administration: Oral use / Maximum duration of treatment: 24 weeks, ESK-001 Results posted: No Overall decision date: 29/04/2025 Countries decision date: AT: 06/05/2025, BE: 29/04/2025, RO: 06/05/2025, LV: 30/04/2025, EE: 06/05/2025, PT: 02/05/2025, FR: 29/04/2025, ES: 30/04/2025, CZ: 30/04/2025, PL: 05/05/2025, HU: 05/05/2025, DE: 30/04/2025, BG: 08/05/2025 Last updated date: 06/07/2026Den kompletten Artikel zeigen

ObjectivesTo compare Sámi and non-Sámi patients with psoriatic arthritis (PsA) and evaluate potential differences in treatment and joint damage.MethodA total of 424 adult PsA patients meeting the ClASsification for Psoriatic ARthritis (CASPAR) criteria were recruited from the Norwegian Arthritis Registry and hospitals in northern Norway. A questionnaire from the SAMINOR (a study in regions with Sámi and Norwegian populations) was used to identify Sámi and non-Sámi patients. Demographic and clinical characteristics, joint damage, and disease-modifying anti-rheumatic drug treatment data were compared between the groups. Binary logistic regression was used to adjust for age and gender differences.ResultsSixty Sámi and 364 non-Sámi patients were identified, and the groups were comparable in demographic characteristics and disease activity measurements. Sámi patients experienced more joint damage than non-Sámi patients (42% vs 26%, p = 0.010), and the highest rate was observed among Sámi men (p = 0.005). Sámi patients also had a higher prevalence of arthritis and axial involvement (92% vs 76%, p = 0.007 vs 32% vs 20%, p = 0.033). In addition, Sámi men showed significant underutilization of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) (83% vs 92%, p = 0.031), particularly methotrexate (68% vs 90%, p = 0.002).ConclusionSámi PsA patients show higher rates of axial involvement, arthritis, and joint damage than their non-Sámi peers. Furthermore, Sámi patients demonstrate underutilization of csDMARDs. These findings underscore the importance of implementing culturally adapted healthcare strategies to improve treatment outcomes for Sámi patients with PsA.Weiterlesen

Psoriasis is a complex chronic inflammatory and autoimmune disease; therefore, reliable and human-relevant animal models are essential for preclinical drug testing and mechanistic studies. SKH-1 mice, which lack functional hair follicles and display a thickened epidermis that more closely resembles human skin than that of C57BL/6 mice, represent a potential psoriasis model, but their suitability remains uncertain. In this study, proliferation, barrier function, differentiation, and inflammatory responses were assessed in the imiquimod (IMQ)-induced dermatitis model of SKH-1 mice using qRT-PCR, immunofluorescence, and flow cytometry. Transcriptomic profiling via RNA sequencing was performed on total RNA from lesional and non-lesional skin of IMQ-induced SKH-1 mice, IMQ-induced C57BL/6 mice, and human psoriatic skin. A psoriasis-like mouse model was also established in SKH-1 mice to evaluate its utility for recurrence studies. The results showed that the IMQ-induced SKH-1 mouse model exhibited hyperproliferation, hypodifferentiation, barrier disruption, and excessive inflammatory responses similar to human psoriasis. Transcriptomic analysis further highlighted the advantages and complementarity of this model in studying psoriasis pathogenesis, and the established recurrence model provided a suitable tool for investigating the mechanisms of psoriasis recurrence. This study compared the transcriptomic signatures of lesional skin between IMQ-induced SKH-1 and C57BL/6 mice and demonstrated that the SKH-1 model can recapitulate vascular dysregulation and disease recurrence, indicating that it serves as a valuable complementary tool for probing psoriasis pathogenesis.Weiterlesen

Psoriasis is a chronic immune-mediated inflammatory disorder with systemic implications. While transcobalamin 2 (TCN2) has been linked to several autoimmune diseases, its role in psoriasis remains unclear. Here, we investigated the contribution of TCN2 to psoriatic pathogenesis. TCN2 expression was significantly elevated in both lesional skin and peripheral blood mononuclear cells (PBMCs) from psoriasis patients, and its levels declined following biologic therapy. Similarly, increased TCN2 expression was observed in imiquimod (IMQ)-induced psoriatic lesions in mice. To further evaluate its function, we generated Tcn2-deficient (Tcn2-/-) mice and established an IMQ-induced psoriasis model. Compared with wild-type controls, Tcn2-/- mice developed attenuated skin lesions with reduced epidermal hyperplasia and inflammation. Transcriptomic analysis of lesional skin revealed downregulation of inflammatory mediators (S100A7, S100A8, S100A9, IL-1β, IL-6) and suppression of STAT3 signaling in Tcn2-/- mice. In parallel, TCN2-knockdown HaCaT cells exhibited impaired proliferation due to G1-phase arrest, along with reduced expression of proinflammatory factors. Together, these findings demonstrate that TCN2 promotes keratinocyte hyperproliferation and amplifies inflammatory responses in psoriasis. In conclusion, this study identifies TCN2 as a previously unrecognized regulator of psoriatic inflammation and keratinocyte biology, highlighting its potential as a novel therapeutic target.Weiterlesen

BackgroundThe IL-23/Th17 axis is the cornerstone of psoriasis pathogenesis, but molecular heterogeneity across different ethnicities remains poorly defined.ObjectiveTo comprehensively define the immunological and pathogenic transcriptomic profiles of a Taiwanese psoriasis cohort.MethodsLesional skin (LS) and non-lesional skin (NL) biopsies from 11 patients with chronic plaque psoriasis and normal skin (N) from 9 healthy controls were analyzed via bulk RNA-sequencing. Differential gene expression (DEG), pathway enrichment (GSEA), and clinical correlations (PASI score) were performed. Serum levels of cytokines were validated via ELISA from all 50 psoriasis patients and 9 healthy controls.ResultsAnalysis identified 4,694 DEGs in LS vs. N. We confirmed robust Th17 upregulation (IL-17A/C, IL-23A). Unanticipatedly, a profound dual immune dysregulation was identified, involving significant upregulation of Type 2 (Th2) signatures (IL-4R, CCL17, TSLP). The IL-36 family was the most highly activated cytokine axis (IL-36G log2FCH=5.5). Barrier function genes (KRT77, GJB4) were significantly downregulated. Correlation analysis identified IL-36RN and the combination of AREG/CDSN (r ≈ -0.9, p=0.002) as potential severity biomarkers.LimitationsThe small sample size and focus on a single ethnic group. Transcriptomic findings represent associations rather than mechanistic evidence of pathogenesis.ConclusionTaiwanese psoriasis is characterized by a dual Th17/Type 2 endotype and extreme IL-36 activation. This molecular landscape underscores the need for stratified therapeutic strategies in Taiwanese populations.Weiterlesen

Methotrexate (MTX) is a widely used, cost-effective systemic treatment for moderate-to-severe psoriasis, but concerns about hepatotoxicity often limit its long-term use. Hepatic adverse effects range from transient enzyme elevations to fibrosis and cirrhosis. Despite established guidelines, monitoring practices remain inconsistent, and the mechanisms underlying MTX-induced hepatotoxicity in psoriasis patients are not fully elucidated. This systematic literature review evaluates the association between MTX and hepatotoxicity, identifies key risk factors, assesses monitoring strategies and addresses misconceptions about its hepatic safety. A comprehensive search of MEDLINE/PubMed, EMBASE, Cochrane Library and grey literature (2003-2024) included English and French studies on human subjects, encompassing guidelines, reviews and observational/interventional studies. MTX-related hepatotoxicity is multifactorial, with risk factors including obesity, diabetes, hyperlipidaemia, excessive alcohol consumption and pre-existing liver disease. Psoriasis itself may also contribute to liver dysfunction. There is no consensus on optimal monitoring frequency for liver function tests or the role of noninvasive tools like transient elastography. While folic acid supplementation may mitigate risk, dosing remains inconsistent.Though MTX carries a potential hepatotoxic risk, this is patient-specific rather than inherent to the drug. Standardized monitoring protocols and risk stratification are essential to optimize safety, prevent unnecessary treatment discontinuation and improve long-term psoriasis management.Weiterlesen

Biologic therapies targeting IL‑17 and IL‑23 have revolutionized psoriasis management, enabling rapid and durable disease control. Yet treatment selection still follows a trial‑and‑error approach, and clinically validated biomarkers for personalization remain absent. To outline current challenges in biomarker development for psoriasis and describe the design and aims of the PICASSO prospective cohort as a platform for future personalized medicine. Despite evidence that IL‑17/IL‑23 inhibitors may induce disease modification through effects on effector, memory, and regulatory immune cells, reliable predictive or prognostic biomarkers have not emerged. Barriers include complex pathogenesis, universally high biologic efficacy reducing need for stratification, inconsistent findings from genetic or transcriptomic studies, and the multifactorial nature of comorbidities. PICASSO is a 10‑year prospective biobank/registry enrolling patients within three years of disease onset. Biological samples are longitudinally linked to clinical and epidemiological data, with follow‑ups every 2.5 years. The ultimate aim is to identify biomarkers predicting disease trajectory. Personalized psoriasis care requires biomarkers predicting progression and comorbidity risk. PICASSO represents a step toward disease‑modifying, preventive precision medicine.Weiterlesen

Psoriasis is a chronic immune-mediated inflammatory disease associated not only with cutaneous manifestations but also with substantial psychosocial burden, including impaired quality of life, depression, anxiety, stigmatization, fatigue, and sexual dysfunction. While cyclosporine A (CsA) is an established systemic therapy for moderate-to-severe psoriasis, its broader psychosocial effects remain insufficiently characterized. This prospective study enrolled 37 patients (20 men, 17 women; mean age 47.8 ± 4.9 years) with moderate-to-severe plaque psoriasis treated with oral CsA for 12 weeks. Therapy was initiated at 5 mg/kg/day for the first 42 days and subsequently reduced to 2.5 mg/kg/day until Day 84. Clinical severity was assessed using the Psoriasis Area and Severity Index (PASI) and Body Surface Area (BSA). Patient-reported outcomes included assessments of quality of life, illness acceptance, life satisfaction, depression, anxiety, fatigue, sexual satisfaction, stigmatization, disability, stress, and pruritus using validated psychometric instruments. Sociodemographic and metabolic determinants were additionally analyzed. CsA therapy resulted in rapid and marked clinical improvement, with PASI scores decreasing from 20.3 ± 4.2 at baseline to 0.9 ± 0.9 at week 12 (p < 0.001) and BSA involvement declining from 41.9% to 1.9% (p < 0.001). Significant improvements were additionally observed across multiple psychosocial domains, including dermatology-related quality of life, depressive and anxiety symptoms, fatigue, sexual satisfaction, illness acceptance, stigmatization, disability, stress, and pruritus (all p < 0.05). Younger age, single marital status, urban residence, longer disease duration, and metabolic comorbidity burden were associated with greater baseline psychosocial impairment. CsA therapy provides multidimensional benefits in patients with moderate-to-severe plaque psoriasis, improving not only clinical disease severity but also psychological well-being, social functioning, fatigue, illness acceptance, and overall quality of life. These findings support the integration of psychosocial assessment into routine therapeutic evaluation and reinforce the continued role of CsA as a multidimensional therapeutic approach in contemporary psoriasis management.Weiterlesen

BackgroundPediatric psoriasis may result in significant cumulative life course impairment, and there is comparatively less evidence available than for adult psoriasis.ObjectiveThe aim of this study is to provide an update on the management of pediatric psoriasis, integrating recent immunogenetic and therapeutic advances. It highlights challenges, including clinical heterogeneity, complex differential diagnosis, and limited treatment options, especially in Brazil.MethodsA narrative review was conducted, including studies published in English, Portuguese, and Spanish between 2009 and 2025, retrieved from the United States National Library of Medicine (PubMed), Cochrane Library, and Scientific Electronic Library Online (SciELO). The following descriptors were used: "psoriasis", "child health", "pediatrics", "therapeutics", "comorbidity", and "T-lymphocyte antigen differentiation".ResultsPediatric psoriasis most commonly presents as chronic plaque. Differential diagnoses are broad and include atopic dermatitis and autoimmune diseases. Data about comorbidities, particularly cardiovascular risk, are controversial. Although severe cases are less frequent, they are associated with a substantial impact on quality of life. Conventional therapies include topical corticosteroids, phototherapy, and non-targeted systemic agents such as acitretin, methotrexate, and cyclosporine. Biologic therapies have been approved for pediatric use and demonstrate safety profiles and superior efficacy compared to conventional treatments.Study limitationsScarcity of pediatric psoriasis guidelines.ConclusionsDespite advances in understanding adult psoriasis, evidence in pediatric populations remains limited, especially in Brazil. Expanding knowledge in pediatric psoriasis is essential to improve diagnosis, optimize treatment strategies, and increase access to innovative therapies, thereby reducing inflammatory burden and cumulative life course impairment.Weiterlesen