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Introduction Paediatric psoriasis is often misdiagnosed, and the overlap condition of psoriasis and atopic dermatitis (AD), known as psoriasis-dermatitis, further complicates accurate identification. Research has shown that interleukin-36 gamma (IL-36γ) measurement via tape stripping can help diagnose complex cases of psoriasis in adults. However, there are no published studies evaluating the applicability of this method in children, especially for distinguishing psoriasis from AD and the overlap condition. We aimed to assess the utility of IL-36γ measurement via tape stripping for distinguishing psoriasis from AD and for predicting the evolution of psoriasis-dermatitis in children and adolescents. Methods We conducted a cross-sectional diagnostic accuracy study in consecutive cases of psoriasis, AD, and psoriasis-dermatitis, and in healthy controls. IL-36γ concentration was measured using tape stripping and enzyme-linked immunosorbent assay (ELISA). Expert paediatric dermatologists independently confirmed the clinical diagnoses (reference standard). Results We included 11 children with psoriasis, 11 with AD, 11 with psoriasis-dermatitis, and 10 healthy controls (mean age 8.7 years, 57% female). Mean IL-36γ levels in psoriasis lesions were significantly higher than in AD lesions (144 pg/mL versus 14.4 pg/mL, P = 0.033) and in healthy controls (144 pg/mL versus 10.4 pg/mL, P = 0.037). The IL-36γ tape stripping method demonstrated a sensitivity of 91% and specificity of 91% for distinguishing psoriasis from AD, with an area under the receiver operating characteristic (ROC) curve of 0.959. The IL-36γ concentrations in participants with psoriasis-dermatitis predicted the evolution to psoriasis or dermatitis in most cases (5 out of 6, 83.3%). Conclusion IL-36γ measurement via tape stripping offers a promising method for distinguishing psoriasis from AD in children. This non-invasive approach is practical for routine clinical application and demonstrates good sensitivity and specificity, which suggests it could improve early diagnosis and patient outcomes.Weiterlesen

IntroductionPsoriasis is a chronic immune-mediated skin disease with known physical and mental health comorbidities, such as cardiovascular disease, depression, and anxiety. Psoriasis also has a significant impact on quality of life and sleep due to factors like itch and pain. This study aims to assess the relationship between sleep quality, mental health, and psoriasis, and specifically investigate the impact of poor sleep quality on mental health outcomes within participants with psoriasis.MethodsIn this cross-sectional study, we enrolled 556 participants into two cohorts: 487 participants were enrolled into the psoriasis cohort, and 69 were enrolled into the healthy control cohort. The demographics, disease severity, family history, sleep quality (PROMIS 8a, PROMIS 8b, and Insomnia Severity Index), and mental health (Patient Health Questionnaire-8 and Generalized Anxiety Disorder-7) of participants were assessed. Descriptive analysis and logistic regression models were employed to examine sleep and mental health, adjusting for potential confounders like demographics and comorbidities.ResultsA comparison of patients with psoriasis and healthy controls revealed worsened sleep and mental health outcomes in patients with psoriasis. Among participants with psoriasis, greater sleep impairment (Patient-Reported Outcomes Measurement Information System (PROMIS) 8a), sleep disturbance (PROMIS 8b), and insomnia were significantly associated with anxiety (ORa 1.22; 95% confidence interval (CI) 1.16, 1.30; ORa 1.26; 95% CI 1.16, 1.80; ORa 5.13; 95% CI 2.91, 9.33; respectively) and depression (ORa 1.42; 95% CI 1.32, 1.56; ORa 1.16; 95% CI 1.08, 1.26; ORa 7.04; 95% CI 4.01, 12.77; respectively).ConclusionThese findings underscore the importance of recognizing how psoriasis can impact mental health and sleep. Building a collaborative relationship between patients with psoriasis and their providers is essential to improve overall sleep and life quality.Weiterlesen

BackgroundThe impact of traditional systemic drugs to treat psoriasis (ciclosporin, methotrexate, and acitretin) in a subsequent response to biologics has not been adequately addressed in the literature. In clinical practice, it is increasingly necessary to initiate, due to concomitant comorbidities, biologics in patients with psoriasis or psoriatic arthritis (PsA) who have not undergone prior treatment with systemics, i.e. full-naive.Objectives and methodsThis study analyzed the possible impact of non-biological systemic therapies on the effectiveness and drug survival of first-line biologic drug up to 12 months in bio-naive psoriatic and PsA patients consecutively enrolled from January 2017 to March 2021.ResultsNinety-five patients with severe psoriasis (13.5%) were full-naive. Being full-naive and having or not having undergone methotrexate or cyclosporine therapy did not impact response to subsequent years of biologic therapy. Only acitretin promotes faster response to subsequent biologic drugs with 59.6% and 74.2% of patients achieving Psoriasis Area Severity Index (PASI) 90 at 16 and 28 week, respectively, vs. 50.5% and 65% (p = 0.034 and 0.026). In multivariate analysis, the advantage given by acitretin was lost.ConclusionPrevious systemic therapy in bio-naive patients does not appear to result in a differential response to biologics during the first year of treatment.Weiterlesen

BackgroundPsoriasis is a chronic skin disease affected by genetic and autoimmunity. The traditional Chinese medicine, Compound Qingdai Capsule (CQC), has shown potential benefits in treating psoriasis in clinical settings. Despite its efficacy, the molecular mechanisms underpinning its therapeutic action remain unclear.PurposeThis study aimed to unravel the molecular mechanism of Compound Qingdai Capsule for psoriasis based on the psoriasis pathogenic pathway network, integrating multi-omics analysis, systems pharmacology, machine learning modeling, and animal experimentation.MethodsPsoriasis pathogenic pathway network was constructed through employing bioinformatics analysis and psoriasis-related multi-omics data mining. The ingredients of CQC were detected by UPLC-MS/MS, and target prediction was performed by systems pharmacology. Machine learning, including Lasso regression, Random Forest, and Support Vector Machine (SVM), were utilized to screen core targets of psoriasis. Molecular docking was employed to evaluate the binding affinity between ingredients and core targets. The expression levels of core targets were determined using qRT-PCR and ELISA.ResultsPsoriasis-related datasets GSE201827 and GSE174763 were comprehensively analyzed to obtain 635 psoriasis-related genes. These genes were further enriched to elucidate signaling pathways involved, leading to the construction of psoriasis pathogenic pathway network. Utilizing UPLC-MS/MS, 29 main ingredients of CQC were characterized. CQC ingredients-targets network was constructed using these ingredients and their targets. Screening of CQC anti-psoriasis core targets using machine learning algorithm. Molecular docking confirmed good binding affinity between these targets and ingredients. Imiquimod (IMQ) induced psoriasis-like rat validated the anti-psoriasis effect of CQC by alleviating symptoms, reducing spleen and thymus index, and modulating the expressions of core targets at mRNA and protein levels.ConclusionCQC effectively modulates the expression levels of AURKB, CCNB1, CCNB2, CCNE1, CDK1, and JAK3 through various ingredients, such as astilbin, salvianolic acid A, and engeletin, via multiple pathways, thereby alleviating psoriasis-like symptoms.Weiterlesen

Psoriasis is a chronic inflammatory skin disease driven by immune dysregulation. This study explores the role of B cells, particularly cytokine-producing subsets, in psoriasis pathogenesis. Although T cells, particularly Th17, have been well documented in psoriasis, recent evidence suggests that B cells contribute to the disease process. Flow cytometry analysis of 50 psoriasis patients and 20 healthy controls revealed a significant increase in IL-6-producing effector B cells (Beffs) and a decrease in IL-10-producing regulatory B cells (Bregs) in psoriasis patients. As IL-6 is pro-inflammatory and IL-10 is anti-inflammatory, this imbalance likely exacerbates inflammation in psoriasis. The study also examined the effects of guselkumab, an IL-23 inhibitor, on cytokine-producing B cells. The frequency of IL-6-producing Beffs in the blood was significantly (p < 0.05) elevated in patients with psoriasis compared with that in healthy controls. In contrast, the frequency of IL-10-producing Bregs in the blood was significantly (p < 0.05) decreased in patients with psoriasis compared with that in healthy controls. In 10 biologic-naïve psoriasis patients, guselkumab significantly reduced IL-6-producing Beffs 4 weeks posttreatment, corresponding with a marked decrease in the Psoriasis Area and Severity Index (PASI). However, IL-10-producing Bregs showed no significant change over this period, suggesting that regulatory B cell recovery may require a longer timeframe or additional stimuli. These findings highlight the potential of B cells as biomarkers for disease activity and therapeutic response in psoriasis. The observed cytokine imbalance suggests that targeting B cell-mediated inflammation could be a novel therapeutic avenue. Further research is needed to assess long-term Breg dynamics and their role in maintaining immune homeostasis in psoriasis. This study reinforces the importance of both effector and regulatory B cells in psoriasis and suggests that monitoring their balance may improve disease characterization and treatment strategies.Weiterlesen

IntroductionResearch findings show a substantial correlation between Crohn's disease and psoriasis. However, the exact cause or pathogenesis of the concurrent manifestations of these two conditions in the same individuals remains uncertain. This research aimed to scrutinize the important molecules and mechanisms responsible for the concomitance of Crohn's disease and Psoriasis by using quantitative bioinformatics utilizing a publicly available RNA sequencing repository.MethodsThe database Gene Expression Omnibus were assessed, specifically for Crohn's disease (GSE95095) and psoriasis (GSE13355). The 'limma' library of the R programming syntax is employed to identify differentially expressed genes. The Search Tool for Interacting Genes dataset was utilized to study the interaction between proteins networks. The Cytoscape software was utilized to efficiently view and analyse these Protein-Protein Interaction networks. The ctoHubba Cytoscape plugin helps in the selection of hub genes. These hub genes have been confirmed using data from GSE102133 for Crohn's disease and GSE14905 for psoriasis. The ROC curves were utilized in this study to assess the diagnostic value of the hub genes. Moreover, new research involving gene-set enriched studies and the study of immunological surveillance associated with these specific genes is attainable.ResultsAmong the identified common DEGs, 40 genes were downregulated and 37 were upregulated, totaling 77 genes. Crohn's disease and Psoriasis had a higher concentration of pathways associated with inflammation. After validation, functionality of hub genes was confirmed for S100A12, CXCL8, IL1RN, S100A9, CXCL10, MMP1, CXCL1, FPR1, CXCR2, and S100A8. The hub genes showed an increase in expression in response to neutrophil infiltration. The expression of S100A12, CXCL8, IL1RN, S100A9, CXCL10, MMP1, CXCL1, FPR1, CXCR2, and S100A8 was found to be significantly linked to immune processes such as neutrophil activation, neutrophil chemotaxis, and neutrophil migration associated with Crohn's and Psoriasis disease.ConclusionsThis bioinformatics study has elucidated S100A12, CXCL8, IL1RN, S100A9, CXCL10, MMP1, CXCL1, FPR1, CXCR2, and S100A8 as the central genes in the pathogenesis of CD and Psoriasis comorbidity. The significance of neutrophil infiltration in promoting inflammatory and immune-mediated dysfunction seems to be crucial in the etiology of concurrent Crohn's and Psoriasis, offering an avenue for diagnostic and therapeutic methods.Weiterlesen

Few studies have examined the features of patients with IgA nephropathy secondary to psoriasis (IgAN-Pso); leaving the long-term renal outcomes and risk factors for this group unclear. A total of ninety patients with IgAN without evidence of a secondary cause other than psoriasis were enrolled in this retrospective study. The participants were categorized into two groups: the mild-to-moderate psoriasis group (n = 74) and the severe psoriasis group (n = 16). A comparative analysis was conducted on the clinicopathological attributes and renal outcomes between the two groups. Additionally, prognostic risk factors for end-stage renal disease (ESRD) were assessed. The patients within the severe psoriasis cohort exhibited a heightened prevalence of eGFR < 60 ml/min/1.73 m2 and urinary protein levels exceeding 1.49 g/d, alongside more pronounced T lesions and an increased incidence of C2 lesions (crescent > 25%) compared to their mild-to-moderate psoriasis counterparts. During a median follow-up period of 34.8 months, 11 patients (5 [35.7%] with severe psoriasis and 6 [8.2%] with mild-moderate psoriasis, P < 0.05) progressed to ESRD. At the time of biopsy, eGFR, CRP > 21.2 mg/l, immunoglobulin G > 8.05 g/l, low C3 and time-average proteinuria emerged as independent predictors of future ESRD. Pathological parameters could not independently predict ESRD when considering the baseline clinical features. Our study indicates that severe psoriasis is associated with worse renal impairment observed at biopsy and a greater likelihood of developing ESRD afterwards.Weiterlesen

IntroductionPalmoplantar pustulosis (PPP) is a chronic inflammatory skin condition characterized by pustules on the palms and soles. Patients with PPP may be at an increased risk of developing psoriatic arthritis (PsA). The Psoriatic Arthritis Screening and Evaluation (PASE) questionnaire is a tool designed to screen for PsA in at-risk populations. The objective of this study was to identify potential risk factors influencing PASE scores in patients with PPP.MethodsThe EPPPIK study was a cross-sectional, multicenter, noninterventional study conducted at 20 sites in Korea, in which patients (≥ 19 years of age) with a confirmed PPP diagnosis were reviewed. In a post hoc analysis of EPPPIK data, PASE outcomes were evaluated for two groups of patients with PPP stratified on the basis of a cutoff score of 37 points.ResultsIn total, 375 patients with PPP (mean age, 51.3 years; 38.9% male) were included. At enrollment, 175 (46.7%) patients had a PASE score ≥ 37, and 200 (53.3%) patients had a PASE score < 37. Significant differences between the groups were demonstrated for sex, age of menarche, presence of arthritis or psoriatic arthropathy, Physician's Global Assessment score, Palmo-Plantar Pustulosis Area and Severity Index (PPPASI) score, and hand PPPASI score (p ≤ 0.05). Quality-of-life (QoL) measurements and patient-reported outcomes were significantly worse in patients with PASE ≥ 37 (p ≤ 0.05). Multivariable linear regression analysis revealed that a PASE score ≥ 37 was positively associated with female sex (β = 7.19; p < 0.001) and high hand PPPASI score (β = 0.22; p = 0.0243).ConclusionsIn patients with PPP, PASE score ≥ 37 correlated with increased presence of any arthritis or psoriatic arthropathy, more severe PPP, worse QoL outcomes, female sex, and higher hand PPPASI scores. Therefore, PASE may serve as a useful tool for initial screening and appropriate treatment selection, management, and ongoing monitoring of patients with PPP.Weiterlesen

PurposePsoriasis is a common chronic inflammatory skin disease. Acupoint injection is reported to be used for the treatment of psoriasis, however its mechanism is not yet clear. The study aimed to investigate the efficiency of combined treatment including acupoint injection in the treatment of psoriasis.Patients and methodsHere, we compared the efficacy of multiple immune intervention therapy (MII, acupoint injection with BCG-PSN combined with thymosin enteric-coated tablets, levamisole, intramuscular injection with BCG-PSN) to NB-UVB and acitretin for psoriasis. One thousand two hundred patients with moderate-severe psoriasis vulgaris were randomly treated with MII, NB-UVB or acitretin. For another 53 patients treated with MII, the T cell subsets and TCR repertoire analysis were investigated with sequencing and flow cytometry.ResultsThe effective rate in MII treated group was similar to acitretin-treated group in 3 months (P > 0.05), though lower than in subjected treated with NB-UVB (P < 0.05). MII treatments maintained a longer remission of both PASI25 and PASI75 in comparison to the treatment with either NB-UVB or acitretin in following 5-year follow-up. Moreover, the relapse rate was lower in MII treatment than in either NB-UVB (P < 0.0001) or acitretin treatment (P < 0.0001), accompanied with longer remission duration (MII vs both NB-UVB and acitretin, P < 0.0001). Meanwhile, MII treatments markedly increased Treg cells (P = 0.04), while decreasing the number of both Th1 (P < 0.001) and Th17 cell (P = 0.01), along with decreased secretion of IFN-γ (P = 0.03) and IL-17 (P = 0.02). Multivariable Cox regression analysis demonstrated that MII significantly reduced psoriasis relapse risk versus NB-UVB (58.7% reduction; HR = 0.413, 95% CI: 0.329-0.517, P < 0.001) and acitretin (65.3% reduction; HR = 0.347, 95% CI: 0.276-0.435, P<0.001).ConclusionAcupoint injection combined with BCG-PSN, thymosin enteric-coated tablets and levamisole treat psoriasis and prevent relapse of psoriasis, via modulation of Treg/Th1/Th17.Weiterlesen

In dieser Studie wird untersucht, wie wirksam, sicher und verträglich das Medikament Risankizumab bei Kindern mit aktiver juveniler Psoriasis-Arthritis ist. Dabei wird Risankizumab mit dem bereits zugelassenen Medikament Adalimumab verglichen. Beide Medikamente werden als Injektion unter die Haut (subkutan) verabreicht und sollen Entzündungen sowie Schmerzen in den Gelenken lindern. Die Kinder, die an der Studie teilnehmen, haben mindestens drei betroffene Gelenke und sprechen nicht ausreichend auf andere Therapien wie Methotrexat an. Die untersuchte Substanz Risankizumab ist ein sogenannter monoklonaler Antikörper. Das bedeutet: Es handelt sich um einen gentechnisch hergestellten Eiweißstoff, der gezielt einen bestimmten Botenstoff im Immunsystem blockiert – Interleukin-23 (IL-23). IL-23 spielt eine wichtige Rolle bei Entzündungsprozessen im Körper und trägt zur Entwicklung von Autoimmunerkrankungen wie Psoriasis-Arthritis bei. Durch die Blockade dieses Botenstoffs kann Risankizumab dazu beitragen, Entzündungssymptome zu verringern und das Fortschreiten der Erkrankung zu bremsen. Originaltitel: Open-label, randomized, assessor-blinded, efficacy, safety, tolerability, and pharmacokinetics study of subcutaneous risankizumab with an adalimumab reference arm in children with active juvenile psoriatic arthritis Erkrankung: Juvenile Psoriasis-Arthritis Phase: Phase III (therapeutisch-bestätigend) Firma: AbbVie Deutschland GmbH & Co. KG Art der Verabreichung: Injektion (subkutan) https://euclinicaltrials.eu/search-for-clinical-trials/?lang=en&EUCT=2023-506026-36-00

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

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

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

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

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

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

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

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

No abstract supplied.Weiterlesen

No abstract supplied.Weiterlesen

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

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

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

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