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No abstract supplied.Weiterlesen

BackgroundAlthough IL-17 inhibitors like Secukinumab and Ixekizumab have shown significant efficacy in psoriasis, the impact of early intervention with biologics to modify the disease course and achieve long-term remission remains unclear.ObjectivesTo examine the potential of early intervention with IL-17 inhibitors for disease modification in psoriasis.MethodsWe conducted a multicenter retrospective cohort study on moderate-to-severe plaque psoriasis patients who received at least 4 weeks of treatment with Secukinumab or Ixekizumab between April 2019 and April 2023, taking the relapse rate one year after cessation of treatment as the primary endpoint.ResultsAmong 400 patients who discontinued treatment after achieving PASI90, the median relapse time was 3.29 months(approximately 14 weeks). Of 141 patients who discontinued treatment after achieving PASI90 for over a year, 24 (88.89%) in the ultra-short disease duration(USDD, psoriasis duration ≤ 1 year) group and 33 (82.5%) in the short disease duration(SDD, psoriasis duration ≤ 2 year) group achieved one year of drug-free remission.LimitationsThe potential impact of early intervention on comorbidity development was not addressed in this study.ConclusionEarly intervention with IL-17 inhibitors leads to faster responses and may promote disease modification in psoriasis.Weiterlesen

Psoriasis is a chronic autoimmune disease of the skin manifested by keratinocyte hyperproliferation, immune dysregulation, and chronic inflammation that result in scaly plaques. Conventional interventions such as corticosteroids, immunosuppressants, and biologics offer symptomatic relief but are limited by side effects and incomplete remission. Psoriasis pathogenesis is complex and entails numerous immune cells (dendritic cells, Th1, Th17, Th22, Tregs, macrophages, NK cells) and molecular pathways (IL-17, IL-22, IL-23, TNF-α, NF-κB). Gene therapy suppresses cytokine production, modulates immune activation, and normalizes keratinocyte turnover to achieve sustained control of disease. Gene therapy is a promising option by modulating inflammatory circuits at the molecular level. Methods such as CRISPR-Cas9, RNA interference (RNAi), and antisense oligonucleotides (ASOs) target major psoriasis-related cytokines (IL-17, IL-22, IL-23, TNF-α) and transcription factors (NF-κB), inhibiting inflammation and abnormal keratinocyte proliferation. With ongoing research, gene-based therapies in combination with biologics and nanotechnology-based drug delivery provide a personalized and efficient option for the treatment of psoriasis. This review discusses conventional and innovative gene therapies, which have been found to hit specific cellular and molecular targets to combat psoriasis therapy.Weiterlesen

Psoriasis, the most common inflammatory skin disease, is marked by excessive proliferation of keratinocytes and infiltration of immune cells into the epidermis. Current treatments, particularly biologics targeting the IL‑23/IL‑17 axis, demonstrate excellent efficacy, but issues of recurrence and side effects persist. Therefore, it is essential to identify safer and more effective alternatives. Lobetyolin (LBT), a key component of polyacetylenes in Codonopsis pilosula, exhibits potent antioxidant and antitumor properties, yet its potential for treating psoriasis remains unexplored. In the present study, it was found that topical treatment with LBT significantly inhibits psoriasis in mice and maintains skin homeostasis during disease progression by regulating genes associated with keratinocyte proliferation and differentiation, enhancing the PPAR signaling pathway, and upregulating genes and metabolites involved in linoleic acid metabolism. Additionally, LBT suppressed gene expression linked to cytokine activity as well as the Il17, Tnf and MAPK signaling pathways in IMQ‑treated dendritic cells (DCs). These findings underscored LBT's efficacy in reducing IMQ‑induced psoriasis‑like skin inflammation by preserving skin homeostasis and inhibiting inflammatory cytokines in DCs. The present results suggested that topically applied LBT could serve as a promising drug candidate for psoriasis treatment or as an adjunct to biologic therapies to prevent disease relapse.Weiterlesen

Psoriasis is a chronic, multifactorial, inflammatory skin disease, increasingly recognized as a systemic disorder influenced by the gut-skin axis, which is a dynamic bidirectional communication between intestinal microbiome and cutaneous immune response. This narrative review explores the understanding of the gut-skin axis with the latest evidence on how gut dysbiosis occurs in psoriasis, characterized by reduced microbial diversity and its shifts, and how it contributes to pathogenesis and exacerbation of psoriasis. Notably, recent scientific literature evidence suggests that the alteration of gut microbiome in psoriasis includes a decreased level of beneficial species like Faecalibacterium prausnitzii and a rise in the level of proinflammatory bacterial species like Prevotella copri. Mechanistic insights reveal that gut-derived metabolites, impaired barrier functions, and immune signaling, particularly involving IL-23 and Th17 cells, play a pivotal role in this axis, linking intestinal health to cutaneous manifestations. Both animal and human trials underscore the therapeutic potential of interventions targeting the gut microbiota, including prebiotics, probiotics, dietary modifications, and FMT, demonstrating some promising but variable effects on disease severity and systemic inflammation. Despite these advances, translating the gut-skin axis into clinical practice presents a notable challenge due to limited scientific evidence, a lack of standardised microbiome profiling, and the absence of universally accepted biomarkers to monitor and stratify therapeutic outcomes. These limitations hinder the development of personalised care approaches and the integration of the gut-skin axis as a promising frontier in many autoimmune diseases, where the gut-skin axis and the intestinal microbiome play a crucial role.Weiterlesen

ObjectiveResidual confounding effects and disease severity are attributed to controversial results in studies of psoriatic disease (PsD) and mortality. We aimed to evaluate the risk of mortality in patients with incident PsD, compared to matched controls from the population.MethodsWe used the nationwide, population-based insurance claim datasets in Taiwan from 2010 to 2018. Incident cases of PsD were identified by International Classification of Diseases (ICD) codes. A nonexposed cohort was established through propensity score matching (PSM). Deaths were identified via the National Mortality Database. We evaluated the risk of all-cause mortality in PsD compared to the PSM nonexposed individuals using Cox regression. The mortality risk was evaluated in patients with more severe disease stratified by systemic therapy use and having psoriatic arthritis (PsA).ResultsThere were 108,642 patients with incident PsD (40.2% women) and an equal number of PSM non-PsD individuals. Compared to the age- and sex-matched controls, there was a higher risk of mortality among patients with PsD (adjusted hazard ratio [aHR] 1.73, 95% CI 1.68-1.77, P < 0.001). After PSM, we found an attenuated but persistent higher risk of mortality in PsD compared to controls (aHR 1.20, 95% CI 1.16-1.24). There was a trend of higher mortality in patients exposed to biologic therapies, but not for PsA.ConclusionThere was an increased risk of all-cause mortality in individuals with PsD compared to individuals without PsD before and after both PSM and adjustment for comorbidities. The risk of mortality was higher in patients with psoriasis but not in patients with PsA as compared to controls.Weiterlesen

ObjectiveTo describe the psoriatic phenotype associated with psoriatic arthritis (PsA) METHODS: Based on the previously published PURE 4 validation study, this work aims to describe the sociodemographic and clinical characteristics, as well as the PURE-4 questionnaire outcomes, of psoriasis patients who completed the study. It compares those diagnosed with PsA during the study to those with only psoriasis . The variables compared were age, gender, time since diagnosis of psoriasis, psoriasis location, psoriasis treatment, Psoriasis Area and Severity Index (PASI), and Dermatology Life Quality Index (DLQI).ResultsThe study included 253 psoriasis patients, from whom 46 developed PsA (28 [60.9%] male; mean age 48.9 [11.1]) during the study. At baseline, patients who developed PsA had more involvement of psoriasis in the neck (13.0% vs. 3.4%, p<0.01), knees (71.4% vs. 50.0%, p=0.02), hands (40.0% 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 [5.6] vs. 6.8 [5.0], p=0.03) and DLQI (9.9 [6.9] vs. 7.6 [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% in Assessment I to 91.7% in Assessment II (91.7% vs. 45.4%, p<0.01).ConclusionGreater psoriasis involvement in neck, knees, hands, and feet as well as high impact areas of patients who developed PsA suggests additional information on arthritogenic phenotype of psoriasis in our study population compared to locations generally linked to arthritis risk (nail or scalp).Weiterlesen

AimOnly limited data is available on the benefit of brodalumab 210 mg, an IL-17 receptor A antagonist, on patient-reported outcomes (PROs) in different psoriasis severity groups under real-world-evidence (RWE) conditions.MethodsLIBERO, a prospective, multicenter, 12- and 52-weeks (W) non-interventional study on brodalumab in adult patients with plaque-type psoriasis assessed its short- and long-term impact on PROs in mild, moderate and severe psoriasis defined by Psoriasis Area Severity Index (PASI).Results200 (31.3%) patients with severe (PASI ≥ 20), 263 (41.2%) with moderate (PASI = 10-19) and 168 (26.3%) with mild (PASI < 10) psoriasis were analyzed. In all severity groups a rapid and sustained reduction of mean(m) PASI was observed as of W2. 76.7, 84.9 and 82.0% of patients assessed their psoriasis as being clear/almost clear in mild, moderate and severe subgroups and mean Dermatological Life Quality Index improved from 11.2, 14.3 and 17.1 to 3.2, 2.9 and 3.8. 73.7% of patients rated brodalumab as being quite/very beneficial (Patient Benefit Index, PBI) and were quite/very satisfied with the treatment (TSQM-9). Regaining disease control and reducing physical impairment achieved highest PBI-scores.ConclusionLIBERO confirms the benefit of brodalumab on PROs including rapid and complete clearance of skin lesions, quality of life and individual patient benefits - irrespective of their disease severity.Weiterlesen

BackgroundPsoriasis is a chronic inflammatory disease associated with abnormalities in the immune system. Microsomal prostaglandin E synthase-1 (mPGES-1), a terminal enzyme for prostaglandin (PG) E2 biosynthesis, is highly expressed in the skin of psoriasis patients. However, the detailed role of mPGES-1 in psoriasis remains unclear. In the present study, we aimed to investigate the role of mPGES-1 in psoriasis-like skin inflammation induced by imiquimod (IMQ), a well-established model of psoriasis.MethodsPsoriasis was induced in mPGES-1-deficient (mPGES-1-/-) and wild-type (WT) mice by administering IMQ for 6 days. Psoriasis was evaluated based on the scores of the macroscopic symptoms, including skin scaling, thickness, and redness, and on the histological features. The skin expression of mPGES-1 was determined by real-time polymerase chain reaction and Western blotting. The impact of mPGES-1 deficiency on T-cell immunity was determined by flow cytometry and γδ T-cell depletion in vivo with anti-T-cell receptor (TCR) γδ antibody.ResultsThe inflamed skin of mPGES-1-/- mice showed severe symptoms after the administration of IMQ. Histological analysis further showed significant exacerbation of psoriasis in mPGES-1-/- mice. In WT mice, the mPGES-1 expression was highly induced at both mRNA and protein levels in the skin, and PGE2 increased significantly after IMQ administration, while the PGE2 production was largely abolished in mPGES-1-/- mice. These data indicate that mPGES-1 is the main enzyme responsible for PGE2 production in the skin. Furthermore, the lack of mPGES-1 increased the numbers of IL-17A-producing γδ T cells in the skin with IMQ-induced psoriasis, and γδ T-cell depletion resulted in a reduction of the facilitated psoriasis symptoms under the condition of mPGES-1 deficiency.ConclusionsOur study results demonstrate that mPGES-1 is the main enzyme responsible for skin PGE2 production, and that mPGES-1 deficiency facilitates the development of psoriasis by affecting the development of T-cell-mediated immunity. Therefore, mPGES-1 might impact both skin inflammation and T-cell-mediated immunity associated with psoriasis.Weiterlesen

Patients with autoimmune diseases are susceptible to developing a second autoimmune disorder. Psoriasis, a common autoimmune disease, frequently occurs alongside other autoimmune conditions in some individuals. We report the case of a young female patient diagnosed with plaque psoriasis, initially treated with secukinumab, and achieved complete skin clearance at 12 weeks. However, she experienced a decline in the efficacy of secukinumab, with recurrence of symptoms and subsequent development of chronic spontaneous urticaria (CSU) and was switched to treatment with deucravacitinib, an oral, selective, allosteric tyrosine kinase 2 inhibitor. The use of deucravacitinib resulted in a favorable therapeutic outcome, effectively managing both psoriasis and CSU 12 weeks after treatment. This case highlights the potential of deucravacitinib as a novel monotherapy for patients with both psoriasis and CSU.Weiterlesen

Entzündliche Hautkrankheiten wie Psoriasis sind weltweit eine große Belastung. In China gibt es besonders viele neue Fälle, die Zahl der Betroffenen ist dort deutlich höher als in den USA. Vor allem Pilz- und bakterielle Infektionen spielen eine große Rolle[5]. In den USA ist die Belastung im Vergleich etwas niedriger, aber auch dort leben viele Menschen mit entzündlichen Hautkrankheiten[1]. Hautkrankheiten zählen weltweit zu den häufigsten chronischen Krankheiten. Sie verursachen viele Jahre, in denen Menschen mit Einschränkungen leben müssen und beeinflussen Lebensqualität und Alltag stark[4][5]. Jede Region braucht eigene Strategien, um Betroffenen besser zu helfen. Originaltitel: Burden of Inflammatory Skin Diseases Based on GBD Data: China vs USA. Link zur Quelle

BackgroundPatients' quality of life is greatly impacted by psoriasis, a prevalent chronic inflammatory skin condition that is frequently linked to a number of systemic disorders. Recent research shows that obesity is a major risk factor for psoriasis. Since Relative Fat Mass (RFM), an innovative way to measure obesity, offers a more precise estimate of body fat percentage, this study aims to investigate the connection between RFM and psoriasis and its potential as a disease predictor.MethodsThe analysis included 6,006 people the National Health and Nutrition Examination Survey (NHANES) conducted between 2003 and 2006, 151 of whom had psoriasis. Weighted multivariable logistic regression, restricted cubic splines (RCS), subgroup analysis, and interaction tests were employed to assess the link between RFM and psoriasis. ROC curves were used to compare RFM with conventional measures of obesity (WWI, BRI). Furthermore, LASSO regression and multivariable regression based on AIC were used to create a psoriasis risk prediction model that included RFM and additional clinical factors.ResultsRFM and psoriasis risk were revealed to be significantly positively correlated. The chance of developing psoriasis increased by 7% for every unit rise in RFM (95% CI: 1.03 to 1.12). RFM showed better predictive ability than conventional markers including BMI, WWI, and BRI (AUC = 0.573). The RFM-psoriasis relationship and diabetes status significantly interacted, with the association being weaker in diabetic individuals, according to subgroup analysis and interaction tests. Promising results were obtained from the created psoriasis risk prediction model that included RFM, age, total dietary sugar, education level, history of heart disease, and hypertension.ConclusionThis research demonstrates that RFM outperforms traditional anthropometric methods in predicting risk. It also presents the initial evidence establishing a positive link between RFM and the likelihood of developing psoriasis.The psoriasis risk prediction model underscores RFM's effectiveness as a valuable approach in both clinical and public health domains, aiming to alleviate the impact of psoriasis-related issues by offering a practical instrument for early risk assessment and personalized clinical strategies.Weiterlesen

Background/objectivesGuttate psoriasis onset and plaque psoriasis flares are associated with streptococcal pharyngitis. Literature regarding the relationship between anogenital bacterial dermatitis and psoriasis in pediatric patients is limited. We aimed to evaluate the clinical characteristics, microbiology, and treatment course of patients with psoriasis/psoriasiform dermatitis and concomitant pharyngeal and/or anogenital bacterial infections.MethodsA multicenter retrospective review of patients ≤ 18 years of age with psoriasis/psoriasiform dermatitis and bacterial infection, defined by positive culture results, was performed. Demographic characteristics, clinical features, microbiology, treatment recommendations, and outcomes were evaluated. Comparisons were made between pharyngeal and anogenital culture groups.ResultsA total of 166 unique patients with psoriasis/psoriasiform dermatitis and suspected pharyngeal and/or anogenital infection were evaluated between 2011 and 2021. Staphylococcus sp. and Streptococcus sp. were isolated in anogenital cultures. Inverse psoriasis was associated with a positive anogenital culture (p = 0.0356). Guttate psoriasis was more common in patients with a positive pharyngeal culture (p < 0.0001). Treatment of a positive bacterial culture did not correlate with the treatment response of psoriasis/psoriasiform dermatitis.ConclusionsInvestigations for anogenital and pharyngeal infections should be considered in pediatric patients presenting with new-onset or worsening psoriasis. A high clinical suspicion should be maintained for anogenital infection in patients with inverse psoriasis, specifically.Weiterlesen

Psoriasis burdens children and adults, but the impact of air pollution and aging is unclear. This study examines the association between air pollution exposure and psoriasis risk, considering the mediating role of biological aging. A prospective cohort study of 284,544 adults (51.3% female, mean age 56.26 ± 8.10 years) from the UK Biobank examined long-term exposure to air pollutants (PM2.5, PM10, PM2.5-10, NO2, and NOX). Biological aging was assessed using phenotypic age algorithms. Cox proportional hazards models were constructed to analyze the relationships with the risk of psoriasis, adjusting for demographic, socioeconomic, and health-related factors. Mediation analysis explored the role of biological aging. During a median follow-up of 15.58 years, 3,446 (1.21%) participants developed psoriasis. After adjusting for all confounders, each ten-unit increase (10 μg/m³) in PM2.5, PM10, NO2, and NOx, corresponded to the significantly increased risk of psoriasis by 95.7% (HR = 1.957, 95% CI 1.435-2.671), 19.7% (HR = 1.197, 95% CI 1.006-1.426), 9.0% (HR = 1.090, 95% CI 1.043-1.138) and 4.4% (HR = 1.044, 95% CI 1.024-1.066), respectively. Moreover, all air pollutants are significantly associated with biologically aging, while each one-year increase in PhenoAge was associated with a 5.0% higher risk of psoriasis (HR = 1.050, 95% CI 1.045-1.056). Finally, accelerated biological aging partially mediated 5.96%-13.86% of these air pollutants. Long-term exposure to air pollution significantly affects psoriasis risk, with biological aging as a partial mediator. Reducing pollution may lower the risk of psoriasis by slowing biological aging.Weiterlesen

BackgroundInvestigating gender-specific differences in rheumatology is crucial for improving personalized treatment. The present study aimed to explore gender differences in psychological characteristics and features associated with impaired physical and mental quality of life in male and female patients affected by axial spondyloarthritis or psoriatic arthritis.MethodsThe present study is cross-sectional. Quality of life was evaluated using a Medical Outcome Study 36-item Short Form health survey (SF-36), and physical and mental component scores were presented. Data about disease activity, anxiety and depression, fatigue, perceived stress, and coping strategies were collected. The patients were stratified by gender, and clinical and psychological data were compared.ResultsA total of 119 patients with axial spondyloarthritis [age 49.0 (SD 11.7); 45.4% F] and 198 patients with psoriatic arthritis [age 56.9 (SD 11.6); 62.6% F] were included. Female patients with axial spondyloarthritis and psoriatic arthritis had worse scores on fatigue, pain, perceived stress, physical quality of life, dysfunctional coping strategies, mental quality of life (only in axial spondyloarthritis), and anxiety (only in psoriatic arthritis) than men. In multivariable analysis, physical quality of life is mainly explained by fatigue and pain, and mental quality of life by fatigue, anxiety and stress in women with axial spondyloarthritis and psoriatic arthritis. Fatigue, pain and anxiety were significant variables across the models with male patients.ConclusionsThe study indicates that female patients with axial spondyloarthritis and psoriatic arthritis experience worse scores in psychological variables compared to men. Additionally, women's quality of life is significantly lower when compared to men's one, primarily due to factors such as fatigue, stress, pain, and anxiety. To enhance patient well-being, therapeutic strategies should be tailored to address the unique clinical and psychological needs that arise from gender differences.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.Results95 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

ObjectivesTo investigate the prevalence of psoriasis in SLE using a Swedish regional cohort and a nationwide cohort from the National Patient Register (NPR). Furthermore, we compared clinical features between patients with and without comorbid psoriasis.MethodsIn total, 351 patients diagnosed with SLE based on the 1982 American College of Rheumatology and/or the 2012 Systemic Lupus International Collaborating Clinics criteria from Linköping University Hospital were evaluated. We obtained patient-reported and relevant clinical data extracted in 2024. Individuals with coexisting psoriasis were identified via the International Classification of Diseases code L40 and subsequent confirmation through chart review in the regional cohort. In the NPR, 7490 subjects with SLE living in Sweden in 2022 were identified, as well as therapies obtained from the Prescribed Drug Register.ResultsWe identified 12 subjects with SLE and coexisting psoriasis (3.4%) in the regional cohort and 367 patients (4.9%) in the nationwide cohort. Men were proportionally more common in the group with comorbid psoriasis in both cohorts. Patients with psoriasis reported more pain on a visual analogue scale (median 45.5/100 mm, IQR 23.3-58.3) compared with those without coexisting psoriasis (median 27.0/100 mm, IQR 7.0-50.5, p<0.04). We observed no differences in damage accrual or clinical phenotypes between the two groups. Subjects with psoriasis were more frequently prescribed methotrexate in the nationwide cohort.ConclusionThe prevalence of coexisting psoriasis in patients with SLE in Sweden was estimated to be 3.4-4.9%. Individuals with comorbid psoriasis reported more pain and were more likely to be prescribed methotrexate than those without psoriasis.Weiterlesen

No abstract supplied.Weiterlesen

BackgroundPsoriasis, a chronic inflammatory skin condition, poses significant management challenges due to its persistent nature, recurrences, and side effects associated with conventional therapies. Ayurveda correlates psoriasis with Ekakushtha (a type of skin disorder), primarily involving Vata-Kapha dosha imbalance.ObjectiveTo evaluate the efficacy of Ayurvedic therapies, including Shodhana (Vamana, Raktamokshana) and Shamana (pacification medications), in managing scalp psoriasis.MethodologyA 35-year-old male with chronic scalp psoriasis underwent Panchakarma, including Vamana (therapeutic emesis). Post-Shodhana, conservative management included 777 oil, Psora soap, Panchatikta Ghrita Guggulu, and Sut Shekhar Ras, along with Leech therapy (Raktamokshana) weekly for one month. Lifestyle and dietary modifications were also advised.ResultsThe patient experienced significant relief from itching, scaling, erythema, and lesion thickness. Follow-up revealed improved scalp texture, reduced scaling, and absence of flare-ups. No adverse effects were reported.ConclusionAyurvedic interventions combining detoxification (Shodhana) and pacification (Shamana) therapies demonstrated a safe and effective approach for managing scalp psoriasis, addressing systemic pathology while minimizing side effects. Further clinical trials are warranted to validate these findings.KeywordsAyurvedic treatment, therapeutic emesis, Vaman, Panchatikta Ghrita, Leech Therapy, Psora soap, scalp psoriasis, case report.Weiterlesen

The aim of this research was to explore the potential causal links between various immune cell profiles and the risk of psoriasis, employing a systematic two-sample Mendelian randomization (MR) analysis. The inverse variance weighted (IVW) model is the most commonly used two-sample MR analysis method for estimating the causal effect of exposure on outcomes. In addition to the IVW, we also used the weighted median method, the MR Egger method, and Steiger test as sensitivity analyses. Sensitivity analyses were performed using Cochran Q test for both IVW and MR Egger methods. The MR Egger intercept test was performed to assess horizontal multidimensionality by testing instrumental variables. All 4 immune cells associated with HLA DR (HLA DR++ monocyte %leukocyte, HLA DR on CD14+ CD16- monocyte, HLA DR on CD14+ monocyte, and HLA DR on monocyte) exhibited a significant negative correlation with psoriasis. Further analysis demonstrated that the performance of HLA DR on CD14+ CD16- monocyte and HLA DR on CD14+ monocyte was consistent and robust across multiple tests, with no significant heterogeneity or horizontal pleiotropy observed. This study corroborates the protective role of these 4 immune cells in psoriasis, with a particular focus on HLA DR on CD14+ CD16- monocytes and HLA DR on CD14+ monocytes.Weiterlesen

IntroductionPsoriasis body surface area (BSA) of 10% or more has been a major criterion for determining systemic therapy eligibility. However, patients with BSA < 10% and even ≤ 3% may have high disease burden and difficulties accessing biologics. To assess psoriasis burden among patients with BSA ≤ 10%, this study characterized patient-reported outcomes (PROs) across BSA categories among systemic treatment-naïve patients initiating biologic therapy.MethodsPatients from the CorEvitas Psoriasis Registry initiating biologics between April 2015 and September 2023 were categorized according to low (< 3%), medium (3-10%), or high (> 10%) BSA involvement. Measures assessed at initiation of biologic therapy included health-related quality of life, itch, pain, fatigue, psoriatic arthritis, psoriasis disease characteristics, and medical history. Overlap between BSA groups for each outcome was calculated via non-parametric Mann-Whitney statistic transformation (range 0.0-1.0; 0.5 indicates complete similarity [i.e., for a comparison between low and high BSA groups, overlap of 0.5 means there is 50% probability that a randomly selected patient with low BSA would have the same or greater PRO burden as one with high BSA]; 0 or 1 indicates complete dissimilarity) to determine whether each measure differed in randomly selected patients with low or medium versus high BSA.ResultsOf 1640 patients who initiated biologics, 7.0% had low BSA, 46.9% had medium BSA, and 46.2% had high BSA involvement. PRO overlap statistics ranged from 0.52 to 0.59 and from 0.60 to 0.70 for randomly selected patients with high versus medium and low BSA, respectively, indicating patients with high and medium BSA are likely to have similar levels of disease burden, and patients with high BSA are slightly more likely to have higher disease burden than those with low BSA. Near complete overlap (range 0.44-0.58) was observed for psoriasis disease characteristics and medical history in the low versus high and medium BSA groups.ConclusionObserved overlap in PROs across BSA categories shows that patients with low BSA can experience similarly poor quality of life and high symptom burden to those with higher BSA. These findings support the appropriateness of considering biologic therapies for patients with low BSA and indicators of high disease burden.Trial registrationClinicalTrials.gov: NCT02707341.Weiterlesen

No abstract supplied.Weiterlesen

Vitamin D ist nicht nur wichtig für die Knochen, sondern auch für die Haut. Unsere Haut stellt Vitamin D her, wenn Sonnenlicht draufscheint. In der Haut wird Vitamin D dann in eine aktive Form umgewandelt, die viele wichtige Aufgaben übernimmt. Sie hilft zum Beispiel dabei, dass die Haut sich erneuert und stärkt das Immunsystem[1][2]. Bei Krankheiten wie Psoriasis, Neurodermitis oder Akne läuft in der Haut einiges schief: Die Haut erneuert sich zu schnell, das Immunsystem spielt verrückt und schädliche Keime können leichter eindringen. Vitamin D kann hier helfen, weil es Entzündungen bremst, die Hautbarriere stärkt und die Abwehrkräfte verbessert[1][3][5]. Salben mit Vitamin D werden schon länger erfolgreich gegen Psoriasis eingesetzt. Es gibt Hinweise, dass auch Vitamin D zum Einnehmen bei anderen Hautkrankheiten wie Neurodermitis helfen könnte. Aber: Ob ein niedriger Vitamin-D-Spiegel wirklich die Krankheit schlimmer macht, ist noch nicht ganz klar. Mehr Forschung ist nötig, aber Vitamin D bleibt ein Hoffnungsträger in der Hautmedizin[1][4]. Originaltitel: Vitamin D in the Prevention and Treatment of Inflammatory Skin Diseases Link zur Quelle

Viele Menschen mit Psoriasis wollen, dass ihre Behandlung einfach läuft und gut wirkt. In einer Umfrage haben Forschende gefragt, wie oft Betroffene ihre Biologika spritzen möchten. Die meisten waren mit ihrem aktuellen Rhythmus zufrieden, egal ob sie ihr Medikament alle 12 Wochen, alle 8 Wochen oder häufiger bekamen[1]. Am wichtigsten war den Patientinnen und Patienten, dass die Schuppenflechte gut unter Kontrolle bleibt und sie mit der Wirkung der Therapie zufrieden sind[1]. Längere Abstände zwischen den Spritzen kamen besonders gut an, denn weniger Termine machen den Alltag oft leichter[3][5]. Trotzdem spielt der Rhythmus meist eine kleinere Rolle als das Gefühl, dass die Therapie hilft[1]. Ärztinnen und Ärzte können gemeinsam mit ihren Patienten schauen, welcher Zeitplan am besten passt. Originaltitel: Understanding Psoriasis Patient Preferences for Biologic Dosing Frequencies: Insights From a Patient Survey Link zur Quelle

In dieser Studie wird untersucht, wie wirksam und sicher Risankizumab im Vergleich zu Deucravacitinib bei erwachsenen Patientinnen und Patienten mit mittelschwerer Plaque-Psoriasis ist, die für eine systemische Therapie infrage kommen. Ziel ist es herauszufinden, welches der beiden Medikamente besser geeignet ist, um die Hauterscheinungen der Schuppenflechte zu beseitigen und die Lebensqualität der Betroffenen zu verbessern. Die Studie vergleicht dabei unter anderem den Anteil der Patientinnen und Patienten, deren Haut nach 16 Wochen komplett erscheinungsfrei ist (PASI 100), sowie weitere Verbesserungen im Hautbild. Risankizumab ist ein sogenannter Interleukin-23-Hemmer. Es handelt sich um einen biotechnologisch hergestellten Antikörper, der gezielt einen bestimmten Botenstoff des Immunsystems blockiert – das Interleukin-23 –, das bei Entzündungsprozessen in der Haut eine zentrale Rolle spielt. Dadurch wird die übermäßige Aktivität des Immunsystems gebremst und die Entzündung in den betroffenen Hautarealen reduziert. Risankizumab wird als Injektion unter die Haut verabreicht. Deucravacitinib hingegen wirkt als Hemmstoff eines Enzyms namens Tyrosin-Kinase 2 (TYK2), das ebenfalls an entzündlichen Prozessen beteiligt ist. Im Gegensatz zu Risankizumab wird Deucravacitinib als Tablette eingenommen. Nähere AngabenOriginaltitel: A Phase 4 Multicenter, Randomized, Open-label, Efficacy Assessor-blinded-Study of Risankizumab Compared to Deucravacitinib for the Treatment of Adult Subjects with Moderate Plaque Psoriasis who are Candidates for Systemic Therapy Erkrankung: Plaque-Psoriasis (Schuppenflechte) Phase: IV Firma: AbbVie Deutschland GmbH & Co. KG Art der Verabreichung: Risankizumab: Injektion; Deucravacitinib: Tablette https://euclinicaltrials.eu/search-for-clinical-trials/?lang=en&EUCT=2023-509738-20-00