1,721,287 research outputs found
Is the routine screening for hyperhomocysteinaemia recommended in patients with chronic plaque psoriasis?
No full textIs the routine screening for hyperhomocysteinaemia recommended in patients with chronic plaque psoriasis
Therapeutic insights from the British Association of Dermatologists Biologic Interventions Register
No full textInsights in the value of epidemiology for skin diseases toda
Recognizing the differential impact of site of involvement on quality of life in dermatology
No full textLinked Article: Augustin et al. Br J Dermatol 2019; 181:358-365
Cardiometabolic Comorbidities and the Approach to Patients with Psoriasis
No full textPsoriasis is a chronic inflammatory, immune-mediated skin disease, which may cause significant deterioration in the quality of life. Recent evidence indicates that psoriasis and psoriatic arthritis are frequently associated with cardiometabolic diseases including myocardial infarction, stroke, diabetes, obesity, dyslipidemia and non-alcoholic fatty liver disease. Although the causal relationship between cardiometabolic comorbidities and psoriasis has not yet been completely proven, it appears that obesity is a relevant risk factor for the development of psoriasis and metabolic syndrome. In addition, moderate to severe psoriasis itself is a risk factor for cardiovascular disease and the metabolic syndrome. Some common genetic traits as well as inflammatory mechanisms may underlie the development of psoriasis and cardiometabolic comorbidities. The presence of comorbidities has important implications in the global approach to patients with psoriasis. Traditional systemic anti-psoriatic agents could negatively affect cardiometabolic comorbidities, and may have important interactions with drugs commonly used by psoriasis patients. In contrast, the recent findings that the risk of myocardial infarction is markedly reduced in rheumatoid arthritis patients who respond to anti-TNF-alpha therapy compared with non-responders supports the hypothesis that the anti-inflammatory effect of TNF-alpha blockers might potentially reduce the cardiovascular risk also in psoriasis patients. Finally, patients with moderate to severe psoriasis should be treated promptly and effectively, should also be encouraged to drastically correct their modifiable cardiovascular risk factors, in particular obesity and smoking habit
Does systemic treatment of psoriasis reduce the risk of comorbidities?
Full text linkIn this issue of the BJD, Neil Korman has published an interesting review article presenting the evidence supporting psoriasis as a systemic disease. He also discusses new psoriasis treatment paradigms, which may potentially reduce the effects of systemic inflammation and consequently prevent or reverse comorbidities.1 Optimizing patient outcomes beyond clearing the skin, such as reducing the risk of cardiovascular diseases, is crucially relevant for our clinical practice. In this commentary, the pathogenesis behind the comorbidities and whether systemic treatment of psoriasis could reduce the risk of comorbidities by damping systemic inflammation will be discussed
Could maternal stress increase the risk of developing psoriasis in the offspring?
Full text linkVery few data exist on the role of prenatal stress as a risk factor for psoriasis. As reported in this issue of the BJD, the impressive findings of the study by Xiaoqin Liu et al. from Aarhus University in Denmark show that prenatal exposure to severe maternal stress increases the risk of developing psoriasis in the offsprin
Efficacy of secukinumab without the initial weekly loading dose in patients with chronic plaque psoriasis.
No full textBACKGROUND: Secukinumab is administered at the labelled dose of 300 mg at weeks 0, 1, 2, 3, 4 (loading dose) and every 4 weeks thereafter. OBJECTIVES: To investigate the efficacy of secukinumab administered without the initial loading dose in patients with psoriasis. METHODS: This was a retrospective observational study including adult patients with psoriasis (n = 156) treated with secukinumab 300 mg administered either according to the labelled dose (n = 75) or without the initial loading dose (n = 81). Efficacy was evaluated by comparing the Psoriasis Area and Severity Index (PASI) 75 and PASI 90 response rates at week 8, 12, 16, 32 and 48. RESULTS: For patients who received the labelled dose vs. those who did not, PASI 75 response rates were achieved at week 8, 12, 16, 32 and 48 by 60% vs. 40% (P < 0·01), 72% vs. 61% (P < 0·01), 77% vs. 75%, 85% vs. 77% and 79% vs. 78%, respectively. PASI 90 responses were achieved at the same time points by 45% vs. 31% (P < 0·01), 49% vs. 40% (P < 0·01), 54% vs. 47%, 55% vs. 47% and 57% vs. 54% for those who received the labelled dose vs. those who did not, respectively. A greater proportion of patients receiving secukinumab without the loading dose discontinued treatment because of inefficacy (25% vs. 13%, P < 0·05), particularly those with body weight greater than 80 kg. CONCLUSIONS: Secukinumab administered without the loading dose is associated with a higher proportion of primary inefficacy, and achieved inferior results compared with the labelled dose at week 8 and week 12, but showed similar efficacy thereafter. What's already known about this topic? Secukinumab is an interleukin (IL)-17A inhibitor for chronic plaque psoriasis administered by subcutaneous injections at the labelled dose of 300 mg at weeks 0, 1, 2, 3, 4 (loading dose) and every 4 weeks thereafter (maintenance dose). Dose adjustment is common in clinical practice, and can consist of dose reduction when a prolonged remission is obtained or a dose increase in order to improve efficacy. What does this study add? The efficacy of secukinumab administered without the initial weekly loading dose was significantly inferior compared with the labelled dose in the short term, but was similar after week 16 and up to week 48. A greater proportion of patients receiving secukinumab without the loading dose showed primary inefficacy, particularly those with body weight greater than 80 kg
Relapse of psoriasis in patients who asked to discontinue etanercept after achieving a stable clinical remission.
No full textIn real-life practice, there are some patients who ask for treatment withdrawal after achieving stable complete remission for a number of reasons including worry regarding adverse events with longterm treatment. The objective of this retrospective study was to investigate psoriasis course (duration of remission and predictors of relapse) in patients who asked to discontinue etanercept after achieving complete and stable remissio
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