Managing the Patient with Psoriasis and Metabolic Comorbidities

IF 8.6 1区 医学 Q1 DERMATOLOGY American Journal of Clinical Dermatology Pub Date : 2024-05-15 DOI:10.1007/s40257-024-00857-0
Francesco Bellinato, Martina Maurelli, Davide Geat, Giampiero Girolomoni, Paolo Gisondi
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Abstract

Epidemiological data demonstrate strong associations between psoriasis and metabolic comorbidities, including obesity, hypertension, diabetes mellitus, dyslipidemia, and non-alcoholic fatty liver disease. The presence of metabolic comorbidities significantly influences the selection and effectiveness of pharmacological treatments. Some drugs should be prescribed with caution in patients with metabolic comorbidities because of an increased risk of adverse events, while others could have a reduced effectiveness. The aim of this narrative review is to highlight the challenges that healthcare professionals may face regarding the management of psoriasis in patients with metabolic comorbidities. In the first part of the article, the epidemiological association between psoriasis and metabolic comorbidities and their pathogenetic mechanisms is summarized. The second part describes the efficacy and safety profile of conventional and biologic drugs in patients with selected metabolic comorbidities including obesity, non-alcoholic fatty liver disease/hepatic steatosis, and diabetes. Finally, the role of pharmacological and non-pharmacological interventions, such as diet, alcohol abstinence, physical activity, and smoking avoidance is discussed. In conclusion, the choice of the best approach to manage patients with psoriasis with metabolic comorbidities should encompass both tailored pharmacological and individualized non-pharmacological interventions.

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管理银屑病和代谢并发症患者。
流行病学数据表明,银屑病与肥胖、高血压、糖尿病、血脂异常和非酒精性脂肪肝等代谢并发症密切相关。代谢并发症的存在会严重影响药物治疗的选择和效果。代谢合并症患者应慎用某些药物,因为会增加不良反应的风险,而另一些药物则可能会降低疗效。这篇叙述性综述旨在强调医护人员在管理有代谢合并症的银屑病患者时可能面临的挑战。文章第一部分概述了银屑病与代谢合并症之间的流行病学关联及其发病机制。第二部分介绍了传统药物和生物药物对肥胖、非酒精性脂肪肝/肝硬变和糖尿病等特定代谢合并症患者的疗效和安全性。最后,讨论了药物和非药物干预措施的作用,如饮食、戒酒、体育锻炼和避免吸烟。总之,在选择最佳方法治疗伴有代谢并发症的银屑病患者时,应同时采取针对性的药物和个体化的非药物干预措施。
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来源期刊
CiteScore
15.20
自引率
2.70%
发文量
84
审稿时长
>12 weeks
期刊介绍: The American Journal of Clinical Dermatology is dedicated to evidence-based therapy and effective patient management in dermatology. It publishes critical review articles and clinically focused original research covering comprehensive aspects of dermatological conditions. The journal enhances visibility and educational value through features like Key Points summaries, plain language summaries, and various digital elements, ensuring accessibility and depth for a diverse readership.
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