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Psoriasis (Auckland, N.Z.)最新文献

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Risk Factors for Psoriasis Flares: A Narrative Review. 牛皮癣复发的风险因素:叙述性综述。
Pub Date : 2024-05-30 eCollection Date: 2024-01-01 DOI: 10.2147/PTT.S323281
Luca Potestio, Giuseppe Lauletta, Nello Tommasino, Antonio Portarapillo, Antonia Salsano, Teresa Battista, Fabrizio Martora, Matteo Megna

Psoriasis is a chronic inflammatory cutaneous disease with multifactorial pathogenesis involving both genetic and environmental factors as well as the innate and acquired immune response. Several triggering factors may exacerbate or worsen the disease. In this context, we performed a review manuscript with the aim of investigating current literature on psoriasis risk factors, also showing possible mechanisms by which they act on psoriasis. Globally, risk factors can be divided in classic risk factors (eg, mechanical stress, infections and dysbiosis of the skin, common drugs, environment and pollution, lifestyle, psychological stress, hormonal and metabolic alterations) which have long been known to be responsible for worsening and/or reoccurrence of psoriatic manifestations, and emerging risk factors (eg, biological drugs, immunotherapy for oncologic disease, Covid-19, and vaccines) defined as those newly identified risk factors. Accurate patient information and monitoring of risk factors as well as planned follow-ups may help to prevent and treat the worsening of psoriasis and consequently improve the quality of life of psoriatic patients.

银屑病是一种慢性皮肤炎症性疾病,其发病机制涉及遗传和环境因素以及先天和后天免疫反应等多因素。一些诱发因素可能会加重或恶化疾病。在此背景下,我们撰写了一篇综述性文章,旨在研究当前有关银屑病风险因素的文献,并说明这些因素对银屑病的可能作用机制。在全球范围内,风险因素可分为传统的风险因素(如机械性压力、皮肤感染和菌群失调、常见药物、环境和污染、生活方式、心理压力、激素和新陈代谢改变)和新出现的风险因素(如生物药物、肿瘤疾病免疫疗法、Covid-19 和疫苗),前者长期以来一直被认为是导致银屑病症状恶化和/或复发的原因,后者则被定义为新发现的风险因素。准确的患者信息、对风险因素的监测以及有计划的随访有助于预防和治疗银屑病的恶化,从而提高银屑病患者的生活质量。
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引用次数: 0
Perception and Impact of COVID-19 Pandemic in Psoriasis Patients: Data from the German PsoBest and the CoronaBest Registries. 银屑病患者对 COVID-19 大流行的认知和影响:来自德国 PsoBest 和 CoronaBest 登记处的数据。
Pub Date : 2024-05-14 eCollection Date: 2024-01-01 DOI: 10.2147/PTT.S451666
María José Valencia López, Brigitte Stephan, Anna Meineke, Sandra Wolf, Diamant Thaci, Ulrich Mrowietz, Valerie Andrees, Stephan Jeff Rustenbach, Kristian Reich, Linus Thalmann, Henriette Bogena, Petra Staubach, Ralph Michael von Kiedrowski, Matthias Augustin

Background: Limited data are available characterizing the impact of the SARS-CoV-2 pandemic on psoriasis care for patients in Germany.

Objective: To analyze patient perception and impact of the pandemic on well-being and psoriasis management of German patients with moderate-to-severe psoriasis or psoriasis arthritis under systemic therapies.

Methods: The CoronaBest registry captures events of SARS-CoV-2 infections and analyzes the impact of the pandemic on patients with psoriasis or psoriasis arthritis. In June 2020, and independently in February 2022, patients with psoriasis or psoriasis arthritis received a standardized questionnaire for current treatment, protective measures, well-being, and individual risks for COVID-19, among others.

Results: Included were 4,194 patients in 2020 (mean age of 47.7 years and 41.8% women) and 4,818 patients in 2022 (mean age of 56.4 and 42.9% women). Treatment discontinuations were observed in 2.7% and 1.7% of patients in 2020 and 2022, respectively. In the vast majority of the cases (>92%), no additional measures were taken concerning the management of psoriasis treatments in either 2020 or 2022. Those patients with changes reported most frequently: telephone calls instead of face-to-face visits (80.2%, in 2020 vs 40.5% in 2022) or more frequent controls (27.1%, 2020 vs 22.0%, 2022). A majority (66.7%, 2020, and 70.6%, 2022) did not perceive the virus as a considerable threat. The proportion of patients feeling well informed about COVID-19 by physicians increased from 42.6% in 2020 to 51.8% in 2022. About 81.1% of patients in 2020 and 67.5% in 2022 stated that their overall personal condition was not affected due to the pandemic. Physicians attributed no special risk of contracting SARS-CoV-2 in most of the patients.

Conclusion: A high rate of systemic treatment persistence and awareness of risks and protective measures indicate that health care for psoriasis largely followed current national and international recommendations during the COVID-19 pandemic.

背景:关于 SARS-CoV-2 大流行对德国银屑病患者护理影响的数据有限:关于SARS-CoV-2大流行对德国银屑病患者护理的影响的数据有限:目的:分析德国中重度银屑病患者或接受系统治疗的关节病型银屑病患者对这一流行病的看法及其对生活和银屑病治疗的影响:方法:CoronaBest 登记系统记录了 SARS-CoV-2 感染事件,并分析了大流行对银屑病或银屑病关节炎患者的影响。2020 年 6 月以及 2022 年 2 月,银屑病或银屑病关节炎患者接受了一份标准化问卷,内容包括当前治疗、保护措施、幸福感以及 COVID-19 的个人风险等:2020 年纳入 4194 名患者(平均年龄 47.7 岁,女性占 41.8%),2022 年纳入 4818 名患者(平均年龄 56.4 岁,女性占 42.9%)。2020 年和 2022 年分别有 2.7% 和 1.7% 的患者中断治疗。绝大多数病例(超过 92%)在 2020 年和 2022 年都没有采取额外的银屑病治疗管理措施。有变化的患者最常报告的是:用电话代替面诊(2020 年为 80.2%,2022 年为 40.5%)或更频繁的控制(2020 年为 27.1%,2022 年为 22.0%)。大多数患者(2020 年为 66.7%,2022 年为 70.6%)认为病毒并不构成严重威胁。认为医生对 COVID-19 非常了解的患者比例从 2020 年的 42.6% 上升到 2022 年的 51.8%。2020 年约有 81.1%的患者和 2022 年约有 67.5%的患者表示,他们的整体个人状况没有受到大流行病的影响。医生认为大多数患者没有感染 SARS-CoV-2 的特殊风险:结论:系统治疗的高坚持率以及对风险和保护措施的认识表明,在COVID-19大流行期间,银屑病的医疗保健在很大程度上遵循了当前的国家和国际建议。
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引用次数: 0
Therapeutic Potential of Spesolimab-Sbzo in the Management of Generalized Pustular Psoriasis Flares in Adults: Evidence to Date. Spesolimab-Sbzo治疗成人泛发性脓疱型银屑病的潜力:迄今为止的证据
Pub Date : 2024-03-15 eCollection Date: 2024-01-01 DOI: 10.2147/PTT.S393978
Federica Rega, Federica Trovato, Giulio Bortone, Giovanni Pellacani, Antonio Giovanni Richetta, Annunziata Dattola

Generalized pustular psoriasis (GPP) is a rare, chronic, and severe skin disorder characterized by the eruption of non-infectious pustules on an erythematous background often associated with systemic symptoms. It may appear in association with plaque psoriasis or occur in previously healthy individuals. It differs from psoriasis vulgaris in clinical presentation, immunopathogenesis, histology, and therapeutic strategies. Overexpression of interleukin 36 (IL-36) or a loss-of-function mutation of IL-36 receptor antagonist (IL-36RA) are thought to play a pivotal role in the pathogenesis of this disease. There are currently no globally approved guidelines for the treatment of GPP, and the therapies used so far, with variable results, have given unsatisfactory results. Spesolimab, a selective humanized antibody against the IL-36 receptor that blocks its activation, is the first biologic drug approved in Europe in December 2022 for the treatment of GPP flares. It represents a promising therapy, demonstrating efficacy in reducing disease severity and improving patient outcomes. In our review, we have analyzed the latest advancements and findings regarding the efficacy and safety of spesolimab in the context of GPP management.

泛发性脓疱型银屑病(GPP)是一种罕见的慢性严重皮肤病,其特征是在红斑背景上爆发非感染性脓疱,通常伴有全身症状。它可能与斑块状银屑病同时出现,也可能发生在以前健康的人身上。它与寻常型银屑病在临床表现、免疫发病机制、组织学和治疗策略上都有所不同。白细胞介素 36(IL-36)的过度表达或 IL-36 受体拮抗剂(IL-36RA)的功能缺失突变被认为在该病的发病机制中起着关键作用。目前,全球尚无批准用于治疗 GPP 的指南,而且迄今为止使用的治疗方法效果不一,结果也不尽人意。Spesolimab是一种针对IL-36受体的选择性人源化抗体,可阻断IL-36受体的激活,是欧洲于2022年12月批准用于治疗GPP复发的第一种生物药物。它是一种前景广阔的疗法,在降低疾病严重程度和改善患者预后方面具有显著疗效。在我们的综述中,我们分析了有关斯派索利单抗在 GPP 治疗方面的疗效和安全性的最新进展和发现。
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引用次数: 0
Experiences of Dermatologists and Patients Regarding Psoriasis and Its Connection to Psoriatic Arthritis in Saudi Arabia. 沙特阿拉伯皮肤科医生和患者对银屑病及其与银屑病关节炎的关系的经验。
IF 5.2 Q1 DERMATOLOGY Pub Date : 2024-01-18 eCollection Date: 2024-01-01 DOI: 10.2147/PTT.S427775
Mohammad I Fatani, Ibrahim Al-Homood, Mohamed Bedaiwi, Sahar Al Natour, Alper Erdogan, Aya Alsharafi, Suzan M Attar

Purpose: Psoriasis is a chronic, inflammatory, immune-mediated skin disease that has significant impact on a patient's quality of life, yet it remains challenging for dermatologists to successfully identify and manage. Without effective screening, diagnosis and treatments, psoriasis can potentially progress to psoriatic arthritis. A descriptive, observational cross-sectional study of Saudi Arabian dermatologists and patients with psoriasis was conducted to explore dermatologist and patient perspectives of psoriasis, including diagnosis, management, disease course and unmet needs.

Patients and methods: This study involved a quantitative questionnaire administered to 31 dermatologists and 90 patients with psoriasis at eight medical centers and was analyzed using descriptive statistics.

Results: Dermatologists and patients perceived that psoriasis treatment was initiated promptly and that follow-up visits were sufficient. Their perspectives differed in the time to diagnosis and patient reaction, symptom severity, input into treatment goals and educational needs. The dermatologists' concerns about underdiagnosed psoriasis (13%) were primarily related to patient awareness (87%), physician awareness (58%), and the absence of a regular screening program (52%). Only 31% of patients with psoriasis were highly satisfied with their psoriasis treatment, with 78% experiencing unpleasant symptoms of pain or swelling in joints indicative of psoriatic arthritis. However, only 56% of these patients reported these symptoms to their physicians. When dermatologists were made aware of this difference, referrals to a rheumatologist increased.

Conclusion: The study highlights the importance of strengthening psoriasis management by enhancing dermatologist referral and screening practices, adopting a multidisciplinary approach to care, and improving education and resources for physicians and patients. These results can help to inform the improvement of psoriasis screening, diagnosis and treatment strategies and ensure that expectations meet treatment outcomes. Further research exploring the dermatologist and patient perspectives of the disease pathway from psoriasis to psoriatic arthritis and tailor-made treatment approaches is recommended.

目的:银屑病是一种慢性、炎症性、免疫介导的皮肤病,对患者的生活质量有很大影响,但对于皮肤科医生来说,成功识别和治疗银屑病仍是一项挑战。如果没有有效的筛查、诊断和治疗,银屑病有可能发展为银屑病关节炎。我们对沙特阿拉伯的皮肤科医生和银屑病患者进行了一项描述性、观察性横断面研究,以探讨皮肤科医生和患者对银屑病的看法,包括诊断、管理、病程和未满足的需求:这项研究对八个医疗中心的 31 名皮肤科医生和 90 名银屑病患者进行了定量问卷调查,并采用描述性统计方法进行了分析:结果:皮肤科医生和患者都认为银屑病治疗启动及时,随访充分。他们对诊断时间、患者反应、症状严重程度、治疗目标和教育需求的看法各不相同。皮肤科医生对银屑病诊断不足(13%)的担忧主要与患者意识(87%)、医生意识(58%)和缺乏定期筛查计划(52%)有关。只有 31% 的银屑病患者对其银屑病治疗非常满意,78% 的患者出现关节疼痛或肿胀等不愉快症状,这表明银屑病关节炎。然而,只有 56% 的患者向医生报告了这些症状。当皮肤科医生意识到这一差异后,转诊给风湿免疫科医生的患者有所增加:这项研究强调了通过加强皮肤科医生的转诊和筛查工作、采用多学科护理方法以及改善医生和患者的教育和资源来加强银屑病管理的重要性。这些结果有助于改进银屑病筛查、诊断和治疗策略,确保达到预期的治疗效果。建议进一步开展研究,从皮肤科医生和患者的角度探讨从银屑病到银屑病关节炎的疾病路径以及量身定制的治疗方法。
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引用次数: 0
The Effects of Cardiometabolic Comorbidities on Biologic Treatment for Psoriasis with Respect to PASI Scores: A Qualitative Systematic Review. 心脏代谢合并症对银屑病生物治疗 PASI 评分的影响:定性系统综述
Pub Date : 2024-01-10 eCollection Date: 2024-01-01 DOI: 10.2147/PTT.S441642
Alim Osman, Alexandra Nigro, Amanda Chen Taylor, Ryan Saal, Ana Ormaza Vera, Clinton Enos

Objective: Cardiometabolic risk factors have been shown to decrease biologic efficacy in patients treated for inflammatory conditions. The purpose of this systematic review is to provide a qualitative evaluation of studies investigating biologic response among psoriasis patients with cardiometabolic comorbidities.

Methods: A comprehensive review was conducted according to the Preferred Reporting Guidelines for Systematic Reviews and Meta-Analysis guidelines to screen for studies including patients with cardiometabolic risk factors receiving biologic therapy for psoriasis. Studies not including a Psoriasis Area and Severity Index (PASI) score to evaluate treatment outcomes were not included. All studies underwent quality/bias analysis using the Methodological Index for Non-Randomized Studies (MINORS) scale.

Results: Obesity and Body Mass Index (BMI) were the most studied cardiometabolic risk factors. The majority of the studies reported a lower frequency of achieving PASI75 and PASI90 response with increasing BMI/obesity rates. Diabetes and hypertension showed similar findings but were not studied as frequently. Hyperlipidemia and other lipid disorders were less frequently studied.

Conclusion: Relationships between cardiometabolic risk factors and lower frequencies of achieving PASI75/90 exist in current literature. This qualitative systematic review reports evidence of lower PASI75 and PASI90 response rates in the presence of cardiometabolic risk factors.

目的:研究表明,心脏代谢风险因素会降低炎症患者的生物疗效。本系统综述的目的是对有心脏代谢合并症的银屑病患者的生物反应研究进行定性评估:方法:根据《系统综述和荟萃分析首选报告指南》(Preferred Reporting Guidelines for Systematic Reviews and Meta-Analysis)进行全面综述,筛选出包括具有心脏代谢风险因素的银屑病患者接受生物制剂治疗的研究。未采用银屑病面积和严重程度指数(PASI)评分来评估治疗效果的研究未被纳入。所有研究均采用非随机研究方法指数(MINORS)量表进行了质量/偏倚分析:结果:肥胖和体重指数(BMI)是研究最多的心脏代谢风险因素。大多数研究报告称,随着体重指数/肥胖率的增加,达到 PASI75 和 PASI90 反应的频率降低。糖尿病和高血压也有类似的研究结果,但研究频率较低。对高脂血症和其他血脂紊乱的研究较少:结论:在目前的文献中,心脏代谢风险因素与较低的 PASI75/90 达标率之间存在关系。这篇定性系统综述报告了存在心脏代谢风险因素时 PASI75 和 PASI90 达标率较低的证据。
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引用次数: 0
The Skin Microbiome and Its Role in Psoriasis: A Review. 皮肤微生物组及其在银屑病中的作用:综述。
IF 5.2 Q1 DERMATOLOGY Pub Date : 2023-10-26 eCollection Date: 2023-01-01 DOI: 10.2147/PTT.S328439
Valentina Celoria, Francois Rosset, Valentina Pala, Paolo Dapavo, Simone Ribero, Pietro Quaglino, Luca Mastorino

The skin microbiome is made of various microorganisms, most of which have the function of protecting individuals from harmful pathogens, and they are involved in innate and adaptive immune responses. The skin acts as a physical and immunological barrier against external stimuli, including pathogens and physical damage. Changes in the composition of the skin microbiome can trigger inflammatory processes leading to inflammatory skin diseases in susceptible individuals. Psoriasis (PsO) is a chronic inflammatory disease with a multifactorial etiology, where breakdown of immune tolerance to cutaneous microorganisms is implicated in its pathogenesis. Dysregulation of the microbiome due to genetic and environmental factors plays a significant role in the development of psoriatic disease. Dermatologic conditions such as atopic dermatitis, acne, psoriasis, and rosacea have been associated with intestinal dysbiosis. The skin microbiota composition is crucial for the development of appropriate immune responses, and alterations in the skin microbiome can contribute to changes in physiology and susceptibility to skin diseases or inflammatory conditions. Understanding the microbial settlement of the skin and the network of interactions that occur throughout life is essential for comprehending the pathogenesis of skin diseases and developing innovative treatments. With this article we tried to explore the relationship between the human microbiome and psoriatic disease, shedding light on the functions of the microbiome and the inflammatory disease processes to identify additional therapeutic targets. This review aims to highlight the relationship between skin and gut microbiome functions and inflammatory processes in skin psoriasis and psoriatic arthritis (PsA). The goal is to facilitate future studies on the skin microbiome to identify potential novel therapies for patients with psoriatic disease.

皮肤微生物组由各种微生物组成,其中大多数具有保护个人免受有害病原体侵害的功能,它们参与先天和适应性免疫反应。皮肤是抵御外部刺激的物理和免疫屏障,包括病原体和物理损伤。皮肤微生物组组成的变化会引发炎症过程,导致易感个体的炎症性皮肤病。银屑病(PsO)是一种多因素病因的慢性炎症性疾病,其发病机制与对皮肤微生物免疫耐受的破坏有关。遗传和环境因素导致的微生物组失调在银屑病的发展中起着重要作用。过敏性皮炎、痤疮、牛皮癣和酒渣鼻等皮肤病与肠道生态失调有关。皮肤微生物群的组成对于产生适当的免疫反应至关重要,皮肤微生物组的改变可能会导致生理学的变化以及对皮肤疾病或炎症条件的易感性。了解皮肤的微生物定居和一生中发生的相互作用网络,对于理解皮肤病的发病机制和开发创新的治疗方法至关重要。通过这篇文章,我们试图探索人类微生物组与银屑病之间的关系,揭示微生物组的功能和炎症性疾病过程,以确定其他治疗靶点。这篇综述旨在强调皮肤银屑病和银屑病关节炎(PsA)中皮肤和肠道微生物组功能与炎症过程之间的关系。目标是促进未来对皮肤微生物组的研究,以确定银屑病患者的潜在新疗法。
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引用次数: 0
Management of Plaque Psoriasis in Adults: Clinical Utility of Tapinarof Cream. 成人斑块型银屑病的治疗:Tapinarof乳膏的临床应用。
Pub Date : 2023-10-25 eCollection Date: 2023-01-01 DOI: 10.2147/PTT.S393997
Riley K Spencer, Joy Q Jin, Kareem G Elhage, Mitchell S Davis, Wilson Liao, Tina Bhutani

Topical medications represent the most commonly used drugs in the treatment of psoriasis. However, topical steroids are mainly limited to short-term or intermittent use, and traditional non-steroidal topicals such as vitamin D analogues, topical calcineurin inhibitors, and topical retinoids are limited by low efficacy and poor local skin tolerability. Tapinarof (GSK2894512, DMVT-505) is a novel, topical aryl hydrocarbon receptor (AHR) agonist, which was recently approved by the FDA for the treatment of plaque psoriasis in adults. Tapinarof acts to improve psoriasis through diminished IL-17A production by CD4+ T cells, increased barrier gene expression in keratinocytes, and reduced production of reactive oxygen species. Both short-term and long-term efficacy and safety have been evaluated in two Phase II and two Phase III (PSOARING 1 and 2) clinical trials in addition to a long-term extension study (PSOARING 3). Overall, the drug has shown beneficial effects in achieving clear skin in adults with moderate-to-severe psoriasis, good local tolerability, and also a long duration of effect even after discontinuation of the drug. Therefore, this therapy provides a new, highly effective and safe non-steroidal option to add to our psoriasis treatment toolbox for both initial clearance and long-term maintenance of disease.

局部用药是治疗银屑病最常用的药物。然而,局部类固醇主要限于短期或间歇性使用,传统的非甾体局部药物,如维生素D类似物、局部钙调神经磷酸酶抑制剂和局部类视黄醇,因疗效低和局部皮肤耐受性差而受到限制。Tapinaraf(GSK2894512,DMVT-505)是一种新型的局部芳香烃受体(AHR)激动剂,最近被美国食品药品监督管理局批准用于治疗成人斑块型银屑病。Tapinaraf通过减少CD4+T细胞产生IL-17A、增加角质形成细胞中屏障基因表达和减少活性氧的产生来改善银屑病。除了一项长期扩展研究(PSOARING 3)外,还在两项II期和两项III期(PSOARING 1和2)临床试验中评估了短期和长期疗效和安全性。总的来说,该药物在中度至重度银屑病患者中显示出良好的皮肤清洁效果、良好的局部耐受性,甚至在停药后也能持续很长时间。因此,这种疗法提供了一种新的、高效且安全的非甾体药物选择,可添加到我们的银屑病治疗工具箱中,用于疾病的初步清除和长期维持。
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引用次数: 0
Palmoplantar Pustulosis: A Systematic Review of Risk Factors and Therapies. 掌跖Pustulosis:危险因素和治疗的系统综述。
Pub Date : 2023-09-22 eCollection Date: 2023-01-01 DOI: 10.2147/PTT.S400402
Kristine Heidemeyer, Marco May Lee, Simone Cazzaniga, Nikhil Yawalkar, Luigi Naldi

Palmoplantar pustulosis (PPP) is a chronic, relapsing, inflammatory disease that can occur alone or in association with arthritis. There is still controversy about whether it should be separated from psoriasis or classified as pustular psoriasis. Furthermore, drug-induced paradoxical PPP is a special variant of PPP that differs from classic PPP in several ways. Treatment of PPP is still challenging, and there are a number of treatment-resistant cases. This review summarizes the risk factors for the development of PPP and the currently available treatment modalities. Female sex, smokers or ex-smokers, obesity, thyroid dysfunction, and treatment with a tumor necrosis factor (TNF)-α inhibitor have been identified as risk factors for the disease's development, severity, and course. Topical treatments and phototherapy are effective for some patients and are used as a first-line or adjuvant treatment modality. Conventional treatments including retinoids and fumaric acid show good effects and can increase the efficacy of treatment with psoralen + ultraviolet light therapy (PUVA). Ciclosporin is fast acting, but relapse mostly occurs immediately after cessation. TNF-α inhibitors are efficient, and an even better response can be achieved with IL-17 and IL-23 blockers as well as apremilast. The effect of Janus kinase inhibitors seems to be promising according to case reports, but further investigations with larger cohorts are needed.

掌跖脓疱病(PPP)是一种慢性、复发性炎症性疾病,可单独发生或与关节炎相关。是否应将其与银屑病分离或归类为脓疱性银屑病仍存在争议。此外,药物诱导的矛盾PPP是PPP的一种特殊变体,在几个方面与经典PPP不同。PPP的治疗仍然具有挑战性,并且存在许多耐药病例。这篇综述总结了PPP发展的风险因素和目前可用的治疗模式。女性、吸烟者或戒烟者、肥胖、甲状腺功能障碍和肿瘤坏死因子(TNF)-α抑制剂的治疗已被确定为疾病发展、严重程度和病程的风险因素。局部治疗和光疗对一些患者有效,并被用作一线或辅助治疗模式。包括类视黄醇和富马酸在内的常规治疗显示出良好的效果,并且可以提高补骨脂素+紫外线治疗(PUVA)的疗效。环孢素起效快,但复发大多发生在停药后。TNF-α抑制剂是有效的,使用IL-17和IL-23阻断剂以及阿普司特可以获得更好的反应。根据病例报告,Janus激酶抑制剂的效果似乎很有希望,但还需要对更大的队列进行进一步研究。
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引用次数: 1
Analysis of Drug Utilization in Patients with Psoriasis: A Real-World Retrospective Study Among the Italian Population. 银屑病患者药物使用分析:意大利人群的真实世界回顾性研究。
Pub Date : 2023-01-01 DOI: 10.2147/PTT.S396003
Valentina Perrone, Serena Losi, Silvia Sabatino, Maurizio Mezzetti, Melania Dovizio, Diego Sangiorgi, Luca Degli Esposti

Purpose: An Italian real-world retrospective study was conducted in patients with psoriasis (PSO) to evaluate their characteristics, treatment patterns, and biological/targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD) drug utilization.

Patients and methods: The retrospective analysis was carried out on real-world data collected from administrative databases of selected Italian health-departments; the dataset covered approximately 22% of the Italian population. PSO patients (identified by PSO hospitalization, and/or active exemption code and/or a topical anti-psoriatic medication prescription) were included. In prevalent patients identified during 2017-2018-2019-2020, baseline characteristics and treatment patterns were investigated. Moreover, b/tsDMARD drug utilization (focusing on persistence, monthly dosage, and mean duration between prescriptions) was evaluated in bionaïve patients included during 2015 and 2018.

Results: PSO was diagnosed in 241,552 (in 2017), 269,856 (in 2018), 293,905 (in 2019) and 301,639 (in 2020) patients. At the index date, almost 50% of patients had not received systemic medications, and 2% had received biological treatment. Among the b/tsDMARD-treated patients, a decrease in the use of tumour necrosis factor (TNF) inhibitors (60.0-36.4%, from 2017 to 2020) and an increase in the use of interleukin (IL) inhibitors (36.3-50.6%, from 2017 to 2020) were observed. In 2018, the persistence rates of TNF inhibitors and IL inhibitors in bionaïve patients ranged from 60.8-79.7% and 83.3-87.9%, respectively.

Conclusion: This real-world study of PSO drug utilization in Italy showed that a significant number of patients were not treated with systemic medications and only 2% of patients were treated with biologics. An increase in the use of IL inhibitors and a decrease in the prescription of TNF inhibitors over years were found. Patients treated with biologics were highly persistent with treatment. These data provide insight into routine clinical practice for PSO patients in Italy, suggesting that the optimization of treatment for PSO still represents an unmet medical need.

目的:意大利对银屑病(PSO)患者进行了一项现实世界回顾性研究,以评估其特征、治疗模式和生物/靶向合成疾病缓解抗风湿药物(b/tsDMARD)的药物使用情况。患者和方法:回顾性分析从选定的意大利卫生部门的行政数据库收集的真实数据;该数据集覆盖了大约22%的意大利人口。包括PSO患者(通过PSO住院,和/或有效豁免代码和/或局部抗银屑病药物处方来确定)。在2017-2018-2019-2020年期间确定的流行患者中,调查基线特征和治疗模式。此外,还评估了2015年至2018年bionaïve患者的b/tsDMARD药物利用情况(重点是持续时间、月剂量和处方间的平均持续时间)。结果:PSO确诊患者分别为241,552例(2017年)、269,856例(2018年)、293,905例(2019年)和301,639例(2020年)。在索引日期,近50%的患者未接受全身药物治疗,2%的患者接受了生物治疗。在b/ tsdmard治疗的患者中,肿瘤坏死因子(TNF)抑制剂的使用减少(从2017年到2020年,60.0-36.4%),白细胞介素(IL)抑制剂的使用增加(从2017年到2020年,36.3-50.6%)。2018年,bionaïve患者中TNF抑制剂和IL抑制剂的持续率分别为60.8-79.7%和83.3-87.9%。结论:意大利PSO药物利用的真实世界研究表明,大量患者没有接受全身药物治疗,只有2%的患者接受了生物制剂治疗。发现多年来IL抑制剂的使用增加,TNF抑制剂的处方减少。接受生物制剂治疗的患者高度坚持治疗。这些数据为意大利PSO患者的常规临床实践提供了见解,表明PSO治疗的优化仍然代表着未满足的医疗需求。
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引用次数: 1
Safety and Efficacy of Covid-19 Vaccination in Patients Undergoing Biological Treatments for Psoriasis. 银屑病生物治疗患者新冠肺炎疫苗接种的安全性和有效性。
Pub Date : 2023-01-01 DOI: 10.2147/PTT.S398135
Luca Potestio, Fabrizio Martora, Gabriella Fabbrocini, Teresa Battista, Matteo Megna

The introduction of biologic drugs revolutionized the treatment of psoriasis, shifting treatment goals to higher treatment outcomes and less frequent safety issues. The outbreak of Coronavirus disease 2019 (COVID-19) represented a worldwide challenge, strongly affecting lifestyle, global economy, and overall health. Among the strategies adopted to contain the spreading of the infection, vaccination is the main one. In this context, the introduction of COVID-19 vaccines raised several doubts about their effectiveness and safety in patients undergoing therapy with biological for psoriasis. Even if molecular and cellular mechanisms by which COVID-19 vaccines lead to psoriasis development have not yet been fully elucidated, vaccination itself can trigger the release of interleukin (IL)-6, interferon (IFN) and tumor necrosis factor (TNF) α by T-helper (Th)1/Th17 cells. All these cytokines are involved in psoriasis pathogenesis. Thus, the aim of this manuscript is to review current literature on the safety and effectiveness of COVID-19 vaccination in psoriasis patients undergoing treatment with biologics, in order to clarify any concerns.

生物药物的引入彻底改变了牛皮癣的治疗,将治疗目标转向更高的治疗效果和更少的安全问题。2019冠状病毒病(COVID-19)的爆发是一项全球性挑战,严重影响了生活方式、全球经济和整体健康。在控制感染蔓延所采取的战略中,接种疫苗是主要的一项。在这种背景下,COVID-19疫苗的引入引发了对其在接受银屑病生物治疗的患者中的有效性和安全性的质疑。即使COVID-19疫苗导致银屑病发展的分子和细胞机制尚未完全阐明,疫苗接种本身也可以触发t辅助(Th)1/Th17细胞释放白细胞介素(IL)-6、干扰素(IFN)和肿瘤坏死因子(TNF) α。这些细胞因子均参与银屑病的发病过程。因此,这篇文章的目的是回顾目前关于在接受生物制剂治疗的银屑病患者中接种COVID-19疫苗的安全性和有效性的文献,以澄清任何担忧。
{"title":"Safety and Efficacy of Covid-19 Vaccination in Patients Undergoing Biological Treatments for Psoriasis.","authors":"Luca Potestio,&nbsp;Fabrizio Martora,&nbsp;Gabriella Fabbrocini,&nbsp;Teresa Battista,&nbsp;Matteo Megna","doi":"10.2147/PTT.S398135","DOIUrl":"https://doi.org/10.2147/PTT.S398135","url":null,"abstract":"<p><p>The introduction of biologic drugs revolutionized the treatment of psoriasis, shifting treatment goals to higher treatment outcomes and less frequent safety issues. The outbreak of Coronavirus disease 2019 (COVID-19) represented a worldwide challenge, strongly affecting lifestyle, global economy, and overall health. Among the strategies adopted to contain the spreading of the infection, vaccination is the main one. In this context, the introduction of COVID-19 vaccines raised several doubts about their effectiveness and safety in patients undergoing therapy with biological for psoriasis. Even if molecular and cellular mechanisms by which COVID-19 vaccines lead to psoriasis development have not yet been fully elucidated, vaccination itself can trigger the release of interleukin (IL)-6, interferon (IFN) and tumor necrosis factor (TNF) α by T-helper (Th)1/Th17 cells. All these cytokines are involved in psoriasis pathogenesis. Thus, the aim of this manuscript is to review current literature on the safety and effectiveness of COVID-19 vaccination in psoriasis patients undergoing treatment with biologics, in order to clarify any concerns.</p>","PeriodicalId":74589,"journal":{"name":"Psoriasis (Auckland, N.Z.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f6/46/ptt-13-11.PMC10106810.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9441231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
期刊
Psoriasis (Auckland, N.Z.)
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