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Effectiveness and Drug Survival of Ixekizumab and Secukinumab in Patients with Moderate to Severe Plaque Psoriasis: Real-World Data from Bucharest, Romania. Ixekizumab 和 Secukinumab 对中重度斑块状银屑病患者的疗效和药物存活率:来自罗马尼亚布加勒斯特的真实世界数据。
IF 5.2 Q1 DERMATOLOGY Pub Date : 2024-06-25 eCollection Date: 2024-01-01 DOI: 10.2147/PTT.S456393
Stefana Bucur, Elena-Daniela Serban, Bogdan Vasile Ileanu, Raluca Simona Costache, Alin Codrut Nicolescu, Traian Constantin, Daniel Octavian Costache, Maria-Magdalena Constantin

Purpose: Multiple biological therapies have been developed for the treatment of inflammatory diseases, including moderate to severe plaque psoriasis. Choosing the optimal treatment for psoriasis can depend on several factors and is strongly influenced by a drug's efficacy and safety profile. Continuous treatment with biological therapies is recommended to achieve effective disease management in patients with psoriasis. However, in real-world, patients often discontinue biologic therapy within the first year of treatment. Therefore, in this study, we aimed to investigate the effectiveness and drug survival of two anti-interleukin 17 agents (ixekizumab and secukinumab) in a group of adult patients with moderate to severe psoriasis from Bucharest, Romania.

Patients and methods: We designed an observational, non-interventional, retrospective study of 255 adult patients with moderate to severe psoriasis receiving ixekizumab and secukinumab. We performed descriptive statistics and inferential methods, such as z-test, median test and Kaplan Meier curve comparison, to characterize the groups with two biological treatments.

Results: Patients treated with ixekizumab had a longer drug survival compared to those treated with secukinumab with lower risks of non-persistence, discontinuation and switching therapy. Patients age-groups and psoriasis durations found to be significant factors in drug survival.

Conclusion: This study contributes to the understanding of the drug survival profile and the factors that may influence it in ixekizumab and secukinumab treatment in a real-world setting.

目的:目前已开发出多种生物疗法用于治疗炎症性疾病,包括中度至重度斑块状银屑病。选择银屑病的最佳治疗方法取决于多种因素,并受到药物疗效和安全性的强烈影响。为了有效控制银屑病患者的病情,建议持续使用生物疗法。然而,在现实世界中,患者往往会在治疗的第一年内中断生物疗法。因此,在这项研究中,我们旨在调查两种抗白细胞介素 17 药物(ixekizumab 和 secukinumab)在罗马尼亚布加勒斯特一组中重度银屑病成年患者中的疗效和药物存活率:我们设计了一项观察性、非干预性、回顾性研究,研究对象是 255 名接受 ixekizumab 和 secukinumab 治疗的中重度银屑病成年患者。我们采用了描述性统计和推理方法,如z检验、中位数检验和卡普兰-梅尔曲线比较,来描述接受两种生物治疗的群体的特征:结果:与使用secukinumab治疗的患者相比,使用ixekizumab治疗的患者的药物存活期更长,不持续、中断和转换疗法的风险更低。患者年龄组和银屑病病程是影响药物存活率的重要因素:这项研究有助于了解在真实世界环境中,ixekizumab和secukinumab治疗的药物存活情况以及可能影响药物存活的因素。
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引用次数: 0
Burden of Herpes Zoster Among Patients with Psoriatic Arthritis in the United States. 美国银屑病关节炎患者的带状疱疹负担。
IF 5.2 Q1 DERMATOLOGY Pub Date : 2024-06-22 eCollection Date: 2024-01-01 DOI: 10.2147/PTT.S430151
David Singer, Philippe Thompson-Leduc, Siyu Ma, Deepshekhar Gupta, Wendy Y Cheng, Selvam R Sendhil, Manasvi Sundar, Ella Hagopian, Nikita Stempniewicz, Mei Sheng Duh, Sara Poston

Purpose: Patients with psoriasis (PsO) and psoriatic arthritis (PsA) are at increased risk of herpes zoster (HZ), but healthcare resource use (HRU) and costs relating to HZ in adults with PsA are unknown. We aimed to estimate the incidence of HZ among adults with PsA vs without psoriatic disease and the additional HRU and costs among patients with PsA with vs without HZ.

Patients and methods: This retrospective, longitudinal, cohort study estimated HZ incidence in PsA+ vs PsO-/PsA- cohorts and HRU and medical/pharmacy costs among PsA+/HZ+ vs PsA+/HZ- cohorts comprised of adults from Optum's de-identified Clinformatics Data Mart Database during 2015-2020. For the HRU/cost analyses, index was the date of first HZ diagnosis (PsA+/HZ+ cohort) or was randomly assigned (PsA+/HZ- cohort). Generalized linear models were used for adjusted comparisons between cohorts.

Results: HZ incidence was higher in the PsA+ (n = 57,126) vs PsO-/PsA- (n = 23,837,237) cohort (14.85 vs 7.67 per 1000 person-years; adjusted incidence rate ratio [aIRR]: 1.23; 95% confidence interval [CI]: 1.16-1.30). Numbers of outpatient visits, emergency department visits, and inpatient admissions were significantly higher in the PsA+/HZ+ (n = 1045) vs PsA+/HZ- (n = 36,091) cohorts during the first month after HZ diagnosis (outpatient: aIRR: 1.74; 95% CI: 1.63-1.86; emergency department: 3.14; 95% CI: 2.46-4.02; inpatient: aIRR: 2.61; 95% CI: 1.89-3.61). Mean all-cause per-patient costs were significantly higher in the PsA+/HZ+ vs PsA+/HZ- cohorts during the first month after index ($6493 vs $4521; adjusted cost difference: $2012; 95% CI: $1204-$3007). HRU and costs were numerically higher in the PsA+/HZ+ cohort during the first 3 and 12 months.

Conclusion: These findings, which provide evidence on the increased incidence and HRU and economic burden associated with HZ among adults with PsA, could be used to inform clinical practice and decision-making.

目的:银屑病(PsO)和银屑病关节炎(PsA)患者罹患带状疱疹(HZ)的风险增加,但成人 PsA 患者与 HZ 相关的医疗资源使用(HRU)和成本尚不清楚。我们的目的是估算成人 PsA 患者与未患银屑病的患者的 HZ 发病率,以及有 HZ 的 PsA 患者与无 HZ 的 PsA 患者的额外医疗资源使用量和成本:这项回顾性纵向队列研究估计了 2015-2020 年期间 PsA+ vs PsO-/PsA- 队列中 HZ 的发病率,以及 PsA+/HZ+ vs PsA+/HZ- 队列中的 HRU 和医疗/药费,这些队列由 Optum 的去标识化临床信息学数据集市数据库中的成人组成。在 HRU/成本分析中,指数为首次 HZ 诊断日期(PsA+/HZ+ 队列)或随机分配日期(PsA+/HZ- 队列)。调整后的队列间比较采用广义线性模型:结果:PsA+队列(n = 57,126)与PsO-/PsA-队列(n = 23,837,237)相比,HZ发病率更高(每千人年14.85 vs 7.67;调整后发病率比[aIRR]:1.23;95% 置信区间 [CI]:1.16-1.30):1.16-1.30).在确诊 HZ 后的第一个月中,PsA+/HZ+ 组群(n = 1045)与 PsA+/HZ-组群(n = 36091)的门诊就诊人数、急诊就诊人数和住院人数均显著高于 PsA+/HZ-组群(门诊:aIRR:1.74;95% CI:1.63-1.86;急诊:3.14;95% CI:3.14):3.14;95% CI:2.46-4.02;住院病人:aIRR:2.61;95% CI:1.89-3.61)。PsA+/HZ+队列与PsA+/HZ-队列相比,发病后第一个月的平均全因患者人均成本明显更高(6493美元 vs 4521美元;调整后成本差异:2012美元;95% CI:1204-3007美元)。PsA+/HZ+队列在头3个月和12个月的HRU和费用在数字上更高:这些研究结果为成人 PsA 患者中 HZ 发病率、HRU 和经济负担的增加提供了证据,可为临床实践和决策提供参考。
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引用次数: 0
The Perspective of Cannabidiol in Psoriasis Therapy. 大麻二酚在牛皮癣治疗中的应用前景。
IF 5.2 Q1 DERMATOLOGY Pub Date : 2024-06-19 eCollection Date: 2024-01-01 DOI: 10.2147/PTT.S469698
Ana Maria Alexandra Stanescu, Gabriel Cristian Bejan, Mihaela Daniela Balta, Octavian Andronic, Cristian Toma, Stefan Busnatu

Psoriasis is a chronic skin condition that can significantly impact the quality of life of those affected. As an autoimmune disease, it can lead to itchy, painful, and scaly patches on the skin. Although various treatments, including topical creams, phototherapy, and systemic medications, are currently available, they may not always offer effective relief and can have side effects. Researchers have thus been exploring the potential benefits of non-psychoactive compounds such as CBD, found in Cannabis sativa plants, for treating psoriasis. CBD treatment may reduce inflammation, oxidative stress, itching, abnormal proliferation of keratinocytes, and may increase hydration. This review aims to provide an overview of the existing literature on the potential uses of CBD for psoriasis treatment.

银屑病是一种慢性皮肤病,会严重影响患者的生活质量。作为一种自身免疫性疾病,它会导致皮肤出现瘙痒、疼痛和鳞屑斑块。虽然目前有各种治疗方法,包括外用药膏、光疗和全身用药,但这些方法并不总能有效缓解病情,而且可能会产生副作用。因此,研究人员一直在探索非精神活性化合物(如大麻中的 CBD)治疗牛皮癣的潜在益处。CBD 治疗可减少炎症、氧化应激、瘙痒、角质细胞异常增殖,并可增加水合作用。本综述旨在概述有关 CBD 治疗银屑病潜在用途的现有文献。
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引用次数: 0
Risk Factors for Psoriasis Flares: A Narrative Review. 牛皮癣复发的风险因素:叙述性综述。
Q1 DERMATOLOGY 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。
Q1 DERMATOLOGY 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。
{"title":"Perception and Impact of COVID-19 Pandemic in Psoriasis Patients: Data from the German PsoBest and the CoronaBest Registries.","authors":"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","doi":"10.2147/PTT.S451666","DOIUrl":"10.2147/PTT.S451666","url":null,"abstract":"<p><strong>Background: </strong>Limited data are available characterizing the impact of the SARS-CoV-2 pandemic on psoriasis care for patients in Germany.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":74589,"journal":{"name":"Psoriasis (Auckland, N.Z.)","volume":"14 ","pages":"29-38"},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11102191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066497","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: 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
Q1 DERMATOLOGY 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。
{"title":"Therapeutic Potential of Spesolimab-Sbzo in the Management of Generalized Pustular Psoriasis Flares in Adults: Evidence to Date.","authors":"Federica Rega, Federica Trovato, Giulio Bortone, Giovanni Pellacani, Antonio Giovanni Richetta, Annunziata Dattola","doi":"10.2147/PTT.S393978","DOIUrl":"https://doi.org/10.2147/PTT.S393978","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":74589,"journal":{"name":"Psoriasis (Auckland, N.Z.)","volume":"14 ","pages":"23-27"},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10950078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178708","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: 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
Q1 DERMATOLOGY 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。
Q1 DERMATOLOGY 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
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Psoriasis (Auckland, N.Z.)
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