Pub Date : 2025-09-22DOI: 10.1007/s40257-025-00986-0
Sarah L Becker, Katelyn Downey, Justin Ng, Alex G Ortega-Loayza
{"title":"Skin Ulcers Mimicking Pyoderma Gangrenosum: A Prospective Cohort Study.","authors":"Sarah L Becker, Katelyn Downey, Justin Ng, Alex G Ortega-Loayza","doi":"10.1007/s40257-025-00986-0","DOIUrl":"https://doi.org/10.1007/s40257-025-00986-0","url":null,"abstract":"","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":" ","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-19DOI: 10.1007/s40257-025-00962-8
Amy S. Paller, Danielle Marcoux, Michele Ramien, Eulalia Baselga, Vania Oliveira Carvalho, Ledit R. F. Ardusso, Marlies de Graaf, Suzanne Pasmans, Mirna Toledo-Bahena, Cory Rubin, Joel C. Joyce, Lara Wine Lee, Rajan Gupta, Bryan Adams, Marius Ardeleanu, Annie Zhang
Background
Atopic dermatitis (AD), a chronic systemic disease, can cause intense skin itching and negatively impact sleep, mood, and quality of life (QoL) for patients and families.
Methods
PEDISTAD is an ongoing, 10-year, observational registry describing disease characteristics, atopic comorbidities, and treatment patterns in pediatric patients (aged <12 years at enrollment) with moderate-to-severe AD. This 3-year interim analysis evaluates clinician-reported and caregiver-reported/patient-reported outcomes (Eczema Area and Severity Index [EASI], percent body surface area affected, worst itching/scratching, Children’s Dermatology Life Quality Index, and Dermatitis Family Impact) in children treated with dupilumab, methotrexate, and/or cyclosporine. Outcomes were assessed as change from therapy start to last observation (either data cutoff date or treatment discontinuation).
Results
Mean (±SE) EASI scores at the time of the last 3-year interim observation were consistent with mild disease in the dupilumab cohort and moderate disease in the methotrexate and cyclosporine cohorts. Improvements in pruritus were numerically greater in the dupilumab cohort relative to the methotrexate and cyclosporine cohorts, while improvements in QoL were similar in the dupilumab and methotrexate cohorts, with no significant change in the cyclosporine cohort. Rates of AD exacerbation were numerically lower with dupilumab treatment relative to methotrexate treatment which were numerically lower than cyclosporine treatment. Dupilumab discontinuation rates were numerically lower relative to methotrexate which were numerically lower than cyclosporine.
Conclusions
This PEDISTAD 3-year interim analysis of dupilumab, methotrexate, and cyclosporine treatment in children with AD demonstrates numerically greater improvements in AD signs, symptoms and QoL with dupilumab treatment relative to methotrexate and cyclosporine [Video abstract and graphical abstract available].
{"title":"Systemic Treatments in Moderate-to-Severe Atopic Dermatitis in Pediatric Patients up to 12 Years of Age: Real-World Treatment Outcomes from the PEDISTAD Registry","authors":"Amy S. Paller, Danielle Marcoux, Michele Ramien, Eulalia Baselga, Vania Oliveira Carvalho, Ledit R. F. Ardusso, Marlies de Graaf, Suzanne Pasmans, Mirna Toledo-Bahena, Cory Rubin, Joel C. Joyce, Lara Wine Lee, Rajan Gupta, Bryan Adams, Marius Ardeleanu, Annie Zhang","doi":"10.1007/s40257-025-00962-8","DOIUrl":"10.1007/s40257-025-00962-8","url":null,"abstract":"<div><h3>Background</h3><p>Atopic dermatitis (AD), a chronic systemic disease, can cause intense skin itching and negatively impact sleep, mood, and quality of life (QoL) for patients and families.</p><h3>Methods</h3><p>PEDISTAD is an ongoing, 10-year, observational registry describing disease characteristics, atopic comorbidities, and treatment patterns in pediatric patients (aged <12 years at enrollment) with moderate-to-severe AD. This 3-year interim analysis evaluates clinician-reported and caregiver-reported/patient-reported outcomes (Eczema Area and Severity Index [EASI], percent body surface area affected, worst itching/scratching, Children’s Dermatology Life Quality Index, and Dermatitis Family Impact) in children treated with dupilumab, methotrexate, and/or cyclosporine. Outcomes were assessed as change from therapy start to last observation (either data cutoff date or treatment discontinuation).</p><h3>Results</h3><p>Mean (±SE) EASI scores at the time of the last 3-year interim observation were consistent with mild disease in the dupilumab cohort and moderate disease in the methotrexate and cyclosporine cohorts. Improvements in pruritus were numerically greater in the dupilumab cohort relative to the methotrexate and cyclosporine cohorts, while improvements in QoL were similar in the dupilumab and methotrexate cohorts, with no significant change in the cyclosporine cohort. Rates of AD exacerbation were numerically lower with dupilumab treatment relative to methotrexate treatment which were numerically lower than cyclosporine treatment. Dupilumab discontinuation rates were numerically lower relative to methotrexate which were numerically lower than cyclosporine.</p><h3>Conclusions</h3><p>This PEDISTAD 3-year interim analysis of dupilumab, methotrexate, and cyclosporine treatment in children with AD demonstrates numerically greater improvements in AD signs, symptoms and QoL with dupilumab treatment relative to methotrexate and cyclosporine [Video abstract and graphical abstract available].</p><h3>Clinical Trial Registration</h3><p>NCT03687359.</p><h3>Graphical abstract</h3><div><figure><div><div><picture><source><img></source></picture></div></div></figure></div><h3>Video abstract</h3>\u0000<div><div><div><iframe></iframe></div></div><div><p>Supplementary file1 (MP4 58163 KB)</p></div></div></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"26 6","pages":"1031 - 1043"},"PeriodicalIF":8.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-025-00962-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-11DOI: 10.1007/s40257-025-00976-2
Brett King, Jennifer Soung, Christos Tziotzios, Lidia Rudnicka, Pascal Joly, Melinda Gooderham, Rodney Sinclair, Natasha A. Mesinkovska, Carle Paul, Yankun Gong, Susan D. Anway, Helen Tran, Robert Wolk, Samuel H. Zwillich, Alexandre Lejeune
{"title":"Correction to: Integrated Safety Analysis of Ritlecitinib, an Oral JAK3/TEC Family Kinase Inhibitor, for the Treatment of Alopecia Areata from the ALLEGRO Clinical Trial Program","authors":"Brett King, Jennifer Soung, Christos Tziotzios, Lidia Rudnicka, Pascal Joly, Melinda Gooderham, Rodney Sinclair, Natasha A. Mesinkovska, Carle Paul, Yankun Gong, Susan D. Anway, Helen Tran, Robert Wolk, Samuel H. Zwillich, Alexandre Lejeune","doi":"10.1007/s40257-025-00976-2","DOIUrl":"10.1007/s40257-025-00976-2","url":null,"abstract":"","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"26 6","pages":"1065 - 1065"},"PeriodicalIF":8.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-025-00976-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-03DOI: 10.1007/s40257-025-00975-3
Alan D. Irvine, Vimal H. Prajapati, Emma Guttman-Yassky, Eric L. Simpson, Kim A. Papp, Andrew Blauvelt, Chia-Yu Chu, H. Chih-ho Hong, Linda F. Stein Gold, Marjolein de Bruin-Weller, Thomas Bieber, Kenji Kabashima, David Rosmarin, Cristina Sancho, Brian M. Calimlim, Ayman Grada, Yang Yang, Xiaoqiang Wu, Gweneth Levy, Eliza M. Raymundo, Henrique D. Teixeira, Jonathan I. Silverberg
Background
Upadacitinib is an oral selective Janus kinase inhibitor approved to treat moderate-to-severe atopic dermatitis (AD) in adults and adolescents; long-term efficacy and safety data beyond 1 year are needed.
Objective
The aim was to evaluate the long-term efficacy and safety of upadacitinib treatment through 140 weeks in patients with moderate-to-severe AD.
Methods
Measure Up 1 (MeUp1; NCT03569293), Measure Up 2 (MeUp2; NCT03607422), and AD Up (NCT03568318) are ongoing, phase 3, randomized clinical trials evaluating upadacitinib 15 mg (UPA15) and 30 mg (UPA30) in adults and adolescents with moderate-to-severe AD. This interim analysis evaluated efficacy and safety through week 140. At baseline, patients were randomized 1:1:1 to receive once-daily UPA15, UPA30, or placebo alone (MeUp1/2) or with concomitant topical corticosteroids (AD Up). At week 16, patients initially randomized to placebo were rerandomized 1:1 to UPA15 or UPA30. Skin and itch efficacy assessments included achievement of ≥ 75%/≥ 90%/100% improvement from baseline in Eczema Area and Severity Index (EASI 75/90/100), validated Investigator Global Assessment for AD score of clear/almost clear (vIGA-AD 0/1), and ≥ 4-point improvement from baseline in Worst Pruritus Numerical Rating Scale (∆WP-NRS≥4). Safety assessments included incidence of treatment-emergent adverse events.
Results
A total of 2782 patients were randomized in MeUp1/2 or AD Up. Efficacy response rates, including optimal outcomes such as EASI 90 and WP-NRS score of 0/1, were sustained through week 140 in all three studies. At week 140, EASI 75 was achieved by 85.5%/90.5% (UPA15/UPA30; integrated MeUp1/2) and 81.5%/90.0% (UPA15/UPA30; AD Up) of patients, and vIGA-AD 0/1 was achieved by 56.6%/64.4% (UPA15/UPA30; integrated MeUp1/2) and 52.0%/56.8% (UPA15/UPA30; AD Up) of patients. Over 60% of patients across all three studies achieved ∆WP-NRS≥4 at week 140. Pooled safety data across all three studies demonstrated safety profiles consistent with 16-week and 52-week analyses.
Conclusions
UPA15 and UPA30 with and without topical corticosteroids demonstrated robust, durable efficacy and a favorable safety profile through 140 weeks in adults and adolescents with moderate-to-severe AD.
Trial Registration
Measure Up 1 (NCT03569293; https://clinicaltrials.gov/study/NCT03569293), Measure Up 2 (NCT03607422; https://clinicaltrials.gov/study/NCT03607422), and AD Up (NCT03568318; https://clinicaltrials.gov/study/NCT03568318).
背景：Upadacitinib是一种口服选择性Janus激酶抑制剂，被批准用于治疗成人和青少年中重度特应性皮炎（AD）；需要1年以上的长期疗效和安全性数据。目的：目的是评估upadacitinib治疗140周中重度AD患者的长期疗效和安全性。方法：Measure Up1 （MeUp1; NCT03569293）、Measure Up2 （MeUp2; NCT03607422）和AD Up （NCT03568318）是正在进行的3期随机临床试验，评估upadacitinib 15 mg （UPA15）和30 mg （UPA30）对成人和青少年中重度AD的治疗效果。该中期分析评估了到第140周的疗效和安全性。在基线时，患者以1:1:1的比例随机分配，接受每日一次的UPA15、UPA30或单独使用安慰剂（MeUp1/2）或同时使用外用皮质类固醇（AD Up）。在第16周，最初随机分配到安慰剂组的患者再按1:1的比例随机分配到UPA15或UPA30组。皮肤和瘙痒疗效评估包括湿疹面积和严重程度指数（EASI 75/90/100）较基线改善≥75%/≥90%/100%，经验证的研究者全球评估AD评分为清晰/几乎清晰（vIGA-AD 0/1），最严重瘙痒数值评定量表（∆WP-NRS≥4）较基线改善≥4分。安全性评估包括治疗中出现的不良事件的发生率。结果：共有2782例患者被随机分为MeUp1/2组或AD Up组。在所有三项研究中，疗效缓解率，包括EASI 90和WP-NRS评分为0/1的最佳结果，持续到140周。在第140周，EASI 75达到85.5%/90.5% （UPA15/UPA30；集成MeUp1/2）和81.5%/90.0% （UPA15/UPA30; AD Up）的患者，vIGA-AD 0/1达到56.6%/64.4% （UPA15/UPA30；集成MeUp1/2）和52.0%/56.8% （UPA15/UPA30; AD Up）的患者。在所有三项研究中，超过60%的患者在第140周达到∆WP-NRS≥4。所有三项研究的汇总安全性数据表明，安全性概况与16周和52周的分析一致。结论：在140周内，UPA15和UPA30在治疗中度至重度AD的成人和青少年患者中表现出强劲、持久的疗效和良好的安全性。试验注册：Measure Up 1 (NCT03569293; https://clinicaltrials.gov/study/NCT03569293), Measure Up 2 (NCT03607422; https://clinicaltrials.gov/study/NCT03607422), AD Up （NCT03568318; https://clinicaltrials.gov/study/NCT03568318）。
{"title":"Efficacy and Safety of Upadacitinib in Patients With Moderate-to-Severe Atopic Dermatitis: Phase 3 Randomized Clinical Trial Results Through 140 Weeks","authors":"Alan D. Irvine, Vimal H. Prajapati, Emma Guttman-Yassky, Eric L. Simpson, Kim A. Papp, Andrew Blauvelt, Chia-Yu Chu, H. Chih-ho Hong, Linda F. Stein Gold, Marjolein de Bruin-Weller, Thomas Bieber, Kenji Kabashima, David Rosmarin, Cristina Sancho, Brian M. Calimlim, Ayman Grada, Yang Yang, Xiaoqiang Wu, Gweneth Levy, Eliza M. Raymundo, Henrique D. Teixeira, Jonathan I. Silverberg","doi":"10.1007/s40257-025-00975-3","DOIUrl":"10.1007/s40257-025-00975-3","url":null,"abstract":"<div><h3>Background</h3><p>Upadacitinib is an oral selective Janus kinase inhibitor approved to treat moderate-to-severe atopic dermatitis (AD) in adults and adolescents; long-term efficacy and safety data beyond 1 year are needed.</p><h3>Objective</h3><p>The aim was to evaluate the long-term efficacy and safety of upadacitinib treatment through 140 weeks in patients with moderate-to-severe AD.</p><h3>Methods</h3><p>Measure Up 1 (MeUp1; NCT03569293), Measure Up 2 (MeUp2; NCT03607422), and AD Up (NCT03568318) are ongoing, phase 3, randomized clinical trials evaluating upadacitinib 15 mg (UPA15) and 30 mg (UPA30) in adults and adolescents with moderate-to-severe AD. This interim analysis evaluated efficacy and safety through week 140. At baseline, patients were randomized 1:1:1 to receive once-daily UPA15, UPA30, or placebo alone (MeUp1/2) or with concomitant topical corticosteroids (AD Up). At week 16, patients initially randomized to placebo were rerandomized 1:1 to UPA15 or UPA30. Skin and itch efficacy assessments included achievement of ≥ 75%/≥ 90%/100% improvement from baseline in Eczema Area and Severity Index (EASI 75/90/100), validated Investigator Global Assessment for AD score of clear/almost clear (vIGA-AD 0/1), and ≥ 4-point improvement from baseline in Worst Pruritus Numerical Rating Scale (∆WP-NRS≥4). Safety assessments included incidence of treatment-emergent adverse events.</p><h3>Results</h3><p>A total of 2782 patients were randomized in MeUp1/2 or AD Up. Efficacy response rates, including optimal outcomes such as EASI 90 and WP-NRS score of 0/1, were sustained through week 140 in all three studies. At week 140, EASI 75 was achieved by 85.5%/90.5% (UPA15/UPA30; integrated MeUp1/2) and 81.5%/90.0% (UPA15/UPA30; AD Up) of patients, and vIGA-AD 0/1 was achieved by 56.6%/64.4% (UPA15/UPA30; integrated MeUp1/2) and 52.0%/56.8% (UPA15/UPA30; AD Up) of patients. Over 60% of patients across all three studies achieved ∆WP-NRS≥4 at week 140. Pooled safety data across all three studies demonstrated safety profiles consistent with 16-week and 52-week analyses.</p><h3>Conclusions</h3><p>UPA15 and UPA30 with and without topical corticosteroids demonstrated robust, durable efficacy and a favorable safety profile through 140 weeks in adults and adolescents with moderate-to-severe AD.</p><h3>Trial Registration</h3><p>Measure Up 1 (NCT03569293; https://clinicaltrials.gov/study/NCT03569293), Measure Up 2 (NCT03607422; https://clinicaltrials.gov/study/NCT03607422), and AD Up (NCT03568318; https://clinicaltrials.gov/study/NCT03568318).</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"26 6","pages":"1003 - 1016"},"PeriodicalIF":8.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-025-00975-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1007/s40257-025-00966-4
Joseph F. Merola, Stephan Weidinger, Sally Y. Tan, Kassim Rahawi, Cori Gray
Atopic dermatitis (AD) is a chronic inflammatory skin condition characterized by fluctuating disease activity. Exacerbations of AD signs and/or symptoms, or flares, have a significant impact on patient quality of life and may require modification or escalation of treatment. However, research into preventing and managing flares may be hampered by the lack of consensus on a clear, clinically relevant, measurable definition of flare. This narrative review provides an overview of disease flare frameworks established through previous systematic literature reviews, flare definitions proposed by American and European guidelines, as well as those used in randomized controlled trials and observational studies published between January 2014 and September 2024. It identifies a range of flare definitions in use in the literature, the majority of which are based on clinician-reported outcomes, with very few referring to the patient perspective. Given the highly individualized experience of disease flare in patients with AD, incorporating the perspective of patients, alongside established measures of disease activity, is vital for creating and validating a definition that is clinically relevant.
{"title":"Defining “Flares” in Atopic Dermatitis: A Narrative Review","authors":"Joseph F. Merola, Stephan Weidinger, Sally Y. Tan, Kassim Rahawi, Cori Gray","doi":"10.1007/s40257-025-00966-4","DOIUrl":"10.1007/s40257-025-00966-4","url":null,"abstract":"<div><p>Atopic dermatitis (AD) is a chronic inflammatory skin condition characterized by fluctuating disease activity. Exacerbations of AD signs and/or symptoms, or flares, have a significant impact on patient quality of life and may require modification or escalation of treatment. However, research into preventing and managing flares may be hampered by the lack of consensus on a clear, clinically relevant, measurable definition of flare. This narrative review provides an overview of disease flare frameworks established through previous systematic literature reviews, flare definitions proposed by American and European guidelines, as well as those used in randomized controlled trials and observational studies published between January 2014 and September 2024. It identifies a range of flare definitions in use in the literature, the majority of which are based on clinician-reported outcomes, with very few referring to the patient perspective. Given the highly individualized experience of disease flare in patients with AD, incorporating the perspective of patients, alongside established measures of disease activity, is vital for creating and validating a definition that is clinically relevant.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"26 6","pages":"905 - 921"},"PeriodicalIF":8.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-025-00966-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1007/s40257-025-00982-4
William J. Nahm, Sameer G. Gupta, Ryan Chen, Vinod E. Nambudiri
{"title":"Exploring Suzetrigine's Role in Dermatologic Surgery: A Novel Nonopioid Analgesic for Postoperative Pain Management","authors":"William J. Nahm, Sameer G. Gupta, Ryan Chen, Vinod E. Nambudiri","doi":"10.1007/s40257-025-00982-4","DOIUrl":"10.1007/s40257-025-00982-4","url":null,"abstract":"","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"26 6","pages":"1061 - 1063"},"PeriodicalIF":8.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1007/s40257-025-00981-5
Francis Li-Tien Hsu, Tsen-Fang Tsai
Background
Ethnic differences in the clinical and molecular features of many immune-mediated dermatoses have been reported, including psoriasis vulgaris and generalized pustular psoriasis. Palmoplantar pustulosis (PPP) is a chronic and relapsing inflammatory skin disease manifesting as crops of sterile pustules over an erythematous base on the palms and soles. To date, ethnic differences in PPP have been rarely studied.
Objectives
To compare the differences in epidemiology, genetic background, clinical manifestations, treatment patterns, and responses among patients with PPP across different ethnicities.
Methods
A systematic review was performed in accordance with the 2020 PRISMA guidelines, including a search across four bibliographical databases, including articles published between the earliest available date until 1 February 2025. Articles were reviewed independently by two assessors. Any discrepancies were addressed and resolved through discussion. A narrative synthesis was performed owing to heterogeneity. The study protocol was registered in INPLASY (INPLASY202530108). No funding was received.
Results
Of 2250 studies screened, 101 studies were included. Among them, 46 studies (42 cohort studies, 1 case-control, and 3 case series) involving 216,257 patients described the clinical characteristics of PPP, with 13 and 14 cohort studies reporting on the epidemiological data and treatment type/response of PPP, respectively. Incidence and prevalence rates of PPP were higher among East Asians, especially in Japanese populations. While PPP is a female-predominant disease worldwide, more men are affected in Asia, likely owing to a lower prevalence of smoking among Asian females. Mutations in IL36RN, CARD14, and different HLA alleles contribute to the genetic landscape of PPP across ethnicities. PPP with preceding vesicles (type A) seemed more common in Asians, and type B (without preceding vesicles) is more common in non-Asians. Asians with PPP had less concurrent psoriasis vulgaris and psoriatic arthritis, as well as lower rates of smoking, obesity, celiac disease, and thyroid disease, while metal allergies were more common. Plantar-only or unilateral involvement were more frequent in non-Asians, whereas nail involvement and synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome/pustulotic arthro-osteitis (PAO) were more common in Asians. Among conventional treatment modalities, acitretin, colchicine, and tonsillectomy seemed more effective for Asians. Biologics were less commonly used in Asia, with ethnic-related differences in treatment response noted across classes.
Conclusions
This systematic review illustrated notable differences in genetic profiles, clinical features, and therapeutic responses of PPP across ethnicities. Although limited by study size and heterogeneity, these findings could enhance our understanding of ethnic-specific PPP traits. Th
{"title":"Ethnic Differences of Palmoplantar Pustulosis: A Systematic Review","authors":"Francis Li-Tien Hsu, Tsen-Fang Tsai","doi":"10.1007/s40257-025-00981-5","DOIUrl":"10.1007/s40257-025-00981-5","url":null,"abstract":"<div><h3>Background</h3><p>Ethnic differences in the clinical and molecular features of many immune-mediated dermatoses have been reported, including psoriasis vulgaris and generalized pustular psoriasis. Palmoplantar pustulosis (PPP) is a chronic and relapsing inflammatory skin disease manifesting as crops of sterile pustules over an erythematous base on the palms and soles. To date, ethnic differences in PPP have been rarely studied.</p><h3>Objectives</h3><p>To compare the differences in epidemiology, genetic background, clinical manifestations, treatment patterns, and responses among patients with PPP across different ethnicities.</p><h3>Methods</h3><p>A systematic review was performed in accordance with the 2020 PRISMA guidelines, including a search across four bibliographical databases, including articles published between the earliest available date until 1 February 2025. Articles were reviewed independently by two assessors. Any discrepancies were addressed and resolved through discussion. A narrative synthesis was performed owing to heterogeneity. The study protocol was registered in INPLASY (INPLASY202530108). No funding was received.</p><h3>Results</h3><p>Of 2250 studies screened, 101 studies were included. Among them, 46 studies (42 cohort studies, 1 case-control, and 3 case series) involving 216,257 patients described the clinical characteristics of PPP, with 13 and 14 cohort studies reporting on the epidemiological data and treatment type/response of PPP, respectively. Incidence and prevalence rates of PPP were higher among East Asians, especially in Japanese populations. While PPP is a female-predominant disease worldwide, more men are affected in Asia, likely owing to a lower prevalence of smoking among Asian females. Mutations in <i>IL36RN</i>, <i>CARD14</i>, and different HLA alleles contribute to the genetic landscape of PPP across ethnicities. PPP with preceding vesicles (type A) seemed more common in Asians, and type B (without preceding vesicles) is more common in non-Asians. Asians with PPP had less concurrent psoriasis vulgaris and psoriatic arthritis, as well as lower rates of smoking, obesity, celiac disease, and thyroid disease, while metal allergies were more common. Plantar-only or unilateral involvement were more frequent in non-Asians, whereas nail involvement and synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome/pustulotic arthro-osteitis (PAO) were more common in Asians. Among conventional treatment modalities, acitretin, colchicine, and tonsillectomy seemed more effective for Asians. Biologics were less commonly used in Asia, with ethnic-related differences in treatment response noted across classes.</p><h3>Conclusions</h3><p>This systematic review illustrated notable differences in genetic profiles, clinical features, and therapeutic responses of PPP across ethnicities. Although limited by study size and heterogeneity, these findings could enhance our understanding of ethnic-specific PPP traits. Th","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"26 6","pages":"863 - 876"},"PeriodicalIF":8.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-31DOI: 10.1007/s40257-025-00968-2
Joseph F. Merola, Richard B. Warren, Diamant Thaçi, Kenneth B. Gordon, Emi Nishida, Bruce Strober, Curdin Conrad, Sarah Kavanagh, José Manuel López Pinto, Bengt Hoepken, Paolo Gisondi
Background
Nail psoriasis can have a substantial negative impact on both the physical and emotional well-being of patients, and is a risk factor for psoriatic arthritis. Achieving complete clearance of nails in addition to skin is therefore an important treatment goal.
Objectives
We aimed to evaluate concurrent complete skin and nail clearance in patients with moderate-to-severe plaque psoriasis treated with bimekizumab or active comparators.
Methods
Data were analyzed from the BE SURE and BE VIVID phase III trials, their open-label extension BE BRIGHT, and the BE RADIANT phase IIIb trial and its open-label extension. Included patients had baseline modified Nail Psoriasis Severity Index (mNAPSI) >0 and entered their respective open-label extension. Proportions of patients achieving complete skin (PASI 100; 100% improvement from baseline in Psoriasis Area and Severity Index) and nail (mNAPSI 0) clearance at the same time are reported for bimekizumab- and active comparator-treated patients during controlled trial periods, and in the long term for continuous bimekizumab-treated patients and those switching from comparators. Data are reported using modified non-responder imputation.
Results
At the end of comparator-controlled periods, 45.8% of bimekizumab (N = 151) versus 18.3% of adalimumab (N = 91) patients (BE SURE week 24), 51.1% of bimekizumab (N = 169) versus 26.5% of ustekinumab (N = 92) patients (BE VIVID week 52), and 63.3% of bimekizumab (N = 182) versus 36.1% of secukinumab (N = 155) patients (BE RADIANT week 48) achieved PASI 100 and mNAPSI 0. Following long-term treatment, 57.7% of adalimumab switchers/49.1% of continuous bimekizumab patients (BE SURE/BE BRIGHT year 4), 52.2% of ustekinumab switchers/48.3% of continuous bimekizumab patients (BE VIVID/BE BRIGHT year 4), and 51.9% of secukinumab switchers/57.4% of continuous bimekizumab patients (BE RADIANT year 3) achieved PASI 100 and mNAPSI 0.
Conclusions
Numerically higher proportions of bimekizumab-treated patients achieved concurrent complete skin and nail clearance versus adalimumab, ustekinumab, and secukinumab. Clearance rates increased following switch to bimekizumab, and were sustained long-term in both switchers to bimekizumab and continuous bimekizumab-treated patients. [Graphical abstract available.]
{"title":"Bimekizumab Complete Clearance of Both Skin and Nail Psoriasis: Comparative Efficacy in Phase III/IIIb Studies","authors":"Joseph F. Merola, Richard B. Warren, Diamant Thaçi, Kenneth B. Gordon, Emi Nishida, Bruce Strober, Curdin Conrad, Sarah Kavanagh, José Manuel López Pinto, Bengt Hoepken, Paolo Gisondi","doi":"10.1007/s40257-025-00968-2","DOIUrl":"10.1007/s40257-025-00968-2","url":null,"abstract":"<div><h3>Background</h3><p>Nail psoriasis can have a substantial negative impact on both the physical and emotional well-being of patients, and is a risk factor for psoriatic arthritis. Achieving complete clearance of nails in addition to skin is therefore an important treatment goal. </p><h3>Objectives</h3><p>We aimed to evaluate concurrent complete skin and nail clearance in patients with moderate-to-severe plaque psoriasis treated with bimekizumab or active comparators.</p><h3>Methods</h3><p>Data were analyzed from the BE SURE and BE VIVID phase III trials, their open-label extension BE BRIGHT, and the BE RADIANT phase IIIb trial and its open-label extension. Included patients had baseline modified Nail Psoriasis Severity Index (mNAPSI) >0 and entered their respective open-label extension. Proportions of patients achieving complete skin (PASI 100; 100% improvement from baseline in Psoriasis Area and Severity Index) and nail (mNAPSI 0) clearance at the same time are reported for bimekizumab- and active comparator-treated patients during controlled trial periods, and in the long term for continuous bimekizumab-treated patients and those switching from comparators. Data are reported using modified non-responder imputation.</p><h3>Results</h3><p>At the end of comparator-controlled periods, 45.8% of bimekizumab (<i>N</i> = 151) versus 18.3% of adalimumab (<i>N</i> = 91) patients (BE SURE week 24), 51.1% of bimekizumab (<i>N</i> = 169) versus 26.5% of ustekinumab (<i>N</i> = 92) patients (BE VIVID week 52), and 63.3% of bimekizumab (<i>N</i> = 182) versus 36.1% of secukinumab (<i>N</i> = 155) patients (BE RADIANT week 48) achieved PASI 100 and mNAPSI 0. Following long-term treatment, 57.7% of adalimumab switchers/49.1% of continuous bimekizumab patients (BE SURE/BE BRIGHT year 4), 52.2% of ustekinumab switchers/48.3% of continuous bimekizumab patients (BE VIVID/BE BRIGHT year 4), and 51.9% of secukinumab switchers/57.4% of continuous bimekizumab patients (BE RADIANT year 3) achieved PASI 100 and mNAPSI 0.</p><h3>Conclusions</h3><p>Numerically higher proportions of bimekizumab-treated patients achieved concurrent complete skin and nail clearance versus adalimumab, ustekinumab, and secukinumab. Clearance rates increased following switch to bimekizumab, and were sustained long-term in both switchers to bimekizumab and continuous bimekizumab-treated patients. [Graphical abstract available.] </p><h3>Clinical Trial Registration</h3><p>NCT03412747, NCT03370133, NCT03598790, NCT03536884.</p><h3>Graphical Abstract</h3><div><figure><div><div><picture><source><img></source></picture></div></div></figure></div></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"26 6","pages":"967 - 979"},"PeriodicalIF":8.8,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-025-00968-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div><h3>Background</h3><p>Erythrodermic psoriasis is a rare subtype of psoriasis with widespread skin lesions, with some patients experiencing severe systemic symptoms.</p><h3>Objective</h3><p>We aimed to develop and validate an artificial intelligence-driven model for accurate classification of erythrodermic psoriasis severity by integrating clinical and laboratory indicators.</p><h3>Methods</h3><p>A retrospective cohort study was conducted at Peking Union Medical College Hospital (2005–22). Patients were divided into mild and moderate-to-severe groups using k-means clustering. After imputing missing values, we trained seven candidate algorithms—K-Nearest Neighbors, Artificial Neural Network, Random Forest, Extreme Gradient Boosting, Support Vector Machine, Bayesian classifier, and logistic regression—using repeated, stratified ten-fold cross-validation with three repeats (10 × 3 CV); performance was summarized by the mean area under the receiver operating characteristic curve across folds. Feature importance was assessed using SHAP (Shapley Additive exPlanations), a game-theoretic approach that quantifies each features contribution to individual model predictions, ten indicators were incorporated into a diagnostic scoring system. The optimal cut-off for mild/moderate-to-severe cases classification was selected with the Youden index on the cross-validated receiver operating characteristic curve.</p><h3>Results</h3><p>Of 260 screened records, 242 erythrodermic patients met the study criteria. Histology confirmed psoriasis in 108 cases, while the remaining patients were diagnosed based on clinical presentation and medical history. K-means clustering assigned 94 patients to the moderate-to-severe group and 148 to the mild group. Moderate-to-severe erythrodermic psoriasis was characterized by a higher inflammatory burden (median neutrophil-to-lymphocyte ratio 4.11 vs 2.70, <i>p</i> < 0.001), more frequent fever (88% vs 41%, <i>p</i> < 0.001), greater edema severity (16% vs 1.4%, <i>p</i> < 0.001), lower albumin and higher calcium levels (both <i>p</i> < 0.001), and longer hospitalization (median 26 vs 20 days, <i>p</i> = 0.005). After adjustment for age and sex, moderate-to-severe cases required systemic therapy roughly twice as often as mild cases (odds ratio 2.21, <i>p</i> < 0.05). Of seven machine-learning algorithms, the Artificial Neural Network yielded the highest mean validation area under the curve. The SHAP analysis highlighted the ten most influential predictors adopted from the Artificial Neural Network—edema, edematous erythema (defined as the combination of both redness and swelling of the skin), fever, albumin, neutrophil-to-lymphocyte ratio, serum calcium, white blood cell count, acute-phase reactants (C-reactive protein or erythrocyte sedimentation rate), pruritus, and superficial lymphadenopathy—and these were converted to integer points to form the bedside score. The receiver operating characteristic analysis identi
背景：红皮病型银屑病是一种罕见的银屑病亚型，具有广泛的皮肤病变，一些患者出现严重的全身症状。目的：我们旨在开发和验证一个人工智能驱动的模型，通过整合临床和实验室指标来准确分类红皮病型银屑病的严重程度。方法：回顾性队列研究于2005-22年在北京协和医院进行。采用k-均值聚类法将患者分为轻度组和中度至重度组。在输入缺失值之后，我们训练了7种候选算法——k近邻、人工神经网络、随机森林、极端梯度增强、支持向量机、贝叶斯分类器和逻辑回归——使用重复的、分层的10倍交叉验证和3次重复（10 × 3 CV）；性能通过接收器工作特性曲线下的平均面积进行总结。特征重要性的评估使用SHAP （Shapley加性解释），这是一种量化每个特征对个体模型预测贡献的博弈论方法，十个指标被纳入诊断评分系统。根据交叉验证的受试者工作特征曲线上的约登指数选择轻度/中度至重度病例分类的最佳截止值。结果：260例筛查记录中，242例红皮病患者符合研究标准。组织学证实108例为牛皮癣，其余患者根据临床表现和病史诊断。K-means聚类将94例患者分配到中度至重度组，148例患者分配到轻度组。中重度红皮病银屑病的特点是较高的炎症负担（中位中性粒细胞与淋巴细胞比值为4.11 vs 2.70, p）。结论：EPICS模型是评估红皮病银屑病严重程度的有力工具，基于易于获得的临床和实验室指标提供精确的分类。然而，其在临床实践中的有效性需要通过进一步的研究来进一步验证。
{"title":"Development and Validation of an Artificial Intelligence-Driven Model for Accurate Classification of Erythrodermic Psoriasis Severity: Erythrodermic Psoriasis Integrated Classification System (EPICS)","authors":"Yuyan Yang, Chao Wu, Xinyuan Zhang, Chenyang Yu, Hanlin Zhang, Hongzhong Jin","doi":"10.1007/s40257-025-00980-6","DOIUrl":"10.1007/s40257-025-00980-6","url":null,"abstract":"<div><h3>Background</h3><p>Erythrodermic psoriasis is a rare subtype of psoriasis with widespread skin lesions, with some patients experiencing severe systemic symptoms.</p><h3>Objective</h3><p>We aimed to develop and validate an artificial intelligence-driven model for accurate classification of erythrodermic psoriasis severity by integrating clinical and laboratory indicators.</p><h3>Methods</h3><p>A retrospective cohort study was conducted at Peking Union Medical College Hospital (2005–22). Patients were divided into mild and moderate-to-severe groups using k-means clustering. After imputing missing values, we trained seven candidate algorithms—K-Nearest Neighbors, Artificial Neural Network, Random Forest, Extreme Gradient Boosting, Support Vector Machine, Bayesian classifier, and logistic regression—using repeated, stratified ten-fold cross-validation with three repeats (10 × 3 CV); performance was summarized by the mean area under the receiver operating characteristic curve across folds. Feature importance was assessed using SHAP (Shapley Additive exPlanations), a game-theoretic approach that quantifies each features contribution to individual model predictions, ten indicators were incorporated into a diagnostic scoring system. The optimal cut-off for mild/moderate-to-severe cases classification was selected with the Youden index on the cross-validated receiver operating characteristic curve.</p><h3>Results</h3><p>Of 260 screened records, 242 erythrodermic patients met the study criteria. Histology confirmed psoriasis in 108 cases, while the remaining patients were diagnosed based on clinical presentation and medical history. K-means clustering assigned 94 patients to the moderate-to-severe group and 148 to the mild group. Moderate-to-severe erythrodermic psoriasis was characterized by a higher inflammatory burden (median neutrophil-to-lymphocyte ratio 4.11 vs 2.70, <i>p</i> < 0.001), more frequent fever (88% vs 41%, <i>p</i> < 0.001), greater edema severity (16% vs 1.4%, <i>p</i> < 0.001), lower albumin and higher calcium levels (both <i>p</i> < 0.001), and longer hospitalization (median 26 vs 20 days, <i>p</i> = 0.005). After adjustment for age and sex, moderate-to-severe cases required systemic therapy roughly twice as often as mild cases (odds ratio 2.21, <i>p</i> < 0.05). Of seven machine-learning algorithms, the Artificial Neural Network yielded the highest mean validation area under the curve. The SHAP analysis highlighted the ten most influential predictors adopted from the Artificial Neural Network—edema, edematous erythema (defined as the combination of both redness and swelling of the skin), fever, albumin, neutrophil-to-lymphocyte ratio, serum calcium, white blood cell count, acute-phase reactants (C-reactive protein or erythrocyte sedimentation rate), pruritus, and superficial lymphadenopathy—and these were converted to integer points to form the bedside score. The receiver operating characteristic analysis identi","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"26 6","pages":"1017 - 1029"},"PeriodicalIF":8.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-025-00980-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-26DOI: 10.1007/s40257-025-00977-1
Luca Mastorino, Francesco Leo, Giada Frigatti, Nicole Macagno, Paolo Dapavo, Pietro Quaglino, Simone Ribero
<div><h3>Background</h3><p>Erythrodermic psoriasis (EP) is a severe and rare variant of psoriasis. Clinical features include scaling and erythema affecting more than 75% of body surface area, associated with systemic symptoms such as lymphadenopathy, arthralgia, fever, fatigue, dehydration, serum electrolyte disturbances, and tachycardia, making this condition a potentially life-threatening disease. Differential diagnosis can be challenging, encompasses atopic dermatitis, cutaneous adverse drug reaction, and advanced cutaneous lymphoma. Following a correct diagnostic framing, appropriate systemic treatment must be initiated. Unfortunately, there are no recent up-to-date guidelines and standardized treatment options for EP are still lacking.</p><h3>Objective</h3><p>To review the current reported systemic treatment options for EP.</p><h3>Methods</h3><p>This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and based on a search in MEDLINE, PubMed, Scopus, and Cochrane Library for articles in English from first available publication to 9 November 2024.</p><h3>Results</h3><p>In all, 145 studies were included in the review. Case reports and case series are the main available work, reporting heterogeneous outcomes and effectiveness with nonbiologic and biologic systemic agents. Among non-biologic systemic treatments, methotrexate and cyclosporin are the most widely reported as treatment for EP, showing clinical response in over 60% of cases, with cyclosporine offering a faster onset of action and being suitable for acute management. Available randomized controlled trials include patients with EP treated with etretinate, infliximab, certolizumab-pegol (CZP), Ixekizumab, guselkumab, risankizumab, and deucravacitinib. However, these trials were not specifically designed for erythrodermic psoriasis, and the sample size of EP patients included is limited, resulting in reduced statistical power and limiting the reliability of the findings. Among TNF-α inhibitors, infliximab is the most reported agent, with data on 103 patients. Certolizumab pegol (CZP) also showed promising results, with PASI 75 achieved in over 80% of patients at 52 weeks. A retrospective analysis comparing infliximab, adalimumab, etanercept, ustekinumab, and efalizumab found TNF-α inhibitors to be superior to other biologic classes. Regarding IL-17 inhibitors, secukinumab is the second most frequently studied biologic, with 93 patients reported. It demonstrated rapid efficacy, achieving PASI 75 in more than 80% of patients by week 8. A head-to-head comparison with ixekizumab showed comparable outcomes. Among IL-23 inhibitors, risankizumab led to PASI 90 in over 75% of patients at week 16, suggesting high efficacy despite more limited data.</p><h3>Conclusions</h3><p>Non-biologic systemic drugs appear to be a rational first-line therapy, with cyclosporine showing good results in managing the acute ph
{"title":"Management of Erythrodermic Psoriasis with Systemic Therapies: A Systematic Review","authors":"Luca Mastorino, Francesco Leo, Giada Frigatti, Nicole Macagno, Paolo Dapavo, Pietro Quaglino, Simone Ribero","doi":"10.1007/s40257-025-00977-1","DOIUrl":"10.1007/s40257-025-00977-1","url":null,"abstract":"<div><h3>Background</h3><p>Erythrodermic psoriasis (EP) is a severe and rare variant of psoriasis. Clinical features include scaling and erythema affecting more than 75% of body surface area, associated with systemic symptoms such as lymphadenopathy, arthralgia, fever, fatigue, dehydration, serum electrolyte disturbances, and tachycardia, making this condition a potentially life-threatening disease. Differential diagnosis can be challenging, encompasses atopic dermatitis, cutaneous adverse drug reaction, and advanced cutaneous lymphoma. Following a correct diagnostic framing, appropriate systemic treatment must be initiated. Unfortunately, there are no recent up-to-date guidelines and standardized treatment options for EP are still lacking.</p><h3>Objective</h3><p>To review the current reported systemic treatment options for EP.</p><h3>Methods</h3><p>This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and based on a search in MEDLINE, PubMed, Scopus, and Cochrane Library for articles in English from first available publication to 9 November 2024.</p><h3>Results</h3><p>In all, 145 studies were included in the review. Case reports and case series are the main available work, reporting heterogeneous outcomes and effectiveness with nonbiologic and biologic systemic agents. Among non-biologic systemic treatments, methotrexate and cyclosporin are the most widely reported as treatment for EP, showing clinical response in over 60% of cases, with cyclosporine offering a faster onset of action and being suitable for acute management. Available randomized controlled trials include patients with EP treated with etretinate, infliximab, certolizumab-pegol (CZP), Ixekizumab, guselkumab, risankizumab, and deucravacitinib. However, these trials were not specifically designed for erythrodermic psoriasis, and the sample size of EP patients included is limited, resulting in reduced statistical power and limiting the reliability of the findings. Among TNF-α inhibitors, infliximab is the most reported agent, with data on 103 patients. Certolizumab pegol (CZP) also showed promising results, with PASI 75 achieved in over 80% of patients at 52 weeks. A retrospective analysis comparing infliximab, adalimumab, etanercept, ustekinumab, and efalizumab found TNF-α inhibitors to be superior to other biologic classes. Regarding IL-17 inhibitors, secukinumab is the second most frequently studied biologic, with 93 patients reported. It demonstrated rapid efficacy, achieving PASI 75 in more than 80% of patients by week 8. A head-to-head comparison with ixekizumab showed comparable outcomes. Among IL-23 inhibitors, risankizumab led to PASI 90 in over 75% of patients at week 16, suggesting high efficacy despite more limited data.</p><h3>Conclusions</h3><p>Non-biologic systemic drugs appear to be a rational first-line therapy, with cyclosporine showing good results in managing the acute ph","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"26 6","pages":"877 - 893"},"PeriodicalIF":8.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40257-025-00977-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号