Journal of Psoriasis and Psoriatic Arthritis最新文献

{"title":"The Role of Probiotics as an Adjunctive Therapy in Psoriasis.","authors":"Isadora O Gilli, Gabriela C da Silva, Victoria Mendes, Marcella G Duarte, Anber A Tanaka","doi":"10.1177/24755303221142296","DOIUrl":"10.1177/24755303221142296","url":null,"abstract":"<p><strong>Background: </strong>During the past decades, several unconventional strategies for controlling chronic inflammatory diseases, including psoriasis, have been developed. The use of probiotics has been gaining importance as an adjuvant therapy in the treatment of these pathologies.</p><p><strong>Objectives: </strong>Evaluate the impact of the use of the <i>Lactobacillus rhamnosus</i> probiotic strain in patients diagnosed with common and palmoplantar psoriasis.</p><p><strong>Methods: </strong>35 patients were randomly divided into two groups: 18 using probiotics and 17 using placebo. They were evaluated on days 0 and 60, with photographic records of lesions, IL17 and IL23 quantification and calculations of Psoriasis Area Severity Index (PASI), Body Surface Area (BSA) and Dermatology Life Quality Index (DLQI) clinical evaluation scores.</p><p><strong>Results: </strong>There was significative improvement in the clinical presentation and a reduction in the index of all clinical scores (PASI from 4.53 ± 4.457 to 3.57 ± 3.333, BSA from 5.44 ± 6.451 to 4.94 ± 5.961 and DLQI from 8.83 ± 8.631 to 7 ± 7.814, in the probiotic group.<b>)</b> However, there was no reduction in the quantification of IL23 and IL17. Adverse events related to the use of probiotics were minimal.</p><p><strong>Conclusions: </strong>There was a Positive correlation between the use of probiotics and improvement of clinical aspects and clinical scores of disease severity, not associated with reduction in interleukins 17 and 23 blood levels.</p>","PeriodicalId":36656,"journal":{"name":"Journal of Psoriasis and Psoriatic Arthritis","volume":"8 1","pages":"49-55"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45754442","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}

{"title":"Palmoplantar Pustulosis has a Greater Disease Burden than Plaque Psoriasis: Real-World Evidence From the CorEvitas Psoriasis Registry.","authors":"Mark G Lebwohl, Rose Anne Medeiros, Rachel H Mackey, Wendell C Valdecantos, Kimberly G Brodovicz, Apinya Lertratanakul, Bruce Strober","doi":"10.1177/24755303221146990","DOIUrl":"10.1177/24755303221146990","url":null,"abstract":"<p><strong>Background: </strong>Palmoplantar pustulosis (PPP) is a rare skin disease characterized by episodes of neutrophilic pustules on the palms of the hands and soles of the feet. Current treatments for PPP have limited efficacy, and there is little real-world evidence characterizing the disease burden of PPP in patients.</p><p><strong>Objective: </strong>To describe and compare the clinical characteristics and patient-reported outcomes (PROs) of patients with PPP with those of patients with plaque psoriasis.</p><p><strong>Methods: </strong>This real-world study used data from patients with PPP or plaque psoriasis enrolled in the CorEvitas Psoriasis Registry. Disease characteristics, historical medical data, PROs, and quality-of-life measures were compared between patients with PPP and those with plaque psoriasis. These measures were also compared following patient stratification by body surface area involvement or Psoriasis Area and Severity Index. This study is purely descriptive; no hypothesis testing was performed.</p><p><strong>Results: </strong>In this data set, patients with PPP (n = 64) reported higher mean overall pain, using the visual analog scale, relative to those with plaque psoriasis (n = 4894). Patients with PPP also reported a greater proportion of work hours missed or affected; greater impairment of work; and greater impairment of daily activity than patients with plaque psoriasis. Similar effects were observed irrespective of patient stratification.</p><p><strong>Conclusion: </strong>Generally, PPP was associated with worse PROs and a greater impact on quality of life compared with plaque psoriasis. These findings highlight a need to develop effective therapies for PPP to improve disease management.</p>","PeriodicalId":36656,"journal":{"name":"Journal of Psoriasis and Psoriatic Arthritis","volume":"8 1","pages":"56-65"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43133625","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}

{"title":"Development of Psoriasis Assessment Tools Among Patients in the CorEvitas Psoriasis Registry.","authors":"Wayne P Gulliver, Kyoungah See, Baojin Zhu, Bruce W Konicek, Ryan W Harrison, Robert R McLean, Samantha J Kerti, Russel T Burge, Craig L Leonardi","doi":"10.1177/24755303231155118","DOIUrl":"10.1177/24755303231155118","url":null,"abstract":"<p><strong>Background: </strong>Dermatologists would benefit from an easy to use psoriasis severity assessment tool in the clinic.</p><p><strong>Objective: </strong>To develop psoriasis assessment tools to predict PASI and Dermatology Life Quality Index (DLQI) using simple measures typically collected in clinical practice.</p><p><strong>Methods: </strong>Data included 33 605 dermatology visits among plaque psoriasis patients enrolled in the CorEvitas Psoriasis Registry (4/15/15-7/11/20). Performance (adjusted coefficient of determination [R² _adj], root mean square error [RMSE]) in predicting PASI and DLQI was assessed for 16 different linear regression models (specified a priori based on combinations of BSA, Investigator's Global Assessment [IGA], itch, skin pain, patient global assessment, age, sex, BMI, comorbidity index, prior biologic use), and 2 stepwise selection models and 1 elastic net model based on 56 available variables. For each prediction model, concordance (sensitivity, specificity) of predicted PASI75, PASI90 and DLQI 0/1 with observed values was evaluated.</p><p><strong>Results: </strong>Mean (SD) age, BSA, and PASI were 51 (14) years, 6 (11), and 4 (6), respectively; 46% were women, and 87% were biologic experienced. A model predicting PASI using BSA plus IGA performed best among a priori specified models (R² _adj = .72, RMSE = 2.93) and only marginally worse than models including additional variables (R² _adj range .64-.74, RMSE range 2.82-3.36). Models including IGA had the best concordance between predicted and observed PASI75 (sensitivity range 83-85%, specificity range 88-91%) and PASI90 (sensitivity range 76-82%, specificity range 94-98%). DLQI prediction was limited.</p><p><strong>Conclusion: </strong>An assessment tool for psoriasis including BSA and IGA may be an ideal option to predict PASI in a clinic setting.</p>","PeriodicalId":36656,"journal":{"name":"Journal of Psoriasis and Psoriatic Arthritis","volume":"8 1","pages":"74-82"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49511943","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}

{"title":"Proportions of Biologic Discontinuation Among Psoriasis Patients With Metabolic Comorbidities.","authors":"Clinton W Enos, Vanessa L Ramos, Robert R McLean, Tin-Chi Lin, Nicole Foster, Blessing Dube, Abby S Van Voorhees","doi":"10.1177/24755303221131257","DOIUrl":"10.1177/24755303221131257","url":null,"abstract":"<p><strong>Background: </strong>Among psoriasis patients, the presence of metabolic comorbidities associates with poorer response to biologics. How the presence of comorbidity impacts treatment patterns with biologics is not fully understood.</p><p><strong>Methods: </strong>Adult patients in the CorEvitas Psoriasis Registry were included if they initiated biologic therapy between 5/2015-12/2019 and had a 6-month follow-up visit. The frequency of biologic discontinuations by 6-months were calculated by metabolic comorbidity status (current obesity and histories of hypertension [HTN], diabetes [DM], and hyperlipidemia [HLD]) for all patients and by drug class (tumor necrosis factor inhibitors [TNFi], interleukin-17i [IL-17i], and IL-23i or IL-12/23i).</p><p><strong>Results: </strong>Among the 2924 participants, discontinuations were more frequent in those with obesity (17%, <i>P</i> < .01) or DM (20%, <i>P</i> < .001) compared to those without these (13% and 14%, respectively). Discontinuations were similar for those with and without histories of HTN or HLD. Frequencies of discontinuation for each biologic class were: TNFi (26%), IL-17i (16%), and IL-23i or IL-12/23i (9%). Among TNFi initiators, the proportions of discontinuations were greater in the presence of obesity (30%, <i>P</i> < .05), DM (34%, <i>P</i> < .05), or HTN (34%, <i>P</i> < .01) compared to those without (22%, 24%, and 22%, respectively). Of the IL-23i or IL-12/23i initiators, discontinuations were more frequent in those with obesity (11%, <i>P</i> < .01) or with DM (13%, <i>P</i> < .05) compared to those without (7% and 8%, respectively). Discontinuations did not statistically differ between comorbidity groups in IL-17i initiators.</p><p><strong>Conclusion: </strong>Comorbid disease status, especially obesity and DM, should be assessed at biologic initiation as it may predict a less optimal clinical outcome.</p>","PeriodicalId":36656,"journal":{"name":"Journal of Psoriasis and Psoriatic Arthritis","volume":"8 1","pages":"7-10"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297486","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}

{"title":"GRAPPA trainee symposium","authors":"","doi":"10.1177/24755303221141161","DOIUrl":"https://doi.org/10.1177/24755303221141161","url":null,"abstract":"Abstract","PeriodicalId":36656,"journal":{"name":"Journal of Psoriasis and Psoriatic Arthritis","volume":"8 1","pages":"24 - 44"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42053374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Multi-Biologic Use in Psoriasis Patients at an Academic Medical Center and Review of Biologic Survival.","authors":"Edward Hadeler, Sugandh Kumar, Samuel Yeroushalmi, Julie Hong, Elizabeth Wallace, George Han, Megan Mosca, Erin Bartholomew, Mimi Chung, Marwa Hakimi, Soumya Reddy, Jose Scher, Tina Bhutani, George Gondo, April Armstrong, Stacie Bell, Wilson Liao","doi":"10.1177/24755303221131259","DOIUrl":"10.1177/24755303221131259","url":null,"abstract":"<p><strong>Background: </strong>Despite their impressive efficacy in phase 3 trials, biologic agents for psoriasis (PsO) may lose efficacy over time. The factors associated with loss of efficacy have yet to be fully elucidated.</p><p><strong>Objective: </strong>We aimed to identify factors associated with PsO patients using multiple biologics in comparison to patients who used 1 biologic. We also reviewed the literature comparing the survival of different biologic agents for PsO.</p><p><strong>Methods: </strong>We examined clinical data from 222 psoriasis patients at the University of California San Francisco, of whom 51 reported use of 3 or more biologics and of whom 171 reported use of only a single biologic agent at the time of enrollment into a research database from 2006-2020. <b>This study was IRB-approved at UCSF (#10-02830) and all subjects provided written informed consent.</b> We performed univariate and multivariate regression analysis to identify significant demographic features, clinical features, and co-morbidities associated with multi-biologic use. We performed a literature review of studies comparing psoriasis biologic survival at 1, 2, and 5 years and factors associated with single biologic failure.</p><p><strong>Results: </strong>In univariate analysis, duration of PsO, initial presentation of PsO on the gluteal cleft, erythrodermic psoriasis, and acne were associated with using 3 or more biologics. In multivariate analysis, duration of PsO, erythrodermic psoriasis, and acne remained significant. Our review of biologic survival revealed differences according to biologic class.</p><p><strong>Conclusion: </strong>We identified novel factors associated with multi-biologic use in PsO. Further studies in this area are needed to achieve a precision medicine approach.</p>","PeriodicalId":36656,"journal":{"name":"Journal of Psoriasis and Psoriatic Arthritis","volume":"8 1","pages":"11-18"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41913544","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}

{"title":"Letter to the Editor: Does Ambient Ultraviolet Radiation Affect Psoriasis Severity.","authors":"Warren A James, Mallory Zaino, Steven R Feldman, Alan B Fleischer","doi":"10.1177/24755303221131255","DOIUrl":"10.1177/24755303221131255","url":null,"abstract":"","PeriodicalId":36656,"journal":{"name":"Journal of Psoriasis and Psoriatic Arthritis","volume":"8 1","pages":"5-6"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49656410","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}

{"title":"Adverse Events in Patients Receiving Placebo in Phase III Trials of Biologics for Psoriasis: A Systematic Review and Meta-Analysis.","authors":"Gayathri Devaraj Ajenthen, Alexander Egeberg, Katrine Elsner Melgaard, Nikolai Loft","doi":"10.1177/24755303221142295","DOIUrl":"10.1177/24755303221142295","url":null,"abstract":"<p><strong>Background: </strong>Patients and practitioners often consider the risk of side effects when starting a treatment for psoriasis and often consult reported adverse events (AE) in studies. However, most of these AEs are unrelated to treatment and patients consider what is the risk of an event should you not start a treatment. This is what would be observed in the placebo-arm of clinical trials.</p><p><strong>Objective: </strong>To investigate the proportion of patients experiencing AEs during treatment with placebo in clinical trials.</p><p><strong>Methods: </strong>We conducted a systematic literature search using PubMed, Embase and Web of Science databases for phase 3 randomized clinical trials that registered adverse events of using placebo vs biological agents for psoriasis. The search term was \"<i>Psoriasis AND (Phase III OR Phase 3)</i>\".</p><p><strong>Results: </strong>Of 7142 screened articles, 54 were included in the metanalysis. The pooled proportion of placebo-treated patients experiencing any AEs was .52 (95% Cl: .51 to .53) after 12 weeks and .53 (95% Cl: .50 to .55) after 16 weeks. The pooled proportion of patients with any serious AEs was .02 (95% Cl: .01 to .02) and .03 (95% Cl: .02 to .03) after 12 and 16 weeks, respectively. The most common AEs in placebo-treated patients were infections, nasopharyngitis, and headache.</p><p><strong>Conclusion: </strong>About half of the patients with moderate-to-severe psoriasis not starting an active treatment would experience disease events that would be categorized as AEs during a 12-16 weeks period.</p>","PeriodicalId":36656,"journal":{"name":"Journal of Psoriasis and Psoriatic Arthritis","volume":"8 1","pages":"19-23"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47947125","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}

{"title":"Coverage of Specialty Drugs for Psoriasis and Psoriatic Arthritis by Commercial Insurance Companies.","authors":"Christine Learned, Sara Alsukait, Kristin R Fiumara, Melissa Ortega, James D Chambers, David Rosmarin","doi":"10.1177/24755303221101843","DOIUrl":"10.1177/24755303221101843","url":null,"abstract":"<p><strong>Background: </strong>Specialty medications provide effective treatment with limited adverse effects to patients with psoriasis and psoriatic arthritis; however, variable coverage and high costs often create a barrier to treatment for patients with commercial health insurance.</p><p><strong>Objective: </strong>We aimed to evaluate coverage of psoriasis and psoriatic arthritis specialty medications by commercial insurance companies.</p><p><strong>Methods: </strong>We compiled data regarding specialty drug coverage for psoriasis and psoriatic arthritis using Tufts Medical Center Specialty Drug Evidence and Coverage (SPEC) database and analyzed the data for any notable trends. The SPEC database lists coverage decisions for 158 specialty drugs by 17 of the largest US commercial health plans, as well as data regarding the types of evidence cited by these insurance plans when making coverage decisions.</p><p><strong>Results: </strong>Our results showed that insurance plans tend to be more restrictive than the U.S. Food and Drug Association (FDA) label when covering medications for psoriasis and psoriatic arthritis. Furthermore, medications for psoriatic arthritis tended to be less restricted than for psoriasis, and medications were most commonly approved as second line agents for both indications.</p><p><strong>Conclusion: </strong>Our analysis confirms that variability in insurance coverage exists for the indications of psoriasis and psoriatic arthritis.</p>","PeriodicalId":36656,"journal":{"name":"Journal of Psoriasis and Psoriatic Arthritis","volume":"7 1","pages":"160-163"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42228639","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}

{"title":"Public Perception of SARS-CoV-2 Vaccines Among Psoriasis Patients in Social Media: Content, Sentiment, and Engagement Analysis.","authors":"Danielle Yee, Sabrina Khan, Caterina Zagona-Prizio, Nicole Maynard, Rasika Reddy, Samiya Khan, Manan Mehta, April W Armstrong","doi":"10.1177/24755303221110095","DOIUrl":"10.1177/24755303221110095","url":null,"abstract":"<p><strong>Background: </strong>Psoriasis patients may seek information about the SARS-CoV-2 vaccine and their disease from social media platforms. Analyses of social media interactions may help guide dermatologists' educational efforts during this pandemic.</p><p><strong>Objectives: </strong>This study analyzes social media interactions among patients with psoriasis and psoriatic arthritis regarding the SARS-CoV-2 vaccine to determine the misinformation circulating and the apprehension to receiving the vaccine.</p><p><strong>Methods: </strong>Publicly accessible Facebook and Reddit groups regarding psoriasis and psoriatic arthritis were identified. Posts uploaded between March 1, 2021 and July 31, 2021 which contained information about the SARS-CoV-2 vaccine were extracted. First-order themes, sub-themes, sentiment scores and engagement scores were assigned to each post.</p><p><strong>Results: </strong>345 posts within the first-order theme of <i>vaccination decision</i> and 1379 posts within the first-order theme of <i>vaccine reaction</i> were analyzed. Within <i>vaccination decision</i>, common sub-themes for refusing the vaccine include <i>fear of psoriasis flare up, vaccine is experimental, vaccine is unnecessary, vaccine is dangerous</i>, and <i>concern for reaction/vaccine efficacy while on psoriasis medications</i>. 41.4% of posts contained positive sentiment; whereas, 38.3% contained negative sentiment. Within <i>vaccine reaction</i>, common sub-themes identified were <i>no change to psoriasis, skin/joint flare up, skin flare up attributed specifically to stopping psoriasis medications, skin/joint improvement,</i> and <i>skin flare up but vaccine was worth it</i>. 77.8% of posts contained positive sentiment; whereas, 6.2% contained negative sentiment.</p><p><strong>Conclusions: </strong>Our study identified common SARS-CoV-2 vaccine concerns within the psoriasis community which should be used to guide educational efforts.</p>","PeriodicalId":36656,"journal":{"name":"Journal of Psoriasis and Psoriatic Arthritis","volume":"7 1","pages":"164-173"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9207593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49522945","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}