Comparison of #Coronary Artery Calcium Scores Between Patients With #Psoriasis and Type 2 Diabetes
http://archderm.jamanetwork.com/mobile/article.aspx?articleid=2546028
Conclusions and Relevance Patients with psoriasis have increased coronary artery calcium by mean total Agatston scores, similar to that of patients with type 2 diabetes, suggesting that patients with psoriasis harbor high rates of subclinical atherosclerosis beyond adjustment for body mass index. Major educational efforts for patients and physicians should be undertaken to reduce the burden of cardiovascular disease in patients with psoriasis.
http://archderm.jamanetwork.com/mobile/article.aspx?articleid=2546028
Conclusions and Relevance Patients with psoriasis have increased coronary artery calcium by mean total Agatston scores, similar to that of patients with type 2 diabetes, suggesting that patients with psoriasis harbor high rates of subclinical atherosclerosis beyond adjustment for body mass index. Major educational efforts for patients and physicians should be undertaken to reduce the burden of cardiovascular disease in patients with psoriasis.
Jamanetwork
Coronary Artery Calcium Scores in Psoriasis and Type 2 Diabetes
This cross-sectional study compares coronary artery calcium scores in patients with moderate to severe psoriasis, type 2 diabetes, and healthy controls.
Association Between Pediatric #Psoriasis and #Waist-to-Height Ratio in the Absence of Obesity
http://archderm.jamanetwork.com/mobile/article.aspx?articleid=2553749
Conclusions and Relevance In this Australian cohort of children with psoriasis, elevated WtHR was significantly more common in patients with psoriasis than in controls, while proportions of participants with metabolic syndrome or BMI-determined obesity were not significantly different between the 2 groups.
This study evaluates waist-to-height ratio in children with psoriasis as a potentially superior measure of central adiposity and increased cardiovascular risk than is body mass index.
http://archderm.jamanetwork.com/mobile/article.aspx?articleid=2553749
Conclusions and Relevance In this Australian cohort of children with psoriasis, elevated WtHR was significantly more common in patients with psoriasis than in controls, while proportions of participants with metabolic syndrome or BMI-determined obesity were not significantly different between the 2 groups.
This study evaluates waist-to-height ratio in children with psoriasis as a potentially superior measure of central adiposity and increased cardiovascular risk than is body mass index.
Jamanetwork
Pediatric Psoriasis and Increased Waist-to-Height Ratio
This study evaluates waist-to-height ratio in children with psoriasis as a potentially superior measure of central adiposity and increased cardiovascular risk than is body mass index.
An intensified dosing schedule of subcutaneous #methotrexate in patients with moderate to severe plaque-type #psoriasis (METOP): a 52 week, multicentre, randomised, double-blind, placebo-controlled, phase 3 trial
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)32127-4/abstract
Our findings show a favourable 52 week risk–benefit profile of subcutaneous methotrexate in patients with psoriasis. The route of administration and the intensified dosing schedule should be considered when methotrexate is used in this patient group.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)32127-4/abstract
Our findings show a favourable 52 week risk–benefit profile of subcutaneous methotrexate in patients with psoriasis. The route of administration and the intensified dosing schedule should be considered when methotrexate is used in this patient group.
The risk of #fracture among patients with psoriatic arthritis and #psoriasis: a population-based study
http://ardbeta.bmj.com/content/early/2017/01/16/annrheumdis-2016-210441
Patients with severe psoriasis had significantly elevated risk of all fracture and vertebral fracture: aHR 1.26 (1.15 to 1.39) and 2.23 (1.54 to 3.22).
PsA and psoriasis are associated with an elevated risk for fracture.
http://ardbeta.bmj.com/content/early/2017/01/16/annrheumdis-2016-210441
Patients with severe psoriasis had significantly elevated risk of all fracture and vertebral fracture: aHR 1.26 (1.15 to 1.39) and 2.23 (1.54 to 3.22).
PsA and psoriasis are associated with an elevated risk for fracture.
Annals of the Rheumatic Diseases
The risk of fracture among patients with psoriatic arthritis and psoriasis: a population-based study
Objective To determine the risk of fracture and osteoporosis among patients with psoriatic arthritis (PsA) and psoriasis, compared with the general population and patients with rheumatoid arthritis (RA).
Methods A population-based cohort study was performed…
Methods A population-based cohort study was performed…
Association Between Skin and Aortic #Vascular #Inflammation in Patients With #Psoriasis
A Case-Cohort Study Using Positron Emission Tomography/Computed Tomography
http://jamanetwork.com/journals/jamacardiology/article-abstract/2629533
Importance Inflammation is critical in the development of atherosclerosis. Psoriasis is a chronic inflammatory skin disease that is associated with increased vascular inflammation by 18fluorodeoxyglucose positron emission tomography/computed tomography in vivo and future cardiovascular events. It provides a human model to understand the effect of treating inflammation in a target organ (eg, the skin) on vascular diseases.
Conclusions and Relevance Improvement in psoriasis skin disease severity was associated with improvement in aortic vascular inflammation by 18fluorodeoxyglucose positron emission tomography/computed tomography, with greater improvement in aortic vascular inflammation observed in those who had higher than 75% reduction in skin disease severity. These findings suggest that controlling remote target organ inflammation (eg, in the skin) may improve vascular diseases; however, randomized clinical trials are needed to confirm these findings.
A Case-Cohort Study Using Positron Emission Tomography/Computed Tomography
http://jamanetwork.com/journals/jamacardiology/article-abstract/2629533
Importance Inflammation is critical in the development of atherosclerosis. Psoriasis is a chronic inflammatory skin disease that is associated with increased vascular inflammation by 18fluorodeoxyglucose positron emission tomography/computed tomography in vivo and future cardiovascular events. It provides a human model to understand the effect of treating inflammation in a target organ (eg, the skin) on vascular diseases.
Conclusions and Relevance Improvement in psoriasis skin disease severity was associated with improvement in aortic vascular inflammation by 18fluorodeoxyglucose positron emission tomography/computed tomography, with greater improvement in aortic vascular inflammation observed in those who had higher than 75% reduction in skin disease severity. These findings suggest that controlling remote target organ inflammation (eg, in the skin) may improve vascular diseases; however, randomized clinical trials are needed to confirm these findings.
Jamanetwork
Skin and Aortic Vascular Inflammation in Patients With Psoriasis
This cohort study investigates the association between change in skin disease severity and change in vascular inflammation at 1 year and characterizes the impact of 1 year of anti–tumor necrosis factor therapy on vascular inflammation in patients with psoriasis.
The effect of #secukinumab on moderate-to-severe scalp #psoriasis: Results of a 24-week, randomized, double-blind, placebo-controlled phase 3b study
http://www.jaad.org/article/S0190-9622(17)31781-4/fulltext
In this 24-week, double-blind, phase 3b study, 102 patients were randomized 1:1 to subcutaneous secukinumab 300 mg or placebo at baseline, weeks 1, 2, and 3, and then every 4 weeks from week 4 to 20. The primary efficacy variable was 90% improvement of Psoriasis Scalp Severity Index (PSSI 90) score from baseline to week 12. At week 12, PSSI 90 (secukinumab 300 mg vs placebo, 52.9% vs 2.0%) and Investigator's Global Assessment modified 2011 scalp responses of 0 or 1 (secukinumab 300 mg vs placebo, 56.9% vs 5.9%) were significantly greater with secukinumab 300 mg than placebo (P < .001 for both). In addition, significantly more patients achieved complete clearance of scalp psoriasis at week 12 with secukinumab 300 mg than placebo (35.3% vs 0%; P < .001). The median time to 50% reduction in PSSI score was 3.29 weeks with secukinumab 300 mg. The safety profile of secukinumab was consistent with previous phase 3 studies.
Secukinumab is efficacious and well-tolerated for patients with extensive moderate-to-severe scalp psoriasis.
http://www.jaad.org/article/S0190-9622(17)31781-4/fulltext
In this 24-week, double-blind, phase 3b study, 102 patients were randomized 1:1 to subcutaneous secukinumab 300 mg or placebo at baseline, weeks 1, 2, and 3, and then every 4 weeks from week 4 to 20. The primary efficacy variable was 90% improvement of Psoriasis Scalp Severity Index (PSSI 90) score from baseline to week 12. At week 12, PSSI 90 (secukinumab 300 mg vs placebo, 52.9% vs 2.0%) and Investigator's Global Assessment modified 2011 scalp responses of 0 or 1 (secukinumab 300 mg vs placebo, 56.9% vs 5.9%) were significantly greater with secukinumab 300 mg than placebo (P < .001 for both). In addition, significantly more patients achieved complete clearance of scalp psoriasis at week 12 with secukinumab 300 mg than placebo (35.3% vs 0%; P < .001). The median time to 50% reduction in PSSI score was 3.29 weeks with secukinumab 300 mg. The safety profile of secukinumab was consistent with previous phase 3 studies.
Secukinumab is efficacious and well-tolerated for patients with extensive moderate-to-severe scalp psoriasis.
#Atopic dermatitis and #psoriasis: two different immune diseases or one spectrum?
http://www.sciencedirect.com/science/article/pii/S0952791517301061
Highlights
•Psoriasis and AD are diseases of distinct T-cell ‘polar’ subsets.
•Targeting Th17/IL-17 is an extremely effective treatment for psoriasis.
•Targeting Th2/IL-4 & IL-13 is a highly effective treatment for atopic dermatitis.
•However, specific sub-types of atopic dermatitis blend Th17 and Th2 cytokine axes.
•Optimal treatment of AD across subtypes might require targeting multiple cytokines.
http://www.sciencedirect.com/science/article/pii/S0952791517301061
Highlights
•Psoriasis and AD are diseases of distinct T-cell ‘polar’ subsets.
•Targeting Th17/IL-17 is an extremely effective treatment for psoriasis.
•Targeting Th2/IL-4 & IL-13 is a highly effective treatment for atopic dermatitis.
•However, specific sub-types of atopic dermatitis blend Th17 and Th2 cytokine axes.
•Optimal treatment of AD across subtypes might require targeting multiple cytokines.
Remission of #Psoriasis After Treatment of Chronic Hepatitis #C Virus Infection With Direct-Acting Antivirals
http://annals.org/aim/article-abstract/2669850/remission-psoriasis-after-treatment-chronic-hepatitis-c-virus-infection-direct
Background: Hepatitis C virus (HCV) infection is a systemic disease with extrahepatic manifestations that include skin involvement, such as mixed cryoglobulinemia, lichen planus, and porphyria cutanea tarda (1). Some studies also suggest an association between HCV infection and psoriasis (2).
Objective: To provide additional information about the possible association between HCV infection and psoriasis.
http://annals.org/aim/article-abstract/2669850/remission-psoriasis-after-treatment-chronic-hepatitis-c-virus-infection-direct
Background: Hepatitis C virus (HCV) infection is a systemic disease with extrahepatic manifestations that include skin involvement, such as mixed cryoglobulinemia, lichen planus, and porphyria cutanea tarda (1). Some studies also suggest an association between HCV infection and psoriasis (2).
Objective: To provide additional information about the possible association between HCV infection and psoriasis.
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Association Between #Mediterranean Anti-inflammatory Dietary Profile and Severity of #Psoriasis
https://jamanetwork.com/journals/jamadermatology/fullarticle/2687981#193430799
Of the 158 361 total NutriNet-Santé participants, 35 735 (23%) replied to the psoriasis questionnaire. The mean (SD) age of the respondents was 47.5 (14.0) years; 27 220 (76%) of the respondents were women. Of these 35 735 respondents, 3557 (10%) individuals reported having psoriasis. The condition was severe in 878 cases (24.7%), and 299 (8.4%) incident cases were recorded (those arising more than 2 years after participant inclusion in the cohort). After adjustment for confounding factors, a significant inverse relationship was found between the MEDI-LITE score and having severe psoriasis: odds ratio (OR), 0.71; 95% CI, 0.55-0.92 for the MEDI-LITE score’s second tertile (score of 8 to 9); and OR, 0.78; 95% CI, 0.59-1.01 for the third tertile (score of 10 to 18).
Conclusions and Relevance Patients with severe psoriasis displayed low levels of adherence to the Mediterranean diet; this finding supports the hypothesis that the Mediterranean diet may slow the progression of psoriasis. If these findings are confirmed, adherence to a Mediterranean diet should be integrated into the routine management of moderate to severe psoriasis
Association Between #Mediterranean Anti-inflammatory Dietary Profile and Severity of #Psoriasis
https://jamanetwork.com/journals/jamadermatology/fullarticle/2687981#193430799
Of the 158 361 total NutriNet-Santé participants, 35 735 (23%) replied to the psoriasis questionnaire. The mean (SD) age of the respondents was 47.5 (14.0) years; 27 220 (76%) of the respondents were women. Of these 35 735 respondents, 3557 (10%) individuals reported having psoriasis. The condition was severe in 878 cases (24.7%), and 299 (8.4%) incident cases were recorded (those arising more than 2 years after participant inclusion in the cohort). After adjustment for confounding factors, a significant inverse relationship was found between the MEDI-LITE score and having severe psoriasis: odds ratio (OR), 0.71; 95% CI, 0.55-0.92 for the MEDI-LITE score’s second tertile (score of 8 to 9); and OR, 0.78; 95% CI, 0.59-1.01 for the third tertile (score of 10 to 18).
Conclusions and Relevance Patients with severe psoriasis displayed low levels of adherence to the Mediterranean diet; this finding supports the hypothesis that the Mediterranean diet may slow the progression of psoriasis. If these findings are confirmed, adherence to a Mediterranean diet should be integrated into the routine management of moderate to severe psoriasis
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Association Between #Psoriasis and Sexual and #Erectile Dysfunction in Epidemiologic Studies
A Systematic Review
https://jamanetwork.com/journals/jamadermatology/article-abstract/2705772
Prevalence of SD and ED ranged from 40.0% to 55.6% and 34.2% to 81.1%, respectively. Two of 2 studies observed an association between psoriasis and SD after adjusting for physical and psychological comorbidities. Five of 8 studies observed an independent association between ED and psoriasis. Among patients with psoriasis, the features that showed the strongest association with SD were anxiety and depression (5 of 5 studies), psoriatic arthritis (3 of 4 studies), and genital psoriasis (5 of 7 studies). Regarding ED, anxiety and depression (2 of 2 studies) and increasing age (3 of 3 studies) showed the strongest association. All 3 clinical trials using biologic drugs showed an improvement in SD compared with placebo.
Conclusions and Relevance Patients with psoriasis have physical and psychological comorbidities that have been associated with a higher risk of SD. In addition, psoriasis may play a role in its development. The presence of anxiety, depression, psoriatic arthritis, genital lesions, and increasing age should raise the awareness of SD. Biologic drugs have demonstrated the improvement of SD in patients with psoriasis.
Association Between #Psoriasis and Sexual and #Erectile Dysfunction in Epidemiologic Studies
A Systematic Review
https://jamanetwork.com/journals/jamadermatology/article-abstract/2705772
Prevalence of SD and ED ranged from 40.0% to 55.6% and 34.2% to 81.1%, respectively. Two of 2 studies observed an association between psoriasis and SD after adjusting for physical and psychological comorbidities. Five of 8 studies observed an independent association between ED and psoriasis. Among patients with psoriasis, the features that showed the strongest association with SD were anxiety and depression (5 of 5 studies), psoriatic arthritis (3 of 4 studies), and genital psoriasis (5 of 7 studies). Regarding ED, anxiety and depression (2 of 2 studies) and increasing age (3 of 3 studies) showed the strongest association. All 3 clinical trials using biologic drugs showed an improvement in SD compared with placebo.
Conclusions and Relevance Patients with psoriasis have physical and psychological comorbidities that have been associated with a higher risk of SD. In addition, psoriasis may play a role in its development. The presence of anxiety, depression, psoriatic arthritis, genital lesions, and increasing age should raise the awareness of SD. Biologic drugs have demonstrated the improvement of SD in patients with psoriasis.
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Prevalence, Incidence, and Risk of Cancer in Patients With #Psoriasis and Psoriatic Arthritis
A Systematic Review and Meta-analysis
..There was an increased risk of several cancers, including keratinocyte cancer (RR, 2.28; 95% CI, 1.73-3.01), lymphomas (RR, 1.56; 95% CI, 1.37-1.78), lung cancer (RR, 1.26; 95% CI, 1.13-1.40), and bladder cancer (RR, 1.12; 95% CI, 1.04-1.19). No increased risk of cancer for patients with psoriasis treated with biologic agents was found (RR, 0.97; 95% CI, 0.85-1.10). Psoriatic arthritis was not associated with increased risk of cancer overall (RR, 1.02; 95% CI, 0.97-1.08).
Conclusions and Relevance Patients with psoriasis appear to have a slightly increased risk of cancer, particularly keratinocyte cancer and lymphomas. Data on treatment with biologic agents did not show an increased risk of cancer. Data on cancer in patients with psoriatic arthritis remain scarce, and further research is warranted in this area.
https://bit.ly/2VjTSa7
Prevalence, Incidence, and Risk of Cancer in Patients With #Psoriasis and Psoriatic Arthritis
A Systematic Review and Meta-analysis
..There was an increased risk of several cancers, including keratinocyte cancer (RR, 2.28; 95% CI, 1.73-3.01), lymphomas (RR, 1.56; 95% CI, 1.37-1.78), lung cancer (RR, 1.26; 95% CI, 1.13-1.40), and bladder cancer (RR, 1.12; 95% CI, 1.04-1.19). No increased risk of cancer for patients with psoriasis treated with biologic agents was found (RR, 0.97; 95% CI, 0.85-1.10). Psoriatic arthritis was not associated with increased risk of cancer overall (RR, 1.02; 95% CI, 0.97-1.08).
Conclusions and Relevance Patients with psoriasis appear to have a slightly increased risk of cancer, particularly keratinocyte cancer and lymphomas. Data on treatment with biologic agents did not show an increased risk of cancer. Data on cancer in patients with psoriatic arthritis remain scarce, and further research is warranted in this area.
https://bit.ly/2VjTSa7
Are biologics combined with methotrexate better than biologics monotherapy in #psoriasis and psoriatic #arthritis: a meta‐analysis of randomized controlled trials
https://2medical.news/2021/03/08/are-biologics-combined-with-methotrexate-better-than-biologics-monotherapy-in-psoriasis-and-psoriatic-arthritis-a-meta%E2%80%90analysis-of-randomized-controlled-trials/
To investigate if the combination of biologics with methotrexate (MTX) would have better performance than biological monotherapy in clinical efficiency and safety for the treatment of psoriasis and psoriatic arthritis (PsA). Methods. A systematic review of randomized controlled trials (RCTs) searched from the Pubmed, Cochrane Library, and Embase was conducted. Psoriasis Area and Severity Index (PASI) responses (including PASI50,75 and 90), and proportion of patients …
https://2medical.news/2021/03/08/are-biologics-combined-with-methotrexate-better-than-biologics-monotherapy-in-psoriasis-and-psoriatic-arthritis-a-meta%E2%80%90analysis-of-randomized-controlled-trials/
To investigate if the combination of biologics with methotrexate (MTX) would have better performance than biological monotherapy in clinical efficiency and safety for the treatment of psoriasis and psoriatic arthritis (PsA). Methods. A systematic review of randomized controlled trials (RCTs) searched from the Pubmed, Cochrane Library, and Embase was conducted. Psoriasis Area and Severity Index (PASI) responses (including PASI50,75 and 90), and proportion of patients …