scholarly journals Cardiometabolic Comorbidities in Patients With Psoriasis: Focusing on Risk, Biological Therapy, and Pathogenesis

2021 ◽  
Vol 12 ◽  
Author(s):  
Jiangluyi Cai ◽  
Lian Cui ◽  
Yu Wang ◽  
Ying Li ◽  
Xilin Zhang ◽  
...  
Keyword(s):  
Biologic Therapy ◽  
Life Quality ◽  
Chronic Inflammatory Disease ◽  
Inflammatory Pathways ◽  
Th 17 ◽  
Increased Risk ◽  
Interleukin 23 ◽  
Psoriasis Severity ◽  
Necrosis Factor

Psoriasis is a chronic inflammatory disease characterized by erythematous scaly plaques, accompanied by systemic damage that leads to the development of multiple comorbidities. In particular, the association between psoriasis and cardiometabolic comorbidities, including cardiovascular diseases (CVDs), obesity, diabetes mellitus, and metabolic syndrome, has been verified in a considerable number of clinical trials. Moreover, the increased risk of cardiometabolic comorbidities positively correlates with psoriasis severity. Biologic therapy targeting inflammatory pathways or cytokines substantially improves the life quality of psoriasis patients and may affect cardiometabolic comorbidities by reducing their incidences. In this review, we focus on exploring the association between cardiometabolic comorbidities and psoriasis, and emphasize the benefits and precautions of biologic therapy in the management of psoriasis with cardiometabolic comorbidities. The pathogenic mechanisms of cardiometabolic comorbidities in psoriasis patients involve common genetic factors, lipid metabolism, insulin resistance, and shared inflammatory pathways such as tumor necrosis factor-α and interleukin-23/Th-17 pathways.

scholarly journals Quality of Life in Iranian Patients with Acne

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
H. Safizadeh ◽  
S. Shamsi-Meymandy ◽  
A. Naeimi
Keyword(s):  
Quality Of Life ◽  
Life Quality ◽  
Chronic Inflammatory Disease ◽  
Self Image ◽  
Related Quality ◽  
Health Related ◽  
Life Threatening ◽  
The Mean ◽  
Iranian Context

Acne is a chronic inflammatory disease of pilosebaceous units. Although the acne isnot a life threatening disease, studies have revealed that it has significant effect on self-image and quality of life. The purpose of this paper was to investigate the health-related quality of life in patients with acne in an Iranian context. Dermatology Life Quality Index (DLQI) and Cardiff Acne Disability Index (CADI) were used for measuring quality of life, and severity of acne was measured by Global Acne Grading System (GAGS). The mean (±SD) of DLQI and CADI scores was 6.42 (±4.77) and 5.97 (±2.97), respectively. Acne influenced the quality of life in 51.8% of patients from moderate to very much, and the quality of life was affected by the severity of acne (P< 0.01). Since acne has significant effects on patient’s quality of life, the management of patients with acne requires more attention to different aspects of quality of life.

scholarly journals Azathioprine and Infliximab: Monotherapy or Combination Therapy in the Treatment of Crohn's Disease

2011 ◽  
Vol 4 ◽  
pp. CGast.S5256 ◽  
Author(s):  
Bryan L. Love ◽  
Lisa S. Smith ◽  
Steedman A. Sarbah ◽  
Fred C. Fowler
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Combination Therapy ◽  
Tumor Necrosis ◽  
Chronic Inflammatory Disease ◽  
First Line ◽  
Tnf Antagonists ◽  
Systemic Corticosteroids ◽  
Necrosis Factor

Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract often resulting in complications resulting in decreased quality of life. Several classes of medications are available to clinicians including mesalamine, budesonide, systemic corticosteroids, thiopurine derivatives, and monoclonal antibodies which target tumor necrosis factor (TNF). Guidelines generally recommend reserving TNF-antagonists for patients who have failed other first-line therapies; however, emerging data suggests there may be some benefit in combining TNF-antagonists, specifically infliximab, with azathioprine. The purpose of this review is to compare the benefits and risks of combination therapy, and identify patients who may benefit most from this approach.

Relationships between psoriasis severity indices and dermatological life quality index in children with psoriasis

2021 ◽  
pp. 11-20
Author(s):  
Е.О. Murzina ◽  
Yu.А. Rokhletsova
Keyword(s):  
Quality Of Life ◽  
Negative Impact ◽  
Age Groups ◽  
Life Quality ◽  
Pathological Process ◽  
Skin Manifestations ◽  
Scalp Psoriasis ◽  
The Impact ◽  
Psoriasis Severity

Objective — to аssess the impact of dermatosis on the quality of life of children with psoriasis. Materials and methods. Psoriasis severity indices (BSA, PASI, PGA) and dermatological life quality indices (DLQI, CDLQI) in children with psoriasis aged 4 to 17 years depending on the clinical and epidemiological features of dermatosis were determined. A correlation analysis of the presence of a relationship between the obtained indicators was carried out. Results and discussion. In 73.81 % of children, the BSA index was higher than 10, which provided an average BSA of 25.85 (8.78—38.38). The calculated PASI index at the beginning of treatment averaged 9.3 (3.6—18.9). 53.06 % of children had PASI < 10. The PASI index at the first diagnosis was almost 1.5 times lower than in relapses (p = 0.043). The average PGA index was 3 (2—3), namely, 32.99 % of children had PGA 1—2, 43.20 % had PGA 3 and 23.81 % of children had PGA 4. In the group of children aged 4—7 years, there was the smallest number of participants with the PGA index 4 (7.69 %), while in the group aged 16/17—17 years, this number was the largest (41.49 %) (p = 0.039). The calculated DLQI in children with psoriasis was 5 [3—9]. The average DLQI indicator in the group of girls was statistically higher than in the group of boys (p = 0.016). Statistically significant differences were identified between DLQI in the age groups, where the highest impact on quality of life was found for the children aged 16—17 years (p < 0.001) and depended on the clinical form of psoriasis: in scalp psoriasis, the impact on quality of life was moderate, and in inverse psoriasis, it was insignificant (p = 0.021). It was found that in moderate­severe/severe psoriasis, the impact on the quality of life in children increased and was assessed as moderate, while in mild psoriasis, the impact was assessed as minor (p < 0.05). Conclusions. The course of psoriasis in children can be assessed as moderate and severe, but in the first episodes of psoriasis in droplet and inverse forms, the course is mostly mild. The intensity of skin manifestations increases with age, especially in case of the disease recurrences in the plaque form. On the whole in children, psoriasis has an ambiguous impact on the quality of life: in boys, the impact of the disease is minor; in girls, it is moderate. Damage to the visible skin areas caused by psoriasis, an increase in the area affected by the pathological process and an increase in the intensity of skin manifestations with age leads to a more negative impact on the quality of life of a child.

scholarly journals Risk of invasive melanoma in patients with rheumatoid arthritis treated with biologics: results from a collaborative project of 11 European biologic registers

2016 ◽  
Vol 76 (2) ◽  
pp. 386-391 ◽  
Author(s):  
Louise K Mercer ◽  
Johan Askling ◽  
Pauline Raaschou ◽  
William G Dixon ◽  
Lene Dreyer ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Biologic Therapy ◽  
Incidence Rates ◽  
Tnf Inhibitors ◽  
Collaborative Project ◽  
Disease Modifying Drugs ◽  
Increased Risk ◽  
Rate Ratios ◽  
Necrosis Factor ◽  
Country Specific

ObjectivesSome studies have reported a possible association between exposure to tumour necrosis factor (TNF) inhibitors and an increased risk of melanoma. The aim of this study was to investigate the incidence of invasive cutaneous melanomas in patients with rheumatoid arthritis (RA) treated with TNF inhibitors (TNFi), other biologic disease modifying drugs and non-biologic therapy.MethodsEleven biologic registers from nine European countries participated in this collaborative project. According to predefined exposure definitions, cohorts of patients with RA were selected. Using the country-specific general population of each register as reference, age, sex and calendar year standardised incidence ratios (SIRs) of invasive histology-confirmed cutaneous melanoma were calculated within each register. Pooled SIR and incidence rate ratios (IRRs) comparing biologic cohorts to biologic-naïve were calculated across countries by taking the size of the register into account.ResultsOverall 130 315 RA patients with a mean age of 58 years contributing 579 983 person-years were available for the analysis and 287 developed a first melanoma. Pooled SIRs for biologic-naïve, TNFi and rituximab-exposed patients were 1.1 (95% CI 0.9 to 1.4), 1.2 (0.99 to 1.6) and 1.3 (0.6 to 2.6), respectively. Incidence rates in tocilizumab and abatacept-exposed patients were also not significantly increased. IRR versus biologic-naïve patients were: TNFi 1.1 (95% CI 0.8 to 1.6); rituximab 1.2 (0.5 to 2.9).ConclusionsThis large European collaborative project did not confirm an overall increased risk of melanoma following exposure to TNFi.

scholarly journals Serious infections in patients with self-reported psoriatic arthritis from the Psoriasis Longitudinal Assessment and Registry (PSOLAR) treated with biologics

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Christopher T. Ritchlin ◽  
Mona Stahle ◽  
Yves Poulin ◽  
Jerry Bagel ◽  
Soumya D. Chakravarty ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Biologic Therapy ◽  
Reference Group ◽  
Incidence Rates ◽  
Tnf Inhibitors ◽  
Longitudinal Assessment ◽  
Increased Risk ◽  
Serious Infections ◽  
History Of ◽  
Necrosis Factor

Abstract Background Patients with psoriatic arthritis (PsA) have increased risk of adverse events, including serious infections (SI), compared with psoriasis patients. Methods Patients eligible for, or receiving conventional systemic and biologic agents for psoriasis were followed prospectively using PSOLAR. Cohorts included: ustekinumab, tumor necrosis factor (TNF) inhibitors; infliximab; etanercept; adalimumab; non-biologic/methotrexate (MTX) (reference group); and non-biologic/non-MTX. Multivariate analyses using Cox hazard regression were used to identify factors associated with time to first SI. Rates of SI in PSOLAR psoriasis patients with self-reported PsA and possible risks with biologic therapy were evaluated. Results PSOLAR enrolled 4315 psoriasis patients with self-reported PsA. The overall population (N = 2401) included patients (n): 628 ustekinumab; 1413 TNF inhibitors; 258 infliximab; 481 etanercept; 674 adalimumab; 54 other biologics, 98 non-biologic/MTX; 208 non-biologic/non-MTX. Overall, 138 SI were reported with incidence rates per 100 patient-years as follows: a) ustekinumab: 1.00; b) TNF inhibitors: 2.22; c) infliximab: 2.12; d) etanercept: 2.58; e) adalimumab: 1.99; f) non-biologic/MTX: 3.01; g) and non-biologic/non-MTX: 2.31. Age, time-dependent disease activity Physician’s Global Assessment (PGA) of 4, 5, history of infection, and diabetes were associated with increased risk for SI (p < 0.05) in self-reported PsA patients. Biologic groups, other than ustekinumab, had numerically higher rates of SI. Conclusions PSOLAR psoriasis patients with self-reported PsA in the TNF inhibitors, infliximab, adalimumab, etanercept, and MTX cohorts had numerically higher SI rates than the ustekinumab cohort, although not statistically significant. Age, PGA 4, 5, history of infection, and diabetes were associated with an increased risk for SI, irrespective of biologic exposure. Trial registration NCT00508547; Registered July 30, 2007.

scholarly journals Ruído Ocupacional, Audição e Qualidade de Vida em Dentistas

2020 ◽  
Vol 10 ◽  
pp. 88-102
Author(s):  
Thayrine Souza ◽  
Claúdia Gonçalves
Keyword(s):  
Hearing Loss ◽  
High Frequency ◽  
General Health ◽  
Noise Exposure ◽  
Life Quality ◽  
High Frequency Audiometry ◽  
Increased Risk ◽  
Sf 36 ◽  
The Impact

ABSTRACT Introduction Workers with excessive noise exposure can develop problems related to general health, hearing and have changes in quality of life, with Noise-Induced Hearing Loss (NIHL) being the most common change associated with hearing. Dentists, when using different types of equipment for clinical and surgical procedures, end up being exposed to noise daily. Hearing loss is associated with decreased life quality, including an increased risk of loneliness, isolation and a decline in functional fitness. Considering that hearing is fundamental in the socialization process and, consequently, for oral communication, any and all changes in auditory perception can trigger problems in social interaction with a negative impact on people’s lives. Objective To analyse the impact of noise on hearing and life quality of dentists in Paraná. Methods This is a descriptive observational, cross-sectional study carried out with forty dentists from southern Brazil. The research subjects underwent basic audiological evaluation and high frequency audiometry, in addition to answering two questionnaires, one about life quality (SF-36) and the other with data about the working conditions, knowledge and perceptions of dentists regarding the exposure to noise at work. Results Auditory changes suggestive of being induced by noise were observed in 15% of dentists. In high frequency audiometry, auditory alterations occurred in six professionals, and in four of them there was bilateral alteration. The SF-36 indicated median values of 62.57 for general health and 64 for vitality; 100 being the maximum score. It was found that 52.5% of dentists are aware of the effects of noise exposure on health, but only 5% declared using ear protectors during the exercise of their profession. Conclusion Early awareness of the effects of noise would bring more comfort and life quality to dentists, as well as less hearing problems.

Anti-cytokine biologics

2013 ◽  
pp. 636-641 ◽  
Author(s):  
Andrew J. K. Östör
Keyword(s):  
Tumour Necrosis ◽  
Signs And Symptoms ◽  
Increased Risk ◽  
Treatment Paradigm ◽  
History Of ◽  
Disease Modifying ◽  
Dramatic Shift ◽  
Disease Modifying Agents ◽  
Necrosis Factor

Following the introduction of biologic disease-modifying agents into the therapeutic armoury against rheumatoid arthritis (RA) a dramatic shift has occurred in the natural history of the condition. Improvements have been seen not only in the signs and symptoms of disease but also in radiographic progression, functionality, quality of life, and productivity. Anti-cytokine biologics have been at the forefront of this management ’revolution’ as tumour necrosis factor (TNF) antagonists were the first to be trialled in this setting, leading to a profound alteration in the treatment paradigm. In addition to the five anti-TNF biologics (infliximab, etanercept, adalimumab, certolizumab, golimumab), IL-6 blockade with tocilizumab has also been shown to be effective in RA. Antagonism of IL-1 with anakinra, however, has not been as successful. In order to optimize outcomes anti-cytokine biologics are being used earlier in the management of RA. Trial data has shown that they work as well, if not better, in early disease, to achieve disease remission. Safety remains of paramount importance, particularly the increased risk of infection, which has been seen in clinical trials and in biologic registries. The side-effect profile is favourable overall, however. A number of novel anti-cytokine biologics are currently being trialled potentially paving the way for ’individualized’ therapy.

scholarly journals IMPROVE 1.0: Individual Monitoring of Psoriasis Activity by Regular Online App Questionnaires and Outpatient Visits

2021 ◽  
Vol 8 ◽  
Author(s):  
Natalie Garzorz-Stark ◽  
Sarah Beicht ◽  
Veronika Baghin ◽  
Sebastian P. Stark ◽  
Tilo Biedermann ◽  
...  
Keyword(s):  
Disease Management ◽  
Disease Activity ◽  
Chronic Diseases ◽  
Life Quality ◽  
Skin Lesions ◽  
Smartphone Apps ◽  
Reported Data ◽  
Study Participants ◽  
Psoriasis Severity

Smartphone apps gain more and more importance in supporting management of chronic diseases. Psoriasis is a highly prevalent, lifelong chronic inflammatory skin disease with a high impact on patient's quality of life. Disease management includes regular topical and systemic treatment of skin lesions as well as co-treatment of metabolic and psychologic disorders. In this study, we investigated the potential of a new smartphone app (IMPROVE 1.0) for individual monitoring of disease activity and disease influencing factors. Twelve out of 50 psoriasis patients asked for study participation performed self-assessment of psoriasis severity, life quality, and stress scores using the app over a period of 1 year. Every 2 months, study participants were carefully examined by a dermatologist in order to control the quality of app-reported data. We found that psoriasis severity and life quality values as entered in the app closely correlate to physician's examination. Furthermore, we detected strong correlations of disease activity with life quality and psoriasis serum biomarker. Temporal relations between psoriasis aggravation and previous changes of lifestyle factors, such as increased stress levels, were observed in individual patients, indicating a high potential for preventive interventions in future psoriasis apps. The vast majority of study participants evaluated IMPROVE 1.0 app positively and wish to include the app into their daily life. Hence, we demonstrate that smartphone apps are a useful tool to raise self-awareness for the dimensions of complex diseases and fully integrate psoriasis patients into individual disease management. These data are important to develop more advanced digital tools supporting the management of chronic diseases in the future.

scholarly journals Psoriasis: clinical and epidemiological features and therapy issues

2018 ◽  
Vol 94 (3) ◽  
pp. 67-76 ◽  
Author(s):  
A. L. Bakulev ◽  
T. V. Fitileva ◽  
E. А. Novodezerkina ◽  
I. Gilloteau ◽  
Н. Tian ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systemic Therapy ◽  
Treatment Satisfaction ◽  
Treatment Success ◽  
Life Quality ◽  
Work Productivity ◽  
Severe Psoriasis ◽  
Activity Impairment ◽  
Psoriasis Severity

Aim. This study sets out to establish the demographic and clinical features of psoriasis and its co-morbidities; to describe approaches to treating patients in Russia, to whom the systemic therapy of drugs has been recommended; to assess the effects of this dermatosis on the patients' quality of life and work productivity; to assess the degree of consistency between dermatologists' and patients' estimates concerning the severity of the disease, complaints/objective manifestations and treatment satisfaction.Methods. Data from the GfK Disease Atlas was used. This ATLAS was filed within a global programme Growth from Knowledge that collected reliable data in the context of everyday clinical practice in 9 countries. The paper presents the results solely for the Russian sample. The study involved patients with moderate or severe psoriasis who were receiving systemic therapy for this disease. Using specially developed forms, ATLAS specialists registered data about patients, their disease and received treatment. The patients affected by psoriasis, who participated in the study, were questioned about their disease. Dermatologists assessed the severity of psoriasis, the patients' complaints, co-morbidities and received treatment. The patients completed questionnaires aimed at assessing the quality of their life [Dermatology Life Quality Index, DLQI] and their work productivity [Work Productivity and Activity Impairment, WPAI]. The concordance between the patients' and the dermatologists' estimates was assessed using Cohen's kappa coefficient.Results. Overall, 3,821 patients participated in the ATLAS programme, out of whom 300 patients were Russians. The average time since psoriasis diagnosis amounted to 9.9 years. 51 % of the patients complained about itching in the lesion areas. Psoriatic arthritis was registered in 19 % of the cases. Among co-morbidities, anxiety or depression was most often recorded (11 %, respectively). The proportion of patients with pruritus and related comorbid conditions increased with psoriasis severity. The disease negatively affected the quality of patients’ life (the average value of DLQI was 7.1) and their work productivity (a decrease in the work productivity reached 33.2 %), with these indicators deteriorating with psoriasis severity. Despite the dominance of moderate and severe psoriasis forms among the participants, 60 % of the patients received therapy only with topical medications. The concordance rate between the patients and the dermatologists concerning the estimation of psoriasis severity and treatment satisfaction was low.Conclusion. Despite the therapy with systemic drugs, the patients' quality of life affected by severe or moderate psoriasis forms remained low. The consistency between the views on the treatment success between the patients and the dermatologists was low.

scholarly journals Once-Weekly Administration of High-Dosage Etanercept in Patients with Plaque Psoriasis: Results of a Pilot Experience (Power Study)

2006 ◽  
Vol 19 (1) ◽  
pp. 205873920601900 ◽  
Author(s):  
N. Cassano ◽  
F. Loconsole ◽  
A. Galluccio ◽  
A. Miracapillo ◽  
M. Pezza ◽  
...  
Keyword(s):  
Plaque Psoriasis ◽  
Life Quality ◽  
Severity Index ◽  
Tumour Necrosis Factor Receptor ◽  
Comparable Rate ◽  
Dosing Regimens ◽  
Efficacy Measures ◽  
Efficacy Parameters ◽  
Necrosis Factor

Etanercept is a soluble tumour necrosis factor receptor fusion protein which is approved for the treatment of plaque psoriasis at the dose of either 25mg twice weekly (BIW) or, for the initial 12 weeks, 50mg BIW. Alternative dosing regimens have not been evaluated in psoriasis. In this study, we compare the efficacy and tolerability of two etanercept dosing regimens - 50mg BIW and 100mg once weekly (OW) - for 12 weeks in 108 patients with moderate-to-severe recalcitrant psoriasis. Efficacy measures included Psoriasis Area and Severity Index (PASI), severity of pruritus recorded on a visual analogue scale (VAS) and the influence on quality of life assessed by means of Dermatology Life Quality Index (DLQI). Both etanercept regimens caused a significant change in all the efficacy parameters after 4 weeks and 12 weeks, at a comparable rate. At week 12, a PASI improvement of at least 50% from baseline (PASI 50) was achieved by 74% of patients treated with 50mg BIW and 78% of patients treated with 100mg OW. A PASI 75 response was obtained in 54% and 50% of patients treated with 50mg BIW and 100mg OW, respectively. Treatment was well tolerated with similar type and frequency of adverse events between the two groups.

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