scholarly journals Apremilast Pharmacogenomics in Russian Patients with Moderate-to-Severe and Severe Psoriasis

2020 ◽  
Vol 11 (1) ◽  
pp. 20
Author(s):  
Dmitry A. Verbenko ◽  
Arfenya E. Karamova ◽  
Olga G. Artamonova ◽  
Dmitry G. Deryabin ◽  
Alexander Rakitko ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Plaque Psoriasis ◽  
Psoriasis Vulgaris ◽  
Therapy Response ◽  
Severity Index ◽  
Pde4 Inhibitor ◽  
Polygenic Risk Score ◽  
Psoriasis Area Severity Index ◽  
Single Single Nucleotide Polymorphism ◽  
Starting Point

One of the target drugs for plaque psoriasis treatment is apremilast, which is a selective phosphodiesterase 4 (PDE4) inhibitor. In this study, 34 moderate-to-severe and severe plaque psoriasis patients from Russia were treated with apremilast for 26 weeks. This allowed us to observe the effectiveness of splitting patient cohorts based on clinical outcomes, which were assessed using the Psoriasis Area Severity Index (PASI). In total, 14 patients (41%) indicated having an advanced outcome with delta PASI 75 after treatment; 20 patients indicated having moderate or no effects. Genome variability was investigated using the Illumina Infinium Global Screening Array. Genome-wide analysis revealed apremilast therapy clinical outcome associations at three compact genome regions with undefined functions situated on chromosomes 2, 4, and 5, as well as on a single single-nucleotide polymorphism (SNP) on chromosome 23. Pre-selected SNP sets were associated with psoriasis vulgaris analysis, which was used to identify four SNP-associated targeted therapy efficiencies: IL1β (rs1143633), IL4 (IL13) (rs20541), IL23R (rs2201841), and TNFα (rs1800629) genes. Moreover, we showed that the use of the global polygenic risk score allowed for the prediction of onset psoriasis in Russians. Therefore, these results can serve as a starting point for creating a predictive model of apremilast therapy response in the targeted therapy of patients with psoriasis vulgaris.

scholarly journals Superiority of a vitamin B12-containing emollient compared to a standard emollient in the maintenance treatment of mild-to-moderate plaque psoriasis

2017 ◽  
Vol 30 (4) ◽  
pp. 439-444 ◽  
Author(s):  
Ester Del Duca ◽  
Francesca Farnetani ◽  
Nathalie De Carvalho ◽  
Ugo Bottoni ◽  
Giovanni Pellacani ◽  
...  
Keyword(s):  
Plaque Psoriasis ◽  
Severity Index ◽  
Vitamin B ◽  
Psoriasis Area Severity Index ◽  
Wide Range ◽  
Significant Difference ◽  
Therapy Option ◽  
The Difference ◽  
Time Point ◽  
Emollient Cream

Psoriasis is a chronic inflammatory skin disease affecting 2%–3% of the population. The wide range of drugs currently available for its treatment could be associated, in the long term, with organ toxicity and adverse events, thus, clinical monitoring throughout treatment is required. This investigator-initiated trial (IIT) evaluated the efficacy and the safety of a vitamin B12-containing ointment in comparison with glycerol-petrolatum-based emollient cream used twice a day to treat mild-to-moderate plaque psoriasis for a period over 12 weeks followed by a wash-out observation period of 4 weeks. This study was conducted as a randomized, controlled, single-blind, intra-patient left- to right-side trial comparing the efficacy and safety of vitamin B12-containing ointment (M-treatment) with a glycerol-petrolatum-based emollient cream (C-treatment). The Psoriasis Area Severity Index (PASI) was determined at baseline (T0), at time points T2 (14 days), T4 (4 weeks), T8 (8 weeks), T12 (12 weeks) and 4 weeks after the end of the wash-out period (F1). In total, 24 patients with plaque psoriasis were randomized to receive left- or right-side treatment with B12 ointment. From time point T2 to time point F1, there was a statistically significant difference in PASI reduction between M-treatment side and C-treatment side. At time point T 12, the difference between the mean reductions from baseline PASI scores by 5.92 ± 2.49 (87, 6%) in the M-treatment side versus 1.08 ± 1.02 (23, 1%) C-treatment side was statistically highly significant ( PWex < 0.001). On the contemporary panorama in the treatment of psoriasis, we conclude that vitamin B12 ointment will represent a new concrete therapy option and should be considered in the update of therapeutic algorithm for the treatment of psoriasis

scholarly journals A comparative study of the efficacy and safety of oral apremilast versus oral methotrexate in patients with moderate to severe chronic plaque psoriasis

2018 ◽  
Vol 4 (4) ◽  
pp. 563
Author(s):  
Vinma H. Shetty ◽  
Saumya Goel ◽  
Amita Murali Babu ◽  
Hafsa Eram
Keyword(s):  
Comparative Study ◽  
Plaque Psoriasis ◽  
Systemic Disease ◽  
Severity Index ◽  
Pde4 Inhibitor ◽  
Efficacy And Safety ◽  
Chronic Plaque Psoriasis ◽  
Oral Methotrexate ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Psoriasis is a chronic, inflammatory systemic disease. Methotrexate acts by inhibiting dihydrofolic reductase enzyme. Apremilast is an oral PDE4 inhibitor approved by US Food and Drug Administration for treatment of psoriasis.</p><p class="abstract"><strong>Methods:</strong> This is hospital based comparative study conducted from February 2018 to August 2018. Seventy patients above 18 years of age with chronic plaque psoriasis were divided into 35 patients in each group and were treated with oral Apremilast (30 mg twice daily) and oral methotrexate (15 mg per week in three divided doses with a 12-hour interval between doses and tab folic acid on methotrexate free days) and were evaluated every 4 weeks for a period of 16 weeks and followed-up at 24th week. Outcome was assessed on basis of psoriasis area-and-severity index score (PASI), psoriasis disability index (PDI) and clinical photographs.<strong></strong></p><p class="abstract"><strong>Results:</strong> % of improvement in Group-A patients (76.8%) after 16 weeks of treatment was relatively more (p&lt;0.05) as compared to group B (71.5%). At the end of 16 weeks PASI score in methotrexate group was statistically significant (p&lt;0.05) as compared to group B, PDI became 17.90±3.87 in group A and was statistically significant (p&lt;0.05) as compared to group B which was 20.34±2.98. Side effects observed were comparatively less in group A patients.</p><p class="abstract"><strong>Conclusions:</strong> On comparing the two drugs, methotrexate was comparatively better tolerated and had better efficacy and safety. More studies are required to further prove the efficacy of Apremilast in treatment of psoriasis.</p>

Vitamin C and Thiobarbituric Acid Reactive Substances (TBARS) in Psoriasis Vulgaris Related to Psoriasis Area Severity Index (PASI)

2017 ◽  
Vol 68 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Mircea Tampa ◽  
Ilinca Nicolae ◽  
Corina Daniela Ene ◽  
Isabela Sarbu ◽  
Clara Matei ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Free Radicals ◽  
Vitamin C ◽  
Psoriasis Vulgaris ◽  
Thiobarbituric Acid ◽  
Severity Index ◽  
Thiobarbituric Acid Reactive Substances ◽  
Psoriasis Area Severity Index ◽  
Pathogenic Potential ◽  
Antioxidant Mechanisms

Oxidative stress is caused by an imbalance between the production of pro-oxidants and the capacity of a biological system of rapid detoxification of free radicals. In this paper the level of pro-oxidants and antioxidants was quantified in patients with psoriasis vulgaris. The results of this study show that the level of oxygen reactive species dramatically increases and the physiologic antioxidant mechanisms are inefficient in patients with psoriasis vulgaris. These findings re-confirm that oxidative stress has a destructive and pathogenic potential in psoriasis.

Pilot Study to Evaluate the Efficacy and Safety of Oral Tacrolimus in Adult Patients With Refractory Severe Plaque Psoriasis

2015 ◽  
Vol 20 (3) ◽  
pp. 228-232 ◽  
Author(s):  
Ankit Mittal ◽  
Sunil Dogra ◽  
Tarun Narang ◽  
Aman Sharma
Keyword(s):  
Pilot Study ◽  
Plaque Psoriasis ◽  
Severity Index ◽  
Term Treatment ◽  
Adult Patients ◽  
Efficacy And Safety ◽  
Open Label ◽  
Short Term Treatment ◽  
Psoriasis Area Severity Index ◽  
Severe Plaque Psoriasis

Background: Tacrolimus, a congener of cyclosporine, has replaced cyclosporine as a first-line treatment for most transplant patients due to its superior efficacy and safety. Tacrolimus has not been extensively studied for the treatment of psoriasis. Objectives: To study the efficacy and safety of oral tacrolimus in adult patients with severe refractory plaque psoriasis. Methods: This was an open-label pilot study. Patients with severe plaque type psoriasis who were unresponsive to at least 1 systemic treatment were treated with oral tacrolimus. Results: Thirty patients were treated. After 12 weeks, improvement in mean Psoriasis Area Severity Index (PASI) score was 80.37% ( P < .001), PASI 75 was observed in 19 of 26 (73.1%) patients, and PASI 90 was observed in 11 of 26 (42.3%) patients. No severe side effects were noted. Conclusion: Oral tacrolimus is an effective and safe option for the short-term treatment of severe plaque psoriasis.

scholarly journals Serum Levels of TNF-α, IL-12/23p40, and IL-17 in Plaque Psoriasis and Their Correlation with Disease Severity

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Aikaterini Kyriakou ◽  
Aikaterini Patsatsi ◽  
Timoleon-Achilleas Vyzantiadis ◽  
Dimitrios Sotiriadis
Keyword(s):  
Disease Severity ◽  
Plaque Psoriasis ◽  
Solid Phase ◽  
Severity Index ◽  
Serum Levels ◽  
Rank Test ◽  
Psoriatic Skin ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Controls ◽  
Psoriasis Area Severity Index

A case-control study was performed to assess the serum levels of TNF-α, IL-12/23p40, and IL-17 in patients with plaque psoriasis, compare them with healthy controls, and correlate them with disease severity, as represented by Psoriasis Area Severity Index (PASI). 32 consecutively selected, untreated patients with active, chronic plaque psoriasis were recruited and compared to 32 age- and sex-matched healthy controls. Serum cytokine levels were determined by solid phase sandwich enzyme linked immunosorbent assay (R&D Systems Europe, Ltd.). The mean serum levels of TNF-αwere significantly higher in psoriatic patients compared to those of controls (Mann-WhitneyUtest;P=0.000). However, the median serum levels of neither IL-12/23p40 nor IL-17 differ significantly between the 2 groups (Mann-WhitneyUtest;P=0.968andP=0.311, resp.). No significant correlations were found between PASI and any of the cytokine serum levels (Spearman’s rank test;P>0.05). Despite the well-evidenced therapeutic efficacy of biologic agents targeting TNF-α, IL-12/23p40, and IL-17, serum levels of TNF-α, IL-12/23p40, and IL-17 do not seem to correlate with the severity of psoriatic skin disease in untreated patients, as represented by PASI. Further investigation may add more data on the pathogenetic cascade of psoriasis.

scholarly journals Newer Biologics for the Treatment of Plaque Psoriasis

2021 ◽  
Vol 1 (9) ◽  
Author(s):  
Anusree Subramonian ◽  
Melissa Walter
Keyword(s):  
Side Effects ◽  
Systematic Reviews ◽  
Plaque Psoriasis ◽  
Meta Analysis ◽  
Severity Index ◽  
Psoriasis Area Severity Index ◽  
Severe Plaque Psoriasis ◽  
Meta Analyses

Eight systematic reviews with network meta-analysis were identified that compared newer biologics with older biologics in patients with moderate-to-severe plaque psoriasis. There was extensive overlap of primary studies across the systematic reviews and network meta-analyses. Newer biologics such as secukinumab, ixekizumab, brodalumab and risankizumab were more favourable compared to older biologics (adalimumab, etanercept, and ustekinumab) in reaching 90% or 100% skin clearance, as measured with the Psoriasis Area Severity Index. The risk of side effects was similar between the newer and older biologics.

scholarly journals PSORIASIS VULGARIS PADA BAYI

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Shienty Gaspersz ◽  
Herry E. J. Pandaleke
Keyword(s):  
Vitamin D3 ◽  
Psoriasis Vulgaris ◽  
Age Of Onset ◽  
Severity Index ◽  
Psoriasis Area Severity Index ◽  
Normal Limits ◽  
Severity Index Score ◽  
Pasi Score ◽  
Erythematous Plaques ◽  
Topical Emollient

Abstract: Psoriasis may begin at any age but most often after puberty and only about 2% occurs in less than 2 years of age. The age of onset plays an important role because early onset psoriasis accompanied by a psoriasis family history is more severe and has a tendency to relapse. The treatment for mild psoriasis is topical and phototherapy. The first-line treatment is topical emollient, glucocorticoids, and vitamin D3 analog. We reported a case of a 3-month-old female infant presenting erythematous plaques with scales on scalp, face, neck, chest, tummy, armpit, back, buttock, and groin accompanied with irritability that had occured for a week. The Psoriasis Area Severity Index score (PASI) was 7% and laboratory examinations were within normal limits. Treatment with topical desonide 0.05% for 1 week did not result in any improvement. The treatment was changed to topical mometason furoat 0.1%. After 7 weeks of therapy, the plaques became flattened and less pigmented, and the PASI score decreased to 0.9%.Keywords: psoriasis vulgaris, infant  Abstrak: Usia awitan psoriasis bervariasi dari bayi hingga usia lanjut, namun sebagian besar timbul setelah pubertas dan hanya sekitar 2% terjadi pada usia kurang dari 2 tahun. Usia awitan perlu diketahui karena semakin dini usia awitan disertai adanya riwayat keluarga dengan psoriasis, perjalanan penyakit akan makin berat dan makin sering kambuh. Pilihan pengobatan pada psoriasis ringan (< 10%) ialah pengobatan topikal dan fototerapi. Pengobatan topikal lini pertama ialah emolien, glukokortikoid, dan analog vitamin D3. Kami melaporkan seorang bayi perempuan berusia 3 bulan yang datang dengan plak eritematosa, berbatas tegas, ukuran bervariasi, dengan skuama pada kepala, wajah, leher, dada, perut, ketiak, punggung, bokong, dan selangkangan, disertai rewel sejak 1 minggu lalu. Perhitungan Psoriasis Area Severity Index (PASI) 7%. Pemeriksan laboratorium masih dalam batas normal. Pasien diterapi dengan krim desonide 0,05%, namun setelah 1 minggu tidak terdapat perbaikan yang memuaskan, sehingga diganti dengan krim mometason furoat 0,1%. Setelah 7 minggu menggunakan mometason furoat, bercak merah yang awalnya meninggi menjadi hipopigmentasi dan mendatar serta perhitungan PASI menjadi 0,9%.Kata kunci: psoriasis vulgaris, bayi

scholarly journals Effects of Rusanda Spa balneotherapy combined with calcipotriol on plaque psoriasis

2015 ◽  
Vol 72 (11) ◽  
pp. 1010-1017 ◽  
Author(s):  
Zoran Golusin ◽  
Marina Jovanovic ◽  
Natasa Magda ◽  
Slobodan Stojanovic ◽  
Milan Matic ◽  
...  
Keyword(s):  
Plaque Psoriasis ◽  
Therapeutic Efficacy ◽  
Clinical Symptoms ◽  
Severity Index ◽  
Mineral Waters ◽  
Treatment Modalities ◽  
Psoriasis Area Severity Index ◽  
Randomized Controlled ◽  
Plaque Type ◽  
Pasi Score

Background/Aim. Treatment of psoriasis is very complex and there are no still universal, nor unique treatment modalities. Apart from conventional treatment, which includes topical calcipotriol (vitamin D3 analogue), balneotherapy is drawing increased attention worldwide. Being part of climatotherapy, balneotherapy is defined as the use of natural environmental factors in the treatment of health conditions, whereas in the treatment of psoriasis it means the use of mineral baths and peloids. The aim of this study was to examine the therapeutic efficacy of mineral waters and peloids of the Rusanda Spa on plaque psoriasis in patients also treated with calcipotriol. Methods. The study included 60 patients divided into two groups. The first group included patients treated with mineral waters, peloids and calcipotriol in the Rusanda Spa, while the second one included those treated only with calcipotriol. The study took 21 days, and each patient was followed up for at least one month after ending the treatment. The treatment efficacy was measured by psoriasis area severity index (PASI) scores on the days 0, 7, 14 and 21 during the treatment and 30 after the end of the therapy. Results. After a 3-week treatment in the Rusanda Spa, the first group showed a decrease in PASI score by 59.45%, whereas in the group of outpatients treated by calcipotriol it was 39.34%. On the day 30 following the treatment, the first group presented with the PASI score reduction of 58.44%, and the second group of 34.78%. The therapeutic efficacy of mineral waters and peloids combined with calcipotriol showed to be significantly higher in regard to monotherapy with calcipotriol (p < 0.05). In regard to clinical symptoms, the best results were obtained in the reduction of desquamation (p < 0.001). Conclusion. The results of our study show that in the treatment of plaque-type psoriasis, topical calcipotriol combined with Spa Rusanda balneotherapy is more effective than topical calcipotriol alone. Randomized controlled trials are needed to confirm the effects of balneotherapy as monotherapy in treatment of this type of psoriasis.

Hypochondriasis and Personality Traits of Patients with Chronic Plaque Psoriasis

Dermatology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Paolo Gisondi ◽  
Davide Geat ◽  
Anna Ferrazzi ◽  
Francesco Bellinato ◽  
Giampiero Girolomoni
Keyword(s):  
Alcohol Consumption ◽  
Personality Traits ◽  
Plaque Psoriasis ◽  
Minnesota Multiphasic Personality Inventory ◽  
Significant Proportion ◽  
Female Gender ◽  
Severity Index ◽  
Coping Resources ◽  
Psoriasis Area Severity Index ◽  
Heavy Alcohol Consumption

<b><i>Background:</i></b> Plaque psoriasis has been associated with anxiety, depression, suicidal ideation and various personality traits. However, studies on hypochondriasis, i.e. the belief of serious illness despite having no or only mild symptoms, are currently scarce. <b><i>Objective:</i></b> The aim of this study was to assess hypochondriasis and personality traits in psoriasis patients using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). <b><i>Methods:</i></b> We conducted an observational study on patients with plaque psoriasis who underwent MMPI-2 testing. Demographic and clinical data, including comorbidities, alcohol consumption, and smoking, were collected. <b><i>Results:</i></b> A total of 136 consecutive psoriatic patients were included. The mean age (±SD) was 53.7 (±13.5), mean PASI (Psoriasis Area Severity Index) was 12.4 (±9.9), and mean disease duration was 23.3 (±15.7) years. Pathologically elevated scores in the Hypochondriasis scale were observed in 27.9% of patients. Furthermore, in a few other MMPI-2 scales (Anxiety, Fears and Negative Treatment Indicators) ≥25% of patients obtained pathologically elevated scores. Conversely, the scales that had the highest proportion of low scorers were Ego Strength and Dominance. At regression analysis, higher psoriasis severity and female gender were associated with higher scores in the Hypochondriasis scale (<i>p</i> = 0.03 and 0.001). Finally, 72.8% reported any alcohol consumption and 8.1% heavy alcohol consumption. <b><i>Conclusion:</i></b> About one third of patients with psoriasis have high scores in the MMPI-2 hypochondriasis evaluation scale. Poor individual coping resources also appeared to be distinctive psychological features in a significant proportion of psoriatic patients.

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