Non-Alcoholic Fatty Liver Disease Is Associated With Reduced Glomerular Filtration Rate in Patients With Chronic Plaque Psoriasis

Background Chronic plaque psoriasis has been associated with metabolic comorbidities, including non-alcoholic fatty liver disease (NAFLD). A causal relationship between NAFLD and chronic kidney disease (CKD) is debated. Objectives To assess whether NAFLD is associated with impaired renal function in patients with psoriasis. Methods A multicenter, retrospective, observational study including 337 patients with moderate-to-severe chronic plaque psoriasis, who had no history of excessive alcohol consumption or other secondary causes of chronic liver and renal diseases was conducted. NAFLD was diagnosed by ultrasonography, and CKD stage ≥2 or stage ≥3 were defined by an estimated glomerular filtration rate (e-GFR) of <90 ml min-1 1.73 m-2 or <60 ml min-1 1.73 m-2, respectively. Logistic and linear regression analyses were undertaken to assess the independent association of NAFLD with CKD or eGFR levels. Results Patients with NAFLD ( n = 212, 62.9% of total) had significantly lower e-GFR levels (83.4 ± 18.0 vs. 93.5 ± 15.8 ml min-1 1.73 m-2, P<.001) and a remarkably higher prevalence of both CKD stage ≥2 (56.1% vs. 30.4%, P<.0001) and CKD stage ≥3 (10.4% vs. 3.2%, P<.0001) compared with their counterparts without NAFLD. Multivariable logistic regression analysis showed that NAFLD was associated with a nearly 2.5-fold increased risk of prevalent CKD stage ≥2 (adjusted-odds ratio= 2.60 95% confidence intervals 1.4–4.8, P=.02), independently of components of metabolic syndrome, psoriasis severity, and psoriatic arthritis. Conclusions Ultrasound-diagnosed NAFLD is strongly associated with a reduced eGFR in patients with moderate-to-severe psoriasis, independently of cardiometabolic risk factors and psoriasis-related variables.

LEVELS OF 25-HYDROXYVITAMIN D IN PATIENTS WITH PSORIASIS- A CROSS SECTIONAL OBSERVATIONAL CASE- CONTROL STUDY

Background: Psoriasis is a common, immunologically mediated, inammatory disease characterized by skin inammation, epidermal hyperplasia, and increased risk of painful and destructive arthritis and cardiovascular morbidity and psychosocial challenges. Recent studies have shown higher prevalence of vitamin D deciency in patients with psoriasis than in control groups. It has been recently discovered that, vitamin D has role in modulation of Type 1 helper T cell (Th1) pathway. Thus low levels of vitamin D is believed to have an important implication in pathogenesis of psoriasis. Aims and objectives: To determine the 25-hydroxyvitamin D status of patients with chronic plaque psoriasis in comparison with age and sex matched controls. Materials and Methods: Thirty consecutive consenting patients with chronic plaque psoriasis and 30 age and sex matched controls with minor dermatological diseases were recruited in this study. Results: The age of the subjects ranged from 18yrs to 62yrs. The number of males was more than females. The overall prevalence of vitamin D in the study sample was 75%. Eighty percent cases and 70% controls had deciency of vitamin D. This study reveals that, the mean vitamin D was 16.23ng/do in case group and 19.29ng/dl in control group. The mean vitamin D was less in the cases as compare to controls, but it was not statistical signicant. Conclusion: Due to high overall prevalence of vitamin D deciency in India, many of the cases and controls had shown deciency. Not statistically signicant difference could be established between cases and controls with respect to serum vitamin D levels.

Long-term Safety and Efficacy of Roflumilast Cream 0.3% in Adult Patients With Chronic Plaque Psoriasis: Results From a 52-Week, Phase 2b Open-Label Study

N/A

Psoriasis Is Associated With Myosteatosis but Not Sarcopenia: A Case-Control Study

Background: The link between psoriasis and body fat (or obesity) has been well established. However, there are no reports detailing the possible relationship between psoriasis and fat infiltration in skeletal muscle, also known as myosteatosis. A recent study reported the possible association between psoriasis, arthritis, and sarcopenia (the loss of skeletal muscle mass or function). The present study aimed to explore the possible associations of chronic plaque psoriasis with myosteatosis and sarcopenia.Methods: We conducted a case-control study. In-patients with chronic plaque psoriasis were retrospectively recruited. Healthy controls were prospectively and continuously recruited. Unenhanced cross-sectional chest computed tomography images at the 12th thoracic vertebral level were analyzed using Mimics software. Skeletal muscle area (SMA), skeletal muscle radiodensity (SMD), and intermuscular adiposity tissue (IMAT) were measured. The skeletal muscle index (SMI) was calculated as SMA/height2. The percentage of IMAT (IMAT%) was calculated as IMAT/SMA × 100%. Myosteatosis was defined by SMD or IMAT%, whereas sarcopenia was defined by SMI. Propensity score matching was performed to adjust for the main confounders. Logistic regression models were used to evaluate the associations of psoriasis with myosteatosis and sarcopenia.Results: We included 155 psoriasis patients and 512 healthy controls. After propensity score matching, we retained 310 controls. The prevalence of sarcopenia was not significantly different between the psoriasis and control groups (men: 9.8% vs. 14.4%, p = 0.244; women: 7.0% vs. 11.7%, p = 0.548). Psoriasis patients were more prone to SMD-defined myosteatosis (men: 39.3% vs. 20.8%; women: 46.5% vs. 16.0%; both p &lt; 0.001) and IMAT%-defined myosteatosis (men: 21.4% vs. 12.5%, p = 0.034; women: 46.5 vs. 28.7%, p = 0.042) than the control group. After adjustment for potential confounders, psoriasis was not significantly associated with sarcopenia (odds ratio [OR] 0.51, 95% confidence interval [CI] 0.25–1.19, p = 0.136). However, psoriasis was associated with SMD-defined myosteatosis (OR 3.16, 95% CI 1.86–5.37, p &lt; 0.001) and IMAT%-defined myosteatosis (OR 1.76, 95% CI 1.04–3.00; p = 0.037).Conclusions: Chronic plaque psoriasis is independently associated with myosteatosis but not sarcopenia. Since fat and muscle are considered endocrine organs and can drive the inflammatory process, further studies detailing the interaction between psoriasis, fat, and skeletal muscle are warranted.

Severe drug-associated colitis with Crohn’s features in setting of ixekizumab therapy for chronic plaque psoriasis

Background Ixekizumab is monoclonal antibody targeted against interleukin-17 (IL-17) and has been approved for use in chronic plaque psoriasis. Despite its efficacy in treating psoriasis, concerns have been raised regarding Ixekizumab’s potential to induce and exacerbate inflammatory bowel disease (IBD). Case presentation Here we report the new onset of severe drug-associated colitis with surgical complications in a 45-year-old male patient who was receiving Ixekizumab therapy for chronic plaque psoriasis. Review of the patient’s colonic pathology demonstrated acute inflammatory changes with features of Crohn’s disease. The patient remained disease-free 9-months following his hospitalization and cessation of Ixekizumab. Conclusions This case raises suspicion for an association between Ixekizumab and IBD and calls on clinicians to have heightened awareness of potential risks before prescribing anti-IL-17 agents.