Comparison of mental health outcomes among adults with psoriasis on biologic versus oral therapies: a population-based study

Salame, Nicole; Ehsani‐Chimeh, Nazanin; Armstrong, April W.

doi:10.1080/09546634.2018.1476654

Cited by 11 publications

(11 citation statements)

References 34 publications

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“…There is some evidence that biologic treatment reduces depression in patients with psoriasis, 21,22 which is consistent with the hypothesis that biologics have this additional benefit. The role of the immune system in depression is well established, 23 so it is plausible that anti-inflammatory therapy for the lung reduces depression, but depression is also a correlate of other somatic and psychological symptoms, the etiology of which is linked to the Networks are complex systems of massive simultaneous causal connections.…”

supporting

confidence: 67%

A Possible Explanation for Non-responders, Responders and Super-responders to Biologics in Severe Asthma

Hyland¹,

Masoli²,

Lanario³

et al. 2019

Exploratory Research and Hypothesis in Medicine

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Response to biologic therapies in severe asthma is variable, with patients being either nonresponders, responders or super-responders. There is currently no explanation for this variation in response. If asthma-specific inflammatory pathways are part of a wider network of pathogenic mechanisms (including systemic inflammation), then the state of this wider network could either help or hinder the effect of the biologic. People with severe asthma are often polysymptomatic with a variable frequency of nonrespiratory symptoms. Application of existing network theory would predict that high systemic inflammation, measurable by the frequency of nonrespiratory symptoms, should decrease the effectiveness of biologics, a prediction consistent with the limited existing data. A detailed examination of the relationship between biologic response and the frequency or profile of nonrespiratory symptoms would provide a testable prediction of this hypothesis. The clinical presentation of super-responders is consistent with biologics sometimes having a positive effect on the pathology (level of dysregulation) in a network system. If that were the case, then network theory predicts the possibility of a short-term increase in nonrespiratory symptoms prior to the improvement reported by super-responders. If biologics lead to less network dysregulation in some patients, then this raises the possibility of new applications for this therapy and of an improved response to biologics if lifestyle improvement is started prior to biologic therapy.

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supporting

confidence: 67%

A Possible Explanation for Non-responders, Responders and Super-responders to Biologics in Severe Asthma

Hyland¹,

Masoli²,

Lanario³

et al. 2019

Exploratory Research and Hypothesis in Medicine

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“…Effective biologic psoriasis treatments reduce signs and symptoms of psoriasis, lower disease impact (DLQI) and may also improve mental health outcomes ( 50 , 51 ). Examination of depression through a prospective, longitudinal psoriasis registry (PSOLAR) demonstrated that treatment with biologics in moderate-to-severe psoriasis patients may reduce the risk of depressive symptoms ( 50 ).…”

Section: Depression and Psoriasismentioning

confidence: 99%

Psoriasis and Mental Health Workshop Report: Exploring the Links between Psychosocial Factors, Psoriasis, Neuroinflammation and Cardiovascular Disease Risk

Kleyn¹,

Talbot²,

Mehta³

et al. 2020

Acta Derm Venerol

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Psoriasis is a systemic, relapsing, inflammatory disease associated with serious comorbidities including mood problems and/or unhealthy lifestyle behaviours. Cutaneous and systemic abnormalities in innate and acquired immunity play a role in its pathogenesis. The exact pathogenetic mechanism remains elusive. Evidence is accumulating that TNF-alpha, IL-17 and IL-23 signalling are highly relevant as targeting these pathways reduces disease activity. Evidence suggests a strong link between psoriasis and depression in adults. The International Psoriasis Council (IPC) held a roundtable event, “Psoriasis and Mental Health”, in Barcelona, Spain which focused on the presence of depression and suicidality, plus the role of neuroinflammation in psoriasis, sleep disruption and the impact of depression on cardiovascular disease outcomes. We summarize here the expert presentations to provide additional insight into the understanding of psychiatric comorbidities of psoriasis and of the impact of chronic, systemic inflammation on neuro- and cardiovascular outcomes. the associations between psoriasis and other psychiatric comorbidities are still controversial and warrant further attention.

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“…The beneficial effect was more significant with continuous treatment 24,25 . Biological treatments seem more effective in reducing depression and insomnia than DMARDs 24,26 . However, there is a lack of robust comparative data between the different biological drugs.…”

Section: Resultsmentioning

confidence: 99%

“…24,25 Biological treatments seem more effective in reducing depression and insomnia than DMARDs. 24,26 However, there is a lack of robust comparative data between the different biological drugs. Although adalimumab, etanercept and ustekinumab were associated with a statistically significant reduction in depressive symptoms, comparison between the drugs could not be made due to different rating scales being used.…”

Section: Clinical Recommendationsmentioning

confidence: 99%

Practical recommendations for systemic treatment in psoriasis according to age, pregnancy, metabolic syndrome, mental health, psoriasis subtype and treatment history (BETA‐PSO: Belgian Evidence‐based Treatment Advice in Psoriasis; part 1)

Lambert

Segaert²,

Ghislain

et al. 2020

Acad Dermatol Venereol

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Background Impressive progress in new therapeutic options has been made for psoriasis. Treatments include topical steroids, phototherapy, conventional, synthetic disease-modifying drugs and an expanding list of biologics. Objective The primary objective of this work was to collect evidence for the creation of practice guidelines for systemic treatment of psoriasis (BETA-PSO: Belgian Evidence-based Treatment Advice in Psoriasis). Methods Evidence-based recommendations were formulated using a quasi-Delphi methodology after a systematic search of the literature and a consensus procedure involving 8 psoriasis experts. Results In this part, the use of systemic treatment in different age groups, during pregnancy, in metabolic syndrome, in patients with mental health problems, in different psoriasis subtypes and in previously systemically treated patients treatment is discussed. Conclusion Guidance on therapeutic choice in specific clinical situations in psoriasis is provided in order to facilitate the decision-making in clinical practice.

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Comparison of mental health outcomes among adults with psoriasis on biologic versus oral therapies: a population-based study

Abstract: Therapeutic choices for psoriasis impact mental health outcomes. Biologic therapy is associated with reductions in psychological distress and depression as compared to oral therapy in the U.S. adult moderate-to-severe psoriasis population.

Cited by 11 publications

References 34 publications

A Possible Explanation for Non-responders, Responders and Super-responders to Biologics in Severe Asthma

A Possible Explanation for Non-responders, Responders and Super-responders to Biologics in Severe Asthma

Psoriasis and Mental Health Workshop Report: Exploring the Links between Psychosocial Factors, Psoriasis, Neuroinflammation and Cardiovascular Disease Risk

Practical recommendations for systemic treatment in psoriasis according to age, pregnancy, metabolic syndrome, mental health, psoriasis subtype and treatment history (BETA‐PSO: Belgian Evidence‐based Treatment Advice in Psoriasis; part 1)

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