EuroGuiDerm Guideline on the systemic treatment of Psoriasis vulgaris – Part 2: specific clinical and comorbid situations

Nast, Alexander; Smith, Catherine; Spuls, Phyllis I.; Valle, Gabriela Avila; Bata-Csorgo, Zsuzsanna; Boonen, H; Jong, E. de; García‐Doval, I.; Gisondi, Paolo; Kaur-Knudsen, Diljit; Mahil, Satveer K.; Mälkönen, Tarja; Maul, Julia‐Tatjana; Mburu, Sicily; Mrowietz, Ulrich; Reich, Kristian; Remenyik, Éva; Rønholt, Kirsten; Sator, Paul; Schmitt‐Egenolf, Marcus; Sikora, Mariusz; Strömer, Klaus; Sundnes, Olav; Trigos, David; Kraaij, G. van der; Yawalkar, Nikhil; Dressler, Corinna

doi:10.1111/jdv.16926

Cited by 110 publications

(168 citation statements)

References 299 publications

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“…Furthermore, some systemic psoriasis therapies are contraindicated during pregnancy owing to their teratogenicity (methotrexate and acitretin) 46 , 47 and others recommended to be used with caution 48 owing to transplacental transfer after the 20th week of gestation (biologics, with the exception of certolizumab pegol) and potential risk of adverse neonatal adverse events 49 , 50 (Supplementary Table IV, available via Mendeley at https://doi.org/10.17632/ccznnnzktg.1 ).…”

Section: Discussionmentioning

confidence: 99%

Psoriasis and adverse pregnancy outcomes: A nationwide case-control study in 491,274 women in Denmark

et al. 2022

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Section: Discussionmentioning

confidence: 99%

Psoriasis and adverse pregnancy outcomes: A nationwide case-control study in 491,274 women in Denmark

et al. 2022

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“…Consecutive adult patients with moderate-to-severe psoriasis unresponsive to topical treatment, phototherapy and/or conventional treatments for psoriasis, undergoing DMF treatment according to the National and International Guidelines [ 15 ], starting treatment from January to September 2020, were included in the study. Patients had to be treated with DMF as monotherapy, as reported in the summary of product characteristics (SPCs), and followed for an observation period of 48 weeks [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

“…Several clinical randomized and observational studies have demonstrated that DMF, among oral traditional systemic agents, presents clinical long-term efficacy and favorable safety profile [ 1 – 3 , 5 ]. A recent European Expert Consensus proposed DMF as a first-line therapeutic option to achieve sustained disease control for patients with moderate-to-severe plaque psoriasis when psoriasis cannot be adequately controlled with topical treatments and phototherapy [ 3 , 10 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

Dimethyl Fumarate's Effectiveness and Safety in Psoriasis: A Real-Life Experience During the COVID-19 Pandemic

Esposito

Campanati

Giunta

et al. 2022

Dermatol Ther (Heidelb)

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Introduction Dimethyl fumarate (DMF) is approved as oral systemic treatment for moderate-to-severe psoriasis. Scarce evidence is available for DMF treatment in psoriatic patients at the time of COVID-19 pandemic. The objective of this study was to assess the long-term effectiveness and safety of DMF monotherapy in moderate-to-severe psoriasis during the COVID-19 pandemic period. Methods This multicenter, retrospective study included patients with moderate-to-severe psoriasis who had received a 48-week DMF treatment during the COVID-19 pandemic. Selected outcomes were: variation of mean PASI, proportion of patients achieving PASI50 and PASI75, variation of mean PGA and face PGA, genital PGA, scalp PGA, mean itch VAS and mean DLQI. Results Forty-four patients were enrolled, and four patients became COVID-19 positive during the observation period but did not discontinue DMF therapy. DMF produced a significant improvement of signs and symptoms of psoriasis as expressed by mean PASI variation from 13.07 at baseline to 6.11 at week 48 ( p < 0.0001), itch VAS from 3.22 at baseline to 1.18 at week 48 ( p < 0.001), PGA from 2.84 at baseline to 1.30 at week 48 ( p < 0.0001) and DLQI from 13.09 at baseline to 6.07 at week 48 ( p < 0.0001). The percentage of patients who achieved PASI50 and PASI75 was 4.55% at week 4 and 59.09% at week 48 and 0% at week 4 and 22.73% at week 48, respectively. A clinical important decrease of mean PGA score was observed in all subgroups, face psoriasis, genital psoriasis and scalp psoriasis. Adverse events were predictable and manageable. Conclusions DMF monotherapy is an effective and safe treatment option in moderate-to-severe psoriasis also in patients who develop SARS-CoV-2 infection.

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“…The internet portal www.embryotox.de was accessed on 10.12.2021. Preparation Summary of Product Characteristics Website www.embryotox.de National Guidelines [96] International Guidelines [64] and [141] Data on exposure during pregnancy and lactation in humans…”

Section: Ciclosporinmentioning

confidence: 99%

Therapy of psoriasis during pregnancy and breast‐feeding

Gerdes

Beissert

Ochsendorf

et al. 2022

J Deutsche Derma Gesell

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Summary There have been multiple systemic drugs approved for the therapy of psoriasis vulgaris and psoriasis arthritis (PsA) in the last decade. However, treatment decisions are difficult to make in women planning a pregnancy and in pregnant and lactating women due to the paucity of data for such cases. The strongest evidence for psoriasis therapy during pregnancy exists for topical corticosteroids. Medically controlled use of UVB‐therapy is also considered safe. The best evidence regarding systemic therapy during pregnancy and lactation is available for the group of TNF‐alpha inhibitors, which is also reflected in the respective medical product information. This is especially important in cases of psoriatic arthritis. Among traditional systemic therapeutics, the largest clinical experience exists for ciclosporin, which, if medically necessary, may be continued during gestation. However, TNF‐alpha inhibitors, especially the pegylated form, should be preferred in case of pregnancy. Furthermore, an elective pregnancy termination is not necessary due to systemic therapy of psoriasis with many further substances during the first pregnancy weeks. The current work provides a comprehensive review of the scientific literature on treatment of psoriasis during pregnancy and lactation. Based on the available scientific information, severity of psoriasis and patient’s comorbidities, the best possible therapeutic approach can be found in consensus with the patient.

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EuroGuiDerm Guideline on the systemic treatment of Psoriasis vulgaris – Part 2: specific clinical and comorbid situations

Cited by 110 publications

References 299 publications

Psoriasis and adverse pregnancy outcomes: A nationwide case-control study in 491,274 women in Denmark

Psoriasis and adverse pregnancy outcomes: A nationwide case-control study in 491,274 women in Denmark

Dimethyl Fumarate's Effectiveness and Safety in Psoriasis: A Real-Life Experience During the COVID-19 Pandemic

Therapy of psoriasis during pregnancy and breast‐feeding

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