Evaluation and Management of Psoriasis: An Internist's Guide

Levine, Danielle; Gottlieb, Alice B.

doi:10.1016/j.mcna.2009.08.003

Cited by 60 publications

(54 citation statements)

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“…• Even when corrected for above risk factors (hypercholesterolemia, diabetes, HTN, and obesity), patients with severe psoriasis have an elevated incidence of myocardial infarction compared with age-matched patients without psoriasis 2,11 • Control of HTN, cholesterol, weight, and diabetes can assist in decreasing psoriasis burden and frequency of flares 2…”

Section: • Have Htnmentioning

confidence: 99%

“…2,10 On the other hand, patients with moderate to severe psoriasis with depression and suicidal ideation who are placed on etanercept, a TNF-␣ blocker, may improve both their psoriasis and their depression. 9,14 TNF, tumor necrosis factor; HTN, hypertension.…”

Section: • Have Htnmentioning

confidence: 99%

“…It is more common in whites and those who live farther from the equator, and it is equally common in men and women. 2 Psoriasis is more common with certain human leukocyte antigen (HLA) subtypes, but these cannot be distinguished histologically or clinically and there is no apparent difference in the response to therapy. 2 Psoriasis can generally be divided into 2 types: Type 1 psoriasis shows a strong family history for the disease, demonstrates an association with HLA-CW6, 3 and usually presents before 40 years of age.…”

mentioning

confidence: 99%

“…2 Psoriasis can generally be divided into 2 types: Type 1 psoriasis shows a strong family history for the disease, demonstrates an association with HLA-CW6, 3 and usually presents before 40 years of age. 2 Type 2 is not familial in presentation, has no association with HLA-CW6, 3 and usually presents after 40 years of age.…”

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Psoriasis Vulgaris: An Evidence-Based Guide for Primary Care

Kupetsky

Keller

2013

The Journal of the American Board of Family Medicine

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Psoriasis Vulgaris: An Evidence-Based Guide for Primary Care

Kupetsky

Keller

2013

The Journal of the American Board of Family Medicine

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“…Patients resistant to the classical treatment can be offered immune biological treatment, which can lead to the control of the process. [3][4][5][6][7][8] Tuberculosis is an infection that contraindicates the use of immune biological drugs and chemoprophylaxis can work by eliminating the probable triggering agent.…”

Section: Introductionmentioning

confidence: 99%

Psoríase eritrodérmica com regressão após profilaxia com isoniazida e terapia antidepressiva: relato de caso

Redighieri

Maia

Nadal

et al. 2011

An. Bras. Dermatol.

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An 83 year old woman, exhibiting severe psoriasis, was treated conventionally (phototherapy, acitretin, and cyclosporine). After poor clinical results and significant changes in laboratory procedures, those treatments were suspended. She was then being prepared to be submitted to biological treatment, when preliminary results disclosed a 30mm PPD. Complete improvement occurred [only] after introducing prophylactic therapy for tuberculosis and anti-depressive medication. Keywords: Acitretin; Antidepressive agents; Cyclosporine; Isoniazid; Psoriasis; Tuberculosis Resumo: Mulher idosa apresentou psoríase em placas do tipo grave, com tendência eritrodérmica, e foi submetida a tratamento de acordo com o algoritmo consensual (fototerapia, acitretina, ciclosporina). Resultados clínicos insuficientes, recorrência e agravamento do quadro laboratorial orientaram no sentido da introdução de terapia biológica. A avaliação preliminar revelou PPD de 30mm. A resolução completa das lesões se verificou quando realizada profilaxia antituberculose e administrado antidepressivo.

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Comparison of Biologics and Oral Treatments for Plaque Psoriasis

et al. 2020

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The clinical benefits of novel treatments for moderate to severe psoriasis are well established, but wide variations exist in patient response across different therapies. In the absence of head-to-head randomized trials, meta-analyses synthesizing data from multiple studies are needed to assess comparative efficacy among psoriasis treatments.OBJECTIVE To estimate the relative short-term and long-term efficacy of biologics and oral agents for the treatment of moderate to severe psoriasis.DATA SOURCES A systematic literature review was conducted on December 4, 2017, and updated on September 17, 2018. The Embase, MEDLINE, and Cochrane Central Register databases were included.STUDY SELECTION Phase 2, 3, or 4 randomized clinical trials of treatments licensed by the US Food and Drug Administration and the European Medicines Agency for adults with moderate to severe psoriasis with data on Psoriasis Area and Severity Index assessment of 75%, 90%, and 100% reductions (PASI 75, 90, and 100) at 10 to 16 weeks (short-term efficacy) or 44 to 60 weeks (long-term efficacy) from baseline.DATA EXTRACTION AND SYNTHESIS Data were extracted based on the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. A bayesian network meta-analysis was conducted to estimate short-term PASI response rates; to account for variation across trials, an ordinal model that adjusted for reference arm response was implemented. The long-term PASI rates were estimated via a traditional meta-analysis. PASI 75,90, and 100 response rates at 10 to 16 weeks and 44 to 60 weeks from baseline. MAIN OUTCOMES AND MEASURES RESULTSSixty trials meeting all inclusion criteria were included. At weeks 10 to 16, the highest PASI 90 rates were seen with risankizumab-rzaa (71.6%; 95% credible interval [CrI], 67.5%-75.4%), brodalumab (70.8%; 95% CrI, 66.8%-74.6%), ixekizumab (70.6%; 95% CrI, 66.8%-74.6%), and guselkumab (67.3%; 62.5%-71.9%). At weeks 44 to 60, the treatments with the highest PASI 90 rates were risankizumab-rzaa (79.4%, 95% CI, 75.5%-82.9%), guselkumab (76.5%; 95% CI, 72.1%-80.5%), brodalumab (74.0%; 95% CI, 69.3%-78.1%), and ixekizumab (73.9%; 95% CI, 69.9%-77.5%). Findings were consistent for short-term and long-term PASI 75 and 100 responses. CONCLUSIONS AND RELEVANCEThis study provides an assessment of the comparative efficacy among treatments for moderate to severe plaque psoriasis. The meta-analysis suggests that brodalumab, guselkumab, ixekizumab, and risankizumab-rzaa were associated with the highest PASI response rates in both short-term and long-term therapy.

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Evaluation and Management of Psoriasis: An Internist's Guide

Cited by 60 publications

References 46 publications

Psoriasis Vulgaris: An Evidence-Based Guide for Primary Care

Psoriasis Vulgaris: An Evidence-Based Guide for Primary Care

Psoríase eritrodérmica com regressão após profilaxia com isoniazida e terapia antidepressiva: relato de caso

Comparison of Biologics and Oral Treatments for Plaque Psoriasis

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