Psoriasis and suicidality: A review of the literature

Liang, Sydney E.; Cohen, Jeffrey M.; Ho, Roger S.

doi:10.1111/dth.12771

Cited by 39 publications

(34 citation statements)

References 47 publications

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“…The FDA approval of brodalumab was issued with a warning relating to suicidal ideation and behavior (SIB). A higher incidence of SIB was noted in clinical trials with brodalumab;8 however, although there is a known association of increased suicide among patients with psoriasis compared to those without,5,24 patients with depression or anxiety were not excluded in the AMAGINE trials (in contrast to other trials), and no causal link between brodalumab and increased risk of SIB has been established 25–27. The most common side effects reported with brodalumab in controlled clinical trials have been nasopharyngitis, upper respiratory tract infections, headache and arthralgia 6,16,21,28.…”

Section: Discussionmentioning

confidence: 99%

<p>Brodalumab for the treatment of moderate-to-severe psoriasis: case series and literature review</p>

Pinter¹,

Bonnekoh²,

Hadshiew³

et al. 2019

CCID

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Brodalumab, a recombinant fully human monoclonal immunoglobulin IgG2 antibody with high affinity to human interleukin (IL)-17RA, is approved for the treatment of moderate-to-severe plaque psoriasis. In controlled clinical trials, brodalumab 210 mg administered by subcutaneous injection at weeks 0, 1, and 2, then 210 mg every 2 weeks, produced a rapid onset and sustained clinical response. Consistently, >80% of patients achieved PASI-75 and efficacy was maintained for >2 years. The benefits are apparent soon after the start of therapy and are maintained in the long term. Such results, from the reviewed literature, support the findings from 4 'real world' cases in mainstream clinical practice which are reported here. Psoriatic plaques, including on the scalp, nails, soles and palms, were largely resolved, and quality of life improved markedly. Therapeutic success was achieved in patients naïve to biologics (2 cases) and in those responding inadequately to other biologics (2 cases). The high affinity of brodalumab to human IL-17RA blocks the biological activities of the pro-inflammatory cytokines IL-17A, IL-17C, IL-17E, IL-17F, and IL-17A/F heterodimer, resulting in inhibition of the inflammation and clinical symptoms associated with psoriasis. This mechanism of blocking multiple IL-17 family cytokines differs from that of other available biologics which selectively target some parts of the Th-17 axis and may account for the effectiveness of brodalumab in patients poorly responsive to other biologics, a feature which has also been shown where subgroup analysis has been undertaken in clinical trials. The drug is well tolerated during the normal 12-week induction phase and with prolonged treatment (52 to 120 weeks), as it was in the current case series.

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Section: Discussionmentioning

confidence: 99%

<p>Brodalumab for the treatment of moderate-to-severe psoriasis: case series and literature review</p>

Pinter¹,

Bonnekoh²,

Hadshiew³

et al. 2019

CCID

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“…Psoriasis may also cause psychological distress causing negative body image, poor self-esteem, anxiety, depression and even increased suicidality. 2 Thus, both the musculoskeletal and the skin manifestation in PsA may have a negative impact on psychological, social and physical aspects of Health-Related Quality of Life (HRQoL). 3 4…”

Section: Introductionmentioning

confidence: 99%

Impact of skin, musculoskeletal and psychosocial aspects on quality of life in psoriatic arthritis patients: A cross-sectional study of outpatient clinic patients in the biologic treatment era

Haugeberg¹,

Michelsen²,

Kavanaugh³

2020

RMD Open

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BackgroundIn psoriatic arthritis (PsA), both psoriasis and musculoskeletal manifestations may impair Health-Related Quality of Life (HRQoL). Our objective was to explore the impact of the various disease manifestations and disease consequences, including psychosocial factors, on HRQoL in PsA patients treated in the biologic treatment era.MethodsData collection in the 131 outpatient clinic PsA patients assessed included demographics, disease activity measures for both skin and musculoskeletal involvement and patient-reported outcome (PRO) measures, treatment and psychosocial burden. The skin dimension of quality of life was assessed by the Dermatology Life Quality Index (DLQI) and the overall HRQoL by the 15-Dimensional (15D) Questionnaire.ResultsThe mean age was 51.9 years, PsA disease duration 8.6 years, 50.4% were men, 56.9% were employed/working and 47.7% had ≥1 comorbidities. Prevalence of monotherapy with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) was 36.6% and with biologic DMARDs 12.2% and combination of both 22.9%. Mean DLQI was 3.3 and 15D 0.84. In adjusted analysis, not employed/working, higher scores for fatigue, sleep disturbances, anxiety and depression, Modified Health Assessment Questionnaire and presence of comorbidities were independently associated with impaired HRQoL (lower 15D scores), whereas Psoriasis Area Severity Index (PASI) and DLQI were not. Younger age and higher Psoriatic Arthritis Disease Activity Score and PASI scores were independently associated with impaired skin quality of life (higher DLQI score).ConclusionOur study highlights the negative impact the psychosocial burden, impaired physical function and comorbidities has on reduced HRQoL in PsA outpatients. Thus, to further improve HRQoL in PsA patients, not only physical concerns but also psychological concerns need to be addressed.

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“…In addition to causing physical symptoms such as pain and fatigue, PsA can also impact aspects of life important for psychological well-being (2,3). In patients with psoriasis (4) and in PsA patients (5), reduced health-related quality of life (HRQoL) has been reported, and sleep disturbances (6)(7)(8), fatigue (9,10), anxiety, and depression have been found to be increased (11). Disease burden seems to be more severe in patients who experience both psoriatic skin disease as well as arthritis (12).…”

Section: Introductionmentioning

confidence: 99%

Physical and Psychosocial Burden of Psoriatic Arthritis: Longitudinal Data From a Population‐Based Study in Norway

Haugeberg

Nilsen

Kavanaugh

et al. 2020

Arthritis Care & Research

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Objective. Psoriatic arthritis (PsA) can have a significant impact on health-related quality of life (HRQoL). Data on the timing of changes in the HRQoL of patients with PsA are limited. The present study was undertaken to explore associations between sleep disturbance, fatigue, pain, anxiety, depression, general health status, and satisfaction with life before and after a diagnosis of PsA compared to the general population. Methods. Patients diagnosed with PsA between the Nord-Trøndelag Health Study (HUNT2 [1995-1997] and HUNT3 [2006-2008]) surveys were compared to the general population. The adjusted odds ratio (OR adj) with 95% confidence interval (95% CI) was estimated at both time points. Results. Among 36,507 individuals participating in both the HUNT2 and HUNT3 surveys, 160 were diagnosed with PsA between the surveys. The prevalence of sleep disturbances and fatigue was higher in PsA patients after diagnosis compared to the general population (OR adj 2.24 [95% CI 1.55-3.25] and OR adj 1.94 [95% CI 1.27-2.98], respectively). The prevalence of pain and poor health status were higher in patients with PsA compared with the general population even before PsA was diagnosed (OR adj 2.81 [95% CI 1.96-4.02] and OR adj 3.08 [95% CI 2.19-4.35], respectively) and increased after diagnosis of PsA (OR adj 12.87 [95% CI 6.27-26.40] and OR adj 5.63 [95% CI 3.99-7.95], respectively). For anxiety, depression, and life satisfaction, patients who developed PsA were comparable to the general population both before and after the diagnosis of PsA. Conclusion. Compared to the general population, PsA patients reported a higher prevalence of pain and poorer health status before diagnosis. Increased prevalence of sleep disturbances and fatigue in PsA patients was only found after the PsA diagnosis, and no differences between patients with PsA and the control group were found for anxiety and depression.

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Psoriasis and suicidality: A review of the literature

Cited by 39 publications

References 47 publications

<p>Brodalumab for the treatment of moderate-to-severe psoriasis: case series and literature review</p>

<p>Brodalumab for the treatment of moderate-to-severe psoriasis: case series and literature review</p>

Impact of skin, musculoskeletal and psychosocial aspects on quality of life in psoriatic arthritis patients: A cross-sectional study of outpatient clinic patients in the biologic treatment era

Physical and Psychosocial Burden of Psoriatic Arthritis: Longitudinal Data From a Population‐Based Study in Norway

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