Translating the 2019 AAD-NPF Guidelines of Care for Psoriasis With Attention to Comorbidities

Chat, Vipawee S; Uppal, S. K.; Kearns, Donovan G; Han, George; Wu, Jashin J.

doi:10.12788/cutis.0309

Cited by 3 publications

(11 citation statements)

References 30 publications

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“…Patients with elevated fasting triglycerides or low-density lipoprotein cholesterol should be referred to their GP for further management. 31 …”

Section: Resultsmentioning

confidence: 99%

“…4–6 For example, apremilast has been associated with weight loss, whereas etanercept and infliximab have been linked to weight gain. 31 …”

Section: Resultsmentioning

confidence: 99%

“…Additionally, these guidelines state that blood pressure measurement, fasting serum glucose, hemoglobin A1c and fasting lipid levels should be performed by the GP annually. 31 We refer to screening recommendations on the separate components of MetS. In addition, we promote educating psoriasis patients about the increased risk of MetS, its association with cardiovascular disease and preventive measures.…”

Section: Resultsmentioning

confidence: 99%

“… Full rheumatologic consultation is warranted in challenging cases. 31 Ideally, dermatologists initiate treatment with a medication that is effective for both psoriasis and PsA 70 Refer to rheumatologist for rheumatological evaluation and treatment Consider systemic treatment effective for both cutaneous and articular psoriatic disease (eg methotrexate, biologics) Consider avoiding treatments not effective for articular disease (eg cyclosporine and/or acitretin) Nonalcoholic fatty liver disease (NAFLD) Weight loss of more than 5–7% reduces hepatic fat content and steatohepatitis, and, for weight loss in excess of 10%, even fibrosis is reduced in a large proportion of people 56 A BMI > 30 kg/m2 increases the risk of NAFLD 9–fold compared to a BMI of 22 71 Weight reduction: −0.5kg/month Refer to nutritionist IBD Interleukin 17 inhibitor therapy should be avoided in patients with IBD. 22 Referral GE and GP if complaints 22 Refer to GE Abbreviations : ACE-I, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blockers; CCB, calcium channel blockers; BMI, body mass index; GP, general practitioner; MetS, metabolic syndrome; AST, alanine-amino-transferase; AST, aspartate-amino-transferase; IBD, inflammatory bowel disease; HDL, high-density lipoprotein; LDL, low-density lipoprotein; BP, blood pressure; GE, gastroenterologist; PsA, psoriatic arthritis.…”

Section: Discussionmentioning

confidence: 99%

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Comorbid Psoriasis and Metabolic Syndrome: Clinical Implications and Optimal Management

Brandt¹,

Hillary²

2022

PTT

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“…Patients with elevated fasting triglycerides or low-density lipoprotein cholesterol should be referred to their GP for further management. 31 …”

Section: Resultsmentioning

confidence: 99%

“…4–6 For example, apremilast has been associated with weight loss, whereas etanercept and infliximab have been linked to weight gain. 31 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Comorbid Psoriasis and Metabolic Syndrome: Clinical Implications and Optimal Management

Brandt¹,

Hillary²

2022

PTT

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“… 1 , 2 Clinically, psoriasis is marked by erythematous patches or plaques covered with slivery‐white scales typically over the extensor surfaces, scalp, and lumbosacral regions, which is associated with increased risks of comorbidities (such as psoriatic arthritis, cardiovascular disease, and obesity). 3 , 4 , 5 , 6 The primary treatment options include topic agents, phototherapy, systematic immunosuppressants, and biologics (such as tumor necrosis factor alpha (TNF‐α) inhibitors, interleukin (IL)‐12/23 inhibitors, and IL‐17 inhibitors). 7 , 8 , 9 , 10 Among the biologics, etanercept is one of the most frequently administered TNF‐α inhibitors in China, which is effective in alleviating disease activity in psoriasis patients.…”

Section: Introductionmentioning

confidence: 99%

MicroRNA‐146a and microRNA‐146b deficiency correlates with exacerbated disease activity, and their longitude increment relates to etanercept response in psoriasis patients

Shen

Wang

Zhan

et al. 2021

Clinical Laboratory Analysis

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Background MicroRNA (miR)‐146a and miR‐146b regulate autoimmunity, inflammation, and keratinocytes proliferation to engage in psoriasis pathology. The current study aimed to investigate their correlation with disease risk and clinical features, and the linkage of their longitudinal changes with clinical response to etanercept in psoriasis patients. Methods Plasma samples were collected from 84 moderate‐to‐severe psoriasis patients who underwent etanercept treatment (at baseline (M0), 1 month (M1), 3 months (M3), and 6 months (M6)), 80 disease controls and 80 health controls (both after enrollment); afterward, miR‐146a and miR‐146b expressions were detected by RT‐qPCR. Furthermore, PASI75 and PASI90 responses were assessed in psoriasis patients. Results Both miR‐146a and miR‐146b were decreased in psoriasis patients compared with disease controls and health controls (all p < 0.001), which also distinguished psoriasis patients from disease controls and health controls by receiver‐operating characteristic analyses. Furthermore, miR‐146a positively correlated with miR‐146b in psoriasis patients (p < 0.001) and disease controls (p = 0.005) but not in healthy controls (p = 0.062). In psoriasis patients, miR‐146a negatively related to psoriatic body surface area (p = 0.011) and PASI score (p = 0.003); miR‐146b negatively linked with PASI score (p = 0.020). At M1, M3, and M6 after etanercept treatment, PASI75 response rate was 14.3%, 32.1%, and 69.0%, respectively; PASI90 response rate was 1.2%, 17.9%, and 36.9%, respectively. During etanercept treatment, both miR‐146a and miR‐146b elevated gradually over time and their longitude increments were associated with PASI75 response (all p < 0.001). Conclusion MiR‐146a and miR‐146b might serve as indicators for optimizing etanercept application and improving treatment outcomes in psoriasis patients.

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Comparative Characteristics of Indicators of Neuroendocrine Regulation in Patients With Lichenoid Dermatoses

Bilovol¹,

Ткаченко²,

Berehova³

2022

D&V

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The aim is to study the indicators of neuroendocrine regulation in patients with chronic lichenoid dermatoses. Materials and methods. Studies of neuroendocrine system indicators were performed in two groups of patients: 1–60 patients with psoriasis, 2–56 patients with lichen planus, the control group consisted of 15 healthy individuals, whose indicators were considered normal. Determination of serotonin, histamine, histaminase, corticotropin, adrenaline in the serum of patients was performed by enzyme-linked immunosorbent assay. Results. There was a reliable increase in mean serum serotonin levels relative to control in both patients with psoriasis (228%) and patients with lichen planus (182%), histamine (85% and 76%, respectively); reliable decrease in serum histaminase level by 35% in patients with psoriasis and by 33% in patients with lichen planus relative to control and significant increase in histamine / histaminase index by 167% and 142%, respectively; reliable increase in serum corticotropin levels relative to control by 179% in patients with psoriasis and by 31% in patients with lichen planus. The level of adrenaline also significantly exceeded the control values by 43% in patients with psoriasis and by 37% in patients with lichen planus. Analysis of the average value of the adrenaline / serotonin ratio showed a decrease in its relative control by 57% in patients with psoriasis and by 52% in patients with lichen planus. Conclusions. Unidirectional changes in biochemical, enzymatic and hormonal constants of ergo- and trophotropic systems in both psoriasis and lichen planus have been reported, with the predominance of histamine biosynthesis over its inactivation and the prevalence of serotonergic system over adrenergic one, which was accompanied by significant increase in serum level of serotonin, histamin, corticotropin and adrenalin relative to control and a decrease in histaminase and the average adrenaline / serotonin ratio.

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Translating the 2019 AAD-NPF Guidelines of Care for Psoriasis With Attention to Comorbidities

Cited by 3 publications

References 30 publications

Comorbid Psoriasis and Metabolic Syndrome: Clinical Implications and Optimal Management

Comorbid Psoriasis and Metabolic Syndrome: Clinical Implications and Optimal Management

MicroRNA‐146a and microRNA‐146b deficiency correlates with exacerbated disease activity, and their longitude increment relates to etanercept response in psoriasis patients

Comparative Characteristics of Indicators of Neuroendocrine Regulation in Patients With Lichenoid Dermatoses

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