An analysis of selected factors influencing the efficacy of psoriasis therapy

Abstract

Psoriasis is a chronic disease characterized by a complex immunopathogenesis of recurrent inflammation of the skin. The course and intensity of the disease depend on many genetic, environmental and behavioural factors. The treatment of psoriasis includes a therapy with ultraviolet radiation, methotrexate, cyclosporine A, keratolytic preparations, tar, anthralin, glucocorticoids, calcineurin inhibitors, retinoids, and vitamin D 3 derivatives. A new class of biological drugs (personalized therapy) that was introduced includes cytokine inhibitors, i.e. TNF-etanercept, adalimumab, infliximab, certolizumab pegol, golimumab; IL-12/23ustekinumab; IL-17-secukinumab, ixekizumab, brodalumab. Effective treatment of psoriasis is a challenge. It is an important matter in anticytokine therapy to determine the influence of factors such as age, sex, environmental factors, viral and bacterial infections, an occurrence of comorbidities, individual rate of drug metabolism, and pharmacologic interactions of additionally taken drugs. The influence of many different factors translates into obtaining a heterogeneous adequate response to molecularly targeted treatments. StreSzczenie Łuszczyca jest przewlekłą, nawracającą chorobą zapalną skóry, charakteryzującą się złożoną immunopatogenezą. Przebieg i nasilenie choroby zależą m.in. od czynników genetycznych, środowiskowych i behawioralnych. Łuszczyca istotnie wpływa na komfort i jakość życia pacjenta. Terapia opiera się na różnych strategiach, takich jak leczenie promieniowaniem ultrafioletowym, metotreksatem, cyklosporyną A, preparatami keratolitycznymi, dziegciem, antraliną, glikokortykosteroidami, inhibitorami kalcyneuryny, retinoidami i pochodnymi witaminy D 3. Do nowej klasy leków biologicznych (terapia spersonalizowana) zalicza się inhibitory TNF-etanercept, adalimumab, infliksymab, certolizumab pegol, golimumab; IL-12/23-ustekinumab; IL-17-seku

Clinical improvement of patients with moderate-to-severe psoriasis treated with methotrexate at Dr. Soetomo General Hospital, Surabaya, Indonesia

“…15 The success of psoriasis therapy is affected by many factors, including lesion severity, genetic factors (e.g., the mutation in the PSORSI gene), environmental factors such as smoking, infection history (especially streptococcus), drug choice, metabolic disease comorbidities, socioeconomic status, the presence of psychopathology, physician-patient relationships, the accessibility of therapy, lifestyle, physical activity, diet pattern, and genetic polymorphism related to therapy response. 16 The difference in treatment outcomes between gender has not been well studied. There was no significant difference in PASI score improvement between gender.…”