Guidelines of care for the management of psoriasis and psoriatic arthritis

Menter, Alan; Gottlieb, Alice B.; Feldman, Steven R.; Voorhees, Abby S. Van; Leonardi, Craig L.; Gordon, Kenneth B.; Lebwohl, Mark; Koo, John; Elmets, Craig A.; Korman, Neil J.; Beutner, Karl R.; Bhushan, Reva

doi:10.1016/j.jaad.2008.02.039

Cited by 1,093 publications

(360 citation statements)

References 162 publications

(176 reference statements)

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“…Psoriasis, a chronic, recurrent, immune‐mediated inflammatory disorder,1, 2 impairs quality of life (QoL)3, 4 to a similar extent to that experienced by patients with other chronic diseases such as diabetes or cancer 5. Although many patients with mild‐to‐moderate psoriasis are treated with topical therapy alone,6, 7, 8 adherence remains a significant issue as the daily treatment regimen can be cumbersome and time consuming 9.…”

Section: Introductionmentioning

confidence: 99%

Calcipotriol plus betamethasone dipropionate aerosol foam provides superior efficacy vs. gel in patients with psoriasis vulgaris: randomized, controlled PSO‐ABLE study

Paul

Gold

Cambazard

et al. 2016

Acad Dermatol Venereol

104

167

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BackgroundFixed combination calcipotriol 50 μg/g (Cal) plus betamethasone 0.5 mg/g (BD) foam has been developed as a new treatment option for patients with psoriasis.MethodsThe randomized, parallel‐group, investigator‐blinded Phase III, 12‐week PSO‐ABLE study compared the efficacy and safety of Cal/BD foam with Cal/BD gel. Patients aged ≥18 years with mild‐to‐severe psoriasis were randomized 4:4:1:1 to once‐daily Cal/BD foam, Cal/BD gel, foam vehicle or gel vehicle (NCT02132936). The primary efficacy endpoint was the proportion of patients who were clear/almost clear with a ≥ 2 grade improvement according to the physician's global assessment of disease severity (i.e. treatment success) at week 4 for Cal/BD foam vs. week 8 for Cal/BD gel. Secondary efficacy endpoints included: proportion of patients achieving at least a 75% reduction in modified psoriasis area and severity index (mPASI75), and time to treatment success (TTTS). Safety was monitored throughout.ResultsA total of 463 patients were randomized: Cal/BD foam (n = 185), Cal/BD gel (n = 188), foam vehicle (n = 47), gel vehicle (n = 43); overall completion rate was 90%. Cal/BD foam achieved higher treatment success rates (38% vs. 22%; P < 0.001) and mPASI75 (52% vs. 35%; P < 0.001) by week 4 than Cal/BD gel by week 8. Median TTTS with Cal/BD foam was 6 weeks; this could not be determined for Cal/BD gel as 50% treatment success was not achieved (P < 0.001). Adverse drug reactions were reported in 14 (7.6%) Cal/BD aerosol foam patients and 7 (3.7%) Cal/BD gel patients; all were single events except for itch with Cal/BD aerosol foam (n = 5; 2.7%) and worsening psoriasis with Cal/BD gel (n = 3; 1.6%).ConclusionCal/BD aerosol foam showed significantly greater efficacy after 4 weeks, than 8 weeks of treatment with Cal/BD gel, with similar tolerability.

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Section: Introductionmentioning

confidence: 99%

Calcipotriol plus betamethasone dipropionate aerosol foam provides superior efficacy vs. gel in patients with psoriasis vulgaris: randomized, controlled PSO‐ABLE study

Paul

Gold

Cambazard

et al. 2016

Acad Dermatol Venereol

104

167

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“…Moreover, disadvantages are represented by their possible side effects and limited availability of long-term safety data. Based on PASI (Psoriasis Area and Severity Index) score, psoriasis can be classified in mild, moderate and severe [33][34][35]. The most frequent type is a mild psoriasis, which mainly requires topical treatment.…”

Section: Introductionmentioning

confidence: 99%

Functionalized gold nanoparticles for topical delivery of methotrexate for the possible treatment of psoriasis

Bessar

Venditti

Benassi

et al. 2016

Colloids and Surfaces B: Biointerfaces

118

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a b s t r a c tGold nanoparticles (AuNPs) represent an effective choice for topical drug delivery systems thanks to their small size, general non-toxicity, ease of functionalization and high surface to volume ratio. Even if systemic, methotrexate still plays an important role in psoriasis treatment: its topical use shows insufficient percutaneus penetration owing to limited passive diffusion, high molecular weight and dissociation at physiological pH. The aim of our study was to design a new drug delivery nanocarrier for Methotrexate and to improve its solubility, stability and biodistribution. AuNPs were on purpose prepared with a hydrophilic stabilizing layer, in order to improve the colloidal stability in water. Watersoluble gold nanoparticles functionalized by sodium 3-mercapto-1-propansulfonate (Au-3MPS) were prepared and loaded with methotrexate (MTX). The loading efficiency of MTX on Au-3MPS was assessed in the range 70-80%, with a fast release (80% in one hour). The release was studied up to 24 h reaching the value of 95%. The Au-3MPS@MTX conjugate was fully characterized by spectroscopic techniques (UV-vis, FTIR) and DLS. Preliminary toxicity tests in the presence of keratinocytes monolayers allowed to assess that the used Au-3MPS are not toxic. The conjugate was then topically used on C57BL/6 mouse normal skin in order to trace the absorption behavior. STEM images clearly revealed the distribution of gold nanoparticles inside the cells. In vitro studies showed that Methotrexate conjugated with Au-3MPS is much more efficient than Methotrexate alone. Moreover, DL50, based on MTT analysis, is 20 folds reduced at 48 h, by the presence of nanoparticles conjugation. UV-vis spectra for in vivo tracing of the conjugate on bare mouse skin after 24 h of application, show increased delivery of Methotrexate in the epidermis and dermis using Au-3MPS@MTX conjugate, compared to MTX alone. Moreover we observed absence of the Au-3MPS in the dermis and in the epidermis, suggesting that these layers of the skin do not retain the nanoparticles. Based on our data, we found that the novel Au-3MPS@MTX conjugate is an effective non-toxic carrier for the satisfactory percutaneous absorption of Methotrexate and could help in possible topical treatment of psoriasis.

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“…For decades, immunosuppressants were the primary pharmacologic treatments for moderate‐to‐severe PsO or PsA 7, 23. The advent of biologic agents in recent years has significantly changed the treatment paradigms.…”

Section: Introductionmentioning

confidence: 99%

Economic and Comorbidity Burden Among Moderate‐to‐Severe Psoriasis Patients with Comorbid Psoriatic Arthritis

Feldman

Zhao

Shi

et al. 2015

Arthritis Care & Research

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ObjectiveTo compare the prevalence of comorbidities, health care utilization, and costs between moderate‐to‐severe psoriasis (PsO) patients with comorbid psoriatic arthritis (PsA) and matched controls.MethodsAdults ages 18–64 years with concomitant diagnoses of PsO and PsA (PsO+PsA) were identified in the OptumHealth Reporting and Insights claims database between January 2007 and March 2012. Moderate‐to‐severe PsO was defined based on the use of at least one systemic or phototherapy during the 12‐month study period after the index date (randomly selected date after the first PsO diagnosis). Control patients without PsO and PsA were demographically matched 1:1 with PsO+PsA patients. Multivariate regressions were employed to examine PsO/PsA‐related comorbidities, medications, health care utilization, and costs between PsO+PsA patients and controls, adjusting for demographics, index year, insurance type, and non–PsO/PsA‐related comorbidities.ResultsAmong 1,230 matched pairs of PsO+PsA patients and controls, PsO+PsA patients had significantly more PsO/PsA‐related comorbidities, with the top 3 most common in both groups being hypertension (35.8% versus 23.5%), hyperlipidemia (34.6% versus 28.5%), and diabetes mellitus (15.9% versus 10.0%). Compared with controls, PsO+PsA patients had a higher number of distinct prescriptions filled (incidence rate ratio 2.3, P < 0.05); were more likely to have inpatient admissions (odds ratio [OR] 1.6), emergency room visits (OR 1.3), and outpatient visits (OR 62.7) (all P < 0.05); and incurred significantly higher total, pharmacy, and medical costs (adjusted annual cost differences per patient $23,160, $17,696, and $5,077, respectively; all P < 0.01).ConclusionCompared with matched PsO‐ and PsA‐free controls, moderate‐to‐severe PsO patients with comorbid PsA had higher comorbidity and health care utilization and costs.

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Guidelines of care for the management of psoriasis and psoriatic arthritis

Cited by 1,093 publications

References 162 publications

Calcipotriol plus betamethasone dipropionate aerosol foam provides superior efficacy vs. gel in patients with psoriasis vulgaris: randomized, controlled PSO‐ABLE study

Calcipotriol plus betamethasone dipropionate aerosol foam provides superior efficacy vs. gel in patients with psoriasis vulgaris: randomized, controlled PSO‐ABLE study

Functionalized gold nanoparticles for topical delivery of methotrexate for the possible treatment of psoriasis

Economic and Comorbidity Burden Among Moderate‐to‐Severe Psoriasis Patients with Comorbid Psoriatic Arthritis

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