Plaque thickness and morphology in psoriasis vulgaris associated with therapeutic response

Abstract

Using a patient's baseline plaque morphology to choose a primary treatment modality may result in earlier disease improvement and reduce the cost of therapy.

Heterogeneity of Response to Biologic Treatment: Perspective for Psoriasis

“…E Edson-Heredia et al Table S1 online) (Naldi et al, 2008;Rakkhit et al, 2009). We found no evidence to suggest that response to psoriasis therapy might be affected by patient gender (Figure 2).…”

“…Interestingly, ustekinumab dosing is weight-dependent, whereas dosing of adalimumab is not. Weight loss, used as a surrogate for BMI reduction, was also predictive of improved Randomized controlled trials (n =3) (Gordon et al, 2006a;Menter et al, 2010b;Papp et al, 2008) Pooled analysis of data from clinical trials (n =2) (Gordon et al, 2006b;Reich et al, 2006) Cohort (n =4) (Driessen et al, 2009;Lebwohl et al, 2010;Mazzotta et al, 2009;Naldi et al, 2008) Case series (n =5) (Antoniou et al, 2009;Bardazzi et al, 2010;Duarte and Chehin, 2011;Na et al, 2008;Rakkhit et al, 2009) Open-label extension study (n =1) (Strober et al, 2006) Level 2 (n =4)…”

“…Figure 2 shows the total number of studies evaluating each factor for a potential effect on response to biologic therapy. Seven of the 15 studies included subgroups of patients with psoriatic arthritis (Gordon et al, 2006b;Reich et al, 2006;Papp et al, 2008;Antoniou et al, 2009;Mazzotta et al, 2009;Rakkhit et al, 2009;Menter et al, 2010b), although all but one study (Mazzotta et al, 2009) considered all enrolled patients together and evaluated skin manifestations only. A majority of the studies included in these analyses were not powered to find differences between different subgroups of patients, reported post hoc analyses, and most had a duration of follow-up of less than 1 year (the usual study duration ranged from 8-28 weeks) (Supplementary Tables S1 and S2 online).These study characteristics preclude clearly identifying factors that affect treatment response, although the study results do provide some insights into potential associations.…”

Early intervention in psoriasis and immune-mediated inflammatory diseases: A hypothesis paper

“…For example, it has been shown that in patients with psoriasis the area of disease involvement during stable disease correlates with nail and joint involvement and the need for a second-line therapy (118). Plaque thickness has also been found to correlate with treatment response, where patients with thin plaques were more likely to report a complete clinical response following treatment with topical corticosteroids and phototherapy, but not systemic therapy (119).…”

“…In RA, one study showed that when assessed using power Doppler and MRI, 19% of patients thought to be in remission displayed deterioration in radiographic damage (105). Likewise, the inflammatory and epithelial genes that are associated with residual disease genomic profile -or genetic memory -in psoriasis may provide an estimation of subclinical disease activity and probability of relapse with or without treatment; while plaque thickness may provide a good measure of treatment response and the likelihood of a patient responding to treatment (62,119).…”