Psoriasis and Psoriatic Arthritis: Flip Sides of the Coin?

Boehncke, Wolf‐Henning

doi:10.2340/00015555-2385

Cited by 22 publications

(15 citation statements)

References 48 publications

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“…The aetiologies of psoriasis, psoriatic arthritis and CD share several candidate genes and common pathogenetic pathways, which is not surprising considering the clinical overlap of the disorders . Mutations in genes upregulated in these conditions, including IL23R , affect the IL‐23/T H 17 immune axis, suggesting anti–IL‐23 agents may have potential as treatments for CD, psoriatic arthritis and other genetically related disorders.…”

Section: Il‐23 Inhibition In Other Inflammatory Diseasesmentioning

confidence: 99%

The role of IL‐23 and the IL‐23/T_H17 immune axis in the pathogenesis and treatment of psoriasis

Girolomoni

Strohal

Puig

et al. 2017

Acad Dermatol Venereol

230

165

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Psoriasis is a chronic, immune‐mediated disease affecting more than 100 million people worldwide and up to 2.2% of the UK population. The aetiology of psoriasis is thought to originate from an interplay of genetic, environmental, infectious and lifestyle factors. The manner in which genetic and environmental factors interact to contribute to the molecular disease mechanisms has remained elusive. However, the interleukin 23 (IL‐23)/T‐helper 17 (TH17) immune axis has been identified as a major immune pathway in psoriasis disease pathogenesis. Central to this pathway is the cytokine IL‐23, a heterodimer composed of a p40 subunit also found in IL‐12 and a p19 subunit exclusive to IL‐23. IL‐23 is important for maintaining TH17 responses, and levels of IL‐23 are elevated in psoriatic skin compared with non‐lesional skin. A number of agents that specifically inhibit IL‐23p19 are currently in development for the treatment of moderate‐to‐severe plaque psoriasis, with recent clinical trials demonstrating efficacy with a good safety and tolerability profile. These data support the role of this cytokine in the pathogenesis of psoriasis. A better understanding of the IL‐23/TH17 immune axis is vital and will promote the development of additional targets for psoriasis and other inflammatory diseases that share similar genetic aetiology and pathogenetic pathways.

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Section: Il‐23 Inhibition In Other Inflammatory Diseasesmentioning

confidence: 99%

The role of IL‐23 and the IL‐23/T_H17 immune axis in the pathogenesis and treatment of psoriasis

Girolomoni

Strohal

Puig

et al. 2017

Acad Dermatol Venereol

230

165

View full text Add to dashboard Cite

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“…A wealth of data documents the association of psoriasis with numerous comorbid diseases, including cardiometabolic, gastrointestinal, and kidney diseases as well as malignancies, infections, and mood disorders ( 8 ). To this end, it is still controversial whether psoriatic arthritis should be considered an extracutaneous manifestation of psoriasis or as a separate entity, and thus comorbidity ( 9 ). Among the comorbid conditions, cardiovascular diseases are of particular importance, as they often directly impact the patients’ mortality ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Systemic Inflammation and Cardiovascular Comorbidity in Psoriasis Patients: Causes and Consequences

2018

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Psoriasis is a common inflammatory skin disease characterized by the appearance of red scaly plaques that can affect any part of the body. High prevalence, chronicity, disfiguration, disability, and associated comorbidity make it a challenge for clinicians of multiple specialties. Likewise, its complex pathogenesis, comprising inflammation, hyperproliferation, and angioneogenesis, intrigues numerous scientific disciplines, namely, immunology. From a clinical perspective, the severity of psoriasis is highlighted by its increased mortality, with cardiovascular diseases contributing the highest excess risk. From a scientific point of view, psoriasis has to be considered a systemic inflammatory condition, as blood biomarkers of inflammation are elevated and imaging techniques document sites of inflammation beyond the skin. While the association of psoriasis with cardiovascular diseases is now widely accepted, causes and consequences of this association are controversially discussed. This review comments on epidemiologic, genetic, and mechanistic studies that analyzed the relation between psoriasis and cardiovascular comorbidity. The hypothesis of psoriasis potentially being an independent cardiovascular risk factor, driving atherosclerosis via inflammation-induced endothelial dysfunction, will be discussed. Finally, consequences for the management of psoriasis with the objective to reduce the patients’ excess cardiovascular risk will be pointed out.

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“…PsA may also feature skin involvement including nail involvement [ 3 ]. In PsA, heterogeneity in clinical presentation and severity of symptoms result in an incomplete understanding of the relationship between the skin and joint components of the disease, and their relative contribution to PsA disease activity and patient-reported outcomes [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Skin Involvement in Psoriatic Arthritis Worsens Overall Disease Activity, Patient-Reported Outcomes, and Increases Healthcare Resource Utilization: An Observational, Cross-Sectional Study

et al. 2018

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IntroductionPsoriatic arthritis (PsA) is an inflammatory arthropathy that exhibits heterogeneity in clinical presentation and severity of skin and joint symptoms. This heterogeneity results in an incomplete understanding of the relationship between the skin and joint components of PsA, and their relative impact on PsA disease activity and patient-reported outcomes. The objective of the study was to Investigate the clinical presentation of joint and active skin symptom involvement and the associated impact on physician- and patient-reported outcomes [patient global assessment (PtGA), health-related quality of life (HRQoL), and physical function), and healthcare resource burden in patients with PsA.MethodsThis was a retrospective analysis of the Adelphi 2015 PsA Disease Specific Programme, a real-world, cross-sectional survey of rheumatologists and their consulting PsA patients from the USA and Europe (France, Germany, Italy, Spain, and UK). The sample included data collected during the fourth quarter of 2015, on 1201 patients from 410 rheumatologists. Physician-reported joint and active skin symptom involvement were investigated for associations with clinical outcomes, patient/physician-reported outcomes, and healthcare resource utilization (HCRU).ResultsThe majority of patients with PsA with documented skin involvement had both joint and active skin involvement (80.9%, njoint+skin = 515, njoint only = 122, noverall = 637). Patients with skin involvement possessed a more severe global clinical profile, and the PsA clinical symptom severity profile positively correlated with skin severity. Physician global assessment scores were not significantly different in patients with joint-only involvement vs. joint with active skin involvement. Patients with skin involvement in PsA possessed significantly worse PtGA scores and increased HCRU.ConclusionPatients with PsA involving both joint and active skin symptoms exhibit a more severe overall disease state, worse patient-reported outcomes, and increased HCRU relative to patients with joint-only involvement in PsA. These results indicate that treating skin involvement should be considered along with treating joint involvement in patients with PsA.FundingEli Lilly and Company.Electronic supplementary materialThe online version of this article (10.1007/s40744-018-0120-8) contains supplementary material, which is available to authorized users.

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Psoriasis and Psoriatic Arthritis: Flip Sides of the Coin?

Cited by 22 publications

References 48 publications

The role of IL‐23 and the IL‐23/T_H17 immune axis in the pathogenesis and treatment of psoriasis

The role of IL‐23 and the IL‐23/T_H17 immune axis in the pathogenesis and treatment of psoriasis

Systemic Inflammation and Cardiovascular Comorbidity in Psoriasis Patients: Causes and Consequences

Skin Involvement in Psoriatic Arthritis Worsens Overall Disease Activity, Patient-Reported Outcomes, and Increases Healthcare Resource Utilization: An Observational, Cross-Sectional Study

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Psoriasis and Psoriatic Arthritis: Flip Sides of the Coin?

Cited by 22 publications

References 48 publications

The role of IL‐23 and the IL‐23/TH17 immune axis in the pathogenesis and treatment of psoriasis

The role of IL‐23 and the IL‐23/TH17 immune axis in the pathogenesis and treatment of psoriasis

Systemic Inflammation and Cardiovascular Comorbidity in Psoriasis Patients: Causes and Consequences

Skin Involvement in Psoriatic Arthritis Worsens Overall Disease Activity, Patient-Reported Outcomes, and Increases Healthcare Resource Utilization: An Observational, Cross-Sectional Study

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The role of IL‐23 and the IL‐23/T_H17 immune axis in the pathogenesis and treatment of psoriasis

The role of IL‐23 and the IL‐23/T_H17 immune axis in the pathogenesis and treatment of psoriasis