Safety and Efficacy of Calcium Folinate in Psoriasis: An Observational Study

Abstract

The first two authors contributed equally to this paper An association between psoriasis and cardiovascular diseases has been reported, and treatment of this condition is often considered difficult because the conventional systemic therapies often show several side effects. To assess the efficacy and tolerability of a new drug, folinate calcium, to treat psoriasis, a total of 58 patients affected by active psoriasis were enrolled in a variable period study. These patients had clinically stable, plaque psoriasis involving~6% body surface area. Thirty ofthese patients were treated with folinate calcium therapy, 15 mg orally once daily, for a variable period based on each patient's clinical response. The comparison was made with 28 psoriatic patients treated with conventional systemic therapies (cyclosporine, acitretin, etanercept, efalizumab, infliximab, adalimumab). A clinical improvement was observed in both group, but in the first one we did not observe any side effects, whereas some important side effects were observed in the second. These preliminary results support the effectiveness and tolerability of folinate calcium treatment in psoriasis.Psoriasis (PsO) is an inflammatory chronic skin disease affecting the skin and potentially the joints. Environmental and genetic factors are important in the etiology of PsO. Dysregulation of T-cell antigen-presenting cell interactions and overexepression of proinflammatory cytokines lead to the hyperproliferation of keratinocytes and the activation of neutrophils and endothelial cells within the skin. Chronic activation of T cells ensues, resulting in a persistent cycle of inflammatory-mediated pathology and formation of the characteristic psoriatic skin lesion (1-2). Patients with immune-mediated inflammatory diseases, such as PsO, have an increased likelihood of comorbidities compared with healthy controls (1,(3)(4). Recently the attention has been focused on the link between psoriasis and cardio-metabolic conditions such as cardiovascular disease, diabetes and obesity, as well as the metabolic syndrome (MetS). Both PsO and MetS have strong inflammatory components and their co-occurrence may be linked to this shared attribute (l, 5). The existence of a tight relationship between metabolic and inflammatory diseases is probably due to the many cytokines released in both disorders, therefore PsO and MetS can share a similar pathogenetic mechanism.

Homocysteine and psoriasis

“…Folinate calcium is a folic acid derivative, a reduced form of folic acid which can be rapidly absorbed after administered orally [127]. Carlesimo et al [128] treated 30 patients affected by active chronic plaque psoriasis associated with other disorders: hypertension, diabetes, dyslipidemia and obesity, with oral folinate calcium 15 mg once daily for a variable period based on the patient’s clinical response. After the therapy a significant reduction of PASI mean values was observed (from 22.78 to 7.92), indicating an improvement of the clinical condition.…”

Inflammatory Markers: Serum Amyloid A, Fibrinogen and C-Reactive Protein — A Revisited Study

“…The acute-phase protein serum amyloid A (SAA) is a clinically useful marker of inflammation and is strongly associated with increased risk of cardiovascular events (12). Chronically elevated SAA concentrations may contribute to physiological processes that lead to atherosclerosis, including endothelial dysfunction, an early and predictive event in the development of cardiovascular disease (13)(14)(15). Studies suggest that SAA can be a direct mediator in the development and progression of atherogenesis and atherothrombosis (16).…”

The Role of Major Inflammatory Biomarkers in the Pathogenesis of Atrial Fibrillation

“…71 Moreover, chronically increased SAA levels could contribute to physiological processes, which may lead to characteristics of atherosclerosis, including endothelial dysfunction, and an early predictive event in the development of CVDs. [72][73][74][75] SAA is a sensitive marker of inflammation, and higher levels of SAA were recorded in study subjects with acute and chronic inflammation. Long-term and repeated infections cause a persistent elevation in SAA.…”