Treatment of Psoriasis

Greaves, Malcolm W.; Weinstein, Gerald D.

doi:10.1056/nejm199503023320907

Cited by 338 publications

(239 citation statements)

References 87 publications

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“…Depending on the stage of disease, current treatment options include UVB, UVA plus psoralen, methotrexate, acitretin, cyclosporine, infliximab, etanercept, adalimumab, efalizumab and alefacept. Whereas infliximab, etanercept and adalimumab are specific TNF blockers, all of the others are immunosuppressive agents that could increase the risk of infections and malignancies, especially with long-term use (Greaves and Weinstein, 1995;Kurd et al, 2007). Psoriasis is a chronic disease, which requires long-term treatment and 51% of patients with psoriasis use complementary and alternative therapies (Fleischer et al, 1996).…”

Section: Psoriasismentioning

confidence: 99%

Curcumin: an orally bioavailable blocker of TNF and other pro‐inflammatory biomarkers

Aggarwal

Gupta

Sung

2013

British J Pharmacology

343

239

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TNFs are major mediators of inflammation and inflammation-related diseases, hence, the United States Food and Drug Administration (FDA) has approved the use of blockers of the cytokine, TNF-a, for the treatment of osteoarthritis, inflammatory bowel disease, psoriasis and ankylosis. These drugs include the chimeric TNF antibody (infliximab), humanized TNF-a antibody (Humira) and soluble TNF receptor-II (Enbrel) and are associated with a total cumulative market value of more than $20 billion a year. As well as being expensive ($15 000-20 000 per person per year), these drugs have to be injected and have enough adverse effects to be given a black label warning by the FDA. In the current report, we describe an alternative, curcumin (diferuloylmethane), a component of turmeric (Curcuma longa) that is very inexpensive, orally bioavailable and highly safe in humans, yet can block TNF-a action and production in in vitro models, in animal models and in humans. In addition, we provide evidence for curcumin's activities against all of the diseases for which TNF blockers are currently being used. Mechanisms by which curcumin inhibits the production and the cell signalling pathways activated by this cytokine are also discussed. With health-care costs and safety being major issues today, this golden spice may help provide the solution. LINKED ARTICLESThis article is part of a themed section on Emerging Therapeutic Aspects in Oncology. To view the other articles in this section visit http://dx

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Section: Psoriasismentioning

confidence: 99%

Curcumin: an orally bioavailable blocker of TNF and other pro‐inflammatory biomarkers

Aggarwal

Gupta

Sung

2013

British J Pharmacology

343

239

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“…[3][4][5][6][7][8] Severely affected patients may be prescribed nonbiologic systemic medication such as ciclosporin or methotrexate, or biologic treatment such as infliximab, etanercept, adalimumab or ustekinumab. These treatments suppress the inflammatory immune response that drives the disease, but they might also affect the risk for other diseases, notably cancer and infections.…”

mentioning

confidence: 99%

Incidence rates of malignancies and hospitalized infectious events in patients with psoriasis with or without treatment and a general population in the U.S.A.: 2005–09

et al. 2014

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SummaryBackground Rates of malignancies and hospitalized infectious events (HIEs) among psoriasis patients are higher than in the general population, but it is unclear if higher rates are associated with the underlying inflammatory state, treatments or both. Objectives To assess the incidence of malignancies and HIEs in a healthy US population, a psoriasis population, and four treated psoriasis populations. Methods Using a US claims database, we identified a general population, a psoriasis cohort, and four treatment cohorts [non-biologic systemics, etanercept, other TNF blockers (adalimumab, infliximab) and phototherapy] to assess the incidence of lymphomas, nonmelanoma skin cancer (NMSC), all malignancies (excluding NMSC), and HIEs, standardized for age and sex. Results Among 40 987 patients with psoriasis, 11% were prescribed non-biologics, 15% etanercept, 6% other TNF blockers and 11% phototherapy. For all cancers, the psoriasis population rate (114/10 000 person-years) was 20% greater than the rate found in the general population (95/10 000 person-years). For NMSC, the psoriasis population rate (129/10 000 person-years) was 65% greater than the general population rate (78/10 000 person-years). The incidence rate for each treatment modality was lower than the overall psoriasis cohort, except for phototherapy. There was little difference in the rates of lymphomas. NMSC rates were higher among patients treated with phototherapy. HIE rates ranged from 165/10 000 person-years for the phototherapy group to 262/10 000 person-years for the other anti-TNF group. Conclusions Patients with psoriasis appear to have higher rates of malignancy and HIE than the general population, with little difference in rates between the treatment methods, except for a higher rate of cancer among those receiving phototherapy.

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“…[37]. * 1999: "Therapies for psoriasis … tend to have a remittent effect (inducing long-term remission) or a suppressive effect (improving Table 3 and Rifampicin (Tsankov 1993(Tsankov ,2011 Therapeutic effectivity of anti-CD4 (Morel et 1992) Clearing after bone marrow transplantation Transfer from transplant donor to recipient lesions but with a prompt recurrence when the treatment is discontinued)" [38].…”

Section: History Of the Pathogenesis Of Psoriasismentioning

confidence: 99%

Lepra vulgaris. History of Psoriasis

Burg¹,

Geiges²

2014

J Turk Acad Dermatol

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Background: The history of psoriasis, remains highly speculative for the time before Willan (1757Willan ( -1812, and can be reliably assigned only for the last 200 years. Terms such as "Leprosy", "Impetigo" and "Psora" have been used in the centuries before. Hebra (1806-1880) gave a morphological and nosologic definition, in which also the histopathology appearance was taken into account. In the early 20th century, it was the biochemistry and histochemistry, which provided new insights. In the second half of the 20th century, immunocytochemistry and immunology shed some light on the pathogenetic processes of the disease. At the end of the 20th and at the beginning of the 21st century, it is the triumph of genetics and immunology, which have opened new therapeutic possibilities due to the interesting insights into the pathogenesis of psoriasis. However besides the new therapeutic modalities, which harbor some health and some economic threats, classical approaches still remain valuable tools. AbstractBackground: The history of psoriasis, remains highly speculative for the time before Willan (1757-1812), and can be reliably assigned only for the last 200 years. Terms such as "Leprosy", "Impetigo" and "Psora" have been used in the centuries before. Hebra (1806-1880) gave a morphological and nosologic definition, in which also the histopathology appearance was taken into account. In the early 20th century, it was the biochemistry and histochemistry, which provided new insights. In the second half of the 20th century, immunocytochemistry and immunology shed some light on the pathogenetic processes of the disease. At the end of the 20th and at the beginning of the 21st century, it is the triumph of genetics and immunology, which have opened new therapeutic possibilities due to the interesting insights into the pathogenesis of psoriasis. However besides the new therapeutic modalities, which harbor some health and some economic threats, classical approaches still remain valuable tools.

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Treatment of Psoriasis

Cited by 338 publications

References 87 publications

Curcumin: an orally bioavailable blocker of TNF and other pro‐inflammatory biomarkers

Curcumin: an orally bioavailable blocker of TNF and other pro‐inflammatory biomarkers

Incidence rates of malignancies and hospitalized infectious events in patients with psoriasis with or without treatment and a general population in the U.S.A.: 2005–09

Lepra vulgaris. History of Psoriasis

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