Moderate Psoriasis Research Articles

Correlation of Disease Activity and Quality of Life of Patients with Psoriasis after Narrow-band Ultraviolet B Therapy.

Treatment with ultraviolet light is a well-established and effective treatment option for mild to moderate psoriasis. The aims of the study were to measure the psoriasis area and severity index (PASI) reduction after narrow-band ultraviolet B (NB UVB) therapy, to evaluate the quality of life before and after treatment using the dermatology life quality index (DLQI), and to compare the clinical effectiveness with quality of life improvement. Twenty two patients (13 male and 9 female patients), aged between 21 to 70 years (mean age 40±14.65 years) were enrolled in the study. NB UVB treatment was performed with 10 to 25 (mean 18.5; SD 3.39) procedures with cumulative doses of 5 to 19.4 J/cm2. The baseline median PASI score was 20.027 which decreased after therapy to 11.11. More than PASI 50% reduction was achieved in 40.91% of the patients after at least 6 weeks of treatment and the results are highly statistically significant. Quality of life (QoL) assessed using DLQI was found moderately affected by disease pretreatment. NB UVB therapy significantly increased DLQI score in spectrum of ‘symptoms and feelings’ and ‘treatment’. The PASI score reduction that we observed after NB-UVB therapy is consistent with the results reported by other authors. Baseline DLQI scores were indicative of moderate QoL impairments associated with disease. At the same time, the reduction of the DLQI index corresponding to improved QoL correlated with the objective clinical symptom assessment. Our data suggest that DLQI and PASI indexes are important complementary methods for comprehensive health assessment of patients with psoriasis.

Profiles of patients with psoriasis for appointment gene-engineering biological therapy — clinical justification

Psoriasis is a chronic immune-mediated disease with predominant damage to the skin and musculoskeletal system.
 This paper describes the clinical manifestations of psoriasis requiring a special therapeutic approach. The profiles of patients who showed the early assignment of genetic engineering biological therapy: patients with moderate and severe psoriasis, with rashes of problem localization (skin of the face, scalp, genital area and palmar-plantar region), with severe psoriatic lesion of the nail plates, as well as psoriatic arthritis.
 Clinical cases of rapid and pronounced resolution of rashes with the use of the new drug netakimab (Efleira) in a dosage of 120 mg according to the standard regimen psoriasis patients with indications for systemic or phototherapy.

Immune Regulation of TNFAIP3 in Psoriasis through Its Association with Th1 and Th17 Cell Differentiation and p38 Activation.

Background Psoriasis is an immune-mediated chronic inflammatory skin disorder in which the dysregulation of immune cells plays an important role in its development. Tumor necrosis factor- (TNF-) α antagonists affect the immune repertoire, while TNF-α-induced protein 3 (TNFAIP3) has a protective role against the deleterious effects of inflammation and participates in immune regulation. Objective We investigated the immune regulation of TNFAIP3 in the pathogenesis of psoriasis and determined whether it is involved in the antipsoriatic effect of TNF-α antagonists. Methods mRNA levels were evaluated in blood from patients with moderate-to-severe psoriasis. The effects of TNF-α antagonists were examined in a mouse imiquimod- (IMQ-) induced psoriasis-like dermatitis model. In the mouse model, TNFAIP3 mRNA expression was determined using RT-PCR. Serum levels of IL-17A, IL-23, IFN-γ, TNF-α, phosphorylated ERK1/2, p38, and JNK were measured using ELISA. The proportion of Th1 and Th17 cells in mouse spleens was analyzed using flow cytometry. Results mRNA expression levels of TNFAIP3 in the blood were significantly lower in patients with moderate and severe psoriasis (mean ± SD = 0.44 ± 0.25) compared with normal subjects (mean ± SD = 1.00 ± 0.82) (P < 0.01). In the mouse model, IMQ downregulated TNFAIP3 expression levels, which were increased after TNF-α antagonist treatment (P < 0.05). Serum levels of Th17 cytokines (IL-17A and IL-23) and Th1 cytokines (IFN-γ and TNF-α) were significantly higher in the IMQ and IMQ/rat IgG1 groups compared with the control group, and the application of TNF-α antagonists significantly decreased the levels of inflammatory cytokines (P < 0.01). Notably, phosphorylated p38 levels were increased in the IMQ and IMQ/rat IgG1 groups compared with the control group but were downregulated by treatment with TNF-α antagonists (P < 0.05). Th1 and Th17 cells were significantly increased in the IMQ group compared with the control group (P < 0.01). Conclusion TNFAIP3 downregulation associated with Th1 and Th17 cell differentiation and p38 activation might contribute in part to the mechanism of immune dysfunction in psoriasis. TNF-α antagonists might partly exert their effects on psoriasis via this pathway.

Abstract P405: Visceral Adipose Tissue Volume is Associated With Prevalent Coronary Plaque Independent of Total Adiposity in Psoriasis

Introduction: Psoriasis (PSO) is a chronic inflammatory condition associated with accelerated atherosclerosis and increased risk of myocardial infarction in part mediated through high visceral adipose tissue (VAT) volume. VAT has been shown to be associated with increased coronary burden; however, the relationship with prevalent coronary plaque in PSO has not been explored. Hypothesis: We hypothesized that VAT would associate with coronary plaque in PSO beyond traditional risk factors. Methods: A total of 164 consecutive PSO patients underwent coronary computed tomography angiography (CCTA) as part of a large cohort study to assess presence of coronary plaque. Low-dose CT was utilized to quantify VAT and subcutaneous adipose tissue (SAT) volume from the level of the diaphragm to the pubic symphysis. Logistic regression was used to assess the association between the presence of coronary plaque and the ratio of VAT-to-total adiposity in adjusted models (STATA 12). Results: The cohort was middle-aged, predominantly male, relatively low CV risk by FRS and mild to moderate PSO (Table 1). Patients with increased VAT-to-total adiposity, had significantly increased coronary plaque presence (70% (45 of 65) vs. 31% (31 of 99), p&lt;0.001) compared to those with low VAT-to-total adiposity. Moreover, increased VAT-to-total adiposity was associated with 3-fold higher odds of having a prevalent coronary plaque (adjusted OR 2.96 (1.22 - 7.22), p=0.016) after adjustment for Framingham risk score, body-mass-index, waist-to-hip ratio and lipid treatment. Conclusions: Having higher VAT was associated with higher prevalence of coronary plaque independent of total adiposity and cardiovascular risk factors. These findings suggest VAT contributes to coronary plaque in psoriasis and that weight loss efforts may improve outcomes in this high-risk population.

Assessment of Serum and Tissue YKL-40 in Egyptian Psoriasis Vulgaris Patients versus Controls

Abstract Background Psoriasis is an inflammatory, papulosquamous disease of the skin. Serum YKL-40 is a useful biomarker of inflammation in psoriasis as well as other inflammatory diseases. Objectives To compare the levels of serum and tissue YKL-40 as a reliable biomarker of inflammation in psoriasis vulgaris patients versus controls. Patients and methods We performed a case-control study in 30 Egyptian patients with psoriasis vulgaris and 30 controls. Cases and controls were selected excluding pregnant females, individuals with any malignancies, patients who received systemic treatment for psoriasis for 1 month prior to their inclusion in the study and patients who received topical treatment for psoriasis 2 weeks prior to their inclusion in the study. The serum &amp; tissue levels of YKL-40 were measured using ELISA technique. Results Both the serum and tissue levels of YKL-40 were elevated in psoriasis patients when compared with controls (p &amp;lt; 0.01). These levels correlated highly with PASI score; both serum and tissue YKl-40 levels were significantly higher in patients with moderate psoriasis as compared with those with mild psoriasis. On the other hand, there was no statistical correlation between the serum and tissue levels of YKL-40 and age, BMI or disease duration. Conclusion The significant elevation in serum and tissue levels of YKl-40 in psoriatic patients when compared with healthy controls validates the marker in question as a reliable biomarker of inflammation in psoriasis vulgaris patients.

The Use of Apremilast in Psoriasis: A Delphi Study

BackgroundExperience in the use of apremilast in clinical practice complements the information available from pivotal clinical trials. Materials and methodsFollowing a review of the literature, a panel of dermatologists with expertise in the management of psoriasis considered 5 scenarios in which the evidence supporting the use of apremilast to treat moderate psoriasis is insufficient or controversial. These scenarios were then assessed using a Delphi questionnaire. ResultsConsensus was reached on 96 (67%) of the 143 items (positive in 85 and negative in 11). The therapeutic goal for apremilast should be based on 4 outcomes: clinical response, symptoms, quality of life, and patient satisfaction. The scenario in which the use of apremilast was considered to have the greatest possibility of success was in patients with stable moderate psoriasis. Most of the clinicians considered apremilast to be an appropriate treatment when conventional therapies fail or are contraindicated, preferably before the prescription of biologic therapy. Consensus was reached that apremilast is an appropriate treatment for psoriasis in difficult locations, such as the scalp or the palms and soles. It was also agreed that apremilast requires less prescreening and monitoring than other conventional and biologic systemic therapies. ConclusionsApremilast could be a treatment option for patients with a different profile to that of clinical trial participants. The limitations of this proposal are the absence of consensus on the definition of moderate psoriasis, the lack of real-world evidence on the use of apremilast, and certain aspects related to tolerability.

Serlopitant for psoriatic pruritus: A phase 2 randomized, double-blind, placebo-controlled clinical trial

Pruritus, a common symptom of psoriasis, negatively affects quality of life; however, treatment of lesional skin does not consistently alleviate psoriatic itch. To examine the effects of serlopitant, an oral, once-daily neurokinin 1 receptor antagonist, for treatment of psoriatic pruritus in a phase 2, randomized clinical trial (NCT03343639). Patients (n=204) were randomized to receive serlopitant, 5mg, or placebo daily for 8weeks. Eligible adult patients had plaque psoriasis for ≥6months, plaques covering ≤10% of body surface area, pruritus for ≥4weeks, and Worst Itch Numeric Rating Scale (WI-NRS) score ≥7 at the initial screening. Participants (54.2% women) had a mean age of 47.5years and 85.2% were white. Mean baseline WI-NRS scores were 8.3 for serlopitant and 8.1 for placebo. The WI-NRS 4-point response rate at 8weeks (primary end point) was 33.3% for serlopitant vs 21.1% for placebo (P=.028); at 4weeks the rates were 20.8% for serlopitant vs 11.5% for placebo (P=.039). Treatment-related adverse events were reported for 4.9% of serlopitant-treated and 4.0% of placebo-treated patients. This was a phase 2 study with a small study population. Patients with severe psoriasis were excluded. Serlopitant significantly reduced pruritus associated with mild to moderate psoriasis, supporting continued development of serlopitant for this patient population.

A multinational assessment of work-related productivity loss and indirect costs from a survey of patients with psoriasis.

SummaryBackgroundTotal work productivity loss (WPL) and associated indirect costs contribute to the economic burden of psoriasis.ObjectivesTo estimate total WPL and related indirect costs, and identify predictors of WPL associated with psoriasis severity in France, Germany, Spain, the U.K. and Italy (EU5) and the U.S.A.MethodsData from the 2015 Adelphi Real World Psoriasis Disease Specific Programme, analysed for absenteeism, presenteeism and total WPL, were quantified (0–100%) from participants who completed the Work Productivity and Activity Impairment (WPAI) instrument. These measures were converted to indirect costs using the human capital method. Univariate and multivariate statistical analyses controlling for patient demographic and clinical characteristics were conducted.ResultsOf the 936 respondents (29·6% U.S.A., 70·4% EU5) who completed the WPAI, 32·6%, 40·7% and 26·6% had mild [body surface area (BSA) 0–2%], moderate (BSA 3–10%) and severe (BSA > 10%) psoriasis, respectively. Average age, Dermatology Life Quality Index (DLQI) score and BSA were, respectively, 42·4 years, 5·1 and 9·6%; and 37·2% of respondents were female. Mean percentages of total WPL for respondents with mild, moderate and severe psoriasis were 10·1%, 18·9% and 29·4%, respectively. Presenteeism contributed considerably more to total WPL than did absenteeism across all countries and disease severity classes. Mean annual indirect costs per patient due to WPL ranged from 3742 U.S. dollars in Spain to 9591 U.S. dollars in the U.S.A. Multivariate regression showed that a one‐unit increase in DLQI score increases total WPL by 1·8% (P < 0·001).Conclusions WPL increased progressively with increasing DLQI scores and BSA, confirming the relationship between psoriasis severity and its economic burden. What's already known about this topic? The economic burden of psoriasis is exceptionally high given the high prevalence and lifelong nature of the condition.Several studies have attempted to assess the overall economic burden of psoriasis but there is a lack of comparative data from different countries, and issues around inconsistent methodologies, including statistical analyses.Total work productivity loss (WPL) and associated indirect costs are believed to contribute to the economic burden of psoriasis. What does this study add? This study measured total WPL and indirect costs via the same method and at the same time point in the U.S.A., France, Germany, Spain, U.K. and Italy.Total WPL increased progressively with psoriasis disease severity.Disease severity and Dermatology Life Quality Index scores significantly correlated with WPL after controlling for patient demographic and clinical characteristics.The U.S.A. had the highest annual mean indirect costs associated with total WPL. Linked Comment: Drabo et al. Br J Dermatol 2020; 183:420–421.

Turmeric extract based therapy for psoriasis

Background: Psoriasis is a chronic inflammatory skin disease affects 3 % of world population on average. Psoriasis can have disfiguring and disabling impacts on patients with increased global burden of the disease. According to WHO, there is continuous need for establishing new modalities for treatment of psoriasis with emphasis on treatment safety concerns of the patients. Objectives: The aim of this study is to assess the efficacy and safety of turmeric extract based ointment in the treatment of mild to moderate psoriasis Methods: 10 patients with psoriasis vulgaris confirmed histopathologically were recruited at Dermatology Department outpatient clinic Zagazig University Hospitals. The diseased severity were assessed clinically using PASI score and the histopathologic severity was assessed before and after 4 weeks of twice daily application the turmeric extract based ointment.Results: Significant reduction in disease severity in all patients used treatment with PASI before PASI before treatment was 19.44 ± 10.7, and after was 10.5 ± 6.3 (P = 0.0007). There was 47% ± 12% improvement in disease severity, with 50% of patients already reached PASI 50 benchmark by 4th week of treatment. Conclusions: In this pilot study, the effectiveness and tolerability of turmeric extract based ointment in the treatment of moderate psoriasis vulgaris was evaluated and proved on both clinical and histopathological levels.

Role of IL-17A and neutrophilic granulocytes in the pathogenesis of psoriasis

To study the expression of IL-17A in the inflammatory infiltrating cells in the plaques as one of the key points in the pathological process in moderate to severe psoriasis. The material obtained from 50 patients with moderate and severe psoriasis was examined by an indirect immunofluorescence assay to determine the composition of cell infiltrate and the type of IL-17A-producing cells in the foci of lesion. The markers of lymphocytes (CD3), dendritic cells (CD11c), neutrophilic granulocytes (Mpo), and mast cells (Trp) were used. The proliferative activity of basal keratinocytes (Ki-67), the expression of IL-17A, and the co-expression of IL-17A, Mpo, and Trp were also studied. A positive correlation was established between the count of neutrophilic granulocytes in the infiltrate, the expression of IL-17A, and the number of neutrophils expressing IL-17A with the duration of the disease and the severity of the patient's condition. Neutrophilic granulocytes and their expression of IL-17A play one of the key roles in the pathogenesis of psoriasis.

Incidence of Psoriatic Arthritis in Patients with Skin Psoriasis and Associated Risk Factors: A Retrospective Population-based Cohort Study in Swedish Routine Clinical Care.

The incidence of psoriatic arthritis in patients with psoriasis is unclear; existing estimates differ by a factor of ten. Complete population-level data is needed to provide accurate estimates with high confidence. A total of 123,814 adults with psoriasis, free from preexisting psoriatic arthritis, were identified in population-based data from secondary care in Sweden during 2007 to 2017. Incidence was calculated as the number of psoriatic arthritis diagnosis events per 100 patient-years. Time to diagnosis was assessed using cumulative incidence and Cox proportional hazards models to identify risk factors. Incidence of psoriatic arthritis in patients with psoriasis was 1.69 per 100 patient-years (95% confidence interval 1.65–1.72) overall, and 1.48, 3.00, and 5.49 per 100 patient-years in patients with mild, moderate and severe psoriasis, respectively. Risk of psoriatic arthritis was 3.2 times higher amongst patients with severe psoriasis compared with mild disease. Dermatologists should regularly assess risk factors for psoriatic arthritis in clinical practice in order to improve the detection of psoriatic arthritis.

Long-term safety and efficacy of adalimumab in psoriasis: a multicentric study focused on infections (connecting study).

IntroductionThis Italian multicenter retrospective study evaluated safety and efficacy of the anti-TNF drug, adalimumab, in a cohort of patients affected by tuberculosis (TB), hepatitis B virus (HBV), hepatitis C virus (HCV) or human immunodeficiency virus (HIV). Psoriasis is an autoimmune disease affecting around 3% of the Italian population and associated with several comorbidities, including arthritis, cardio-metabolic diseases and depression. In its moderate-to-severe form, psoriasis profoundly impairs quality of life of patients.AimTherefore, these patients deserve systemic treatments including conventional DMARDS (disease modifying anti-rheumatic drugs) and biologics. Management of moderate and severe psoriasis patients affected by relevant infections such as TB, HBV, HCV and HIV may be difficult because of the toxicity of the conventional systemic treatment.Material and methodsThe CONNECTING study analysed 28 moderate to severe psoriasis patients infected by TB, HBV, HCV and HIV who were treated with adalimumab for up to 96 weeks together with respective prophylactic treatment.ResultsWe observed a rapid decrease in PASI (psoriasis area severity index) reaching a 75% improvement in 91% of patients. Some of these patients (n = 9) were also affected by arthritic comorbidity. The patients experienced a rapid decrease in pain, measured by pain VAS (visual analogic scale) that reached 0 in all of them. Monitoring of the respective infection did not show any worsening or reactivation of infection or any severe adverse events during the entire observation period.ConclusionsAdalimumab is effective and safe in patients affected by these important infections.

Tapinarof to treat psoriasis.

There is a need for new and effective topical treatment options for psoriasis. Recent phase I and II clinical trials have demonstrated efficacy of the novel nonsteroidal drug tapinarof to treat mild to moderate plaque psoriasis. Tapinarof is an aryl hydrocarbon receptor (AHR) agonist that induces antioxidant, immunomodulatory and epidermal differentiation regulation pathways. In this review, we examine the current preclinical and clinical studies with a focus on the mechanism of action, pharmacokinetics, safety and efficacy of tapinarof to treat psoriasis.

Cardiovascular risk in patients with plaque psoriasis and psoriatic arthritis without a clinically overt cardiovascular disease: the role of endothelial progenitor cells.

Psoriasis is an autoimmune, chronic disease determined by environmental and genetic factors. The occurrence of psoriasis is accompanied by metabolic diseases, cardiovascular diseases (CVD) and depression, disturbances on interpersonal interactions and a tendency towards social isolation. Regardless of the form of psoriasis and the severity of the disease, early arterial lesions are recorded in arterial vessels of patients. Nevertheless, the chance of CVD is higher in the population of patients with severe psoriasis than in patients with mild to moderate psoriasis. The correlation between the presence of atherosclerotic plaque and psoriatic plaque is partially explained by: (1) a similar inflammatory pathway – via the T helper cells, (2) impaired angiogenesis, and (3) endothelial dysfunction. In the considered tests, the diagnostic tools used showed a reduced level of endothelial progenitor cells in the circulation of patients with psoriasis. Endogenous angiopoietin stimulation in patients with psoriasis leads to deterioration of endothelial regeneration, atherosclerosis which secondarily contributes to the progression of heart failure. Clinical and experimental data confirm the potential of immunomodulatory methods to combat both autoimmune and cardiovascular diseases through the use of immunosuppressive drugs. Full understanding of the way in which CVD develops in patients with autoimmune diseases would enable the implementation of targeted cell therapy allowing the quality and life expectancy of patients to be improved. Modern cellular diagnostic tools allow the use of highly specific biomarkers, which in the near future will enable a reduction in morbidity and mortality due to CVD.

Estudio Delphi para el uso de apremilast en la psoriasis

BackgroundExperience in the use of apremilast in clinical practice complements the information available from pivotal clinical trials. Material and methodFollowing a review of the literature, a panel of dermatologists with expertise in the management of psoriasis considered 5 scenarios in which the evidence supporting the use of apremilast to treat moderate psoriasis is insufficient or controversial. These scenarios were then assessed using a Delphi questionnaire. ResultsConsensus was reached on 96 (67%) of the 143 items (positive in 85 and negative in 11). The therapeutic goal for apremilast should be based on 4 outcomes: clinical response, symptoms, quality of life, and patient satisfaction. The scenario in which the use of apremilast was considered to have the greatest possibility of success was in patients with stable moderate psoriasis. Most of the clinicians considered apremilast to be an appropriate treatment when conventional therapies fail or are contraindicated, preferably before the prescription of biologic therapy. Consensus was reached that apremilast is an appropriate treatment for psoriasis in difficult locations, such as the scalp or the palms and soles. It was also agreed that apremilast requires less prescreening and monitoring than other conventional and biologic systemic therapies. ConclusionsApremilast could be a treatment option for patients with a different profile to that of clinical trial participants. The limitations of this proposal are the absence of consensus on the definition of moderate psoriasis, the lack of real-world evidence on the use of apremilast, and certain aspects related to tolerability.

A novel vehicle for the treatment of psoriasis.

This study evaluates the effectiveness of the topical use of an aerosol foam combination of calcipotriol 50 μg/g plus betamethasone dipropionate 0.5 mg/g (Cal/BD foam, Enstilar®) in adults with moderate plaque psoriasis. A total of 120 male and female adult psoriasis patients (53.3% male) from two Italian dermatological units were enrolled in an 8-week prospective study performed between November 2018 and January 2019. Psoriasis Area and Severity Index (PASI) was evaluated at baseline (T0) and 4 weeks (T4) of daily application, and a further evaluation was carried out 4 weeks after suspension (T8). Furthermore, the Dermatology Life Quality Index (DLQI) was evaluated at baseline and after 4 weeks of treatment (T4). At baseline, patients presented a mean PASI of 7 (7.0 ± 2.1). After 4 weeks (T4) of once-daily application, an important improvement in PASI was observed (1.1 ± 0.3). At Week 4, DLQI was reduced by 5.5 points from baseline (mean: 12 ± 3.1 at T0 vs 6.5 ± 1.8 at T4). Four weeks after suspension (T8), mean PASI was 2.6 ± 1.9, which was stable compared to the previous evaluation; only 8.3% of the treated patients showed worsening of plaque psoriasis. This study suggested that the Cal/BD aerosol foam is an effective topical therapy to treat plaque psoriasis.

EVALUATION OF THE EFFECTIVENESS OF TOPICAL TREATMENT COMBINATION OF BETAMETHASONE DIPROPIONATE 0.05%/CALCIPOTRIOL MONOHYDRATE 0.005% GEL AND CLOBETASOLE PROPIONATE 0.05% OINTMENT IN PATIENTS WITH PSORIATIC ONYCHODYSTROPHY

Psoriatic onychodystrophy is a comorbidity that often occurs in patients with psoriasis, affecting their quality of life. Although success has recently been achieved in the treatment of the cutaneous form of psoriasis, there are few publications about nail therapy with proven effectiveness. The development of effective and safe therapies remains relevant for nail psoriasis. Objective. to evaluate the effectiveness and tolerability of the fixed combination of betamethasone dipropionate 0.05%/calcipotriol monohydrate 0.005% gel and clobetasole propionate 0.05% ointment in patients with psoriatic onychodystrophy. Material and methods. the study included 50 patients with psoriasis vulgaris, mild to moderate severity with lesions of the nail plates. Patients were divided into two groups and used betamethasone dipropionate 0.05%/calcipotriol monohydrate 0.005% gel (group A) and clobetasole propionate 0.05% ointment with occlusion (group B) for 24 weeks with hardware treatment of nail plates at 0, 8, 16 weeks. They did not receive any other local or systemic treatment. The severity of nail psoriasis was assessed by the NAPSI index at week 0, 8, 16, and 24, and by the IGA after treatment. results. 43 patients completed the study. At the beginning of the study, the average NAPSI was 32.8 ± 10.3 in group A and 33.1 ± 9.8 in group B. At week 24 the average NAPSI score decreased to 12.8 ± 7.2 in group A and 11.8 ± 68 in group B. IGA for evaluation treatment score was 3 ± 0.74 in group A and 3.1 ± 0.79 in group B. Conclusions. Combined treatments in the form of hardware processing nail plates with betamethasone dipropionate 0.05%/calcipotriol monohydrate 0.005% gel and clobetasol propionate 0.05% ointment are effective and can be used in patients with moderate and severe nail psoriasis, which is confirmed by the results in clinical improvement of 60.8% and 64.5%, respectively, based on a decrease in NAPSI at 24 weeks and an assessment of the therapeutic response after treatment using the IGA.

Long-term use of fumaric acid esters for the treatment of psoriasis in daily practice

Background Fumaric acid ester (FAE) is the most commonly prescribed first-line systemic therapy for the treatment of psoriasis in Germany. Although developed in the 1990s, only limited long-term data are available. Methods Data of 200 adult psoriatic patients from 10 study centers were collected in a noninterventional, multicenter, retrospective analysis. The inclusion criteria was treatment with FAE in 2015. Results Eighty-two percent of the patients were naive to systemic treatment. Ten percent of all patients had FAE-treatment for 10 years or longer with an average drug survival of 4.32 years. The maintenance dose was ranging from 1–4 120 mg tablets for 87.5% of the patients. In our population, 14% of the patients stopped therapy during the first six month mainly due to gastro-intestinal side effects. No serious side effects were reported. Seventy-eight percent of the patients responded to FAE therapy with improvement of their psoriasis to mild (61%) or clear (17%). The PASI 75 response was achieved in 44% of the patient during long-term treatment without remarkable differences between moderate or severe plaque psoriasis. Conclusion Our study confirms FAE therapy as a long-term, first-line treatment for moderate-to-severe plaque psoriasis.

Halobetasol 0.01% Lotion in the Treatment of Moderate-to-Severe Plaque Psoriasis of the Lower Extremities

Abstract not available.

Efficacy of Halobetasol 0.01%/Tazarotene 0.045% (HP/TAZ) Fixed Combination in the Treatment of Moderate Plaque Psoriasis: Indirect Comparison Between Pooled Phase 3 Trials of HP/TAZ and Oral Treatment (Apremilast)

Abstract not available.