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Turkish Journal of Medical Sciences 2023Craniocervical junction (CCJ) can be involved in inflammatory arthritis. We aimed to define types of CCJ involvement in rheumatoid arthritis (RA), spondyloarthritis...
BACKGROUND/AIM
Craniocervical junction (CCJ) can be involved in inflammatory arthritis. We aimed to define types of CCJ involvement in rheumatoid arthritis (RA), spondyloarthritis (SpA), and psoriatic arthritis (PsA) and compare them with patients without inflammatory arthritides.
MATERIALS AND METHODS
In this retrospective analysis, cervical CT or MRIs of patients with RA, SpA, or PsA, taken for any reason between 2010 and 2020, according to ICD-10 codes, were scanned. Demographic data of the patients were recorded. CCJ involvements (atlantoaxial, vertical, or subaxial subluxation, odontoid process involvement) were reevaluated by an experienced radiologist. The control group consisted of consecutive patients without inflammatory arthritis.
RESULTS
Exactly 459 patients (204 RA, 200 SpA, and 55 PsA) and 78 patients in the control group were included in the study. CCJ involvement was detected in 101 (49.5%) RA, 53 (26.5%) SpA, 10 (18.2%) PsA, and 4 patients (5.1%) in the control group (p < 0.001). The odontoid process was one of the main targets, especially in RA patients (69 (33.8%)), which was significantly higher than in the SpA, PsA, and control groups. Although vertical subluxation (VS) was numerically higher in the RA and SpA groups compared to the control group, VS-related brainstem compression was relatively uncommon: 6 (2.9%) in RA, 1 (0.5%) in AS, and none in the PsA and control groups.
CONCLUSION
CCJ involvement can often be detected in patients with inflammatory arthritis, especially in RA and SpA patients. The odontoid process is the main target of inflammation.
Topics: Humans; Female; Male; Middle Aged; Retrospective Studies; Arthritis, Rheumatoid; Adult; Magnetic Resonance Imaging; Tomography, X-Ray Computed; Spondylarthritis; Aged; Arthritis, Psoriatic; Atlanto-Axial Joint; Cervical Vertebrae; Odontoid Process
PubMed: 38813511
DOI: 10.55730/1300-0144.5740 -
Frontiers in Medicine 2024Psoriasis is a chronic inflammatory skin disease. EDP1815 is an oral, gut-restricted preparation of non-live , the first of a new immunomodulatory therapeutic class...
BACKGROUND
Psoriasis is a chronic inflammatory skin disease. EDP1815 is an oral, gut-restricted preparation of non-live , the first of a new immunomodulatory therapeutic class targeting the small intestine to generate systemic anti-inflammatory responses.
OBJECTIVE
To evaluate safety and efficacy of EDP1815 in mild-to-moderate psoriasis in a proof-of-concept study.
METHODS
A phase 2, multicenter, randomized, double-blinded, placebo-controlled, parallel-group study with a 16-week treatment period and up to 24 weeks of follow-up. Participants were randomized to receive 1, 4, or 10 capsules daily.
RESULTS
EDP1815 was well tolerated with comparable rates of treatment-emergent adverse events to placebo, and no drug-related serious adverse events. Clinically meaningful responses to EDP1815, defined as at least 50% reduction in Psoriasis Area and Severity Index (PASI-50) at week 16, were observed in all 3 cohorts, statistically significant in the 1-capsule (29.7%; = 0.048) and 4-capsule (31.9%; = 0.022) groups, compared with placebo (12.1%). Among EDP1815-treated PASI-50 responders at week 16, 60% (18/30) maintained or improved off-treatment responses at week 40.
LIMITATIONS
Continued off-treatment improvement past 16 weeks shows potential for greater therapeutic benefit that was not assessed.
CONCLUSION
EDP1815 was well-tolerated with a placebo-like safety profile, and had meaningful efficacy outcomes in psoriasis, validating this novel immunomodulatory approach.
CLINICAL TRIAL REGISTRATION
https://www.clinicaltrials.gov/search?term=NCT04603027, identifier NCT04603027.
PubMed: 38813388
DOI: 10.3389/fmed.2024.1292406 -
Dermatology Practical & Conceptual Apr 2024Data about the long-term effectiveness of brodalumab could be valuable in assessing patient adherence to treatment and improving psoriasis management.
INTRODUCTION
Data about the long-term effectiveness of brodalumab could be valuable in assessing patient adherence to treatment and improving psoriasis management.
OBJECTIVE
The aim of our study was to evaluate the drug survival of brodalumab and identify any predictive factors for discontinuation.
METHODS
A multicenter retrospective study was conducted in patients with moderate-to-severe psoriasis who were treated for up to 3 years. We extracted data from patient files, related to the characteristics of the patients and the disease. Drug survival analysis was descriptively analyzed using Kaplan-Meier survival curves. Univariable and multivariable analyses were performed to assess baseline patient characteristics that predicted clinical response.
RESULTS
The study included 90 patients. Among them, 28 (31.1%) suspended brodalumab through the observation period. At weeks 52, 104 and 156 the median PASI score were 0.0 [0.0 - 0.8], 0.0 [0.0 - 1.0] and 0.0 [0.0 - 0.0], respectively. The estimated cumulative survival rates at weeks 52 and 104 were 86.32% and 78.09%, respectively. In the multivariable survival analysis, predictor factors for overall discontinuation included body mass index (BMI) (OR 1.10, 95% CI 1.03 - 1.18), baseline PASI (OR 1.06, 95% CI 1.02 - 1.10), and psoriatic arthritis (OR 5.05, 95% CI 0.89 - 13.50).
CONCLUSIONS
Brodalumab has shown long-term effectiveness for up to 3 years. Considering baseline disease severity and patient characteristics could aid in optimizing the long-term management of psoriasis.
PubMed: 38810071
DOI: 10.5826/dpc.1402a152 -
Dermatology Practical & Conceptual Apr 2024Psoriasis is a systemic disease of the skin and nails associated with a wide range of comorbidities such as depression, psoriatic arthritis and metabolic syndrome.
INTRODUCTION
Psoriasis is a systemic disease of the skin and nails associated with a wide range of comorbidities such as depression, psoriatic arthritis and metabolic syndrome.
OBJECTIVES
The study aimed to examine a potential association between inflammatory markers (C- reactive protein [CRP] and erythrocyte sedimentation rate [ESR]) and depression in patients with psoriasis.
METHODS
A total of 80 individuals were enrolled in the study. Case participants included 28 patients diagnosed with Psoriasis (Beck Depression Inventory-II: :0-13) and 24 patients diagnosed with Psoriasis and Depression (Beck Depression Inventory-II:14-63). Twenty-eight (28) healthy participants comprised the control group.Psoriasis severity was evaluated by using Psoriasis Area and Severity Index, Physician Global Assessment, Body Surface Area and Dermatology Life Quality Index. Written approval was obtained for its use in this study: Cardiff University (09/2015). Other factors considered in the study were obesity using the Body Mass Index, the levels of stress using the Beck Anxiety Inventory, and the presence of insomnia using the Athens Insomnia Scale. Blood draws and inflammatory markers measurements were performed for all participants.
RESULTS
Both CRP and ESR levels were higher in the case group (ie Psoriasis and Depression and Psoriasis) compared to healthy controls. Furthermore, psoriatic patients with depression showed increased CRP and ESR levels compared to those of psoriatic patients without depression.
CONCLUSIONS
The evaluation of both CRP and ESR and their use to detect the presence of depression in patients with psoriasis can be an important tool for their holistic treatment of theirs.
PubMed: 38810053
DOI: 10.5826/dpc.1402a104 -
Anais Da Academia Brasileira de Ciencias 2024The epidemiology of psoriasis and cutaneous mycoses is scarce in Brazil. Thus, this cross-sectional study aimed to characterize the distribution of these diseases in...
The epidemiology of psoriasis and cutaneous mycoses is scarce in Brazil. Thus, this cross-sectional study aimed to characterize the distribution of these diseases in Paraná. Data was obtained from the Outpatient Information System (SIA - Sistema de Informações Ambulatoriais), between 2016 and 2020. The procedures were filtered by the International Classification of Diseases (ICD). A total of 201,161 outpatient procedures were registered for psoriasis and psoriatic arthritis. The distribution concerning gender was similar (50.93% feminine; 49.07% masculine). The mean age was 51.55 years. The most frequent procedure was methotrexate dispensing (23.17%), followed by acitretin (14.29%) and adalimumab (12.55%). Adjusting to total population, the prevalence of procedures was 0.35%. Regarding cutaneous mycoses, 1,756 procedures were registered. 65% of them referred to females. White race/color was predominant (82.97%). The mean age was 37.6 years. The distribution concerning age varied according to the type of mycosis. Medical appointments (48.92%) and surgical pathology exam/biopsy (38.71%) were the most frequent procedures. The prevalence of procedures was 0.004%. This is the first epidemiological study using SIA about the population affected by psoriasis, psoriatic arthritis, and cutaneous mycoses in a Brazilian state. We believe that these findings allow relevant contribution to science and public policies in Brazil.
Topics: Humans; Brazil; Male; Female; Psoriasis; Cross-Sectional Studies; Middle Aged; Prevalence; Adult; Dermatomycoses; Young Adult; Adolescent; Aged; Sex Distribution; Age Distribution; Child
PubMed: 38808876
DOI: 10.1590/0001-3765202420230828 -
Caspian Journal of Internal Medicine 2024Psoriasis is a common, chronic, immune-mediated inflammatory disease with a variety of skin manifestations. The aim of this study was to determine the...
BACKGROUND
Psoriasis is a common, chronic, immune-mediated inflammatory disease with a variety of skin manifestations. The aim of this study was to determine the prevalence of subclinical Achilles tendon disorder in cutaneous psoriasis patients and compare it with healthy controls.
METHODS
This was a cross-sectional case-control study conducted on psoriasis patients that were referred to dermatology clinic. Thirty patients in the case group and 30 healthy controls were included in the study. Thickness of Achilles tendon enthesis was scanned by an expert rheumatologist using ultrasound equipped with a 5-14 MHz linear prob bilaterally.
RESULTS
The mean age of the patient and control groups was 43.97±16.82 years and 38.87±12.71 years, respectively (P=0.190). The mean thickness of the Achilles tendon enthesis in the dominant limb was 4.31±0.86 mm in the patient group and 4.10±0.54 mm in the control group. There was no significant difference between the two groups in terms of thickness of the Achilles tendon enthesis in the dominant limb (P=0.276). The mean thickness of the Achilles tendon enthesis in the non-dominant limb was 4.44±0.91 mm in the patient group and 4.14±0.59 mm in the control group. There was no significant difference between the two groups in terms of thickness of Achilles tendon enthesis in the non-dominant limb (P = 0.134).
CONCLUSION
Although ultrasonography may be utilized for assessment of both structural and inflammatory changes, we revealed no difference in the mean thickness of Achilles tendon enthesis in patients with cutaneous psoriasis. Contradiction between clinical and ultrasonography features required further research.
PubMed: 38807726
DOI: 10.22088/cjim.15.2.313 -
Arthritis Research & Therapy May 2024Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis. PsA disease involves flares, which are associated with increased joint inflammation and...
BACKGROUND
Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis. PsA disease involves flares, which are associated with increased joint inflammation and tissue remodeling. There is a need for identifying biomarkers related to PsA disease activity and flares to improve the management of PsA patients and decrease flares. The tissue turnover imbalance that occurs during the inflammatory and fibro-proliferative processes during flares leads to an increased degradation and/or reorganization of the extracellular matrix (ECM), where increased proteolysis plays a key role. Hence, protease-mediated fragments of inflammatory and tissue-remodeling components could be used as markers reflecting flares in PsA patients.
METHODS
A broad panel of protease-mediated biomarkers reflecting inflammation and tissue remodeling was measured in serum and synovial fluid (SF) obtained from PsA patients experiencing flares (acutely swollen joint[s], PsA-flare). In serum, biomarker levels assessed in PsA-flare patients were compared to controls and in early-diagnosed PsA patients not experiencing flares (referred to as PsA without flare). Furthermore, the biomarker levels assessed in SF from PsA-flare patients were compared to the levels in SF of osteoarthritis (OA) patients.
RESULTS
In serum, levels of the PRO-C3 and C3M, reflecting formation and degradation of the interstitial matrix, were found significantly elevated in PsA-flare compared to controls and PsA without flare. The remodeling marker of the basement membrane, PRO-C4, was significantly elevated in PsA-flare compared to PsA without flare. The inflammation and immune cell activity related markers, CRPM, VICM, and CPa9-HNE were significantly elevated in PsA-flare patients compared to controls and PsA without flare. In addition, VICM (AUC = 0.71), CPa9-HNE (AUC = 0.89), CRPM (AUC = 0.76), and PRO-C3 (AUC = 0.86) showed good discriminatory performance for separating PsA-flare from PsA without flare. In SF, the macrophage activity marker, VICM, was significantly elevated whereas the type II collagen formation marker, PRO-C2, was significantly reduced in the PsA-flare compared to OA. The combination of five serum markers reflecting type III and IV collagen degradation (C3M and C4M, respectively), type III and VI collagen formation (PRO-C3 and PRO-C6, respectively), and neutrophil activity (CPa9-HNE) showed an excellent discriminatory performance (AUC = 0.98) for separating PsA-flare from PsA without flares.
CONCLUSIONS
The serum biomarker panel of C3M, C4M, PRO-C3, PRO-C6, and CPa9-HNE reflecting synovitis, enthesitis, and neutrophil activity may serve as novel tool for quantitatively monitoring flares in PsA patients.
Topics: Humans; Arthritis, Psoriatic; Biomarkers; Male; Female; Middle Aged; Adult; Synovial Fluid; Peptide Hydrolases; Inflammation; Aged; Peptides
PubMed: 38802975
DOI: 10.1186/s13075-024-03332-7 -
Arthritis Research & Therapy May 2024Psoriatic arthritis (PsA) is a chronic, potentially debilitating inflammatory arthritis often associated with psoriasis. Understanding the epidemiology of PsA across...
BACKGROUND
Psoriatic arthritis (PsA) is a chronic, potentially debilitating inflammatory arthritis often associated with psoriasis. Understanding the epidemiology of PsA across diverse populations can provide valuable insights into its global burden and the role of genetic and environmental factors. This study aimed to estimate PsA's temporal trends, prevalence, and incidence, while assessing variations in age, gender, and ethnicity in Israel from 2016 to 2022.
METHODS
Data were sourced from the Clalit Health Services (CHS) database, covering over half of the Israeli population. Algorithm-based definitions for PsA and psoriasis cases were used. Demographic factors, including age, gender, socioeconomic status (SES), ethnicity, urban/rural residence, BMI, and smoking status, were analyzed. Standardized prevalence and incidence rates were calculated. Logistic regression analyses examined associations of sociodemographic variables with PsA.
RESULTS
In 2022, the prevalence of PsA was 0.221%, with an incidence rate of 13.54 per 100,000 population. This prevalence has tripled since 2006, reflecting a rising trend in PsA over time. Females exhibited a higher prevalence (1.15; 95%CI 1.09-1.21), and PsA was more common in Jewish individuals (1.58; 95%CI 1.45-1.71) those with higher SES (1.4; 95% CI 1.31, 1.5), and those with obesity (2.17; 95%CI 2.04-2.31).
CONCLUSIONS
This comprehensive population-based study pointed to an increase prevalence of PsA, emphasizing the rising healthcare demands and economic burden faced by this patient population. Further research is essential to delve into the factors driving these trends.
Topics: Humans; Arthritis, Psoriatic; Female; Male; Israel; Middle Aged; Adult; Prevalence; Aged; Incidence; Young Adult; Adolescent; Aged, 80 and over
PubMed: 38802958
DOI: 10.1186/s13075-024-03339-0 -
Frontiers in Immunology 2024levels are elevated in the blood and synovial fluid of patients with inflammatory arthritis. can be produced by Th17 cells and locally within joints by tissue-resident...
OBJECTIVES
levels are elevated in the blood and synovial fluid of patients with inflammatory arthritis. can be produced by Th17 cells and locally within joints by tissue-resident cells. induces osteoblast mineralization . As osteoproliferation and Th17 cells are important factors in the pathogenesis of axial spondyloarthritis (axSpA), we aimed to clarify the cellular sources of in spondyloarthritis.
METHODS
Serum, peripheral blood mononuclear cells ( = 15-35) and synovial tissue ( = 3-9) of adult patients with axSpA, psoriatic arthritis (PsA) and rheumatoid arthritis (RA) and healthy controls (HCs, = 5) were evaluated by ELISA, flow cytometry including PrimeFlow assay, immunohistochemistry and immunofluorescence and quantitative PCR.
RESULTS
Synovial tissue of axSpA patients shows significantly more -positive cells than that of HCs ( < 0.01), but numbers are also elevated in PsA and RA patients. Immunofluorescence shows co-localization of with CD68, but not with CD3, SMA, CD163, cadherin-11, or CD90. is elevated in the serum of RA and PsA (but not axSpA) patients compared with HCs ( < 0.001 and < 0.01). However, peripheral blood CD4 T cells from axSpA and PsA patients show higher positivity for in the PrimeFlow assay compared with HCs. CD4 memory T cells from axSpA patients produce more under Th17-favoring conditions (IL-1β and IL-23) than cells from PsA and RA patients or HCs.
CONCLUSION
production is increased in the synovial tissue of SpA and can be localized to CD68 macrophage-like synoviocytes, whereas circulating Th17 cells are only modestly enriched. Considering the osteoproliferative properties of , this offers new therapeutic options independent of Th17 pathways.
Topics: Humans; Arthritis, Psoriatic; Synoviocytes; Male; Adult; Female; Antigens, CD; Interleukins; Middle Aged; Antigens, Differentiation, Myelomonocytic; Axial Spondyloarthritis; Th17 Cells; Synovial Membrane; Joints; Arthritis, Rheumatoid
PubMed: 38799447
DOI: 10.3389/fimmu.2024.1355824 -
Narra J Apr 2024Psoriasis vulgaris is a significant health problem and up to 30% of the patients are most likely to develop psoriatic arthritis. Secukinumab, an interleukin-17A (IL-17A)...
Psoriasis vulgaris is a significant health problem and up to 30% of the patients are most likely to develop psoriatic arthritis. Secukinumab, an interleukin-17A (IL-17A) inhibitor, is used to treat patients with moderate-to-severe plaques associated with psoriatic arthritis. The aim of this case report was to highlight the efficacy of secukinumab treatment in a patient with both psoriasis vulgaris and psoriatic arthritis focusing the how to balance the benefits and adverse effects. A 36-year-old female came to Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia with chief complaint of itchy and scaly red plaques almost all over the body. The patient also experienced pain in both knees, both ankle joints and index finger as well as thumb in the right hand in the last year. The patient was diagnosed with psoriasis vulgaris and psoriatic arthritis, then treated with phototherapy and 15 mg of oral methotrexate each week for four weeks. Due to no improvement of the initial treatment, the patient received emollient and secukinumab at a dose of 300 mg/week subcutaneously for five weeks. The lesions began to disappear and the joint pain began to relieve. Secukinumab therapy was continued with a dose of 300 mg/month for six months. However, after six months, the patient complained of acnes appeared on the face. Therefore, the maintenance dose of secukinumab was decreased to 150 mg/month. After the reduced maintenance therapy was given, the patient came back with no complained of acnes. The erythematous plaques on trunk, back, arms and legs have subsided, as well as the joint pain. This case highlights that in a moderate-to-severe psoriasis associated with psoriatic arthritis, secukinumab is highly effective. However, since the potential adverse effects, education and regular follow-up are needed to analyze the success of the treatment and to be able to manage the adverse effects.
Topics: Humans; Female; Adult; Arthritis, Psoriatic; Antibodies, Monoclonal, Humanized; Psoriasis; Interleukin-17
PubMed: 38798877
DOI: 10.52225/narra.v4i1.207