Psoriasis and Psoriatic Arthritis: How to Treat in the Era of Biologics and Small Molecule Inhibitors—Volume 2

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dermatology".

Deadline for manuscript submissions: closed (25 August 2023) | Viewed by 10110

Special Issue Editor

Department of Dermatology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke 329-0498, Japan
Interests: dermatology; keratinocyte biology; psoriasis; psoriatic arthritis; inflammatory reaction; ichthyosis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The clinical significance and pathogenesis of psoriasis and psoriatic arthritis have received greater recognition since effective biologics became available and people started to think about how and when to start biologic drugs. We launched the Special Issue “Psoriasis and Psoriatic Arthritis: How to Treat in the Era of Biologics and Small Molecule Inhibitors?” last year (https://www.mdpi.com/journal/jcm/special_issues/Psoriasis_Psoriatic_Arthritis), and various important novel findings and review articles were published, attracting significant attention. The progress of science in this filed is rapid, and the novel recognition of the disease has led to recommendations for early intervention to prevent development of psoriatic arthritis in psoriasis vulgaris patients. However, the disease markers to recognize who needs early intervention and who does not have not yet been developed. Because of the good response and substantial needs for the collection of advanced knowledge in the field of psoriasis and psoriatic arthritis, we decided to launch “Psoriasis and Psoriatic Arthritis: How to Treat in the Era of Biologics and Small Molecule Inhibitors—Volume 2” as a sequel to the previous Special Issue.

We welcome articles assessing and providing novel insights into the following issues: 1) How and when to treat psoriasis and psoriatic arthritis patients, 2) which patients need early intervention, 3) whether there are any disease markers to identify patients in need for early intervention, 4) how to detect early clinical signs for psoriatic arthritis, and 5) what dermatologists should do to address comorbid systemic disorders. We also welcome other topics related to psoriasis and psoriatic arthritis.

We welcome both review articles and research articles to present novel findings in this field, to improve readers’ recognition of this systemic disease and provide a novel understanding of the disease.

Dr. Mayumi Komine
Guest Editor

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Keywords

  • psoriasis
  • psoriatic arthritis
  • biologics
  • small molecule inhibitors
  • conventional therapies

Published Papers (5 papers)

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Research

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14 pages, 1613 KiB  
Article
Impact of Pretreatment Systemic Inflammatory Markers on Treatment Persistence with Biologics and Conventional Systemic Therapy: A Retrospective Study of Patients with Psoriasis Vulgaris and Psoriatic Arthritis
by Eiki Sugimoto, Hiroki Matsuda, Sayaka Shibata, Yuka Mizuno, Asumi Koyama, Lixin Li, Haruka Taira, Yukiko Ito, Kentaro Awaji, Takashi Yamashita and Shinichi Sato
J. Clin. Med. 2023, 12(8), 3046; https://doi.org/10.3390/jcm12083046 - 21 Apr 2023
Cited by 7 | Viewed by 1737
Abstract
Systemic inflammation plays a central role in the pathophysiology of psoriasis. This study examined accessible systemic inflammatory markers in patients with psoriasis vulgaris and psoriatic arthritis. We aimed to evaluate their association with psoriasis severity, the presence of arthritis, and drug continuation rates. [...] Read more.
Systemic inflammation plays a central role in the pathophysiology of psoriasis. This study examined accessible systemic inflammatory markers in patients with psoriasis vulgaris and psoriatic arthritis. We aimed to evaluate their association with psoriasis severity, the presence of arthritis, and drug continuation rates. The findings revealed that neutrophil, monocyte, and platelet count, neutrophil/lymphocyte ratio, monocyte/lymphocyte ratio, systemic inflammation response index, systemic immune/inflammation index (SII), and CRP were positively correlated with Psoriasis Area and Severity Index scores. Patients presenting with higher platelet/lymphocyte ratio (PLR) or CRP values were more likely to be diagnosed with psoriatic arthritis than with psoriasis vulgaris in the multivariate regression analysis. Importantly, patients with higher pretreatment neutrophil or platelet count, PLR, and SII were associated with lower treatment continuation rates of conventional systemic agents. Higher pretreatment scores of systemic inflammatory markers did not affect treatment retention rates of biologics. These findings suggest that several accessible systemic inflammatory markers may effectively assess underlying systemic inflammation and may provide an indication for a therapeutic approach in patients with psoriasis vulgaris and psoriatic arthritis. Full article
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18 pages, 1046 KiB  
Article
Biomarkers and Predictive Factors for Treatment Response to Tumor Necrosis Factor-α Inhibitors in Patients with Psoriasis
by Teppei Hagino, Hidehisa Saeki and Naoko Kanda
J. Clin. Med. 2023, 12(3), 974; https://doi.org/10.3390/jcm12030974 - 27 Jan 2023
Cited by 5 | Viewed by 1557
Abstract
We performed a retrospective and observational study of patients with psoriasis. The aim of this study was to define the laboratory indicators reflecting the treatment response to tumor necrosis factor (TNF)-α inhibitors and the predictors for the treatment response. From January 2010 to [...] Read more.
We performed a retrospective and observational study of patients with psoriasis. The aim of this study was to define the laboratory indicators reflecting the treatment response to tumor necrosis factor (TNF)-α inhibitors and the predictors for the treatment response. From January 2010 to June 2022, 28, 15 and 12 patients with psoriasis were treated with infliximab (IFX), adalimumab (ADA) and certolizumab pegol (CZP), respectively. The values of C-reactive protein (CRP), platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio and monocyte to lymphocyte ratio decreased in parallel with psoriasis area and severity index (PASI) at weeks 12 and 52 of treatment. The percentage reduction of the CRP was correlated with that of the PASI at week 52 in all patients and subgroups treated with IFX. The percentage reduction of the PLR was correlated with that of the PASI at week 52 in all patients. Linear multivariate regression analyses revealed that the presence of scalp lesions was associated with a high percentage reduction of the PASI at week 52 in the ADA subgroup. The CRP and PLR might act as biomarkers reflecting the treatment response to TNF-α inhibitors in patients with psoriasis. The presence of scalp lesions might be a predictive factor for a high treatment response to ADA in patients with psoriasis. Full article
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8 pages, 518 KiB  
Article
Tildrakizumab: Efficacy, Safety and Survival in Mid-Term (52 Weeks) in Three Tertiary Hospitals in Andalucia (Spain)
by Ricardo Ruiz-Villaverde, Lourdes Rodriguez Fernandez-Freire, Pilar Font-Ugalde and Manuel Galan-Gutierrez
J. Clin. Med. 2022, 11(17), 5098; https://doi.org/10.3390/jcm11175098 - 30 Aug 2022
Cited by 2 | Viewed by 1386
Abstract
Tildrakizumab (TIL) binds selectively to the p19 subunit of interleukin 23. Its introduction has managed to increase the levels of efficacy, safety (improving that previously presented by the anti-IL-12/23 class) and survival. Retrospective analysis of a multicenter, observational study of real clinical practice [...] Read more.
Tildrakizumab (TIL) binds selectively to the p19 subunit of interleukin 23. Its introduction has managed to increase the levels of efficacy, safety (improving that previously presented by the anti-IL-12/23 class) and survival. Retrospective analysis of a multicenter, observational study of real clinical practice including patients with moderate-to-severe plaque psoriasis in treatment with TIL. This cross-sectional analysis includes information of patients between February 2019 to February 2022. A total of three tertiary hospitals in Andalusia (Spain) participated in this study. Analyses were performed “as observed” using IBM SPSS v28 for Windows. A total of 61 patients were included in the analysis. The mean age of our patients was 49.5 years; 50.18% of the patients were female and 34.42% of the patients had a BMI greater than 30. It was notable that 44.26% of our patients had scalp involvement. Almost 35% of the patients had psoriatic arthropathy, although skin involvement was predominant. At week 52 (n = 34), 68% of the patients presented an absolute PASI equal to or less than 1. Regarding the drug survival, eight patients discontinued treatment due to inefficacy: five primary and three secondary failures, and one death due to causes not drug related showing survival of 86% at week 52. In the analysis of subgroups of patients, we found that scalp involvement determined greater survival (94%), as well as a shorter duration of the disease (91.7% vs. 84.4% in those with less than 10 years versus more than 15 years of evolution) and with a lower number of previous biological therapies (100% naïve, 90% in those who have used one line of biological therapy and 82.1% in those who have completed two or more lines of biological treatment. Tildrakizumab showed excellent results in the control of psoriasis in the mid-term with an elevated number of patients maintaining treatment after 52 weeks. There were no statistically significant differences in the efficiency, safety or survival results of TIL between patients coming from previous therapies. Full article
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Review

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17 pages, 1027 KiB  
Review
Molecular Background and Clinical Implications of Glucose Disorders in Patients with Psoriatic Arthritis
by Bogna Grygiel-Górniak and Weronika Skoczek
J. Clin. Med. 2023, 12(18), 5814; https://doi.org/10.3390/jcm12185814 - 07 Sep 2023
Viewed by 929
Abstract
Psoriatic arthritis (PsA) is an inflammatory musculoskeletal disease characterized by joint and entheses involvement. This condition is often associated with an increased prevalence of obesity, encompassing more than one-third of all patients. Given the presence of metabolic disorders, it becomes crucial to enhance [...] Read more.
Psoriatic arthritis (PsA) is an inflammatory musculoskeletal disease characterized by joint and entheses involvement. This condition is often associated with an increased prevalence of obesity, encompassing more than one-third of all patients. Given the presence of metabolic disorders, it becomes crucial to enhance clinical oversight of metabolic parameters. An early diagnosis of glucose irregularities in PsA allows for the assessment of an effective treatment strategy. The approach proves valuable in preventing the development of insulin resistance (IR) or diabetes mellitus type 2 (DMt2). Similar pathways characterize the pathomechanism of PsA and DMt2, offering an innovative perspective on treatment management. The cytokines and adipokines synthesized in the course of PsA significantly impact the development process of IR and DMt2 in different mechanisms of action. Conversely, glucose disorders influence the activity of PsA and therapy outcomes. Given the chronic inflammatory background shared by PsA, obesity, and DMt2, it is evident that inadequate management of any of the mentioned conditions can exacerbate the others. Thus, when PsA coincides with DMt2, a comprehensive multidimensional approach is necessary. This includes an effective immunosuppressive regimen complemented by appropriate anti-diabetic and insulin therapies. Moreover, often overlooked recommendations concerning overall well-being and lifestyle adjustments hold significance. This manuscript explores the connections and the relationship between the molecular background of PsA and glucose disorders. It provides a detailed exposition of specific therapeutic approaches for both conditions. Full article
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15 pages, 1113 KiB  
Review
Biologics for Reducing Cardiovascular Risk in Psoriasis Patients
by Hitoshi Terui and Yoshihide Asano
J. Clin. Med. 2023, 12(3), 1162; https://doi.org/10.3390/jcm12031162 - 01 Feb 2023
Cited by 4 | Viewed by 3870
Abstract
Psoriasis is a chronic inflammatory skin disease with a high prevalence of cardiovascular disease (CVD), obesity, dyslipidemia, hypertension, diabetes mellitus, and metabolic syndrome. Among them, CVD is the most common cause of morbidity and mortality in psoriasis patients. Since CVD is associated with [...] Read more.
Psoriasis is a chronic inflammatory skin disease with a high prevalence of cardiovascular disease (CVD), obesity, dyslipidemia, hypertension, diabetes mellitus, and metabolic syndrome. Among them, CVD is the most common cause of morbidity and mortality in psoriasis patients. Since CVD is associated with considerable morbidity and mortality, primary care clinicians are increasingly committed to reducing the risk of CVD in patients with psoriasis. Biologics targeting TNF-α, IL-12/23, and IL-17 are systemic therapies that can dramatically improve the condition of psoriasis. Recent studies have reported that these inflammatory cytokine signals may promote atherosclerosis, suggesting that biologics might be effective for improving psoriasis as well as reducing the risk of CVD. Here, we reviewed cardiovascular risk in psoriasis patients, the association between psoriatic inflammation and atherosclerosis, and the efficacy of biologics for reducing the risk of cardiovascular diseases. Full article
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