Psoriatic arthritis for dermatologists.

Psoriatic arthritis for dermatologists. J Dermatolog Treat. 2019 Apr 24;:1-63 Authors: Gottlieb A, Merola JF Abstract Psoriatic arthritis (PsA) affects up to one-third of patients with psoriasis and is the major comorbidity of psoriasis because of the likelihood that loss of function and permanent disability will develop if initiation of treatment is delayed. Dermatologists are uniquely positioned to recognize early signs of PsA and be the first-line healthcare practitioners to detect PsA in patients with psoriasis. PsA can affect 6 clinical domains: peripheral arthritis, dactylitis, enthesitis, psoriasis, psoriatic nail disease, and axial disease. However, not every patient will have involvement of all domains, and the domains affected can change over time. Complicating the diagnosis is the condition's similarity with other arthritic diseases and potential heterogeneity. In this article, we provide practical guidance for dermatologists for detecting PsA in patients with psoriasis. We also review the available treatment options by each clinical domain of PsA and give advice on how to interpret the results of PsA clinical trials. Through early recognition of PsA in patients with psoriasis and initiation of proper treatment, dermatologists can help prevent PsA disease progression, irreversible joint damage, and resultant permanent disability, and improve quality of life. PMID: 31014154 [PubMed - as supplied by publisher]
Source: Journal of Dermatological Treatment - Category: Dermatology Tags: J Dermatolog Treat Source Type: research

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Authors: Krakowski P, Gerkowicz A, Pietrzak A, Krasowska D, Jurkiewicz A, Gorzelak M, Schwartz RA Abstract Psoriatic arthritis (PsA) is a seronegative arthropathy with many clinical manifestations, and it may affect nearly a half of patients with psoriasis. PsA should be diagnosed as early as possible to slow down joint damage and progression of disability. To improve the diagnosis of PsA, physicians should look for peripheral inflammatory pain, axial inflammatory pain, dactylitis, and buttock and sciatic pain. In most patients with PsA, pharmacologic treatment with non-steroidal anti-inflammatory drugs, disease-mo...
Source: Archives of Medical Science - Category: General Medicine Tags: Arch Med Sci Source Type: research
AbstractTofacitinib (Xeljanz®) is the first Janus kinase (JAK) inhibitor approved at a dosage of 5  mg twice daily (BID) in the EU and the USA for the treatment of active psoriatic arthritis (PsA), where it is indicated in combination with methotrexate for patients who have had an inadequate response or who have been intolerant to a prior therapy with a disease-modifying antirheumatic drug (DMAR D). Two well-designed phase III trials (OPAL Broaden and OPAL Beyond) in patients with PsA with or without prior tumour necrosis factor inhibitor (TNFi) therapy showed that tofacitinib 5 mg BID (co-administered w...
Source: Drugs - Category: Drugs & Pharmacology Source Type: research
This study investigated the effectiveness of adalimumab treatment in improving Work Productivity and Activity Impairment (WPAI) in patients with psoriatic arthritis (PsA) in real-world settings in Japan.MethodsThis 24-week, single-arm, postmarketing surveillance study (2014 –2017), conducted at 75 centers in Japan, enrolled adalimumab-naïve patients (paid workers, including part-time) meeting ClASsification criteria for Psoriatic ARthritis (CASPAR). The primary endpoint was improvement in overall work impairment (OWI) scores from baseline to week 24. Secondary endpo ints included changes in WPAI-PsA (OWI, absent...
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research
In conclusion, chemerin can seduce inflammatory response and promote nuclear factor ‐κB (NF‐κB) activation through inhibition of sirtuin 1 (sirt1) activity by reactive oxygen species (ROS) production AbstractPsoriasis is a chronic disease which carries the emotional and social burden, promotes joint disability and raises comorbidity possibility in patients. Obesity is closely correlated with the occurrence of psoriasis and adipokines produced by adipose tissues were found to be critical culprits. Chemerin is one of them and its expression was increased in patients with psoriatic arthritis. In our hypothesis...
Source: Journal of Cellular Biochemistry - Category: Biochemistry Authors: Tags: RESEARCH ARTICLE Source Type: research
ConclusionsIn a pooled analysis of csDMARD-IR/TNFi-na ïve and TNFi-IR patients, tofacitinib was superior to placebo at month 3 across four PsA domains: peripheral arthritis, psoriasis, enthesitis and dactylitis.Trial RegistrationOPAL Broaden (NCT01877668); OPAL Beyond (NCT01882439).FundingPfizer Inc.
Source: Rheumatology and Therapy - Category: Rheumatology Source Type: research
Authors: Marchesoni A, Caporali R, Lubrano E Abstract While the destructive changes of peripheral articular damage of psoriatic arthritis (PsA) are extensively studied, the productive modifications have been somewhat neglected. This literature-based study focuses on the clinically relevant aspects of peripheral bone proliferation in PsA. New bone proliferation frequently occurs as juxta-articular and entheseal apposition in PsA patients but also in psoriatic patients without arthritis, the Psoriatic Arthritis Ratingen Score is the only radiographic method to evaluate peri-articular new bone formation, numerous ultr...
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
Authors: Berekmeri A, Mahmood F, Wittmann M, Helliwell P Abstract INTRODUCTION: Psoriasis and psoriatic arthritis (PsA) are inflammatory immune mediated conditions which can cause considerable disability and reduced quality of life. Management can be complex as clinical heterogeneity may lead to different treatment pathways. Tofacitinib is a novel, oral janus kinase (JAK) inhibitor with proven efficacy in rheumatoid arthritis. Areas covered: This review analyses recent studies of tofacitinib in psoriatic disease treatment. The relevant literature was identified using clinicaltrials.gov, PubMed and Google Scholar. T...
Source: Expert Review of Clinical Immunology - Category: Allergy & Immunology Tags: Expert Rev Clin Immunol Source Type: research
Introduction: Psoriasis is a chronic, autoimmune inflammatory condition that can affect different parts of the body including scalp, nails, palms and soles. Psoriasis localized in these areas remains difficult-to-treat, and can result in significant physical and psychosocial disability. Secukinumab, a fully human monoclonal antibody that selectively neutralizes IL-17A, has been shown to have significant efficacy in the treatment of moderate to severe plaque psoriasis and psoriatic arthritis, demonstrating a rapid onset of action and sustained responses up to 5 years with a favorable safety profile.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
AbstractObjectivesThe PALACE 4 trial evaluated apremilast monotherapy in patients with active PsA who were DMARD-naive.MethodsEligible patients were randomized (1:1:1) to placebo, apremilast 20 mg twice a day or apremilast 30 mg twice a day. At week 16 or 24, placebo patients were rerandomized to apremilast. Double-blind apremilast treatment continued to week 52, with extension up to 4 years. The primary endpoint was the proportion of patients achieving ⩾20% improvement in ACR response criteria (ACR20) at week 16; secondary endpoints included the mean change in the HAQ Disability Index (HAQ-DI) score at week 16.ResultsA ...
Source: Rheumatology - Category: Rheumatology Source Type: research
ConclusionsIn our analysis, patients with PsA receiving secukinumab were more likely to achieve higher ACR responses through 1  year (weeks 16–48) than those treated with adalimumab. Although informative, these observations rely on a subgroup of patients from FUTURE 2 and thus should be considered interim until the ongoing head-to-head RCT EXCEED can validate these findings.FundingNovartis Pharma AG.
Source: Rheumatology and Therapy - Category: Rheumatology Source Type: research
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