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Psoriasis: HELP
Articles by Joel M. Gelfand
Based on 103 articles published since 2008
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Between 2008 and 2019, J. Gelfand wrote the following 103 articles about Psoriasis.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5
1 Guideline Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics. 2019

Menter, Alan / Strober, Bruce E / Kaplan, Daniel H / Kivelevitch, Dario / Prater, Elizabeth Farley / Stoff, Benjamin / Armstrong, April W / Connor, Cody / Cordoro, Kelly M / Davis, Dawn M R / Elewski, Boni E / Gelfand, Joel M / Gordon, Kenneth B / Gottlieb, Alice B / Kavanaugh, Arthur / Kiselica, Matthew / Korman, Neil J / Kroshinsky, Daniela / Lebwohl, Mark / Leonardi, Craig L / Lichten, Jason / Lim, Henry W / Mehta, Nehal N / Paller, Amy S / Parra, Sylvia L / Pathy, Arun L / Rupani, Reena N / Siegel, Michael / Wong, Emily B / Wu, Jashin J / Hariharan, Vidhya / Elmets, Craig A. ·Baylor Scott and White, Dallas, Texas. · University of Connecticut, Farmington, Connecticut; Probity Medical Research, Waterloo, Ontario, Canada. · University of Pittsburgh, Pittsburgh, Pennsylvania. · University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. · Emory University School of Medicine, Atlanta, Georgia. · University of Southern California, Los Angeles, San Francisco. · University of Alabama, Birmingham, Alabama. · University of California, San Francisco School of Medicine, Department of Dermatology, San Francisco, California. · Mayo Clinic, Rochester, Minnesota. · University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. · Medical College of Wisconsin, Milwaukee, Wisconsin. · Department of Dermatology, Icahn School of Medicine at Mt. Sinai, New York. · University of California San Diego, San Diego, California. · National Psoriasis Foundation, Portland, Oregon. · University Hospitals Cleveland Medical Center, Cleveland, Ohio. · Massachusetts General Hospital, Boston, Massachusetts. · Central Dermatology, St. Louis, Missouri. · Department of Dermatology, Henry Ford Hospital, Detroit, Michigan. · National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland. · Northwestern University Feinberg School of Medicine, Chicago, Illinois. · Dermatology and Skin Surgery, Sumter, South Carolina. · Colorado Permanente Medical Group, Centennial, Colorado. · San Antonio Uniformed Services Health Education Consortium, Joint-Base San Antonio. · Dermatology Research and Education Foundation, Irvine, California. · American Academy of Dermatology, Rosemont, Illinois. Electronic address: vhariharan@aad.org. ·J Am Acad Dermatol · Pubmed #30772098.

ABSTRACT: Psoriasis is a chronic, inflammatory multisystem disease that affects up to 3.2% of the US population. This guideline addresses important clinical questions that arise in psoriasis management and care, providing recommendations based on the available evidence. The treatment of psoriasis with biologic agents will be reviewed, emphasizing treatment recommendations and the role of the dermatologist in monitoring and educating patients regarding benefits as well as associated risks.

2 Guideline Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities. 2019

Elmets, Craig A / Leonardi, Craig L / Davis, Dawn M R / Gelfand, Joel M / Lichten, Jason / Mehta, Nehal N / Armstrong, April W / Connor, Cody / Cordoro, Kelly M / Elewski, Boni E / Gordon, Kenneth B / Gottlieb, Alice B / Kaplan, Daniel H / Kavanaugh, Arthur / Kivelevitch, Dario / Kiselica, Matthew / Korman, Neil J / Kroshinsky, Daniela / Lebwohl, Mark / Lim, Henry W / Paller, Amy S / Parra, Sylvia L / Pathy, Arun L / Prater, Elizabeth Farley / Rupani, Reena / Siegel, Michael / Stoff, Benjamin / Strober, Bruce E / Wong, Emily B / Wu, Jashin J / Hariharan, Vidhya / Menter, Alan. ·University of Alabama, Birmingham, Alabama. · Central Dermatology, St. Louis, Missouri. · Mayo Clinic, Rochester, Minnesota. · University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. · National Psoriasis Foundation, Portland, Oregon. · National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland. · University of Southern California, Los Angeles, California. · Department of Dermatology, University of California San Francisco School of MedicineSan Francisco, California. · Medical College of Wisconsin, Milwaukee, Wisconsin. · Department of Dermatology, Icahn School of Medicine at Mt. Sinai, New York, New York. · University of Pittsburgh, Pennsylvania. · University of California San Diego, San Diego, California. · Baylor Scott and White, Dallas, Texas. · University Hospitals Cleveland Medical Center, Cleveland, Ohio. · Massachusetts General Hospital, Boston, Massachusetts. · Department of Dermatology, Henry Ford Hospital, Detroit, Michigan. · Northwestern University Feinberg School of Medicine, Chicago, Illinois. · Dermatology and Skin Surgery, Sumter, South Carolina. · Colorado Permanente Medical Group, Centennial, Colorado. · University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. · Icahn School of Medicine at Mount Sinai, New York, New York. · Emory University School of Medicine, Atlanta, Georgia. · University of Connecticut, Farmington, Connecticut; Probity Medical Research, Waterloo, Canada. · San Antonio Uniformed Services Health Education Consortium, Joint-Base San Antonio, Texas. · Dermatology Research and Education Foundation, Irvine, California. · American Academy of Dermatology, Rosemont, Illinois. Electronic address: vhariharan@aad.org. ·J Am Acad Dermatol · Pubmed #30772097.

ABSTRACT: Psoriasis is a chronic, inflammatory, multisystem disease that affects up to 3.2% of the US population. This guideline addresses important clinical questions that arise in psoriasis management and care, providing recommendations on the basis of available evidence.

3 Guideline Consensus guidelines for the management of plaque psoriasis. 2012

Hsu, Sylvia / Papp, Kim Alexander / Lebwohl, Mark G / Bagel, Jerry / Blauvelt, Andrew / Duffin, Kristina Callis / Crowley, Jeffrey / Eichenfield, Lawrence F / Feldman, Steven R / Fiorentino, David F / Gelfand, Joel M / Gottlieb, Alice B / Jacobsen, Carmen / Kalb, Robert E / Kavanaugh, Arthur / Korman, Neil J / Krueger, Gerald G / Michelon, Melissa A / Morison, Warwick / Ritchlin, Christopher T / Stein Gold, Linda / Stone, Stephen P / Strober, Bruce E / Van Voorhees, Abby S / Weiss, Stefan C / Wanat, Karolyn / Bebo, Bruce F / Anonymous4210715. ·Department of Dermatology, Baylor College of Medicine, Houston, TX 77030, USA. shsu@bcm.edu ·Arch Dermatol · Pubmed #22250239.

ABSTRACT: The Canadian Guidelines for the Management of Plaque Psoriasis were reviewed by the entire National Psoriasis Foundation Medical Board and updated to include newly approved agents such as ustekinumab and to reflect practice patterns in the United States, where the excimer laser is approved for psoriasis treatment. Management of psoriasis in special populations is discussed. In the updated guidelines, we include sections on children, pregnant patients or pregnant partners of patients, nursing mothers, the elderly, patients with hepatitis B or C virus infections, human immunodeficiency virus-infected patients, and patients with malignant neoplasms, as well as sections on tumor necrosis factor blockers, elective surgery, and vaccinations.

4 Guideline Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies. 2009

Menter, Alan / Korman, Neil J / Elmets, Craig A / Feldman, Steven R / Gelfand, Joel M / Gordon, Kenneth B / Gottlieb, Alice / Koo, John Y M / Lebwohl, Mark / Lim, Henry W / Van Voorhees, Abby S / Beutner, Karl R / Bhushan, Reva / Anonymous150622. ·Baylor University Medical Center, Dallas, Texas, USA. ·J Am Acad Dermatol · Pubmed #19217694.

ABSTRACT: Psoriasis is a common, chronic, inflammatory, multi-system disease with predominantly skin and joint manifestations affecting approximately 2% of the population. In this third of 6 sections of the guidelines of care for psoriasis, we discuss the use of topical medications for the treatment of psoriasis. The majority of patients with psoriasis have limited disease (<5% body surface area involvement) and can be treated with topical agents, which generally provide a high efficacy-to-safety ratio. Topical agents may also be used adjunctively for patients with more extensive psoriasis undergoing therapy with either ultraviolet light, systemic or biologic medications. However, the use of topical agents as monotherapy in the setting of extensive disease or in the setting of limited, but recalcitrant, disease is not routinely recommended. Treatment should be tailored to meet individual patients' needs. We will discuss the efficacy and safety of as well as offer recommendations for the use of topical corticosteroids, vitamin D analogues, tazarotene, tacrolimus, pimecrolimus, emollients, salicylic acid, anthralin, coal tar, as well as combination therapy.

5 Guideline National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening. 2008

Kimball, Alexa B / Gladman, Dafna / Gelfand, Joel M / Gordon, Kenneth / Horn, Elizabeth J / Korman, Neil J / Korver, Gretchen / Krueger, Gerald G / Strober, Bruce E / Lebwohl, Mark G / Anonymous5660593. ·Department of Dermatology, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts 02114, USA. harvardskinstudies@partners.org ·J Am Acad Dermatol · Pubmed #18313171.

ABSTRACT: There have been several articles and reports in recent months about comorbidities and risks that affect psoriasis patients in addition to their underlying disease. This piece reviews the current literature and begins to address what should be done with this new information by updating the clinician about what health screening tests, preventative exams, and referrals should be considered in this population.

6 Editorial Commentary: Does biologic treatment of psoriasis lower the risk of cardiovascular events and mortality?: A critical question that we are only just beginning to answer. 2018

Gelfand, Joel M. ·Departments of Dermatology and Epidemiology, the Dermatology Clinical Studies Unit, and Psoriasis and Phototherapy Treatment Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. Electronic address: Joel.Gelfand@uphs.upenn.edu. ·J Am Acad Dermatol · Pubmed #29625133.

ABSTRACT: -- No abstract --

7 Editorial Psoriasis, Type 2 Diabetes Mellitus, and Obesity: Weighing the Evidence. 2016

Gelfand, Joel M. ·Department of Dermatology and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia. ·JAMA Dermatol · Pubmed #27120484.

ABSTRACT: -- No abstract --

8 Editorial Aortic valve stenosis: a new cardiovascular comorbidity of psoriasis? 2015

Gelfand, Joel M / Mehta, Nehal N. ·University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA Joel.Gelfand@uphs.upenn.edu. · National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA. ·Eur Heart J · Pubmed #26074463.

ABSTRACT: -- No abstract --

9 Editorial Identification of risk factors for psoriatic arthritis: scientific opportunity meets clinical need. 2010

Ogdie, Alexis / Gelfand, Joel M. · ·Arch Dermatol · Pubmed #20644042.

ABSTRACT: -- No abstract --

10 Review How similar are the treatment responses to biosimilars in patients with psoriasis? A systematic review of statistical margins in comparative clinical trials. 2017

Wan, Marilyn T / Strober, Bruce E / Wu, Jashin J / Shin, Daniel B / Gelfand, Joel M. ·Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. · University of Connecticut Health Center, Farmington, Connecticut. · Kaiser Permanente Los Angeles Medical Center, Los Angeles, California. · Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. Electronic address: joel.gelfand@uphs.upenn.edu. ·J Am Acad Dermatol · Pubmed #28807110.

ABSTRACT: -- No abstract --

11 Review Psoriasis and comorbid diseases: Implications for management. 2017

Takeshita, Junko / Grewal, Sungat / Langan, Sinéad M / Mehta, Nehal N / Ogdie, Alexis / Van Voorhees, Abby S / Gelfand, Joel M. ·Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. Electronic address: Junko.Takeshita@uphs.upenn.edu. · Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. · London School of Hygiene and Tropical Medicine and St. John's Institute of Dermatology, London, United Kingdom. · National Heart, Lung and Blood Institute, Bethesda, Maryland. · Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Division of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. · Department of Dermatology, Eastern Virginia Medical School, Norfolk, Virginia. · Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. ·J Am Acad Dermatol · Pubmed #28212760.

ABSTRACT: As summarized in the first article in this continuing medical education series, the currently available epidemiologic data suggest that psoriasis may be a risk factor for cardiometabolic disease. Emerging data also suggest associations between psoriasis and other comorbidities beyond psoriatic arthritis, including chronic kidney disease, inflammatory bowel disease, hepatic disease, certain malignancies, infections, and mood disorders. Recognizing the comorbid disease burden of psoriasis is essential for ensuring comprehensive care of patients with psoriasis. The clinical implications of the comorbid diseases that are associated with psoriasis and recommendations for clinical management are reviewed in this article.

12 Review Psoriasis and comorbid diseases: Epidemiology. 2017

Takeshita, Junko / Grewal, Sungat / Langan, Sinéad M / Mehta, Nehal N / Ogdie, Alexis / Van Voorhees, Abby S / Gelfand, Joel M. ·Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. Electronic address: Junko.Takeshita@uphs.upenn.edu. · Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. · London School of Hygiene and Tropical Medicine and St. John's Institute of Dermatology, London, United Kingdom. · National Heart, Lung and Blood Institute, Bethesda, Maryland. · Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Division of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. · Department of Dermatology, Eastern Virginia Medical School, Norfolk, Virginia. · Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. ·J Am Acad Dermatol · Pubmed #28212759.

ABSTRACT: Psoriasis is a common chronic inflammatory disease of the skin that is increasingly being recognized as a systemic inflammatory disorder. Psoriatic arthritis is a well-known comorbidity of psoriasis. A rapidly expanding body of literature in various populations and settings supports additional associations between psoriasis and cardiometabolic diseases, gastrointestinal diseases, kidney disease, malignancy, infection, and mood disorders. The pathogenesis of comorbid disease in patients with psoriasis remains unknown; however, shared inflammatory pathways, cellular mediators, genetic susceptibility, and common risk factors are hypothesized to be contributing elements. As additional psoriasis comorbidities continue to emerge, education of health care providers is essential to ensuring comprehensive medical care for patients with psoriasis.

13 Review From the Medical Board of the National Psoriasis Foundation: Treatment targets for plaque psoriasis. 2017

Armstrong, April W / Siegel, Michael P / Bagel, Jerry / Boh, Erin E / Buell, Megan / Cooper, Kevin D / Callis Duffin, Kristina / Eichenfield, Lawrence F / Garg, Amit / Gelfand, Joel M / Gottlieb, Alice B / Koo, John Y M / Korman, Neil J / Krueger, Gerald G / Lebwohl, Mark G / Leonardi, Craig L / Mandelin, Arthur M / Menter, M Alan / Merola, Joseph F / Pariser, David M / Prussick, Ronald B / Ryan, Caitriona / Shah, Kara N / Weinberg, Jeffrey M / Williams, MaryJane O U / Wu, Jashin J / Yamauchi, Paul S / Van Voorhees, Abby S. ·Keck School of Medicine, University of Southern California, Los Angeles, California. Electronic address: aprilarmstrong@post.harvard.edu. · National Psoriasis Foundation, Portland, Oregon. · Windsor Dermatology, East Windsor, New Jersey; University Medical Center of Princeton at Plainsboro, Plainsboro, New Jersey. · Tulane University School of Medicine, New Orleans, Louisiana. · University Hospitals Case Medical Center, Cleveland, Ohio. · University of Utah School of Medicine, Salt Lake City, Utah. · University of California, San Diego School of Medicine, La Jolla, California. · Northwell Health and Hofstra North Shore University Hospital, Long Island Jewish Medical Center School of Medicine, Manhasset, New York. · University of Pennsylvania, Philadelphia, Pennsylvania. · Tufts University School of Medicine, Boston, Massachusetts. · University of California San Francisco Medical Center, San Francisco, California. · Icahn School of Medicine at Mount Sinai, New York, New York. · St Louis University Medical School, St Louis, Missouri. · Northwestern University Feinberg School of Medicine, Chicago, Illinois. · Baylor University Medical Center and Texas A&M Health Science Center, Dallas, Texas. · Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. · Eastern Virginia Medical School, Norfolk, Virginia; Virginia Clinical Research Inc, Norfolk, Virginia. · George Washington University, Washington, District of Columbia. · Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. · Keck School of Medicine, University of Southern California, Los Angeles, California. · Kaiser Permanente Los Angeles Medical Center, Los Angeles, California. · Division of Dermatology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California. · Eastern Virginia Medical School, Norfolk, Virginia. ·J Am Acad Dermatol · Pubmed #27908543.

ABSTRACT: BACKGROUND: An urgent need exists in the United States to establish treatment goals in psoriasis. OBJECTIVE: We aim to establish defined treatment targets toward which clinicians and patients with psoriasis can strive to inform treatment decisions, reduce disease burden, and improve outcomes in practice. METHODS: The National Psoriasis Foundation conducted a consensus-building study among psoriasis experts using the Delphi method. The process consisted of: (1) literature review, (2) pre-Delphi question selection and input from general dermatologists and patients, and (3) 4 Delphi rounds. RESULTS: A total of 25 psoriasis experts participated in the Delphi process. The most preferred instrument was body surface area (BSA). The most preferred time for evaluating patient response after starting new therapies was at 3 months. The acceptable response at 3 months postinitiation was either BSA 3% or less or BSA improvement 75% or more from baseline. The target response at 3 months postinitiation was BSA 1% or less. During the maintenance period, evaluation every 6 months was most preferred. The target response at every 6 months maintenance evaluation is BSA 1% or less. LIMITATIONS: Although BSA is feasible in practice, it does not encompass health-related quality of life, costs, and risks of side effects. CONCLUSION: With defined treatment targets, clinicians and patients can regularly evaluate treatment responses and perform benefit-risk assessments of therapeutic options individualized to the patient.

14 Review Clinical Risk Factors for the Development of Psoriatic Arthritis Among Patients with Psoriasis: A Review of Available Evidence. 2015

Ogdie, Alexis / Gelfand, J M. ·Division of Rheumatology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, 5 White Room 5024, 3400 Spruce St., Philadelphia, PA, 19104, USA, Alexis.ogdie@uphs.upenn.edu. ·Curr Rheumatol Rep · Pubmed #26290111.

ABSTRACT: Psoriatic arthritis (PsA), a chronic inflammatory arthritis, affects about 10% of patients with psoriasis with higher prevalence seen in patients with more extensive skin disease. Early identification of PsA may result in improved outcomes. While it remains unclear which patients with psoriasis will develop PsA, several studies have identified potential risk factors for PsA among patients with psoriasis. This review examines the basic epidemiologic principles of identifying risk factors and reviews the evidence to date about risk factors for PsA among patients with psoriasis.

15 Review Research gaps in psoriasis: opportunities for future studies. 2014

Ryan, Caitriona / Korman, Neil J / Gelfand, Joel M / Lim, Henry W / Elmets, Craig A / Feldman, Steven R / Gottlieb, Alice B / Koo, John Y M / Lebwohl, Mark / Leonardi, Craig L / Van Voorhees, Abby S / Bhushan, Reva / Menter, Alan. ·Psoriasis Research Center, Baylor University Medical Center, Dallas, Texas. · Department of Dermatology, Murdough Family Center for Psoriasis, University Hospitals Case Medical Center, Cleveland, Ohio. · Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania. · Department of Dermatology, Henry Ford Hospital, Detroit, Michigan. · Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama. · Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina. · Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts. · Department of Dermatology, University of California-San Francisco, California. · Department of Dermatology, Mount Sinai School of Medicine, New York, New York. · Saint Louis University, St Louis, Missouri. · Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania. · American Academy of Dermatology, Schaumburg, Illinois. Electronic address: rbhushan@aad.org. ·J Am Acad Dermatol · Pubmed #24126079.

ABSTRACT: Over the past 2 decades, considerable progress has been made to further elucidate the complex pathogenesis of psoriasis, facilitating the development of a new armamentarium of more effective, targeted therapies. Despite these important advances, substantial deficits remain in our understanding of psoriasis and its treatment, necessitating further research in many areas. In the sixth section of the American Academy of Dermatology Psoriasis Guidelines of Care, gaps in research and care were identified. We discuss the most important gaps in research that currently exist and make suggestions for studies that should be performed to address these deficits. These encompass both basic science and clinical research studies, including large, prospective epidemiologic studies to determine the true prevalence and natural history of psoriasis; further molecular studies in patients with psoriatic and psoriatic arthritis to understand the function of psoriasis susceptibility genes and to identify novel therapeutic targets; studies to examine the role of environmental factors in the development of psoriasis; further investigation of the relationship between psoriasis and cardiometabolic disease; studies that examine the role of adjunctive therapies such as psychological interventions in appropriate patient groups; and finally, studies to identify biomarkers of disease severity and treatment response to optimize patient therapy.

16 Review The risk of infection and malignancy with tumor necrosis factor antagonists in adults with psoriatic disease: a systematic review and meta-analysis of randomized controlled trials. 2011

Dommasch, Erica D / Abuabara, Katrina / Shin, Daniel B / Nguyen, Josephine / Troxel, Andrea B / Gelfand, Joel M. ·Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. ·J Am Acad Dermatol · Pubmed #21315483.

ABSTRACT: BACKGROUND: There is a need to better understand the safety of tumor necrosis factor (TNF) inhibitors in patients with psoriatic disease in whom TNF inhibitors are frequently used as monotherapy. OBJECTIVE: We sought to examine the risks of infection and malignancy with the use of TNF antagonists in adult patients with psoriatic disease. METHODS: We conducted a systematic search for trials of TNF antagonists for adults with plaque psoriasis and psoriatic arthritis. We included randomized, placebo-controlled trials of etanercept, infliximab, adalimumab, golimumab, and certolizumab for the treatment of plaque psoriasis and psoriatic arthritis. Twenty of 820 identified studies with a total of 6810 patients were included. Results were calculated using fixed effects models and reported as pooled odds ratios. RESULTS: Odds ratios for overall infection and serious infection over a mean of 17.8 weeks were 1.18 (95% confidence interval [CI] 1.05-1.33) and 0.70 (95% CI 0.40-1.21), respectively. When adjusting for patient-years, the incidence rate ratio for overall infection was 1.01 (95% CI 0.92-1.11). The odds ratio for malignancy was 1.48 (95% CI 0.71-3.09) and 1.26 (95% CI 0.39-4.15) when nonmelanoma skin cancer was excluded. LIMITATIONS: Short duration of follow-up and rarity of malignancies and serious infections are limitations. CONCLUSIONS: There is a small increased risk of overall infection with the short-term use of TNF antagonists for psoriasis that may be attributable to differences in follow-up time between treatment and placebo groups. There was no evidence of an increased risk of serious infection and a statistically significant increased risk in cancer was not observed with short-term use of TNF inhibitors.

17 Review Guidelines of care for the management of psoriasis and psoriatic arthritis: section 6. Guidelines of care for the treatment of psoriasis and psoriatic arthritis: case-based presentations and evidence-based conclusions. 2011

Anonymous2160686 / Menter, Alan / Korman, Neil J / Elmets, Craig A / Feldman, Steven R / Gelfand, Joel M / Gordon, Kenneth B / Gottlieb, Alice / Koo, John Y M / Lebwohl, Mark / Leonardi, Craig L / Lim, Henry W / Van Voorhees, Abby S / Beutner, Karl R / Ryan, Caitriona / Bhushan, Reva. ·Psoriasis Research Center, Baylor University Medical Center, Dallas, Texas, USA. ·J Am Acad Dermatol · Pubmed #21306785.

ABSTRACT: Psoriasis is a common, chronic, inflammatory, multisystem disease with predominantly skin and joint manifestations affecting approximately 2% of the population. In the first 5 parts of the American Academy of Dermatology Psoriasis Guidelines of Care, we have presented evidence supporting the use of topical treatments, phototherapy, traditional systemic agents, and biological therapies for patients with psoriasis and psoriatic arthritis. In this sixth and final section of the Psoriasis Guidelines of Care, we will present cases to illustrate how to practically use these guidelines in specific clinical scenarios. We will describe the approach to treating patients with psoriasis across the entire spectrum of this fascinating disease from mild to moderate to severe, with and without psoriatic arthritis, based on the 5 prior published guidelines. Although specific therapeutic recommendations are given for each of the cases presented, it is important that treatment be tailored to meet individual patients' needs. In addition, we will update the prior 5 guidelines and address gaps in research and care that currently exist, while making suggestions for further studies that could be performed to help address these limitations in our knowledge base.

18 Review Assessing long-term drug safety: lessons (re) learned from raptiva. 2010

Seminara, Nicole M / Gelfand, Joel M. ·Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA. ·Semin Cutan Med Surg · Pubmed #20430303.

ABSTRACT: Efalizumab was approved for moderate to severe psoriasis in 2003 based on studies in approximately 2700 patients, of whom only 218 were exposed to the drug for more than 1 year. In 2009, after more than 46,000 patients were exposed to efalizumab, the drug was withdrawn from the market after 3 confirmed and 1 suspected case of progressive multifocal leukoencephalopathy (PML) were spontaneously reported. As PML is very rare, it is extremely unlikely that the 4 reported cases were due to chance and given that PML occurs primarily in patients who are immunosuppressed, the association is likely causal. The identification of PML as a serious, but statistically rare risk of efalizumab demonstrates the strengths and weaknesses of the current drug approval and pharmacovigilance processes for fully measuring the safety of a drug. Patients and clinicians need to be aware of the relative completeness and limitations of existing safety data of a drug when selecting a treatment.

19 Review Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 5. Guidelines of care for the treatment of psoriasis with phototherapy and photochemotherapy. 2010

Menter, Alan / Korman, Neil J / Elmets, Craig A / Feldman, Steven R / Gelfand, Joel M / Gordon, Kenneth B / Gottlieb, Alice / Koo, John Y M / Lebwohl, Mark / Lim, Henry W / Van Voorhees, Abby S / Beutner, Karl R / Bhushan, Reva. ·Psoriasis Research Center, Baylor University Medical Center, Dallas, Texas, USA. ·J Am Acad Dermatol · Pubmed #19811850.

ABSTRACT: Psoriasis is a common, chronic, inflammatory, multisystem disease with predominantly skin and joint manifestations affecting approximately 2% of the population. In this fifth of 6 sections of the guidelines of care for psoriasis, we discuss the use of ultraviolet (UV) light therapy for the treatment of patients with psoriasis. Treatment should be tailored to meet individual patients' needs. We will discuss in detail the efficacy and safety as well as offer recommendations for the use of phototherapy, including narrowband and broadband UVB and photochemotherapy using psoralen plus UVA, alone and in combination with topical and systemic agents. We will also discuss the available data for the use of the excimer laser in the targeted treatment of psoriasis. Finally, where available, we will summarize the available data that compare the safety and efficacy of the different forms of UV light therapy.

20 Review Is there truly a risk of lymphoma from biologic therapies? 2009

Dommasch, Erica / Gelfand, Joel M. ·Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. Joel.Gelfand@uphs ·Dermatol Ther · Pubmed #19845719.

ABSTRACT: The treatment of psoriasis has undergone a revolution with the advent of biologic therapies, including infliximab, etanercept, adalimumab, efalizumab, and alefacept. Biologics are generally safe and well tolerated. However, there has been concern over the risk of lymphoma with use of these agents because of their immunosuppressive properties. This review summarizes the current evidence in regards to lymphoma risk with biologic therapy obtained from case reports and case series, observational studies, clinical trials, and meta-analyses. The majority of data for T-cell inhibitors comes from case reports and relatively small, short-term clinical trials. In addition to published case reports and case series, TNF-alpha inhibitors have also been studied extensively in large cohort studies and meta-analyses of clinical trials derived primarily from the rheumatoid arthritis population. Current data are neither sufficient to completely rule out an increased risk of lymphoma associated with biologics, nor to firmly establish a causal relationship between biologics and lymphoma. Short- to intermediate-term treatment with biologics (e.g., up to 4 years) appears to be very safe with respect to lymphoma risk, especially with TNF-alpha inhibitors in which their potential risks appear to be well defined. Continued vigilance is warranted; however, in the appropriate patient, the risk-to-benefit profile of psoriasis treatment with respect to lymphoma risk appears highly favorable.

21 Review Complementary and alternative medicine for psoriasis: a qualitative review of the clinical trial literature. 2009

Smith, Nana / Weymann, Alex / Tausk, Francisco A / Gelfand, Joel M. ·Department of Dermatology, University of Rochester, Rochester, New York, USA. nanasmithmd@gmail.com ·J Am Acad Dermatol · Pubmed #19664846.

ABSTRACT: BACKGROUND: Patients with psoriasis often inquire about complementary and alternative medicine in an effort to do everything possible to control the disease. OBJECTIVE: We sought to review the clinical trial literature regarding complementary and alternative medicine for the treatment of psoriasis. METHODS: We conducted qualitative systematic review of randomized, clinical trials. RESULTS: Although many randomized controlled trials were found, both the results and the quality of the studies varied. LIMITATIONS: The main limitations were the relatively low quality of studies (as assessed by Jadad scores), lack of inclusion of unpublished studies, and the fact that only one author determined inclusion of studies and assignment of Jadad scores. CONCLUSION: There is a large body of literature in regard to complementary and alternative medicine for the treatment of psoriasis. More work is necessary before these modalities should be recommended to our patients.

22 Review Update on the natural history and systemic treatment of psoriasis. 2008

Richardson, Stephen K / Gelfand, Joel M. ·Florida State University College of Medicine/Dermatology Associates of Tallahassee, 1714 Mahan Center Boulevard, Tallahassee, FL 32308, USA. ·Adv Dermatol · Pubmed #19256309.

ABSTRACT: The onset of psoriatic disease and its associated comorbidities involves the interplay among a myriad of genetic and environmental risk factors. As we gain further insight into the immunopathogenesis of psoriasis, we hope it will provide the basis for the development of safer, more efficacious, and more durable therapeutics in the future. Given its enormous toll on patient health and quality of life, steps should be taken to prevent or decrease the risk for psoriasis-associated comorbidities through behavior modification and use of preventative health screenings and treatments. Future studies will need to be performed to determine if successful treatment of psoriasis will lead to a decreased risk for developing psoriasis-associated comorbidities over time.

23 Review AJC editor's consensus: psoriasis and coronary artery disease. 2008

Friedewald, Vincent E / Cather, Jennifer C / Gelfand, Joel M / Gordon, Kenneth B / Gibbons, Gary H / Grundy, Scott M / Jarratt, Michael T / Krueger, James G / Ridker, Paul M / Stone, Neil / Roberts, William C. ·Department of Internal Medicine, The University of Texas Medical School at Houston, Houston, Texas, USA. vfriedew@nd.edu ·Am J Cardiol · Pubmed #19064017.

ABSTRACT: -- No abstract --

24 Review Psoriasis and metabolic disease: epidemiology and pathophysiology. 2008

Azfar, Rahat S / Gelfand, Joel M. ·Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA. ·Curr Opin Rheumatol · Pubmed #18525354.

ABSTRACT: PURPOSE OF REVIEW: The scientific literature linking psoriasis to metabolic syndrome, and its components, as well as atherosclerosis and myocardial infarction has rapidly expanded. Increasingly, epidemiological studies are establishing the directionality of these associations and psoriasis' role as an independent risk factor in developing these outcomes. RECENT FINDINGS: Psoriasis is associated with metabolic syndrome, and its components, such as obesity, diabetes, and hypertension. Obesity has been shown to be an independent risk factor for the development of psoriasis, and is also associated with more severe psoriasis. Psoriasis is associated with diabetes, coronary artery disease, and an increased risk for myocardial infarction independent of traditional risk factors for these disorders. These phenotypically diverse conditions share similar pathologic changes such as chronic inflammation, angiogenesis, oxidative stress, and selected susceptibility genes and loci. SUMMARY: The broad literature linking psoriasis to metabolic disorders has led to changes in standard of care recommendations for patients with psoriasis. In particular, practitioners are encouraged to screen psoriasis patients, especially when disease is severe, for metabolic disorders and cardiovascular risk factors and institute appropriate prevention strategies. Additional studies investigating the role of psoriasis activity and severity as an independent risk factor for developing metabolic disorders, atherosclerosis, and myocardial infarction and the role of psoriasis treatment in altering the risk of developing these serious morbidities are urgently needed.

25 Clinical Trial Secukinumab treatment of plaque psoriasis shows early improvement in DLQI response - results of a phase II regimen-finding trial. 2016

Augustin, M / Abeysinghe, S / Mallya, U / Qureshi, A / Roskell, N / McBride, D / Papavassillis, C / Gelfand, J. ·Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · RTI Health Solutions, Didsbury, UK. · Novartis Pharmaceuticals Corp., East Hanover, NJ, USA. · Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA. · CROS NT Ltd., Milton Keynes, UK. · Novartis Pharma AG, Basel, Switzerland. · Department of Dermatology and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA. ·J Eur Acad Dermatol Venereol · Pubmed #26660143.

ABSTRACT: BACKGROUND: The social stigma and chronicity of psoriasis significantly affect health-related quality of life (HRQoL). OBJECTIVE: We examined the effect of three regimens of secukinumab on HRQoL in moderate to severe psoriasis patients. METHODS: Twelve-week data from a phase II, randomized, double-blind, placebo-controlled, regimen-finding study evaluated HRQoL, measured by the Dermatology Life Quality Index (DLQI). Secukinumab or placebo was administered subcutaneously in three treatment regimens: single (baseline only), monthly (baseline, weeks 4, 8) and early (baseline, weeks 1, 2, 4). Differences among regimens were assessed with logistic regression models and Fisher's exact test. RESULTS: Patients (n = 404) were randomized to single (baseline) treatment regimen, n = 66; monthly, (baseline, weeks 4 and 8), n = 138; early, (baseline, weeks 1, 2, 4), n = 133; and placebo, n = 67. DLQI response was significantly higher in early, monthly and single regimens than in placebo regimen (40.8%, 33.6% and 13.1% vs. 1.6%, respectively; P < 0.001 for all). CONCLUSION: Moderate to severe psoriasis patients receiving monthly and early treatment with secukinumab demonstrated improved HRQoL compared with placebo.

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