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Psoriasis: HELP
Articles from Greece
Based on 160 articles published since 2008
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These are the 160 published articles about Psoriasis that originated from Greece during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7
1 Editorial Psoriasis and Cardiovascular Disease: Two Sides of the Same Coin? 2018

Doumas, Michael / Katsiki, Niki / Papademetriou, Vasilios. ·1 Second Department of Propaedeutic Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece. · 2 VAMC and George Washington University, Washington, DC, USA. · 3 VAMC and Georgetown University, Washington, DC, USA. ·Angiology · Pubmed #28401789.

ABSTRACT: -- No abstract --

2 Review Epidemiological characteristics of psoriatic arthritis. 2019

Migkos, Michael P / Somarakis, Georgios-Petros / Markatseli, Theodora E / Voulgari, Paraskevi V / Drosos, Alexandros A. ·Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Greece. · Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Greece. adrosos@cc.uoi.gr. ·Clin Exp Rheumatol · Pubmed #30299245.

ABSTRACT: Psoriatic arthritis (PsA) is a specific form of inflammatory arthritis associated with skin psoriasis. PsA makes part of a heterogeneous group of arthritides called the spondyloarthropathies. Several studies regarding the prevalence and incidence of PsA have been published during the last decades, showing a considerable variation of the disease occurrence among different populations. The purpose of this review is to discuss recent observations of epidemiological features for PsA patients. Thus, the literature was reviewed until May 2018 for studies regarding PsA epidemiology, classification criteria and risk factors for PsA development. Systematic reviews based on the international bibliography, are reporting the prevalence of the disease from 1/100.000 inhabitants in Japan to as high as 420/100.000 inhabitants in Italy. The annual incidence also varies, ranging from 1 to 23/100.000 inhabitants, while the average incidence rate is 6.5 cases/100.000 inhabitants. The random effect pooled PsA prevalence and incidence rates are 133/100.000 and 83/100.000 subjects respectively. Thus, a large heterogeneity between studies is observed. This variability could be explained by a number of factors such as the use of multiple and different classification criteria in the studies. Geographical variations are also observed regarding disease occurrence. Differences were found not only between different continents, but also within the same geographic regions. This could be explained by the different genetic background especially the distribution of the human leucocyte antigens. In addition, other factors such as environmental (infections, climate, sun exposure), dietary habits (fish oil consumption, Mediterranean diet) or life style habits (obesity, smoking), could explain the geographic variability in the prevalence estimates. The implementation of unanimous classification criteria and the conformation by the scientific community could lead to a better understanding of the disease epidemiology.

3 Review Dermoscopy of Common Inflammatory Disorders. 2018

Sgouros, Dimitrios / Apalla, Zoe / Ioannides, Dimitrios / Katoulis, Alexander / Rigopoulos, Dimitrios / Sotiriou, Elena / Stratigos, Alexander / Vakirlis, Efstratios / Lallas, Aimilios. ·2nd Department of Dermatology - Venereology, National Kapodistrian University of Athens, ATTIKON University Hospital, 1 Rimini Street, Chaidari, Athens 12462, Greece. · 1st Department of Dermatology - Venereology, State Clinic of Dermatology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, 124 Delfon Street, Thessaloniki 54643, Greece. · 1st Department of Dermatology - Venereology, National Kapodistrian University of Athens, A. Syggros Hospital, 5 I.Dragoumi Street, Athens 16121, Greece. · 1st Department of Dermatology - Venereology, State Clinic of Dermatology, Aristotle University of Thessaloniki, Hospital of Skin and Venereal Diseases, 124 Delfon Street, Thessaloniki 54643, Greece. Electronic address: emlallas@gmail.com. ·Dermatol Clin · Pubmed #30201145.

ABSTRACT: In addition to its "traditional" application for the early diagnosis of melanoma and nonmelanoma skin cancers, dermoscopy gains appreciation in fields beyond dermato-oncology. Nowadays, dermoscopy has been established as a reliable adjunctive tool to the everyday clinical practice of general dermatology. Morphology and distribution of vascular structures, background colors, follicular abnormalities, and the presence of scales are important features that should be evaluated. Clinical examination remains the undoubted mainstay of diagnosis in inflammatory and infectious diseases.

4 Review Systemic Inflammatory Response and Atherosclerosis: The Paradigm of Chronic Inflammatory Rheumatic Diseases. 2018

Arida, Aikaterini / Protogerou, Athanasios D / Kitas, George D / Sfikakis, Petros P. ·First Department of Propaedeutic and Internal Medicine and Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, GR-115 27 Athens, Greece. aridakater@yahoo.gr. · First Department of Propaedeutic and Internal Medicine and Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, GR-115 27 Athens, Greece. athanprot@gmail.com. · First Department of Propaedeutic and Internal Medicine and Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, GR-115 27 Athens, Greece. george.kitas@nhs.net. · First Department of Propaedeutic and Internal Medicine and Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, GR-115 27 Athens, Greece. psfikakis@med.uoa.gr. ·Int J Mol Sci · Pubmed #29954107.

ABSTRACT: Patients with Chronic Inflammatory Rheumatic diseases (CIRD) are at increased risk of cardiovascular disease (CVD), ascribed not only to classical risk factors, but also to the presence of chronic systemic inflammatory response. Αtherosclerosis, the cornerstone of CVD, is known to be accelerated in CIRD; rheumatoid arthritis promotes atheromatosis and associates with preclinical atherosclerosis equivalent to Diabetes Mellitus, which also seems to apply for systemic lupus erythematosus. Data on ankylosing spondylitis and psoriatic arthritis, albeit more limited, also support an increased CV risk in these patients. The association between inflammation and atherosclerosis, has been thoroughly investigated in the last three decades and the role of inflammation in the pathogenesis and progression of atherogenesis has been well established. Endothelial dysfunction, oxidative stress in vascular endothelial cells and macrophage accumulation, toll-like receptor signaling, NLPR-3 formation and subsequent pro-inflammatory cytokine production, such as TNFa, IL-1β, IL-6, and TNF-like cytokine 1A, are few of the mechanisms implicated in the atherogenic process. Moreover, there is evidence that anti-inflammatory biologic drugs, such as anti-TNF and anti-IL1β agents, can decelerate the atherogenic process, thus setting new therapeutic targets for early and effective disease control and suppression of inflammation, in addition to aggressive management of classical CV risk factors.

5 Review Interaction between microbiome and host genetics in psoriatic arthritis. 2018

Chimenti, Maria Sole / Perricone, Carlo / Novelli, Lucia / Caso, Francesco / Costa, Luisa / Bogdanos, Dimitrios / Conigliaro, Paola / Triggianese, Paola / Ciccacci, Cinzia / Borgiani, Paola / Perricone, Roberto. ·Rheumatology, Allergology and Clinical Immunology, Department of Medicina dei Sistemi, University of Rome Tor Vergata, Rome, Italy. · Rheumatology, Department of Internal Medicine, Sapienza University of Rome, Rome, Italy. Electronic address: carlo.perricone@uniroma1.it. · Rheumatology, Allergology and Clinical Immunology, Department of Medicina dei Sistemi, University of Rome Tor Vergata, Rome, Italy; Rheumatology, Department of Internal Medicine, Sapienza University of Rome, Rome, Italy. · Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy. · Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece. · Department of Biomedicine and Prevention, Section of Genetics, School of Medicine, University of Rome "Tor Vergata", Rome, Italy. ·Autoimmun Rev · Pubmed #29378263.

ABSTRACT: Psoriatic arthritis (PsA) is a chronic inflammatory joint disease, seen in combination with psoriasis. Both genetic and environmental factors are responsible for the development of PsA, however little is known about the different weight of these two distinctive components in the pathogenesis of the disease. Genomic variability in PsA is associated with the disease and/or some peculiar clinical phenotypes. Candidate genes involved are crucial in inflammation, immune system, and epithelial permeability. Moreover, the genesis and regulation of inflammation are influenced by the composition of the human intestinal microbiome that is able to modulate both mucosal and systemic immune system. It is possible that pro-inflammatory responses initiated in gut mucosa could contribute to the induction and progression of autoimmune conditions. Given such premises, the aim of this review is to summarize immune-mediated response and specific bacterial changes in the composition of fecal microbiota in PsA patients and to analyze the relationships between bacterial changes, immune system, and host genetic background.

6 Review Serum Leptin, Resistin, and Adiponectin Concentrations in Psoriasis: A Meta-Analysis of Observational Studies. 2017

Kyriakou, Aikaterini / Patsatsi, Aikaterini / Sotiriadis, Dimitrios / Goulis, Dimitrios G. ·2nd Department of Dermatology and Venereology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece. ·Dermatology · Pubmed #29232663.

ABSTRACT: BACKGROUND: Psoriasis is an immune-mediated, inflammatory disease. Adipokines contribute to the regulation of immune-mediated processes and inflammation. OBJECTIVE: The aim of our study was to systematically review the literature for studies that have evaluated the circulating concentrations of adipokines in patients with psoriasis and controls and to meta-analyze the best evidence available. METHODS: Eligible were studies that have assessed leptin, resistin, or adiponectin concentrations in psoriatic patients and a reference group. The study was conducted in adherence with the PRISMA standards. RESULTS: Psoriatic patients had higher leptin concentrations compared to controls (random effects model, mean difference, MD = 5.64 ng/mL, 95% CI: 3.00-8.29, p < 0.0001). Heterogeneity among studies was high (I2 = 95.9%). Psoriatic patients had higher resistin concentrations compared to controls (MD = 4.66 ng/mL, 95% CI: 2.62-6.69, p < 0.0001). Heterogeneity was high (I2 = 99.2%). Finally, psoriatic patients had lower adiponectin concentrations compared to controls (MD = -1.87 μg/mL, 95% CI: -2.76 to -0.98, p < 0.0001). Heterogeneity was high (I2 = 95.9%). CONCLUSION: The study supported the hypothesis that leptin and resistin concentrations are higher and adiponectin concentrations are lower in patients with psoriasis compared to controls. Hereby, the suggested pathogenic link between psoriasis and metabolic syndrome/obesity is reinforced and the role of comorbidities in psoriasis is highlighted.

7 Review Psychological parameters of psoriasis. 2017

Kouris, A / Platsidaki, E / Kouskoukis, C / Christodoulou, C. ·Department of Dermatology, Democritus University Medical School, Alexandroupolis. · Department of Dermatology and Venereology, "Andreas Syggros" Skin Hospital, Athens. · 2nd Department of Psychiatry, "Attikon" General Hospital, Athens University Medical School, Athens, Greece. ·Psychiatriki · Pubmed #28541239.

ABSTRACT: Psoriasis is a chronic, inflammatory scaling dermatosis. The marked visible appearance of the lesions have a negative impact on body image that leads to decreased self-esteem, hence seriously compromising the patient's quality of life. The clinical picture critically affects the social well-being of the patient since the disease is commonly misunderstood and feared by the social environment as being contagious. The patient feels stigmatized and this further intensifies their lack of self-confidence and self-esteem. Feelings of shame and guilt increase the tendency toward suicidal ideation. The poor quality of life of psoriatic patients has been associated with excessive alcohol consumption, increased smoking and greater use of tranquilizers, sedatives and antidepressants. As far as mental impairment is concerned, a correlation has been found between psychological stress and the clinical severity of symptoms: the more mentally affected the patient, the more severe the dermatologic lesions. Similarly, stressful life events constitute a major risk for the occurrence and recurrence, exacerbating the severity and duration of the symptoms. Depression and anxiety can worsen the disease or cause resistance to treatment or patient's indifference, which in turn can lead to expensive and prolonged treatment. Not least, the disease itself contributes to anxiety, depression and psychological stress, thus creating a "vicious circle" that is difficult to manage. Given that women seem to invest more in their personal appearance than men, it is hardly surprising that female psoriatic patients report higher levels of depression. Similarly, the risk of mental disorders is also higher in younger patients for whom body image plays an equally significant role. The severity of the disease, side effects of therapy and mental disorders are among the causes that have been attributed to sexual dysfunction reported by some psoriatic patients. At the social level, stigma, social rejection, feelings of shame, embarrassment and lack of confidence provoked by the disease often lead to the discontinuation of daily activities and social withdrawal. This review attempts to describe the prevalence of psychological stress and its negative social impact on patients with psoriasis. The recognition and treatment of these psychosocial problems may contribute to improving the quality of life for patients and reduce treatment costs. The collaboration between the psychiatrist and the dermatologist is a fundamental prerequisite toward addressing these issues.

8 Review Reformulations of well-known active ingredients in the topical treatment of psoriasis vulgaris can improve clinical outcomes for patients. 2017

Iversen, L / Dauden, E / Segaert, S / Freeman, K / Magina, S / Rigopoulos, D / Thaci, D. ·Department of Dermatology and Venereology, Aarhus University Hospital, Aarhus, Denmark. · Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain. · Department of Dermatology, University Hospital Leuven, Leuven, Belgium. · Bunny Hill Primary Care Centre, County Durham and Darlington NHS Foundation Trust & Sunderland Teaching Primary Care Trust, Sunderland, UK. · Department of Dermatology, CHSJoão, Porto, Portugal. · Department of Pharmacology and Therapeutics, Faculty of Medicine, Porto University, Porto, Portugal. · 2nd Department of Dermatology, University of Athens Medical School, Attikon Hospital, Athens, Greece. · Comprehensive Centre for Inflammation Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany. ·J Eur Acad Dermatol Venereol · Pubmed #28419600.

ABSTRACT: Although the majority of patients with psoriasis vulgaris are treated exclusively with topical therapies, research to develop more effective topical therapies that are associated with higher patient satisfaction has lagged behind the development of systemic agents. The aim of this literature review was to determine whether there is documented evidence that applying an innovative approach to improving the formulation of active ingredients commonly used in the topical treatment of psoriasis can have a positive effect on clinical outcomes and patient-reported outcomes (PROs). The Embase and PubMed databases were searched for articles published between 2001 and 2016 that made direct head-to-head comparisons of different formulations of an active pharmaceutical ingredient (API), focusing on clinical outcomes and PROs. In total, 22 publications on APIs or API combinations met the eligibility criteria (19 head-to-head clinical trials, one pooled analysis, one health-economic modelling study and one systematic review). Significant clinical benefit associated with the use of a reformulated API over an older formulation was reported in three trials of clobetasol propionate, one trial of calcipotriol, three trials of betamethasone and five trials/pooled analyses of calcipotriol/calcipotriene + betamethasone dipropionate (Cal/BD) formulations. Significantly improved PROs associated with the use of a reformulated API over an older formulation were reported in three trials of clobetasol propionate, one trial of betamethasone valerate and two trials of Cal/BD formulations. These results demonstrate that the innovative reformulation of APIs used in the treatment of psoriasis can produce therapies that attain significantly improved clinical outcomes and PROs. This suggests that improvement in topical therapy for psoriasis need not only to be achieved by the identification of new targets and the development of new APIs, but that improvement in the vehicle used to deliver existing APIs has the potential to result in significant clinical and patient benefits.

9 Review Invasive fungal infections in pediatric patients treated with tumor necrosis alpha (TNF-α) inhibitors. 2017

Tragiannidis, Athanasios / Kyriakidis, Ioannis / Zündorf, Ilse / Groll, Andreas H. ·Second Department of Pediatrics, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece. · Institute of Pharmaceutical Biology, Goethe-University of Frankfurt, Frankfurt am Main, Germany. · Department of Pediatric Hematology and Oncology, Center for Bone Marrow Transplantation, Infectious Disease Research Program, University Childrens Hospital, Muenster, Germany. ·Mycoses · Pubmed #27766695.

ABSTRACT: Macromolecular immunosuppressive monoclonal antibodies and fusion proteins directed against molecules or cells involved in inflammation and immunity represent a recent and important addition to our therapeutic armamentarium. Tumor necrosis alpha (TNFα) is a cytokine involved in systemic inflammation and clinical utilization of its antagonists has revolutionized treatment of juvenile rheumatoid and psoriatic arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, and plaque psoriasis. Clinical utility has also been demonstrated for use against steroid-refractory graft-vs-host disease and other immune-mediated conditions. Currently, five anti-TNFα agents are approved by the European Medicines Agency (EMA), including the monoclonal anti-TNF antibodies infliximab, adalimumab, golimumab and certolizumab pegol along with etanercept, a TNFα-receptor/IgG-Fc fusion protein. Theoretical considerations related to their mode of action and clinical observations suggest that opportunistic infectious complications should be seriously considered as possible adverse events of macromolecular immunosuppressants. The purpose of this review is to critically analyze the literature on invasive fungal infections (IFIs) occurring in association with TNFα inhibitors alone or in combination with other immunosuppressive agents, with a focus on pediatric patients, and to provide a framework of evaluating the risk for IFIs in this population.

10 Review Are psoriasis and psoriatic arthritis the same disease? The IL-23/IL-17 axis data. 2017

Sakkas, Lazaros I / Bogdanos, Dimitrios P. ·Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece. Electronic address: lsakkas@med.uth.gr. · Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece. ·Autoimmun Rev · Pubmed #27666819.

ABSTRACT: Psoriatic arthritis (PsA) is a psoriasis (Ps)-associated inflammatory joint disease that affects peripheral joints, entheses, spine, and eyes. PsA and Ps are likely to be the same disease. PsA develops in nearly 70% of patients with Ps, and the hallmark of the disease is bone erosions and bone formation. Both innate and adaptive immunity appear to contribute to pathogenesis of PsA and Ps. Trauma may be a trigger factor for both PsA and Ps. The same T cell clones were reported to be present in both synovial tissues and skin lesions suggesting that a common antigen drives T cell immune response in the joints and skin lesions of patients with PsA. The IL-23/IL-17 axis plays a critical pathogenic role for both PsA and Ps, and biologics neutralizing IL-17A or IL-23/IL-12 are effective therapies for PsA and Ps. The differential expression of Th17 cytokines IL-17 and IL-22 at various sites could explain the different manifestations of the disease. IL-17 is highly expressed in peripheral joints and skin lesions and causes bone erosions. IL-22 is highly expressed in skin lesions and entheses, not peripheral joints, and cause bone formation. Finally, mannan from baker's yeast caused PsA-like arthritis and Ps-like skin lesions that were blocked by IL-17 treatment. These data suggest that PsA and Ps are likely to be the same disease exhibiting different manifestations depending on the local cytokine production.

11 Review Onychomycosis in patients with nail psoriasis: a point to point discussion. 2017

Rigopoulos, Dimitrios / Papanagiotou, Vasilios / Daniel, Ralph / Piraccini, Bianca Maria. ·2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, Attikon University Hospital, Athens, Greece. · University of Mississippi Medical Center and University of Alabama, Birmingham, AL, USA. · Department of Specialized, Diagnostic and Experimental Medicine, Division of Dermatology, University of Bologna, Bologna, Italy. ·Mycoses · Pubmed #27523738.

ABSTRACT: Onychomycosis is the most common nail disease and affects large parts of the population. Psoriasis is a frequently encountered skin disorder with nail involvement being found in up to 80% of the patients at some time of the course of the disease. It has been postulated that onychomycosis occurs more frequently in patients with nail psoriasis, but the results of studies in the literature are controversial. Moreover, onychomycosis could exacerbate psoriasis through Koebner phenomenon and the treatment of psoriasis could predispose to onychomycosis. Finally, the differential diagnosis could be a real challenge due to many same clinical signs, the high prevalence and the possible coexistence of the two diseases. This article attempts to enlighten all these different aspects of a very close relationship.

12 Review Risk of malignancies using anti-TNF agents in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: a systematic review and meta-analysis. 2016

Bonovas, Stefanos / Minozzi, Silvia / Lytras, Theodore / González-Lorenzo, Marien / Pecoraro, Valentina / Colombo, Silvia / Polloni, Ilaria / Moja, Lorenzo / Cinquini, Michela / Marino, Valentina / Goletti, Delia / Matucci, Andrea / Tocci, Giuliano / Milano, Giuseppe Maria / Scarpa, Raffaele / Cantini, Fabrizio. ·a Humanitas Clinical and Research Center , Milan , Italy. · b Department of Epidemiology , Lazio Regional Health Service , Rome , Italy. · c Department of Experimental and Health Sciences , Universitat Pompeu Fabra , Barcelona , Spain. · d Centre for Research in Environmental Epidemiology , Barcelona , Spain. · e Hellenic Centre for Disease Control and Prevention , Athens , Greece. · f Department of Biomedical Sciences for Health , University of Milan , Milan , Italy. · g Clinical Epidemiology Unit, IRCCS Galeazzi Orthopedic Institute , Milan , Italy. · h Postgraduate School of Public Health , University of Milan , Milan , Italy. · i Methodology of Systematic Reviews and Guidelines Development Unit, Department of Oncology , IRCCS Mario Negri Institute for Pharmacological Research , Milan , Italy. · j Medical Department , Pfizer , Rome , Italy. · k Translational Research Unit, Department of Epidemiology and Preclinical Research , National Institute for Infectious Diseases , Rome , Italy. · l Immunoallergology Unit, Department of Biomedicine, Azienda Ospedaliero-Universitaria Careggi , Florence , Italy. · m Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology , University of Rome Sapienza, Sant'Andrea Hospital , Rome , Italy. · n IRCCS Neuromed , Pozzilli , Rome , Italy. · o Department of Pediatric Hematology, Oncology and Transplant Unit , IRCCS Ospedale Pediatrico Bambino Gesù , Rome , Italy. · p Rheumatology Research Unit, Department of Clinical Medicine and Surgery , University of Naples Federico II , Naples , Italy. · q Division of Rheumatology , Misericordia e Dolce Hospital , Prato , Italy. ·Expert Opin Drug Saf · Pubmed #27924644.

ABSTRACT: INTRODUCTION: Malignancies have been reported in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis, treated with anti-tumour necrosis factor (anti-TNF) agents. Areas covered: We conducted a systematic review of randomized controlled trials (RCTs) to determine the effect of anti-TNF agents on the occurrence of cancer (any type). Literature databases were searched up to May 2014 to identify relevant studies that evaluated adalimumab, certolizumab, etanercept, golimumab, or infliximab, compared with placebo or no treatment. Data on cancer occurrence were extracted at the maximum follow-up time reported. Expert opinion: Fifty-five RCTs with 20,631 patients met the eligibility criteria. Of these, 32 trials with 15,539 patients reported at least one case of cancer, for a total of 112 malignancies. The degree of variability between studies was consistent with what would be expected to occur by chance alone. There was no evidence of an association between anti-TNF agents and cancer risk (fixed-effects model (OR: 1.31, 95% CI: 0.89, 1.95); a random-effects model (OR: 1.16, 95% CI: 0.75, 1.81)). We found evidence of selective outcome reporting or publication bias suggesting that the pooled effect estimate for cancer may have been overestimated. The evidence is imprecise, and the risk of bias was high or unclear across primary studies.

13 Review Risk of infections using anti-TNF agents in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: a systematic review and meta-analysis. 2016

Minozzi, Silvia / Bonovas, Stefanos / Lytras, Theodore / Pecoraro, Valentina / González-Lorenzo, Marien / Bastiampillai, Anan Judina / Gabrielli, Eugenia Maria / Lonati, Andrea Carlo / Moja, Lorenzo / Cinquini, Michela / Marino, Valentina / Matucci, Andrea / Milano, Giuseppe Maria / Tocci, Giuliano / Scarpa, Raffaele / Goletti, Delia / Cantini, Fabrizio. ·a Department of Epidemiology , Lazio Regional Health Service , Rome , Italy. · b Humanitas Clinical and Research Center , Milan , Italy. · c Department of Experimental and Health Sciences , Universitat Pompeu Fabra , Barcelona , Spain. · d Centre for Research in Environmental Epidemiology , Barcelona , Spain. · e Hellenic Centre for Disease Control and Prevention , Athens , Greece. · f Clinical Epidemiology Unit , IRCCS Galeazzi Orthopedic Institute , Milan , Italy. · g Department of Biomedical Sciences for Health , University of Milan , Milan , Italy. · h Postgraduate School of Public Health , University of Milan , Milan , Italy. · i Methodology of Systematic Reviews and Guidelines Development Unit, Department of Oncology , IRCCS Mario Negri Institute for Pharmacological Research , Milan , Italy. · j Medical Department , Pfizer , Rome , Italy. · k Immunoallergology Unit, Department of Biomedicine, Azienda Ospedaliero-Universitaria Careggi , Florence , Italy. · l Department of Pediatric Hematology , Oncology and Transplant Unit, IRCCS Ospedale Pediatrico Bambino Gesù , Rome , Italy. · m Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology , University of Rome Sapienza , Sant'Andrea Hospital, Rome , Italy. · n IRCCS Neuromed , Pozzilli , Rome , Italy. · o Rheumatology Research Unit, Department of Clinical Medicine and Surgery , University of Naples Federico II , Naples , Italy. · p Translational Research Unit, Department of Epidemiology and Preclinical Research , National Institute for Infectious Diseases , Rome , Italy. · q Division of Rheumatology , Misericordia e Dolce Hospital , Prato , Italy. ·Expert Opin Drug Saf · Pubmed #27924643.

ABSTRACT: INTRODUCTION: Five anti-tumor necrosis factor (anti-TNF) agents have received regulatory approval for use in rheumatology: adalimumab, golimumab, infliximab, certolizumab, and etanercept. Apart from their well-documented therapeutic value, it is still uncertain to what extent they are associated with an increased risk of infectious adverse events. Areas covered: We conducted a systematic review and meta-analysis of published randomized studies to determine the effect of anti-TNF drugs on the occurrence of infectious adverse events (serious infections; tuberculosis; opportunistic infections; any infection). We searched Medline, Embase, and the Cochrane Library up to May 2014 to identify eligible studies in adult patients with rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis that evaluated anti-TNF drugs compared with placebo or no treatment. Expert opinion: Our study encompassed data from 71 randomized controlled trials involving 22,760 participants (range of follow-up: 1-36 months) and seven open label extension studies with 2,236 participants (range of follow-up: 6-48 months). Quantitative synthesis of the available data found statistically significant increases in the occurrence of any infections (20%), serious infections (40%), and tuberculosis (250%) associated with anti-TNF drug use, while the data for opportunistic infections were scarce. The quality of synthesized evidence was judged as moderate. Further evidence from registries and long-term epidemiological studies are needed to better define the relationship between anti-TNF agents and infection complications.

14 Review Replication of a distinct psoriatic arthritis risk variant at the IL23R locus. 2016

Budu-Aggrey, Ashley / Bowes, John / Loehr, Sabine / Uebe, Steffen / Zervou, Maria I / Helliwell, Philip / Ryan, Anthony W / Kane, David / Korendowych, Eleanor / Giardina, Emiliano / Packham, Jonathan / McManus, Ross / FitzGerald, Oliver / McHugh, Neil / Behrens, Frank / Burkhardt, Harald / Huffmeier, Ulrike / Ho, Pauline / Martin, Javier / Castañeda, Santos / Goulielmos, George / Reis, Andre / Barton, Anne. ·Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, The University of Manchester, UK NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester Foundation Trust and University of Manchester, Manchester Academy of Health Sciences, Manchester, UK. · Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, The University of Manchester, UK. · Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany. · Laboratory of Molecular Medicine and Human Genetics, Department of Internal Medicine, University of Crete, Heraklion, Greece. · NIHR-Leeds Musculoskeletal Biomedical Research Unit Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. · Department of Clinical Medicine, Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland. · Department of Rheumatology, Adelaide and Meath Hospital and Trinity College Dublin, Ireland. · Royal National Hospital for Rheumatic Diseases and Department Pharmacy and Pharmacology, University of Bath, Bath, UK. · Department of Biomedicine and Prevention, University of Rome 'Tor Vergata' and Laboratory of Molecular Genetics UILDM, Fondazione Santa Lucia IRCCS, Rome, Italy. · Rheumatology Department, Haywood Hospital, Health Services Research Unit, Institute of Science and Technology in Medicine, Keele University, Stoke on Trent, UK. · Department of Rheumatology, St. Vincent's University Hospital, UCD School of Medicine and Medical Sciences and Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland. · Division of Rheumatology and Fraunhofer IME-Project-Group Translational Medicine and Pharmacology, Goethe University, Frankfurt, Germany. · Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, The University of Manchester, UK The Kellgren Centre for Rheumatology, Central Manchester Foundation Trust, NIHR Manchester Biomedical Research Centre, Manchester, UK. · CSIC, Instituto de Parasitologia y Biomedicina Lopez-Neyra, Granada, Spain. · Department of Rheumatology, Hospital La Princesa, IIS-IPrincesa, Madrid, Spain. · Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, The University of Manchester, UK NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester Foundation Trust and University of Manchester, Manchester Academy of Health Sciences, Manchester, UK The Kellgren Centre for Rheumatology, Central Manchester Foundation Trust, NIHR Manchester Biomedical Research Centre, Manchester, UK. ·Ann Rheum Dis · Pubmed #27016051.

ABSTRACT: -- No abstract --

15 Review Psoriatic cheilitis: a report of 2 cases treated successfully with topical tacrolimus and a review of the literature. 2015

Apalla, Z / Sotiriou, E / Trigoni, A / Ioannides, D. ·First Dermatology Department, Aristotle University of Thessaloniki, Greece. · First Dermatology Department, Aristotle University of Thessaloniki, Greece. Electronic address: elenasotiriou@yahoo.gr. · State Clinic, Hospital of Skin and Venereal Diseases, Thessaloniki, Greece. ·Actas Dermosifiliogr · Pubmed #26164836.

ABSTRACT: -- No abstract --

16 Review Golimumab, the newest TNF-α blocker, comes of age. 2015

Papagoras, Charalampos / Voulgari, Paraskevi V / Drosos, Alexandros A. ·Laboratory of Molecular Haematology, Medical School, Democritus University of Thrace, Alexandroupolis; and Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece. · Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece. ·Clin Exp Rheumatol · Pubmed #25602858.

ABSTRACT: Golimumab, a fully human monoclonal antibody against tumour necrosis factor-α (TNF-α) is one of the newest biologics that has become available for the treatment of rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. Following the initial randomised double-blind placebo-controlled clinical trials, which demonstrated the efficacy and safety of the drug in the context of a limited patient sample and a relatively short time frame, golimumab has been the focus of continuous investigation through the extensions of the above-mentioned trials, new clinical trials and registries of biologic drug use in daily clinical practice. The review of this data and their inclusion in meta-analyses and indirect comparisons across TNF-α blockers suggest that golimumab possesses similar properties regarding efficacy and safety as the older monoclonal anti-TNF-α antibodies. The novelty of golimumab is perhaps its dosing regimen, i.e. subcutaneous self-administration once monthly, which allows for the least disturbance in the life of patients.

17 Review Visceral leishmaniasis in a psoriatic arthritis patient treated with methotrexate. 2014

Hadjipetrou, Athanasios / Anyfantakis, Dimitrios / Gkogkou, Argyro / Palla, Katerina / Lagoudaki, Eirini / Milonaki, Theoharoula / Kastanakis, Serafim. ·Department of Internal Medicine, Chania General Hospital St. George; Primary Health Care Centre of Kissamos, Chania; Department of Haematology, Chania General Hospital St. George, Chania, Crete, Greece. ·Infez Med · Pubmed #25269966.

ABSTRACT: Visceral leishmaniasis, in Greece, represents a relatively rare, potentially fatal clinical entity. Here we describe a case of visceral leishmaniasis infection in a 65-year old Greek male with psoriatic arthritis treated with methotrexate, who presented with high grade fever, chills, splenomegaly, pancytopenia and polyclonal hypergammaglobulinaemia. A diagnosis of visceral leishmaniasis was finally established. Visceral leishmaniasis should be included in the differential diagnosis for infections in patients receiving methotrexate for rheumatic diseases, especially in endemic areas.

18 Review Therapeutic human monoclonal antibodies in inflammatory diseases. 2014

Kotsovilis, Sotirios / Andreakos, Evangelos. ·Laboratory of Immunogenetics, Center of Immunology and Transplantation, Immunobiology Division, Biomedical Research Foundation of the Academy of Athens, Athens, Hellas, Greece. ·Methods Mol Biol · Pubmed #24037835.

ABSTRACT: Monoclonal antibodies (mAbs) are antibodies of a single antigen specificity produced by identical immune cells, i.e., clones of a common germ cell. They offer unprecedented opportunities to drug development because of their ability to target almost any cell surface or secreted molecule with remarkable efficacy and safety. In this chapter, the application of human mAbs in the treatment of inflammatory diseases is reviewed. We discuss in detail several mAb-based drugs such as anti-tumor necrosis factor (anti-TNF), anti-interleukin-1 (anti-IL-1) receptor, anti-IL-6 receptor, anti-α4 integrin subunit, and anti-CD20 agents, all of which have been documented by clinical trials to be efficacious and have been approved for the therapy of several inflammatory and immune diseases, including rheumatoid arthritis, Crohn's disease, ulcerative colitis, spondyloarthropathies, juvenile arthritis, psoriasis, psoriatic arthritis, and others. These novel drugs can be used either as a monotherapy or in combination with other conventional therapeutic modalities, particularly if the disease under treatment is refractory to therapy using solely conventional techniques. As a large variety of mAb-based agents targeting a plethora of cytokines, chemokines, adhesion and co-stimulatory molecules, receptors, as well as diverse cell types, are presently under investigation, the therapeutic armamentarium of the clinician is expected to greatly broaden in the near future, providing improved patient care for a wide range of devastating diseases of our times.

19 Review Biologic agents in nail psoriasis: efficacy data and considerations. 2013

Kyriakou, Aikaterini / Patsatsi, Aikaterini / Sotiriadis, Dimitrios. ·Aristotle University School of Medicine, 2nd Dermatology Department , Thessaloniki , Greece docmouli@gmail.com. ·Expert Opin Biol Ther · Pubmed #24156504.

ABSTRACT: INTRODUCTION: Nail psoriasis plays a major role in the overall assessment of psoriatic disease. Four biologic agents are officially labeled for the treatment of moderate to severe, stable plaque psoriasis (adalimumab, etanercept, infliximab, ustekinumab) and have enriched subsequently the therapeutic armamentarium against psoriatic nails. However, evidence for the efficacy of these agents for nail psoriasis is under investigation. AREAS COVERED: In this review an effort has been made to summarize evidence regarding the efficacy of biologics in nail psoriasis. A systemic search for reports of biologic agents in psoriatic patients with nail involvement was carried out (MEDLINE and CENTRAL in the Cochrane Library). Relevant data are thoroughly presented. EXPERT OPINION: All four biologic agents have shown efficacy on psoriatic nail disease. However, published data are heterogeneous, based on studies assessing the therapeutic efficacy with different scoring indexes and at different time points, depending on the time table of each drug administration. Therefore, the need for consensus on core outcome to be used is mandatory. Additionally, optimization of the scoring systems and the conduction of further trials of high quality and validity could lead to more accurate conclusions on the efficacy of biologic agents in the treatment of nail psoriasis.

20 Review The role of p38 MAPK in the aetiopathogenesis of psoriasis and psoriatic arthritis. 2013

Mavropoulos, Athanasios / Rigopoulou, Eirini I / Liaskos, Christos / Bogdanos, Dimitrios P / Sakkas, Lazaros I. ·Cellular Immunotherapy and Molecular Immunodiagnostics, Institute of Research and Technology Thessaly, 41222 Larissa, Greece ; Division of Transplantation Immunology and Mucosal Biology, Institute of Liver Studies, King's College London School of Medicine at King's College Hospital, Denmark Hill Campus, London SE5 9RS, UK. ·Clin Dev Immunol · Pubmed #24151518.

ABSTRACT: The pathogenetic mechanisms responsible for the induction of immune-mediated disorders, such as psoriasis, remain not well characterized. Molecular signaling pathways are not well described in psoriasis, as well as psoriatic arthritis, which is seen in up to 40% of patients with psoriasis. Signaling pathway defects have long been hypothesized to participate in the pathology of psoriasis, yet their implication in the altered psoriatic gene expression still remains unclear. Emerging data suggest a potential pathogenic role for mitogen activated protein kinases p38 (p38 MAPK) extracellular signal-regulated kinase 1/2 (ERK1/2), and c-Jun N-terminal kinase (JNK) in the development of psoriasis. The data are still limited, though, for psoriatic arthritis. This review discusses the current data suggesting a crucial role for p38 MAPK in the pathogenesis of these disorders.

21 Review Infliximab in psoriasis and psoriatic arthritis. 2013

Papoutsaki, Marina / Osório, Filipa / Morais, Paulo / Torres, Tiago / Magina, Sofia / Chimenti, Sergio / Costanzo, Antonio. ·Third Department of Dermatology, A. Syggros Hospital, Athens, Greece. marinapapoutsaki@hotmail.com ·BioDrugs · Pubmed #23990278.

ABSTRACT: Psoriasis is a chronic inflammatory disorder of the skin and joints. Although rarely life threatening, psoriasis can significantly impair quality of life (QOL) and cause considerable physical and psychological distress. Between 6 and 42% of patients with psoriasis develop psoriatic arthritis, which is characterized by stiffness, pain, swelling and tenderness of the joints. Nail psoriasis is highly prevalent in both plaque-type psoriasis and psoriatic arthritis and is found in approximately 50% of patients with psoriasis and in 80% of patients with psoriatic arthritis. Infliximab, a chimeric human-murine monoclonal antibody directed against tumour necrosis factor α, is approved in the USA and EU for the treatment of plaque psoriasis and psoriatic arthritis at a recommended dosage of 5 mg/kg administered by intravenous infusion at 0,2 and 6 weeks, then every 8 weeks thereafter. The EXPRESS and EXPRESS II trials demonstrated that infliximab is efficacious as induction and maintenance therapy in the treatment of moderate to severe plaque psoriasis and also improved health-related QOL. Infliximab is also efficacious in the treatment of psoriatic arthritis, as shown in the IMPACT and IMPACT II studies. Infliximab is generally well tolerated, with a similar adverse event profile in both psoriasis and psoriatic arthritis. The use of infliximab in three case reports is presented. The patients are similar to those normally seen by clinicians, and include a male patient with plaque psoriasis and a history of severe psoriatic arthritis who was corticosteroid dependent and in whom other systemic treatments were not effective or were not able to be used. This patient showed a rapid response to infliximab with no skin lesions or arthritis after 7 weeks' treatment. Infliximab was also safe and effective in the treatment of a female patient with plaque and nail psoriasis and a history of psoriatic arthritis. Importantly, this case report supports the efficacy of infliximab in psoriatic nail disease in the context of severe skin and joint involvement. Case 3 describes a young male patient with moderate plaque-type psoriasis associated with severe nail involvement and early signs of psoriatic arthritis. Treatment with infliximab improved nail psoriasis and appears to be an effective biological treatment for nail psoriasis. Importantly, ultrasound was able to diagnose joint involvement, as seen from the proliferative synovitis in the distal interphalangeal joint and mild enthesitis, despite there being no clinical evidence of psoriatic arthritis. This case report highlights the importance of early screening. If such abnormalities are detected early on in the course of psoriasis, clinicians may be able to predict which patients are more likely to develop psoriatic arthritis, and therefore offer effective and long-term treatment that may reduce the disability and impairment of daily activities that can be associated with psoriatic arthritis.

22 Review Treatment of psoriasis and psoriatic arthritis. 2013

Papoutsaki, Marina / Costanzo, Antonio. ·Third Department of Dermatology, A. Syggros Hospital, Athens, Greece. marinapapoutsaki@hotmail.com ·BioDrugs · Pubmed #23990277.

ABSTRACT: Skin and joint manifestations associated with psoriasis and psoriatic arthritis (PsA) can significantly impact a patient's quality of life. Successful treatment is imperative in order to improve signs and symptoms of the disease, and to alleviate physical or psychological distress. For patients with mild psoriasis with or without PsA, topical agents and targeted phototherapy are appropriate treatments for psoriasis. Systemic therapies, such as methotrexate and phototherapy are recommended options for patients with more severe psoriasis, but their long-term use is hindered by safety concerns. Advancements in understanding the pathogenesis of psoriasis, including the role of T cells and cytokines, have been crucial to the development of biological therapies. These target the immune system and are suitable options for patients with extensive disease. Biological therapies for the treatment of psoriasis include targeted therapies (alefacept) and anti-cytokine therapies (anti-tumour necrosis factor [TNF] therapies [adalimumab, etanercept, infliximab] and a monoclonal antibody against interleukin [IL]-12 and IL-23 [ustekinumab]). Patients with PsA should be treated appropriately in order to improve symptoms and inhibit structural joint damage. Non-steroidal anti-inflammatory drugs or local intra-articular injections of corticosteroids can be used successfully in patients with mild PsA; however, neither treatment prevents the development of structural joint damage. For patients with moderate to severely active PsA, disease-modifying antirheumatic drugs (such as methotrexate), TNF inhibitor treatments (adalimumab, etanercept, infliximab and golimumab) or their combination are considered first-line treatment. This review provides a brief overview of treatment options for psoriasis and PsA, with an emphasis on the efficacy and safety of anti-TNF therapies.

23 Review Seborrheic dermatitis: etiology, risk factors, and treatments: facts and controversies. 2013

Dessinioti, Clio / Katsambas, Andreas. ·1st Department of Dermatology, Andreas Syggros Hospital, University of Athens, 5, Dragoumi Str, 16121, Athens, Greece. · 1st Department of Dermatology, Andreas Syggros Hospital, University of Athens, 5, Dragoumi Str, 16121, Athens, Greece. Electronic address: katsabas1@ath.forthnet.gr. ·Clin Dermatol · Pubmed #23806151.

ABSTRACT: Seborrheic dermatitis (SD) is a common skin condition seen frequently in clinical practice. The use of varying terms such as sebopsoriasis, seborrheic dermatitis, seborrheic eczema, dandruff, and pityriasis capitis reflects the complex nature of this condition. Despite its frequency, much controversy remains regarding the pathogenesis of SD. This controversy extends to its classification in the spectrum of cutaneous diseases, having being classified as a form of dermatitis, a fungal disease, or an inflammatory disease, closely related with psoriasis. Some have postulated that SD is caused by Malassezia yeasts, based on the observation of their presence in affected skin and the therapeutic response to antifungal agents. Others have proposed that Malassezia is incidental to a primary inflammatory dermatosis that resulted in increased cell turnover, scaling, and inflammation in the epidermis, similar to psoriasis. The presence of host susceptibility factors, permitting the transition of M furfur to its pathogenic form, may be associated with immune response and inflammation. Metabolites produced by Malassezia species, including oleic acid, malssezin, and indole-3-carbaldehyde, have been implicated. SD also has been traditionally considered to be a form of dermatitis based on the presence of Malassezia in healthy skin, the absence the pathogenic mycelial form of Malassezia yeasts in SD, and its chronic course. As a result, proposed treatments vary, ranging from topical corticosteroids to topical antifungals and antimicrobial peptides.

24 Review Enthesitis in psoriatic arthritis. 2013

Sakkas, Lazaros I / Alexiou, Ioannis / Simopoulou, Theodora / Vlychou, Marianna. ·Department of Rheumatology, School of Health Sciences, University of Thessaly, Larissa, Greece; Center for Molecular Medicine, Old Dominion University, Norfolk, VA. Electronic address: lsakkas@med.uth.gr. ·Semin Arthritis Rheum · Pubmed #23731532.

ABSTRACT: OBJECTIVES: It is increasingly recognized that enthesitis in patients with psoriatic arthritis (PsA) is of clinical importance. We review data on the detection, assessment, and treatment of enthesitis and its related dactylitis in PsA. METHODS: We searched Pubmed with the search terms psoriatic arthritis or psoriasis in combination with enthesitis, enthesopathy, and treatment, or enthesitis in combination with imaging. RESULTS: One hundred fifty-seven papers were selected. Enthesitis occurs frequently in PsA and may be asymptomatic or painful. It can also affect patient's function and quality of life. New imaging modalities, such as ultrasonography and magnetic resonance imaging, have revealed that enthesitis may be the initial osteoarticular inflammatory site in patients with PsA. Enthesitis indices have been developed and should be incorporated in clinical trials. Dactylitis, a characteristic and frequent manifestation of PsA can be tender or not tender and is prognostic of disease progression. Treatment of enthesitis includes non-steroidal anti-inflammatory drugs, classical DMARDs, and adjunctive local steroid injections. In inadequate response, TNFα inhibitors are used. CONCLUSIONS: Enthesitis and dactylitis are important manifestations of PsA, and their evaluation is increasingly used in drug trials and clinical practice.

25 Review Atherosclerosis and cardiovascular disease in the spondyloarthritides, particularly ankylosing spondylitis and psoriatic arthritis. 2013

Papagoras, Charalampos / Voulgari, Paraskevi V / Drosos, Alexandros A. ·Department of Internal Medicine, University of Ioannina, Ioannina, Greece. charispapagoras@yahoo.com ·Clin Exp Rheumatol · Pubmed #23406817.

ABSTRACT: The spondyloarthritides (SpA) are a group of idiopathic inflammatory diseases affecting the axial and/or peripheral skeleton. Recent evidence points towards an increased mortality and morbidity due to cardiovascular disease, especially within the two major forms of SpA, ankylosing spondylitis and psoriatic arthritis. Several studies have identified alterations of the lipid profile, insulin sensitivity and other metabolic cardiovascular risk factors in SpA patients. An array of vascular morphologic and functional abnormalities has also been reported in these diseases, supporting the hypothesis of accelerated atherosclerosis in SpA. Inflammation appears to be a major player, involved both in the impairment of the classic cardiovascular risk factors, as well as directly in the process of endothelial injury, dysfunction and ultimately atherosclerosis. Multiple studies in rheumatoid arthritis have suggested that effective suppression of inflammation with synthetic disease-modifying anti-rheumatic drugs or with biologics may also exert favourable effects in the cardiovascular risk. Although such evidence is currently lacking for SpA, there is little doubt that physicians caring for patients with SpA should aim at controlling both inflammation and traditional cardiovascular risk factors. Such an integrated approach is expected to benefit patients in multiple levels.

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