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Psoriasis: HELP
Articles from Oxfordshire
Based on 46 articles published since 2008
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These are the 46 published articles about Psoriasis that originated from Oxfordshire during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Guideline Treating axial spondyloarthritis and peripheral spondyloarthritis, especially psoriatic arthritis, to target: 2017 update of recommendations by an international task force. 2018

Smolen, Josef S / Schöls, Monika / Braun, Jürgen / Dougados, Maxime / FitzGerald, Oliver / Gladman, Dafna D / Kavanaugh, Arthur / Landewé, Robert / Mease, Philip / Sieper, Joachim / Stamm, Tanja / Wit, Maarten de / Aletaha, Daniel / Baraliakos, Xenofon / Betteridge, Neil / Bosch, Filip van den / Coates, Laura C / Emery, Paul / Gensler, Lianne S / Gossec, Laure / Helliwell, Philip / Jongkees, Merryn / Kvien, Tore K / Inman, Robert D / McInnes, Iain B / Maccarone, Mara / Machado, Pedro M / Molto, Anna / Ogdie, Alexis / Poddubnyy, Denis / Ritchlin, Christopher / Rudwaleit, Martin / Tanew, Adrian / Thio, Bing / Veale, Douglas / Vlam, Kurt de / van der Heijde, Désirée. ·Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria. · 2nd Department of Medicine, Hietzing Hospital, Vienna, Austria. · Health Consult, Vienna, Austria. · Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany. · Department of Rheumatology, Paris Descartes University, Paris, France. · Department of Rheumatology, St Vincent's University Hospital, Dublin, Ireland. · Division of Rheumatology, University of Toronto, Toronto, Ontario, Canada. · Division of Rheumatology, University of California, San Diego, CA, USA. · Amsterdam Rheumatology & Immunology Center, Amsterdam, The Netherlands. · Division of Rheumatology Research, Swedish-Providence St. Joseph Health System, University of Washington, Seattle, WA, USA. · Department of Gastroenterology, Infectiology and Rheumatology, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Berlin, Germany. · Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria. · Department of Medical Humanities, VU University Medical Centre, Amsterdam, The Netherlands. · Neil Betteridge Associates, UK. · Ghent University Hospital, Ghent, Belgium. · Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK. · Department of Medicine, University of California, San Francisco, CA, USA. · Department of Rheumatology, UPMC Univ Paris 06, GRC-UPMC 08 (EEMOIS); AP-HP, Pitié Salpêtrière Hospital, Paris, France. · Institute of Molecular Medicine, University of Leeds, Leeds, UK. · Seayn Medical, Voorschoten, The Netherlands. · Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. · University Health Network and University of Toronto, Toronto, Ontario, Canada. · University of Glasgow, College of Medical Veterinary and Life Sciences, Glasgow, UK. · A.DI.PSO. (Associazione per la Difesa degli Psoriasici)-PE.Pso.POF (Pan European Psoriasis Patients' Organization Forum), Rome, Italy. · Centre for Rheumatology & MRC Centre for Neuromuscular Diseases, University College London, London, UK. · Division of Rheumatology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, USA. · German Rheumatism Research Centrer, Berlin, Germany. · Allergy, Immunology and Rheumatology Division, University of Rochester Medical Center Rochester, New York, NY, USA. · Division of Internal Medicine and Rheumatology, Klinikum Bielefeld, Bielefeld, Germany. · Department of Dermatology, Medical University of Vienna, Vienna, Austria. · Department of Dermatology, Erasmus Medical Center, Erasmus University, Rotterdam, The Netherlands. · Department of Rheumatology, Klinikum Bielefeld, Bielefeld, Germany. · Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium. · Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. ·Ann Rheum Dis · Pubmed #28684559.

ABSTRACT: Therapeutic targets have been defined for axial and peripheral spondyloarthritis (SpA) in 2012, but the evidence for these recommendations was only of indirect nature. These recommendations were re-evaluated in light of new insights. Based on the results of a systematic literature review and expert opinion, a task force of rheumatologists, dermatologists, patients and a health professional developed an update of the 2012 recommendations. These underwent intensive discussions, on site voting and subsequent anonymous electronic voting on levels of agreement with each item. A set of 5 overarching principles and 11 recommendations were developed and voted on. Some items were present in the previous recommendations, while others were significantly changed or newly formulated. The 2017 task force arrived at a single set of recommendations for axial and peripheral SpA, including psoriatic arthritis (PsA). The most exhaustive discussions related to whether PsA should be assessed using unidimensional composite scores for its different domains or multidimensional scores that comprise multiple domains. This question was not resolved and constitutes an important research agenda. There was broad agreement, now better supported by data than in 2012, that remission/inactive disease and, alternatively, low/minimal disease activity are the principal targets for the treatment of PsA. As instruments to assess the patients on the path to the target, the Ankylosing Spondylitis Disease Activity Score (ASDAS) for axial SpA and the Disease Activity index for PSoriatic Arthritis (DAPSA) and Minimal Disease Activity (MDA) for PsA were recommended, although not supported by all. Shared decision-making between the clinician and the patient was seen as pivotal to the process. The task force defined the treatment target for SpA as remission or low disease activity and developed a large research agenda to further advance the field.

2 Guideline British Association of Dermatologists guidelines for biologic therapy for psoriasis 2017. 2017

Smith, C H / Jabbar-Lopez, Z K / Yiu, Z Z / Bale, T / Burden, A D / Coates, L C / Cruickshank, M / Hadoke, T / MacMahon, E / Murphy, R / Nelson-Piercy, C / Owen, C M / Parslew, R / Peleva, E / Pottinger, E / Samarasekera, E J / Stoddart, J / Strudwicke, C / Venning, V A / Warren, R B / Exton, L S / Mohd Mustapa, M F. ·St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, SE1 9RT, U.K. · The Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9NT, U.K. · British Dermatology Nursing Group representative, Aneurin Bevan Health Board, Wales, U.K. · Department of Dermatology, Royal Infirmary of Edinburgh, Edinburgh, EH3 9HA, U.K. · British Society for Rheumatology, Chapel Allerton Hospital, Leeds, LS7 4SA, U.K. · Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, U.K. · National Guideline Centre, Royal College of Physicians, London, NW1 4LE, U.K. · Patient representatives. · Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, SE1 9RT, U.K. · Department of Dermatology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, S10 2JF, U.K. · Women's Health Academic Centre, Guy's and St Thomas' NHS Foundation Trust, London, SE1 9RT, U.K. · Department of Dermatology, East Lancashire Hospitals NHS Trust, Burnley, BB10 2PQ, U.K. · Department of Dermatology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, L7 8XP, U.K. · Independent chair, Healthcare Quality Improvement Partnership, London, EC2Y 9AE, U.K. · Department of Dermatology, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 7LE, U.K. · British Association of Dermatologists, London, W1T 5HQ, U.K. ·Br J Dermatol · Pubmed #28513835.

ABSTRACT: -- No abstract --

3 Editorial Residents' corner December 2014. Residents' editorial choice: what's new this month? 2014

Matin, Rubeta N H / Martin-Gorgojo, Alejandro / Travassos, Ana Rita / Buder-Bakhaya, Kristina / Clayton, Helena / Nosbaum, Audrey. ·Department of Dermatology, Churchill Hospital, Old Road, Headington, Oxford, OX3 7LJ, United Kingdom. · Dermatology Department. General University Hospital Gregorio Marañon. Doctor Esquerdo 46, 28007, Madrid, Spain. · Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal; Dermatology Center, Hospital CUF Descobertas, Lisbon, Portugal. · Dermatology, Venereology, Allergology, University Hospital Wurzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany. · Department of Dermatology, University Hospital CHUV, Lausanne, Switzerland. · University of California, San Francisco, Department of Dermatology, 513 Parnassus Avenue HSW-518, San Francisco CA 94143-0511, United States. ·Eur J Dermatol · Pubmed #25672794.

ABSTRACT: -- No abstract --

4 Review Clinical management of psoriatic arthritis. 2018

Van den Bosch, Filip / Coates, Laura. ·Department of Rheumatology, Ghent University Hospital, Ghent, Belgium; VIB Center for Inflammation Research, Unit for Molecular Immunology and Inflammation, Department of Internal Medicine, Ghent University, Ghent, Belgium. Electronic address: filip.vandenbosch@ugent.be. · Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK. ·Lancet · Pubmed #29893227.

ABSTRACT: Psoriatic arthritis, or the broader term psoriatic disease, refers to an inflammatory disorder that affects multiple organs, including the skin and joints, and that also has related extra-articular manifestations and can have comorbidities. Patients with psoriatic disease have a substantial clinical burden. Early identification leading to timely diagnosis and treatment is crucial to prevent long-term structural damage and disability and the associated socioeconomic consequences. The increase in therapeutic options, such as disease-modifying anti-rheumatic drugs, both biological and targeted synthetic, has revolutionised the treatment of skin and joint disease, and has prompted clinicians to use the full clinical picture of an individual patient to make rational treatment decisions. Current research is also focused on treatment strategies, including treat to target, early remission-induction, and tapering.

5 Review Considerations for the definition of remission criteria in psoriatic arthritis. 2018

Mease, Philip J / Coates, Laura C. ·Swedish Medical Center, University of Washington, Seattle, United States of America. Electronic address: pmease@philipmease.com. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom. ·Semin Arthritis Rheum · Pubmed #29566966.

ABSTRACT: OBJECTIVES: Psoriatic arthritis (PsA) is an autoimmune disease that can cause progressive structural damage of the joints and irreversible disability. The potentially achievable results of biologic therapy for PsA has led to the view that disease remission should be the goal of treatment. However, the heterogeneity of disease manifestations and need for validated outcome measures makes defining remission in PsA challenging. This article evaluates proposed criteria for defining remission in PsA and discusses how these criteria can be applied in clinical practice. METHODS: A primary literature search was conducted in PubMed to identify articles discussing potential PsA treatment goals or targets, including minimal disease activity. English-language publications from the last 10 years were included in this assessment. RESULTS: There are 5 clinical domains in PsA that must be considered when evaluating remission: synovitis, enthesitis, dactylitis, spondylitis, and psoriasis/nail psoriasis. Due to variability in the completeness of remission and time to achieve remission with different therapies between these domains, remission should be measured clinically through a combination of objective measures, or a composite assessment tool. Composite measures are more efficient than unidimensional instruments in measuring remission, but remission rates differ between the available composite indices. CONCLUSION: Although the concept of remission as a treatment goal in PsA is gaining acceptance among rheumatologists, further work is necessary to develop a broadly acceptable definition of remission.

6 Review Current concepts and unmet needs in psoriatic arthritis. 2018

Mahmood, Farrouq / Coates, Laura C / Helliwell, Philip S. ·Clinical Research Fellow in Rheumatology, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK. · Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. · Leeds Institute of Rheumatic & Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK. p.helliwell@leeds.ac.uk. ·Clin Rheumatol · Pubmed #29134513.

ABSTRACT: Psoriatic arthritis is a chronic inflammatory arthritis that is part of the spondyloarthropathy group of rheumatic diseases and has associated co-morbidities. It can present with various clinical manifestations making diagnosis and treatment challenging, resulting in significant disability and reduced quality of life for patients. Whilst there have been advances in understanding the pathogenic mechanisms of the disease which have resulted in targeted therapies, there is still the need for further studies as some patients fail or are intolerant of current therapies. Better identification of early disease and knowledge of prognostic markers would enable clinicians to initiate appropriate therapy with the expectation that early aggressive treatment will minimise joint damage progression. Improved knowledge of the condition would also enable clinicians to better tailor specific treatment strategies for each of the various clinical domains in psoriatic arthritis.

7 Review Quantitative Evaluation of Biologic Therapy Options for Psoriasis: A Systematic Review and Network Meta-Analysis. 2017

Jabbar-Lopez, Zarif K / Yiu, Zenas Z N / Ward, Victoria / Exton, Lesley S / Mohd Mustapa, M Firouz / Samarasekera, Eleanor / Burden, A David / Murphy, Ruth / Owen, Caroline M / Parslew, Richard / Venning, Vanessa / Warren, Richard B / Smith, Catherine H. ·Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, UK. · Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK. · University College London Hospital, London, UK. · British Association of Dermatologists, London, UK. · National Guideline Centre, Royal College of Physicians, London, UK. · Department of Dermatology, Royal Infirmary of Edinburgh, Edinburgh, UK. · Sheffield University Teaching Hospitals and Sheffield Children's Hospitals, Sheffield, UK. · Department of Dermatology, East Lancashire Hospitals NHS Trust, Royal Blackburn Hospital, Blackburn, UK. · Department of Dermatology, Royal Liverpool and Broadgreen University Hospitals Trust, Liverpool, UK. · Department of Dermatology, Oxford University Hospitals Foundation Trust, Oxford, UK. · St John's Institute of Dermatology, Guy's and St. Thomas' NHS Foundation Trust, London, UK. Electronic address: catherine.smith@kcl.ac.uk. ·J Invest Dermatol · Pubmed #28457908.

ABSTRACT: Multiple biologic treatments are licensed for psoriasis. The lack of head-to-head randomized controlled trials makes choosing between them difficult for patients, clinicians, and guideline developers. To establish their relative efficacy and tolerability, we searched MEDLINE, PubMed, Embase, and Cochrane for randomized controlled trials of licensed biologic treatments for skin psoriasis. We performed a network meta-analysis to identify direct and indirect evidence comparing biologics with one another, methotrexate, or placebo. We combined this with hierarchical cluster analysis to consider multiple outcomes related to efficacy and tolerability in combination for each treatment. Study quality, heterogeneity, and inconsistency were evaluated. Direct comparisons from 41 randomized controlled trials (20,561 participants) were included. All included biologics were efficacious compared with placebo or methotrexate at 3-4 months. Overall, cluster analysis showed adalimumab, secukinumab, and ustekinumab were comparable in terms of high efficacy and tolerability. Ixekizumab and infliximab were differentiated by very high efficacy but poorer tolerability. The lack of longer term controlled data limited our analysis to short-term outcomes. Trial performance may not equate to real-world performance, and so results need to be considered alongside real-world, long-term safety and effectiveness data. These data suggest that it is possible to discriminate between biologics to inform clinical practice and decision making (PROSPERO 2015:CRD42015017538).

8 Review Measurement, Classification and Evaluation of Sleep Disturbance in Psoriasis: A Systematic Review. 2016

Henry, Alasdair L / Kyle, Simon D / Bhandari, Sahil / Chisholm, Anna / Griffiths, Christopher E M / Bundy, Christine. ·Centre for Dermatology Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom. · Manchester Centre for Health Psychology, University of Manchester, Manchester, United Kingdom. · Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom. · Manchester Medical School, University of Manchester, Manchester, United Kingdom. · Salford Royal NHS Foundation Trust, Salford, United Kingdom. ·PLoS One · Pubmed #27327082.

ABSTRACT: BACKGROUND: Psoriasis is a long-term immune-mediated inflammatory disorder mainly, but not only, affecting skin, and is associated with significant medical and psychological morbidity. Evidence suggests that sleep is disrupted in psoriasis, however high quality empirical evidence is lacking. Given the importance of sleep for health, characterisation of sleep disruption in psoriasis is an important goal. We therefore conducted a systematic review of the sleep-psoriasis literature. METHODS: Searches were conducted in Pubmed, SCOPUS and Web of Science from inception to May 2016. Studies were compared against inclusion/exclusion criteria and underwent a quality evaluation. Given the heterogeneity of studies, we conducted a narrative synthesis of the findings. RESULTS: Searches revealed 32 studies which met our predetermined inclusion/exclusion criteria. Whilst 93.7% of studies reported sleep disruption in this population, ranging from 0.05% to 85.4%, many had important methodological shortcomings. Over half of all quantitative studies (54.8%; 17/31) relied on non-validated measures, contributing to heterogeneity in study findings. In those that employed valid measures, assessing sleep was often not the primary objective. We frequently found the absence of adequate sample size calculations and poor statistical reporting. CONCLUSION: This review showed that in psoriasis, reported sleep rates of sleep disturbance varied substantially. Most studies lacked a hypothesis driven research question and/or failed to use validated measures of sleep. We were unable to draw firm conclusions about the precise prevalence and nature of sleep disturbance within the psoriasis population. We offer suggestions to help advance understanding of sleep disturbance in psoriasis.

9 Review Risk of Serious Infections in Patients with Psoriasis on Biologic Therapies: A Systematic Review and Meta-Analysis. 2016

Yiu, Zenas Z N / Exton, Lesley S / Jabbar-Lopez, Zarif / Mohd Mustapa, M Firouz / Samarasekera, Eleanor J / Burden, A David / Murphy, Ruth / Owen, Caroline M / Parslew, Richard / Venning, Vanessa / Ashcroft, Darren M / Griffiths, Christopher E M / Smith, Catherine H / Warren, Richard B. ·Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; Centre for Pharmacoepidemiology and Drug Safety, Manchester Pharmacy School, The University of Manchester, Manchester, UK. · British Association of Dermatologists, London, UK. · Department of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK. · National Clinical Guideline Centre, Royal College of Physicians of London, London, UK. · Department of Dermatology, Western Infirmary, Glasgow, UK. · Sheffield University Teaching Hospitals and Sheffield Children's Hospitals, Sheffield, UK. · Department of Dermatology, East Lancashire Hospitals NHS Trust, Royal Blackburn Hospital, Blackburn, Lancashire, UK. · Department of Dermatology, Royal Liverpool and Broadgreen University Hospitals Trust, Liverpool, UK. · Department of Dermatology, Oxford University Hospitals Foundation Trust, Oxford, UK. · Centre for Pharmacoepidemiology and Drug Safety, Manchester Pharmacy School, The University of Manchester, Manchester, UK. · Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK. · St John's Institute of Dermatology, Guy's and St. Thomas' NHS Foundation Trust, London, UK. Electronic address: catherine.smith@kcl.ac.uk. · Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK. Electronic address: richard.warren@manchester.ac.uk. ·J Invest Dermatol · Pubmed #27085754.

ABSTRACT: A comprehensive evaluation of the risk of serious infections in biologic therapies for psoriasis is lacking. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) and prospective cohort studies reporting serious infections in people taking any licensed biologic therapy for psoriasis compared with those taking placebo, nonbiologic therapy, or other biologic therapies. The quality of the studies was assessed using Grading of Recommendations Assessment, Development and Evaluation criteria. No significant heterogeneity was detected in data from 32 RCTs (n = 13,359 participants) and one cohort study (n = 4,993 participants). In adults, low- to very-low-quality RCT data showed no significant difference between any biologic therapy and placebo at weeks 12-16 (overall pooled Peto odds ratio = 0.71, 95% confidence interval = 0.36-1.41) and weeks 20-30 (odds ratio = 2.27, 95% confidence interval = 0.45-11.49). No significant differences were found in any of the other comparisons in underpowered RCT data. Prospective cohort study data of low quality suggests that only adalimumab (adjusted hazard ratio [adjHR] = 2.52, 95% confidence interval = 1.47-4.32) was associated with a significantly higher risk of serious infection compared with retinoid and/or phototherapy in adults. No association between biologic therapies and serious infections in patients with psoriasis who were eligible for RCTs was detected. Further observational studies are needed to inform the uncertainty around this risk in the real world.

10 Review Innate lymphoid cells and the skin. 2014

Salimi, Maryam / Ogg, Graham. ·Department of Medicine, MRC Human Immunology Unit, NIHR Biomedical Research Centre, Radcliffe University of Oxford, Oxford, UK. Graham.ogg@ndm.ox.ac.uk. ·BMC Dermatol · Pubmed #25427661.

ABSTRACT: Innate lymphoid cells are an emerging family of effector cells that contribute to lymphoid organogenesis, metabolism, tissue remodelling and protection against infections. They maintain homeostatic immunity at barrier surfaces such as lung, skin and gut (Nature 464:1367-1371, 2010, Nat Rev Immunol 13: 145-149, 2013). Several human and mouse studies suggest a role for innate lymphoid cells in inflammatory skin conditions including atopic eczema and psoriasis. Here we review the innate lymphoid cell family and discuss their function in the skin and during inflammation.

11 Review Ustekinumab for the treatment of psoriatic arthritis. 2014

Chandler, David John / Bewley, Anthony. ·Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, OX3 9DS, UK. ·Expert Rev Clin Pharmacol · Pubmed #24494794.

ABSTRACT: Psoriatic arthritis occurs commonly in those with psoriasis and is associated with progressive joint destruction, physical disability, reduced quality of life and increased mortality. For many patients the currently available treatment options including the anti-TNF treatments are inadequate. Recent data suggest that ustekinumab can provide an effective treatment option in these patients. We discuss the role of ustekinumab in the treatment of psoriatic arthritis and highlight areas requiring further work.

12 Review New developments in the management of psoriasis and psoriatic arthritis: a focus on apremilast. 2013

Palfreeman, Andrew C / McNamee, Kay E / McCann, Fiona E. ·The Kennedy Institute of Rheumatology, Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, London, UK. andrew.palfreeman@kennedy.ox.ac.uk ·Drug Des Devel Ther · Pubmed #23569359.

ABSTRACT: Psoriasis is a chronic inflammatory skin disease, most commonly resulting in the occurrence of red and silver scaly plaques. About 30% of psoriasis sufferers develop psoriatic arthritis (PsA), a disorder that presents with additional joint inflammation and other clinical features. At present, the most effective treatment for moderate and severe psoriasis and PsA are biologics such as antitumor necrosis factor alpha therapy. Biologics are costly and typically require repeated injections; hence, the development of novel, orally available, small molecular inhibitors that are less expensive to produce is highly desirable. The phosphodiesterase 4 inhibitor apremilast is a small molecular inhibitor that acts by increasing cyclic adenosine monophosphate levels, ultimately suppressing tumor necrosis alpha production. Apremilast has been tested in a number of psoriasis and PsA pilot and Phase II trials to evaluate its efficacy and safety. More recently, three larger double-blinded, and randomized multicenter studies demonstrate that apremilast is efficacious in the treatment of psoriasis and PsA, with significantly higher numbers of apremilast-treated patients achieving endpoints of a 75% reduction compared to baseline in Psoriasis Area and Severity Index (PASI-75) or American College of Rheumatology-20 scores, relative to placebo. This encouraging data, along with a tolerable incidence of mild to moderate adverse events, has led to the initiation of several large Phase III trials that aim to further validate apremilast as a treatment for psoriasis and PsA. Here, we provide an overview of the current treatments for psoriasis and PsA, and summarize the findings from multiple Phase II clinical trials where the effects of apremilast in the treatment of psoriasis and PsA patients have been investigated.

13 Review ERAP1 and ankylosing spondylitis. 2013

Keidel, Sarah / Chen, Liye / Pointon, Jennifer / Wordsworth, Paul. ·University of Oxford Institute of Musculoskeletal Sciences, Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, Windmill Road, Oxford OX3 7LD, UK. ·Curr Opin Immunol · Pubmed #23452840.

ABSTRACT: The strong genetic association of ERAP1 (endoplasmic reticulum aminopeptidase 1) with ankylosing spondylitis (AS), which is restricted to HLA-B27 positive cases, has profound pathogenetic implications. ERAP1 is involved in trimming peptides to optimal length for binding to HLA class 1 molecules, thereby not only affecting the stability and processing of HLA-B27 but also influencing the peptide repertoire presented to the immune system. This could have secondary effects on specific adaptive or autoimmune responses in AS. However, it appears increasingly likely that the pathogenic effect of ERAP1 may be mediated through effects on innate immunity, such as altering the interaction between HLA-B27 and immune receptors such as the killer immunoglobulin-like receptors (KIR) found on a range of innate immune cells or via the endoplasmic reticulum unfolded protein response. ERAP1 variants associated with reduced endopeptidase activity appear to be protective against AS, raising the possibility that ERAP1 inhibition could represent a future treatment strategy.

14 Clinical Trial Efficacy and safety of filgotinib, a selective Janus kinase 1 inhibitor, in patients with active psoriatic arthritis (EQUATOR): results from a randomised, placebo-controlled, phase 2 trial. 2018

Mease, Philip / Coates, Laura C / Helliwell, Philip S / Stanislavchuk, Mykola / Rychlewska-Hanczewska, Anna / Dudek, Anna / Abi-Saab, Walid / Tasset, Chantal / Meuleners, Luc / Harrison, Pille / Besuyen, Robin / Van der Aa, Annegret / Mozaffarian, Neelufar / Greer, Joy M / Kunder, Rebecca / Van den Bosch, Filip / Gladman, Dafna D. ·Swedish-Providence-St Joseph Health Systems, Seattle WA, USA; University of Washington, Seattle, WA, USA. Electronic address: pmease@philipmease.com. · Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK. · National Pirogov Memorial Medical University, Vinnytsya, Ukraine. · Ai Centrum Medyczne, Poznan, Poland. · Centrum Medyczne AMED, Warszawa, Poland. · Galapagos NV, Mechelen, Belgium. · Galapagos BV, Leiden, Netherlands. · Gilead Sciences, Foster City, CA, USA. · Ghent University Hospital, Ghent, Belgium; VIB-UGent Center for Inflammation Research, Ghent University, Ghent, Belgium. · University of Toronto and Krembil Research Institute, Toronto Western Hospital, Toronto, Canada. ·Lancet · Pubmed #30360969.

ABSTRACT: BACKGROUND: The Janus kinase 1 (JAK1) pathway has been implicated in the pathogenesis of psoriatic arthritis. We aimed to investigate the efficacy and safety of filgotinib, a selective JAK1 inhibitor, for the treatment of psoriatic arthritis. METHODS: The EQUATOR trial was a randomised, double-blind, placebo-controlled phase 2 trial that enrolled adults from 25 sites in seven countries (Belgium, Bulgaria, Czech Republic, Estonia, Poland, Spain, and Ukraine). Patients (aged ≥18 years) had active moderate-to-severe psoriatic arthritis (defined as at least five swollen joints and at least five tender joints) fulfilling Classification for psoriatic arthritis (CASPAR) criteria, active or a documented history of plaque psoriasis, and an insufficient response or intolerance to at least one conventional synthetic disease-modifying anti-rheumatic drug (csDMARD). Patients continued to take csDMARDs during the study if they had received this treatment for at least 12 weeks before screening and were on a stable dose for at least 4 weeks before baseline. Using an interactive web-based system, we randomly allocated patients (1:1) to filgotinib 200 mg or placebo orally once daily for 16 weeks (stratified by current use of csDMARDs and previous use of anti-tumour necrosis factor). Patients, study team, and sponsor were masked to treatment assignment. The primary endpoint was proportion of patients achieving 20% improvement in American College of Rheumatology response criteria (ACR20) at week 16 in the full analysis set (patients who received at least one dose of study drug), which was compared between groups with the Cochran-Mantel-Haenszel test and non-responder imputation method. This trial is registered with ClincalTrials.gov, number NCT03101670. FINDINGS: Between March 9, and Sept 27, 2017, 191 patients were screened and 131 were randomly allocated to treatment (65 to filgotinib and 66 to placebo). 60 (92%) patients in the filgotinib group and 64 (97%) patients in the placebo group completed the study; five patients (8%) in the filgotinib group and two patients (3%) in the placebo group discontinued treatment. 52 (80%) of 65 patients in the filgotinib group and 22 (33%) of 66 in the placebo group achieved ACR20 at week 16 (treatment difference 47% [95% CI 30·2-59·6], p<0·0001). 37 (57%) patients who received filgotinib and 39 (59%) patients who received placebo had at least one treatment-emergent adverse event. Six participants had an event that was grade 3 or worse. The most common events were nasopharyngitis and headache, occurring at similar proportions in each group. One serious treatment-emergent adverse event was reported in each group (pneumonia and hip fracture after a fall), one of which (pneumonia) was fatal in the filgotinib group. INTERPRETATION: Filgotinib is efficacious for the treatment of active psoriatic arthritis, and no new safety signals were identified. FUNDING: Galapagos and Gilead Sciences.

15 Clinical Trial Anti-tumour necrosis factor treatment increases circulating T helper type 17 cells similarly in different types of inflammatory arthritis. 2015

Hull, D N / Williams, R O / Pathan, E / Alzabin, S / Abraham, S / Taylor, P C. ·Department of Medicine, Imperial College London, UK. · Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK. · Epistem Ltd., Manchester, UK. · Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK. ·Clin Exp Immunol · Pubmed #25766640.

ABSTRACT: We investigated changes in circulating T helper type 17 (Th17) cells following anti-tumour necrosis factor (TNF) in rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) patients. Peripheral blood mononuclear cells (PBMC) were isolated from 25 RA, 15 AS and eight PsA patients at baseline 4 and 12 weeks after treatment, and Th17 cell frequencies were analysed using interleukin (IL)-17 enzyme-linked immunospot (ELISPOT) and flow cytometry. A significant increase in IL-17-producing cells was observed by ELISPOT in RA and AS patients at 12 weeks. Flow cytometry confirmed significant increases in CD4(+) IL-17(+) cells at 12 weeks in RA and AS and 4 weeks in PsA patients. Anti-TNF treatment increases circulating Th17 cells in three different diseases.

16 Article Prevalence of psoriatic arthritis in patients with psoriasis: A systematic review and meta-analysis of observational and clinical studies. 2019

Alinaghi, Farzad / Calov, Monika / Kristensen, Lars Erik / Gladman, Dafna D / Coates, Laura C / Jullien, Denis / Gottlieb, Alice B / Gisondi, Paolo / Wu, Jashin J / Thyssen, Jacob P / Egeberg, Alexander. ·Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark. · The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark. · Division of Rheumatology, Department of Medicine, University of Toronto, Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada. · Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom. · Department of Dermatology, Edouard Herriot Hospital, University Claude Bernard Lyon-1, University of Lyon, Lyon, France. · Department of Dermatology, New York Medical College, Metropolitan Hospital, New York, New York. · Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy. · Kaiser Permanente Los Angeles Medical Center, Department of Dermatology, Los Angeles, California. · Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark. Electronic address: alexander.egeberg@gmail.com. ·J Am Acad Dermatol · Pubmed #29928910.

ABSTRACT: BACKGROUND: Wide-ranging prevalence estimates of psoriatic arthritis (PsA) in patients with psoriasis have been reported. OBJECTIVES: To assess the prevalence and incidence of PsA in patients with psoriasis. METHODS: Two authors independently searched 3 databases for studies reporting on the prevalence or incidence of PsA in patients with psoriasis. A proportion meta-analysis was performed to calculate the pooled proportion estimates of PsA in patients with psoriasis. RESULTS: A total of 266 studies examining 976,408 patients with psoriasis were included. Overall, the pooled proportion (95% confidence interval [CI]) of PsA among patients with psoriasis was 19.7% (95% CI, 18.5%-20.9%). In children and adolescents (<18 years of age), the pooled prevalence was 3.3% (95% CI, 2.1%-4.9%). The PsA prevalence was 22.7% (95% CI, 20.6%-25.0%) in European patients with psoriasis, 21.5% (95% CI, 15.4%-28.2%) in South American patients with psoriasis, 19.5% (95% CI, 17.1%-22.1%) in North American patients with psoriasis, 15.5% (95% CI, 0.009%-51.5%) in African patients with psoriasis, and 14.0% (95% CI, 95% CI, 11.7%-16.3%) in Asian patients with psoriasis. The prevalence of PsA was 23.8% (95% CI, 20.1%-27.6%) in studies in which the Classification Criteria for Psoriatic Arthritis were applied. The incidence of PsA among patients with psoriasis ranged from 0.27 to 2.7 per 100 person-years. LIMITATIONS: Between-study heterogeneity may have affected the estimates. CONCLUSIONS: We found that 1 in 4 patients with psoriasis have PsA. With the growing recognition of the Classification Criteria for Psoriatic Arthritis, more homogenous and comparable prevalence estimates are expected to be reported.

17 Article GRAPPA 2017 Project Report. 2018

Callis Duffin, Kristina / FitzGerald, Oliver / Kavanaugh, Artie / Mease, Philip J / Merola, Joseph F / Ogdie, Alexis / O'Sullivan, Denis / Reddy, Soumya M / Ritchlin, Christopher T / Coates, Laura C. ·From the University of Utah, Salt Lake City, Utah; University of California at San Diego, La Jolla, California; Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington; Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; New York University School of Medicine, New York; Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, New York, USA; Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital; Conway Institute for Biomolecular Research, University College Dublin; Our Lady's Hospice and Care Services, Dublin, Ireland; Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK. · K. Callis Duffin, MD, University of Utah; O. FitzGerald, MD, FRCPI, FRCP(UK), Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital, and Conway Institute for Biomolecular Research, University College Dublin; A. Kavanaugh, MD, Professor of Medicine, University of California at San Diego; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine; J.F. Merola, Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital; A. Ogdie, MD, Assistant Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania; D. O'Sullivan, BE, Patient Research Partner, Our Lady's Hospice and Care Services; S. Reddy, MD, Assistant Professor of Medicine, New York University School of Medicine; C.T. Ritchlin, MD, MPH, Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center; L.C. Coates, MBChB, PhD, Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford. · From the University of Utah, Salt Lake City, Utah; University of California at San Diego, La Jolla, California; Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington; Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; New York University School of Medicine, New York; Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, New York, USA; Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital; Conway Institute for Biomolecular Research, University College Dublin; Our Lady's Hospice and Care Services, Dublin, Ireland; Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK. laura.coates@ndorms.ox.ac.uk. · K. Callis Duffin, MD, University of Utah; O. FitzGerald, MD, FRCPI, FRCP(UK), Newman Clinical Research Professor, Department of Rheumatology, St. Vincent's University Hospital, and Conway Institute for Biomolecular Research, University College Dublin; A. Kavanaugh, MD, Professor of Medicine, University of California at San Diego; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine; J.F. Merola, Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital; A. Ogdie, MD, Assistant Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania; D. O'Sullivan, BE, Patient Research Partner, Our Lady's Hospice and Care Services; S. Reddy, MD, Assistant Professor of Medicine, New York University School of Medicine; C.T. Ritchlin, MD, MPH, Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center; L.C. Coates, MBChB, PhD, Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford. laura.coates@ndorms.ox.ac.uk. ·J Rheumatol Suppl · Pubmed #29858355.

ABSTRACT: At the 2017 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), members received updates on several ongoing educational and research efforts. Among them were updates on GRAPPA's continued education efforts; GRAPPA's continued research efforts, including the Biomarker Project, a collaborative research effort to identify and study biomarkers of joint damage; treatment recommendations, including recommendations and core principles related to biosimilars; efforts to update GRAPPA's Website and to create a GRAPPA smart-phone application (app); and the Psoriasis and Psoriatic Arthritis Clinics Multicenter Advancement Network.

18 Article Report of the Skin Research Working Groups from the GRAPPA 2017 Annual Meeting. 2018

Gottlieb, Alice Bendix / Coates, Laura C / van Mens, Leonieke J J / Armstrong, April W / Merola, Joseph F. ·From the Department of Dermatology, New York Medical College, Metropolitan Hospital, New York, New York; Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Dermatology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Clinical Immunology and Rheumatology, Amsterdam Rheumatology and Immunology Center, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands. gottlieba@nychhc.org. · A.B. Gottlieb, MD, PhD, Professor of Dermatology, Department of Dermatology, New York Medical College, Metropolitan Hospital; L.C. Coates, MD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; L.J. van Mens, MD, Department of Clinical Immunology and Rheumatology, Amsterdam Rheumatology and Immunology Center, Academic Medical Center/University of Amsterdam; A.W. Armstrong, MD, MPH, Department of Dermatology, Keck School of Medicine, University of Southern California; J.F. Merola, MD, MMSc, Department of Dermatology, Harvard Medical School, Brigham and Women's Hospital. gottlieba@nychhc.org. · From the Department of Dermatology, New York Medical College, Metropolitan Hospital, New York, New York; Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Dermatology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Clinical Immunology and Rheumatology, Amsterdam Rheumatology and Immunology Center, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands. · A.B. Gottlieb, MD, PhD, Professor of Dermatology, Department of Dermatology, New York Medical College, Metropolitan Hospital; L.C. Coates, MD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; L.J. van Mens, MD, Department of Clinical Immunology and Rheumatology, Amsterdam Rheumatology and Immunology Center, Academic Medical Center/University of Amsterdam; A.W. Armstrong, MD, MPH, Department of Dermatology, Keck School of Medicine, University of Southern California; J.F. Merola, MD, MMSc, Department of Dermatology, Harvard Medical School, Brigham and Women's Hospital. ·J Rheumatol Suppl · Pubmed #29858353.

ABSTRACT: At the 2017 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), the International Dermatology Outcome Measures (IDEOM) psoriasis working group presented an overview of its cutaneous domain of psoriatic arthritis (PsA) projects. First, the group presented an overview of IDEOM's work to establish psoriasis outcome measures that satisfy the needs of all those involved. Second, the group discussed replacements for the Psoriasis Area and Severity Index (PASI) that can be used in clinical practice, including data that support the use of the physician's global assessment × body surface area measurement score as a PASI surrogate. Third, the group discussed the contribution of skin disease to composite measures of PsA. Last, the group summarized the National Psoriasis Foundation's efforts to establish treat-to-target strategies for psoriasis care.

19 Article The Benefits and Challenges of Setting Up a Longitudinal Psoriatic Arthritis Database. 2018

Gladman, Dafna D / Coates, Laura C / Jadon, Deepak R / Tillett, William / Mease, Philip J / Vis, Marijn. ·From the University of Toronto; Krembil Research Institute; Psoriatic Arthritis Program University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada; Department of Orthopedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford; Department of Rheumatology, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge; Royal National Hospital for Rheumatic Diseases; University of Bath, Bath, UK; Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington, USA; Department of Rheumatology, Erasmus Medical Center, Rotterdam, the Netherlands. dafna.gladman@utoronto.ca. · D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto, and Senior Scientist, Krembil Research Institute, and Director, Psoriatic Arthritis Program University Health Network, Toronto Western Hospital; L.C. Coates, MBChB, PhD, Department of Orthopedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford; D.R. Jadon, MBBCh, MRCP, PhD, Consultant Rheumatologist, Department of Rheumatology, Cambridge University Hospitals NHS Foundation Trust; W. Tillett, MBChB, PhD, Consultant Rheumatologist, Royal National Hospital for Rheumatic Diseases, and Senior Lecturer, University of Bath; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine; M. Vis, MD, Department of Rheumatology, Erasmus Medical Center, Rotterdam, the Netherlands. dafna.gladman@utoronto.ca. · From the University of Toronto; Krembil Research Institute; Psoriatic Arthritis Program University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada; Department of Orthopedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford; Department of Rheumatology, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge; Royal National Hospital for Rheumatic Diseases; University of Bath, Bath, UK; Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington, USA; Department of Rheumatology, Erasmus Medical Center, Rotterdam, the Netherlands. · D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto, and Senior Scientist, Krembil Research Institute, and Director, Psoriatic Arthritis Program University Health Network, Toronto Western Hospital; L.C. Coates, MBChB, PhD, Department of Orthopedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford; D.R. Jadon, MBBCh, MRCP, PhD, Consultant Rheumatologist, Department of Rheumatology, Cambridge University Hospitals NHS Foundation Trust; W. Tillett, MBChB, PhD, Consultant Rheumatologist, Royal National Hospital for Rheumatic Diseases, and Senior Lecturer, University of Bath; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine; M. Vis, MD, Department of Rheumatology, Erasmus Medical Center, Rotterdam, the Netherlands. ·J Rheumatol Suppl · Pubmed #29858349.

ABSTRACT: The members of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) have shown great interest in developing a common GRAPPA database. To address this interest, GRAPPA included a symposium at its 2017 annual meeting to examine the concepts of registries and databases. At this symposium, examples of existing databases were reviewed, and their challenges and achievements were discussed.

20 Article Content and Face Validity and Feasibility of 5 Candidate Instruments for Psoriatic Arthritis Randomized Controlled Trials: The PsA OMERACT Core Set Workshop at the GRAPPA 2017 Annual Meeting. 2018

Holland, Richard / Tillett, William / Ogdie, Alexis / Leung, Ying Y / Gladman, Dafna D / Callis Duffin, Kristina / Coates, Laura C / Mease, Philip J / Eder, Lihi / Strand, Vibeke / Elmamoun, Musaab / Højgaard, Pil / Chau, Jeffrey / de Wit, Maarten / Goel, Niti / Lindsay, Chris A / FitzGerald, Oliver / Shea, Bev / Beaton, Dorcas / Orbai, Ana-Maria. ·From the Royal Prince Alfred Hospital Medical Centre, Sydney, Australia; Royal National Hospital for Rheumatic Diseases, Bath, UK; University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Rheumatology and Immunology, Singapore General Hospital, Singapore; University of Toronto, Krembil Research Institute, Psoriatic Arthritis Program, University Health Network, Toronto, Ontario, Canada; Department of Dermatology, University of Utah, Salt Lake City, Utah, USA; University of Oxford, Oxford, UK; Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington, USA; Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada; Division of Immunology/Rheumatology, Stanford University, Palo Alto, California, USA; Department of Rheumatology, St. Vincents University Hospital and Conway Institute for Biomolecular Research, University College Dublin, Dublin, Ireland; The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark; Hong Kong Psoriatic Arthritis Association, Hong Kong, China; VU Medical Centre, Amsterdam, the Netherlands; IQVIA, Duke University School of Medicine, Durham, North Carolina, USA; School of Epidemiology, Public Health, and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada; Musculoskeletal Health and Outcomes Research, St. Michael's Hospital and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, and the Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. · R. Holland, MB ChB, Royal Prince Alfred Hospital Medical Centre; W. Tillett, BSc, MB ChB, PhD, MRCP, Royal National Hospital for Rheumatic Diseases; A. Ogdie, MD, MSCE, University of Pennsylvania; Y.Y. Leung, MB ChB, MD, Department of Rheumatology and Immunology, Singapore General Hospital, Singapore; D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto, Senior Scientist, Krembil Research Institute, Director, Psoriatic Arthritis Program, University Health Network; K. Callis Duffin, MD, MS, Department of Dermatology, University of Utah; L.C. Coates, MB ChB, PhD, University of Oxford; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine; L. Eder, MD, PhD, Women's College Research Institute, Women's College Hospital, University of Toronto; V. Strand, MD, Division of Immunology/Rheumatology, Stanford University; M. Elmamoun, MBBS, MRCPI, Department of Rheumatology, St. Vincents University Hospital and Conway Institute for Biomolecular Research, University College Dublin; P. Højgaard, MD, The Parker Institute, Bispebjerg and Frederiksberg Hospital; J. Chau, BA, MCS, Patient Research Partner, Hong Kong Psoriatic Arthritis Association; M. de Wit, PhD, Patient Research Partner, VU Medical Centre; N. Goel, MD, Patient Research Partner, IQVIA, Duke University School of Medicine; C.A. Lindsay, PharmD, Patient Research Partner; O. FitzGerald, MD, FRCPI, FRCP(UK), Newman Clinical Research Professor, Department of Rheumatology, St. Vincents University Hospital and Conway Institute for Biomolecular Research, University College Dublin; B. Shea, School of Epidemiology, Public Health, and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; D. Beaton, BScOT, PhD, Musculoskeletal Health and Outcomes Research, St. Michael's Hospital and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, and the Institute for Health Policy Management and Evaluation, University of Toronto; A.M. Orbai, MD, MHS, Division of Rheumatology, Johns Hopkins University School of Medicine. · From the Royal Prince Alfred Hospital Medical Centre, Sydney, Australia; Royal National Hospital for Rheumatic Diseases, Bath, UK; University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Rheumatology and Immunology, Singapore General Hospital, Singapore; University of Toronto, Krembil Research Institute, Psoriatic Arthritis Program, University Health Network, Toronto, Ontario, Canada; Department of Dermatology, University of Utah, Salt Lake City, Utah, USA; University of Oxford, Oxford, UK; Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington, USA; Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada; Division of Immunology/Rheumatology, Stanford University, Palo Alto, California, USA; Department of Rheumatology, St. Vincents University Hospital and Conway Institute for Biomolecular Research, University College Dublin, Dublin, Ireland; The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark; Hong Kong Psoriatic Arthritis Association, Hong Kong, China; VU Medical Centre, Amsterdam, the Netherlands; IQVIA, Duke University School of Medicine, Durham, North Carolina, USA; School of Epidemiology, Public Health, and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada; Musculoskeletal Health and Outcomes Research, St. Michael's Hospital and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, and the Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. aorbai1@jhmi.edu. · R. Holland, MB ChB, Royal Prince Alfred Hospital Medical Centre; W. Tillett, BSc, MB ChB, PhD, MRCP, Royal National Hospital for Rheumatic Diseases; A. Ogdie, MD, MSCE, University of Pennsylvania; Y.Y. Leung, MB ChB, MD, Department of Rheumatology and Immunology, Singapore General Hospital, Singapore; D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto, Senior Scientist, Krembil Research Institute, Director, Psoriatic Arthritis Program, University Health Network; K. Callis Duffin, MD, MS, Department of Dermatology, University of Utah; L.C. Coates, MB ChB, PhD, University of Oxford; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine; L. Eder, MD, PhD, Women's College Research Institute, Women's College Hospital, University of Toronto; V. Strand, MD, Division of Immunology/Rheumatology, Stanford University; M. Elmamoun, MBBS, MRCPI, Department of Rheumatology, St. Vincents University Hospital and Conway Institute for Biomolecular Research, University College Dublin; P. Højgaard, MD, The Parker Institute, Bispebjerg and Frederiksberg Hospital; J. Chau, BA, MCS, Patient Research Partner, Hong Kong Psoriatic Arthritis Association; M. de Wit, PhD, Patient Research Partner, VU Medical Centre; N. Goel, MD, Patient Research Partner, IQVIA, Duke University School of Medicine; C.A. Lindsay, PharmD, Patient Research Partner; O. FitzGerald, MD, FRCPI, FRCP(UK), Newman Clinical Research Professor, Department of Rheumatology, St. Vincents University Hospital and Conway Institute for Biomolecular Research, University College Dublin; B. Shea, School of Epidemiology, Public Health, and Preventive Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program; D. Beaton, BScOT, PhD, Musculoskeletal Health and Outcomes Research, St. Michael's Hospital and Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, and the Institute for Health Policy Management and Evaluation, University of Toronto; A.M. Orbai, MD, MHS, Division of Rheumatology, Johns Hopkins University School of Medicine. aorbai1@jhmi.edu. ·J Rheumatol Suppl · Pubmed #29858348.

ABSTRACT: The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)-Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis (PsA) Core Set working group is in the process of selecting core instruments for PsA clinical trials. During a 2-h workshop and breakout group discussions at the GRAPPA 2017 annual meeting in Amsterdam, the Netherlands, participants discussed the first set of candidate instruments to be taken through the OMERACT Filter 2.1 instrument selection process: 66/68 swollen/tender joint count (66/68JC), Spondyloarthritis Consortium of Canada (SPARCC) enthesitis index, patient's global assessment (GRAPPA and OMERACT formulations), Health Assessment Questionnaire-Disability Index (HAQ-DI), Psoriatic Arthritis Impact of Disease (PsAID) questionnaires 9 and 12, and Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue. Based on the assessment of domain match (content and face validity) and feasibility according to the OMERACT instrument selection criteria, the working group recommends continuing with appraisal of construct validity and discrimination for 66/68JC, SPARCC, PsAID 9 and 12, HAQ-DI, and FACIT-Fatigue. In addition, it recommends repeating the OMERACT Filter 2.1 process for patient global instruments because of insufficient votes. Additional sets of candidate instruments for the PsA core instrument set will be evaluated in a similar process.

21 Article Group for Research and Assessment of Psoriasis and Psoriatic Arthritis/Outcome Measures in Rheumatology Consensus-Based Recommendations and Research Agenda for Use of Composite Measures and Treatment Targets in Psoriatic Arthritis. 2018

Coates, Laura C / FitzGerald, Oliver / Merola, Joseph F / Smolen, Josef / van Mens, Leonieke J J / Bertheussen, Heidi / Boehncke, Wolf-Henning / Callis Duffin, Kristina / Campbell, Willemina / de Wit, Maarten / Gladman, Dafna / Gottlieb, Alice / James, Jana / Kavanaugh, Arthur / Kristensen, Lars Erik / Kvien, Tore K / Luger, Thomas / McHugh, Neil / Mease, Philip / Nash, Peter / Ogdie, Alexis / Rosen, Cheryl F / Strand, Vibeke / Tillett, William / Veale, Douglas J / Helliwell, Philip S. ·University of Leeds, Leeds, UK, and University of Oxford, Oxford, UK. · St. Vincent's University Hospital and University College Dublin, Dublin, Ireland. · Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. · Medical University of Vienna, Vienna, Austria. · Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands. · Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) , Oslo, Norway, and People with Arthritis/Rheumatism in Europe, Zurich, Switzerland. · Geneva University Hospital and Geneva University, Geneva, Switzerland. · University of Utah, Salt Lake City. · GRAPPA and Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada. · VU University Medical Centre and EMGO+ Research Institute, Amsterdam, The Netherlands. · University of Toronto and Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada. · New York Medical College, Valhalla, New York. · GRAPPA, Bath, UK. · University of California at San Diego. · Copenhagen University Hospital, Copenhagen, Denmark. · Diakonhjemmet Hospital, Oslo, Norway. · University Hospital Münster, Münster, Germany. · University of Bath, Bath, UK. · St. Joseph Health System, University of Washington, Seattle. · University of Queensland, Brisbane, Queensland, Australia. · University of Pennsylvania, Philadelphia. · Stanford University, Palo Alto, California. · Royal National Hospital for Rheumatic Diseases and University of Bath, Bath, UK. · University of Leeds, Leeds, UK. ·Arthritis Rheumatol · Pubmed #29193765.

ABSTRACT: OBJECTIVE: A meeting was convened by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) and Outcome Measures in Rheumatology (OMERACT) to further the development of consensus among physicians and patients regarding composite disease activity measures and targets in psoriatic arthritis (PsA). METHODS: Prior to the meeting, physicians and patients completed surveys on outcome measures. A consensus meeting of 26 rheumatologists, dermatologists, and patient research partners reviewed evidence on composite measures and potential treatment targets plus results of the surveys. The meeting consisted of plenary presentations, breakout sessions, and group discussions. International experts including members of GRAPPA and OMERACT were invited to the meeting, including the developers of all of the measures discussed. After discussions, participants voted on proposals for use, and consensus was established in a second survey. RESULTS: Survey results from 128 health care professionals and 139 patients were analyzed alongside a systematic literature review summarizing evidence. A weighted vote was cast for composite measures. For randomized controlled trials, the most popular measures were the PsA disease activity score (40 votes) and the GRAPPA composite index (28 votes). For clinical practice, the most popular measures were an average of scores on 3 visual analog scales (45 votes) and the disease activity in PsA score (26 votes). After discussion, there was no consensus on a composite measure. The group agreed that several composite measures could be used and that future studies should allow further validation and comparison. The group unanimously agreed that remission should be the ideal target, with minimal disease activity (MDA)/low disease activity as a feasible alternative. The target should include assessment of musculoskeletal disease, skin disease, and health-related quality of life. The group recommended a treatment target of very low disease activity (VLDA) or MDA. CONCLUSION: Consensus was not reached on a continuous measure of disease activity. In the interim, the group recommended several composites. Consensus was reached on a treatment target of VLDA/MDA. An extensive research agenda was composed and recommends that data on all PsA clinical domains be collected in ongoing studies.

22 Article Ideal target for psoriatic arthritis? Comparison of remission and low disease activity states in a real-life cohort. 2018

van Mens, Leonieke J J / van de Sande, Marleen G H / van Kuijk, Arno W R / Baeten, Dominique / Coates, Laura C. ·Clinical Immunology & Rheumatology, Amsterdam Rheumatology and Immunology Center, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands. · Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam, The Netherlands. · Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. ·Ann Rheum Dis · Pubmed #29080861.

ABSTRACT: BACKGROUND: Psoriatic arthritis (PsA) recommendations state that the target of treatment should be remission or low disease activity (LDA). We used a real-life dataset to compare different potential targets. METHODS: 250 patients with PsA considered in an acceptable disease state according to their rheumatologist were included. Targets for remission were the Disease Activity Index for Psoriatic Arthritis (DAPSA) and clinical DAPSA (cDAPSA) remission (≤4), very low disease activity (VLDA) and Psoriatic Arthritis Disease Activity Score ≤1.9. LDA targets analysed were the DAPSA ≤14, cDAPSA ≤13, minimal disease activity (MDA) and adjusted MDA targets: MDAjoints with both tender joint count (TJC) and swollen joint count (SJC) mandated, MDAskin (psoriasis area and severity index (PASI) mandated) and MDAjoints&skin with TJC, SJC and PASI mandated. RESULTS: Comparison of the several candidate targets demonstrates that VLDA is achieved by the lowest proportion of patients and includes patients with the lowest residual disease activity compared with the other remission targets. The modified MDA measures are the most stringent targets for LDA in terms of residual disease on joints, psoriasis and enthesitis within patients achieving the target. In both remission and LDA, the inclusion of C reactive protein did not show an added value. The exclusion of a skin domain, as in the DAPSA measures, resulted in negligence of skin disease and a negative impact on the quality of life in some patients. CONCLUSIONS: The different remission and LDA targets show us significant overlap between measures, but these measures targeting the same definition do differ in terms of allowance of residual disease. Inclusion of laboratory markers seems unnecessary, although exclusion of a skin domain may result in psoriasis not being assessed resulting in residual impactful skin disease.

23 Article C5a and C5aR are elevated in joints of rheumatoid and psoriatic arthritis patients, and C5aR blockade attenuates leukocyte migration to synovial fluid. 2017

Hornum, Lars / Hansen, Anker Jon / Tornehave, Ditte / Fjording, Marianne Scheel / Colmenero, Paula / Wätjen, Inger Falbe / Søe Nielsen, Niels Henrik / Bliddal, Henning / Bartels, Else Marie. ·Novo Nordisk A/S, Måløv, Denmark. · Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom. · The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Frederiksberg, Denmark. · Hand Section, Department of Orthopaedics, Herlev and Gentofte Hospital, Gentofte, Denmark. · Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. ·PLoS One · Pubmed #29220376.

ABSTRACT: Complement activation correlates to rheumatoid arthritis disease activity, and increased amounts of the complement split product C5a is observed in synovial fluids from rheumatoid arthritis patients. Blockade of C5a or its receptor (C5aR) is efficacious in several arthritis models. The aim of this study was to investigate the role of C5a and C5aR in human rheumatoid arthritis and psoriatic arthritis-both with respect to expression and function. Synovial fluid, blood and synovial samples were obtained from rheumatoid arthritis, psoriatic arthritis and osteoarthritis patients as a less inflammatory arthritis type, and blood from healthy subjects. Cells infiltrating synovial tissue were analysed by immunohistochemistry and flow cytometry. SF and blood were analysed for biomarkers by flow cytometry or ELISA. The effect of a blocking anti-human C5aR mAb on leukocyte migration was determined using a Boyden chamber. Appropriate statistical tests were applied for comparisons. C5aR+ cells were detected in most rheumatoid arthritis, in all psoriatic arthritis, but not in non-inflammatory control synovia. C5aR+ cells were primarily neutrophils and macrophages. C5aR+ macrophages were mainly found in lymphoid aggregates in close contact with T cells. C5a levels were increased in both rheumatoid arthritis and psoriatic arthritis synovial fluid compared to osteoarthritis, and in blood from rheumatoid arthritis compared to healthy subjects. Neutrophil and monocyte migration to rheumatoid arthritis synovial fluid was significantly inhibited by anti-C5aR. The data support that the C5a-C5aR axis may be driving the infiltration of inflammatory cells into the synovial fluid and synovium in both rheumatoid and psoriatic arthritis, and suggest that C5a or C5aR may be a promising treatment target in both diseases.

24 Article Re: Quantitative Evaluation of Biologic Therapy Options for Psoriasis: A Systematic Review and Network Meta-Analysis. 2017

Jabbar-Lopez, Zarif K / Yiu, Zenas Z N / Ward, Victoria / Exton, Lesley S / Mohd Mustapa, M Firouz / Samarasekera, Eleanor / Burden, A David / Murphy, Ruth / Owen, Caroline M / Parslew, Richard / Venning, Vanessa / Warren, Richard B / Smith, Catherine H. ·St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust & King's College, London, UK. · Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK. · University College London Hospital, London, UK. · British Association of Dermatologists, London, UK. · National Guideline Centre, Royal College of Physicians, London, UK. · Department of Dermatology, Royal Infirmary of Edinburgh, Edinburgh, UK. · Sheffield University Teaching Hospitals and Sheffield Children's' Hospitals, Sheffield, UK. · Department of Dermatology, East Lancashire Hospitals NHS Trust, Royal Blackburn Hospital, Blackburn, UK. · Department of Dermatology, Royal Liverpool and Broadgreen University Hospitals Trust. Liverpool, UK. · Department of Dermatology, Oxford University Hospitals Foundation Trust, Oxford, UK. · St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust & King's College, London, UK. Electronic address: catherine.smith@kcl.ac.uk. ·J Invest Dermatol · Pubmed #28864078.

ABSTRACT: -- No abstract --

25 Article Increased risk of herpes zoster in patients with psoriasis: A population-based retrospective cohort study. 2017

Tsai, Shin-Yi / Chen, Hsuan-Ju / Lio, Chon-Fu / Ho, Hui-Ping / Kuo, Chien-Feng / Jia, Xiaofeng / Chen, Chi / Chen, Yu-Tien / Chou, Yi-Ting / Yang, Tse-Yen / Sun, Fang-Ju / Shi, Leiyu. ·Department of Laboratory Medicine, Mackay Memorial Hospital, Taipei City, Taiwan. · Department of Medicine, Mackay Medical College, New Taipei City, Taiwan. · Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States. · Management Office for Health Data, China Medical University Hospital, Taichung City, Taiwan. · College of Medicine, China Medical University, Taichung City, Taiwan. · Centro Hospitalar Conde de São Januário, Macao. · Department of Infectious Disease, Mackay Memorial Hospital, Taipei City, Taiwan. · Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland, United States. · Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, United States. · Department of Psychiatry, University of Oxford, Oxford, United Kingdom. · Molecular and Genomic Epidemiology Center, China Medical University Hospital, Taichung City, Taiwan. · Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua County, Lugang Town, Taiwan. · Department of Medical Research, Mackay Memorial Hospital, Taipei City, Taiwan. · Mackay Junior College of Medicine, Nursing and Management, Taipei City, Taiwan. ·PLoS One · Pubmed #28829784.

ABSTRACT: OBJECTIVES: The risk of herpes zoster (HZ) between patients with psoriasis receiving and not receiving systemic therapy has received increasing attention. This study investigated the association of psoriasis with the risk of HZ. METHODS: We conducted a population-based retrospective cohort study by using the Taiwan National Health Insurance Research Database. The psoriasis cohort consisted of 4077 patients with newly diagnosed psoriasis between 2000 and 2006. Each patient with psoriasis was frequency-matched with four people without psoriasis, by sex, age and index year. (nonpsoriasis cohort; 16308 subjects). Patients who received systemic therapy were classified as having severe psoriasis, whereas those who did not receive systemic therapy were classified as having mild psoriasis. The Cox proportional hazards regression analysis was conducted to estimate the association between psoriasis and HZ risk. RESULTS: The overall incidence density rate of HZ in the psoriasis cohort than in the nonpsoriasis cohort (4.50 vs. 3.44 per 1,000 person-years), with a multivariable Cox proportional hazards model measured adjusted HR of 1.29 [95% confidence interval (CI) = 1.07-1.56]. In additional, compared with the nonpsoriasis cohort, the risk of HZ was higher in the severe psoriasis cohort than in the nonpsoriasis cohort (adjusted hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.15-2.27). The comparison between psoriasis and nonpsoriasis cohorts revealed a greatest magnitude risk of HZ in women (adjusted HR, 1.36; 95% CI, 1.04-1.79), study participants in the age group of 20-39 years (adjusted HR, 1.77; 95% CI, 1.17-2.66), and study participants without any comorbidities (adjusted HR, 1.37; 95% CI, 1.02-1.84). CONCLUSIONS: Our results suggest that psoriasis is associated with an increased risk of HZ, which involves differences in sex and age. Although systemic therapy may have a major role in the risk of HZ, the intrinsic factors of psoriasis cannot be excluded.

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