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Psoriasis: HELP
Articles from Utah
Based on 146 articles published since 2009
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These are the 146 published articles about Psoriasis that originated from Utah during 2009-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6
1 Guideline Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. 2019

Singh, Jasvinder A / Guyatt, Gordon / Ogdie, Alexis / Gladman, Dafna D / Deal, Chad / Deodhar, Atul / Dubreuil, Maureen / Dunham, Jonathan / Husni, M Elaine / Kenny, Sarah / Kwan-Morley, Jennifer / Lin, Janice / Marchetta, Paula / Mease, Philip J / Merola, Joseph F / Miner, Julie / Ritchlin, Christopher T / Siaton, Bernadette / Smith, Benjamin J / Van Voorhees, Abby S / Jonsson, Anna Helena / Shah, Amit Aakash / Sullivan, Nancy / Turgunbaev, Marat / Coates, Laura C / Gottlieb, Alice / Magrey, Marina / Nowell, W Benjamin / Orbai, Ana-Maria / Reddy, Soumya M / Scher, Jose U / Siegel, Evan / Siegel, Michael / Walsh, Jessica A / Turner, Amy S / Reston, James. ·University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama. · McMaster University, Hamilton, Ontario, Canada. · University of Pennsylvania, Philadelphia. · University of Toronto and Toronto Western Hospital, Toronto, Ontario, Canada. · Cleveland Clinic, Cleveland, Ohio. · Oregon Health & Science University, Portland. · Boston Medical Center, Boston, Massachusetts. · New York, New York. · Premier Orthopaedics, Malvern, Pennsylvania. · Stanford University, Stanford, California. · Concorde Medical Group, New York, New York. · Swedish-Providence Health Systems and University of Washington, Seattle, Washington. · Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. · Comprehensive Therapy Consultants and Therapy Steps, Roswell, Georgia. · University of Rochester Medical Center, Rochester, New York. · University of Maryland School of Medicine, Baltimore. · Florida State University College of Medicine School of Physician Assistant Practice, Tallahassee. · Eastern Virginia Medical School, Norfolk. · American College of Rheumatology, Atlanta, Georgia. · ECRI Institute, Plymouth Meeting, Pennsylvania. · University of Oxford, Oxford, UK. · New York Medical College at Metropolitan Hospital, New York, New York. · Case Western/MetroHealth, Cleveland, Ohio. · Global Healthy Living Foundation, Nyack, New York. · Johns Hopkins University, Baltimore, Maryland. · New York University School of Medicine, New York, New York. · Arthritis & Rheumatism Associates, Rockville, Maryland. · National Psoriasis Foundation, Portland, Oregon. · University of Utah and George E. Wahlen VeteranS Affairs Medical Center, Salt Lake City, Utah. ·Arthritis Rheumatol · Pubmed #30499246.

ABSTRACT: OBJECTIVE: To develop an evidence-based guideline for the pharmacologic and nonpharmacologic treatment of psoriatic arthritis (PsA), as a collaboration between the American College of Rheumatology (ACR) and the National Psoriasis Foundation (NPF). METHODS: We identified critical outcomes in PsA and clinically relevant PICO (population/intervention/comparator/outcomes) questions. A Literature Review Team performed a systematic literature review to summarize evidence supporting the benefits and harms of available pharmacologic and nonpharmacologic therapies for PsA. GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to rate the quality of the evidence. A voting panel, including rheumatologists, dermatologists, other health professionals, and patients, achieved consensus on the direction and the strength of the recommendations. RESULTS: The guideline covers the management of active PsA in patients who are treatment-naive and those who continue to have active PsA despite treatment, and addresses the use of oral small molecules, tumor necrosis factor inhibitors, interleukin-12/23 inhibitors (IL-12/23i), IL-17 inhibitors, CTLA4-Ig (abatacept), and a JAK inhibitor (tofacitinib). We also developed recommendations for psoriatic spondylitis, predominant enthesitis, and treatment in the presence of concomitant inflammatory bowel disease, diabetes, or serious infections. We formulated recommendations for a treat-to-target strategy, vaccinations, and nonpharmacologic therapies. Six percent of the recommendations were strong and 94% conditional, indicating the importance of active discussion between the health care provider and the patient to choose the optimal treatment. CONCLUSION: The 2018 ACR/NPF PsA guideline serves as a tool for health care providers and patients in the selection of appropriate therapy in common clinical scenarios. Best treatment decisions consider each individual patient situation. The guideline is not meant to be proscriptive and should not be used to limit treatment options for patients with PsA.

2 Guideline 2017 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty. 2017

Goodman, Susan M / Springer, Bryan / Guyatt, Gordon / Abdel, Matthew P / Dasa, Vinod / George, Michael / Gewurz-Singer, Ora / Giles, Jon T / Johnson, Beverly / Lee, Steve / Mandl, Lisa A / Mont, Michael A / Sculco, Peter / Sporer, Scott / Stryker, Louis / Turgunbaev, Marat / Brause, Barry / Chen, Antonia F / Gililland, Jeremy / Goodman, Mark / Hurley-Rosenblatt, Arlene / Kirou, Kyriakos / Losina, Elena / MacKenzie, Ronald / Michaud, Kaleb / Mikuls, Ted / Russell, Linda / Sah, Alexander / Miller, Amy S / Singh, Jasvinder A / Yates, Adolph. ·Susan M. Goodman, MD, Lisa A. Mandl, MD, MPH, Peter Sculco, MD, Barry Brause, MD, Kyriakos Kirou, MD, Ronald MacKenzie, MD, Linda Russell, MD: Hospital for Special Surgery/Weill Cornell Medicine, New York, New York. Electronic address: goodmans@hss.edu. · Bryan Springer, MD: OrthoCarolina Hip and Knee Center, Charlotte, North Carolina. · Gordon Guyatt, MD: McMaster University, Hamilton, Ontario, Canada. · Matthew P. Abdel, MD: Mayo Clinic, Rochester, Minnesota. · Vinod Dasa, MD: Louisiana State University, New Orleans. · Michael George, MD: University of Pennsylvania, Philadelphia. · Ora Gewurz-Singer, MD: University of Michigan, Ann Arbor. · Jon T. Giles, MD, MPH: Columbia University, New York, New York. · Beverly Johnson, MD: Albert Einstein College of Medicine, Bronx, New York. · Steve Lee, DO: Kaiser Permanente, Fontana, California. · Susan M. Goodman, MD, Lisa A. Mandl, MD, MPH, Peter Sculco, MD, Barry Brause, MD, Kyriakos Kirou, MD, Ronald MacKenzie, MD, Linda Russell, MD: Hospital for Special Surgery/Weill Cornell Medicine, New York, New York. · Michael A. Mont, MD: Cleveland Clinic, Cleveland, Ohio. · Scott Sporer, MD: Midwest Orthopaedics at Rush, Chicago, Illinois. · Louis Stryker, MD: University of Texas Medical Branch, Galveston. · Marat Turgunbaev, MD, MPH, Amy S. Miller: American College of Rheumatology, Atlanta, Georgia. · Antonia F. Chen, MD, MBA: Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. · Jeremy Gililland, MD: University of Utah, Salt Lake City. · Mark Goodman, MD, Adolph Yates, MD: University of Pittsburgh, Pittsburgh, Pennsylvania. · Arlene Hurley-Rosenblatt, ANP: Rockefeller University, New York, New York. · Elena Losina, PhD: Brigham and Women's Hospital, Boston, Massachusetts. · Kaleb Michaud, PhD: National Data Bank for Rheumatic Diseases, Wichita, Kansas and University of Nebraska Medical Center, Omaha. · Ted Mikuls, MD, MSPH: University of Nebraska Medical Center, Omaha. · Alexander Sah, MD: Dearborn-Sah Institute for Joint Restoration, Fremont, California. · Jasvinder A. Singh, MBBS, MPH: University of Alabama at Birmingham. ·J Arthroplasty · Pubmed #28629905.

ABSTRACT: OBJECTIVE: This collaboration between the American College of Rheumatology and the American Association of Hip and Knee Surgeons developed an evidence-based guideline for the perioperative management of antirheumatic drug therapy for adults with rheumatoid arthritis (RA), spondyloarthritis (SpA) including ankylosing spondylitis and psoriatic arthritis, juvenile idiopathic arthritis (JIA), or systemic lupus erythematosus (SLE) undergoing elective total hip (THA) or total knee arthroplasty (TKA). METHODS: A panel of rheumatologists, orthopedic surgeons specializing in hip and knee arthroplasty, and methodologists was convened to construct the key clinical questions to be answered in the guideline. A multi-step systematic literature review was then conducted, from which evidence was synthesized for continuing versus withholding antirheumatic drug therapy and for optimal glucocorticoid management in the perioperative period. A Patient Panel was convened to determine patient values and preferences, and the Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of evidence and the strength of recommendations, using a group consensus process through a convened Voting Panel of rheumatologists and orthopedic surgeons. The strength of the recommendation reflects the degree of certainty that benefits outweigh harms of the intervention, or vice versa, considering the quality of available evidence and the variability in patient values and preferences. RESULTS: The guideline addresses the perioperative use of antirheumatic drug therapy including traditional disease-modifying antirheumatic drugs, biologic agents, tofacitinib, and glucocorticoids in adults with RA, SpA, JIA, or SLE who are undergoing elective THA or TKA. It provides recommendations regarding when to continue, when to withhold, and when to restart these medications, and the optimal perioperative dosing of glucocorticoids. The guideline includes 7 recommendations, all of which are conditional and based on low- or moderate-quality evidence. CONCLUSION: This guideline should help decision-making by clinicians and patients regarding perioperative antirheumatic medication management at the time of elective THA or TKA. These conditional recommendations reflect the paucity of high-quality direct randomized controlled trial data.

3 Guideline 2017 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty. 2017

Goodman, Susan M / Springer, Bryan / Guyatt, Gordon / Abdel, Matthew P / Dasa, Vinod / George, Michael / Gewurz-Singer, Ora / Giles, Jon T / Johnson, Beverly / Lee, Steve / Mandl, Lisa A / Mont, Michael A / Sculco, Peter / Sporer, Scott / Stryker, Louis / Turgunbaev, Marat / Brause, Barry / Chen, Antonia F / Gililland, Jeremy / Goodman, Mark / Hurley-Rosenblatt, Arlene / Kirou, Kyriakos / Losina, Elena / MacKenzie, Ronald / Michaud, Kaleb / Mikuls, Ted / Russell, Linda / Sah, Alexander / Miller, Amy S / Singh, Jasvinder A / Yates, Adolph. ·Hospital for Special Surgery/Weill Cornell Medicine, New York, New York. · OrthoCarolina Hip and Knee Center, Charlotte, North Carolina. · McMaster University, Hamilton, Ontario, Canada. · Mayo Clinic, Rochester, Minnesota. · Louisiana State University, New Orleans. · University of Pennsylvania, Philadelphia. · University of Michigan, Ann Arbor. · Columbia University, New York, New York. · Albert Einstein College of Medicine, Bronx, New York. · Kaiser Permanente, Fontana, California. · Cleveland Clinic, Cleveland, Ohio. · Midwest Orthopaedics at Rush, Chicago, Illinois. · University of Texas Medical Branch, Galveston. · American College of Rheumatology, Atlanta, Georgia. · Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. · University of Utah, Salt Lake City. · University of Pittsburgh, Pittsburgh, Pennsylvania. · Rockefeller University, New York, New York. · Brigham and Women's Hospital, Boston, Massachusetts. · National Data Bank for Rheumatic Diseases, Wichita, Kansas, and University of Nebraska Medical Center, Omaha. · University of Nebraska Medical Center, Omaha. · Dearborn-Sah Institute for Joint Restoration, Fremont, California. · University of Alabama at Birmingham. ·Arthritis Rheumatol · Pubmed #28620948.

ABSTRACT: OBJECTIVE: This collaboration between the American College of Rheumatology and the American Association of Hip and Knee Surgeons developed an evidence-based guideline for the perioperative management of antirheumatic drug therapy for adults with rheumatoid arthritis (RA), spondyloarthritis (SpA) including ankylosing spondylitis and psoriatic arthritis, juvenile idiopathic arthritis (JIA), or systemic lupus erythematosus (SLE) undergoing elective total hip (THA) or total knee arthroplasty (TKA). METHODS: A panel of rheumatologists, orthopedic surgeons specializing in hip and knee arthroplasty, and methodologists was convened to construct the key clinical questions to be answered in the guideline. A multi-step systematic literature review was then conducted, from which evidence was synthesized for continuing versus withholding antirheumatic drug therapy and for optimal glucocorticoid management in the perioperative period. A Patient Panel was convened to determine patient values and preferences, and the Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of evidence and the strength of recommendations, using a group consensus process through a convened Voting Panel of rheumatologists and orthopedic surgeons. The strength of the recommendation reflects the degree of certainty that benefits outweigh harms of the intervention, or vice versa, considering the quality of available evidence and the variability in patient values and preferences. RESULTS: The guideline addresses the perioperative use of antirheumatic drug therapy including traditional disease-modifying antirheumatic drugs, biologic agents, tofacitinib, and glucocorticoids in adults with RA, SpA, JIA, or SLE who are undergoing elective THA or TKA. It provides recommendations regarding when to continue, when to withhold, and when to restart these medications, and the optimal perioperative dosing of glucocorticoids. The guideline includes 7 recommendations, all of which are conditional and based on low- or moderate-quality evidence. CONCLUSION: This guideline should help decision-making by clinicians and patients regarding perioperative antirheumatic medication management at the time of elective THA or TKA. These conditional recommendations reflect the paucity of high-quality direct randomized controlled trial data.

4 Review Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. 2019

Singh, Jasvinder A / Guyatt, Gordon / Ogdie, Alexis / Gladman, Dafna D / Deal, Chad / Deodhar, Atul / Dubreuil, Maureen / Dunham, Jonathan / Husni, M Elaine / Kenny, Sarah / Kwan-Morley, Jennifer / Lin, Janice / Marchetta, Paula / Mease, Philip J / Merola, Joseph F / Miner, Julie / Ritchlin, Christopher T / Siaton, Bernadette / Smith, Benjamin J / Van Voorhees, Abby S / Jonsson, Anna Helena / Shah, Amit Aakash / Sullivan, Nancy / Turgunbaev, Marat / Coates, Laura C / Gottlieb, Alice / Magrey, Marina / Nowell, W Benjamin / Orbai, Ana-Maria / Reddy, Soumya M / Scher, Jose U / Siegel, Evan / Siegel, Michael / Walsh, Jessica A / Turner, Amy S / Reston, James. ·University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama. · McMaster University, Hamilton, Ontario, Canada. · University of Pennsylvania, Philadelphia. · University of Toronto and Toronto Western Hospital, Toronto, Ontario, Canada. · Cleveland Clinic, Cleveland, Ohio. · Oregon Health & Science University, Portland. · Boston Medical Center, Boston, Massachusetts. · New York, New York. · Premier Orthopaedics, Malvern, Pennsylvania. · Stanford University, Stanford, California. · Concorde Medical Group, New York, New York. · Swedish-Providence Health Systems and University of Washington, Seattle, Washington. · Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. · Comprehensive Therapy Consultants and Therapy Steps, Roswell, Georgia. · University of Rochester Medical Center, Rochester, New York. · University of Maryland School of Medicine, Baltimore. · Florida State University College of Medicine School of Physician Assistant Practice, Tallahassee. · Eastern Virginia Medical School, Norfolk. · American College of Rheumatology, Atlanta, Georgia. · ECRI Institute, Plymouth Meeting, Pennsylvania. · University of Oxford, Oxford, UK. · New York Medical College at Metropolitan Hospital, New York, New York. · Case Western/MetroHealth, Cleveland, Ohio. · Global Healthy Living Foundation, Nyack, New York. · Johns Hopkins University, Baltimore, Maryland. · New York University School of Medicine, New York, New York. · Arthritis & Rheumatism Associates, Rockville, Maryland. · National Psoriasis Foundation, Portland, Oregon. · University of Utah and George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, Utah. ·Arthritis Care Res (Hoboken) · Pubmed #30499259.

ABSTRACT: OBJECTIVE: To develop an evidence-based guideline for the pharmacologic and nonpharmacologic treatment of psoriatic arthritis (PsA), as a collaboration between the American College of Rheumatology (ACR) and the National Psoriasis Foundation (NPF). METHODS: We identified critical outcomes in PsA and clinically relevant PICO (population/intervention/comparator/outcomes) questions. A Literature Review Team performed a systematic literature review to summarize evidence supporting the benefits and harms of available pharmacologic and nonpharmacologic therapies for PsA. GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to rate the quality of the evidence. A voting panel, including rheumatologists, dermatologists, other health professionals, and patients, achieved consensus on the direction and the strength of the recommendations. RESULTS: The guideline covers the management of active PsA in patients who are treatment-naive and those who continue to have active PsA despite treatment, and addresses the use of oral small molecules, tumor necrosis factor inhibitors, interleukin-12/23 inhibitors (IL-12/23i), IL-17 inhibitors, CTLA4-Ig (abatacept), and a JAK inhibitor (tofacitinib). We also developed recommendations for psoriatic spondylitis, predominant enthesitis, and treatment in the presence of concomitant inflammatory bowel disease, diabetes, or serious infections. We formulated recommendations for a treat-to-target strategy, vaccinations, and nonpharmacologic therapies. Six percent of the recommendations were strong and 94% conditional, indicating the importance of active discussion between the health care provider and the patient to choose the optimal treatment. CONCLUSION: The 2018 ACR/NPF PsA guideline serves as a tool for health care providers and patients in the selection of appropriate therapy in common clinical scenarios. Best treatment decisions consider each individual patient situation. The guideline is not meant to be proscriptive and should not be used to limit treatment options for patients with PsA.

5 Review Dactylitis: A hallmark of psoriatic arthritis. 2018

Kaeley, Gurjit S / Eder, Lihi / Aydin, Sibel Z / Gutierrez, Marwin / Bakewell, Catherine. ·University of Florida College of Medicine, 653-1 West 8th St., LRC 2nd Floor L-14, Jacksonville, FL 32209. Electronic address: Gurjit.Kaeley@jax.ufl.edu. · Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Canada. · University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. · Division of Musculoskeletal and Rheumatic Diseases, Instituto Nacional de Rehabilitación, Mexico City, Mexico. · Intermountain Healthcare, Salt Lake City, UT. ·Semin Arthritis Rheum · Pubmed #29573849.

ABSTRACT: OBJECTIVE: Dactylitis-long considered a hallmark clinical feature of psoriatic arthritis (PsA)-occurs in 16-49% of patients with PsA. In this review, we discuss the pathology of dactylitis in PsA and clinical and imaging tools used to diagnose and monitor dactylitis. METHODS: PubMed literature searches were conducted using the terms psoriatic arthritis, dactylitis, pathology, imaging, ultrasound, magnetic resonance imaging, clinical, and indices. Articles were deemed relevant if they provided insight into the pathology, diagnosis, and/or monitoring of dactylitis in PsA, or if they discussed clinical or imaging indices used to assess dactylitis. RESULTS: Dactylitis in PsA often occurs asymmetrically, involves the feet more than the hands, and affects multiple digits simultaneously. Although dactylitis can be assessed clinically, imaging (radiography, ultrasound, magnetic resonance imaging, and bone scintigraphy) has provided key insights by documenting the various anatomic targets affected. Although inflammation can occur in most of the digital compartments, the nail has not been as well studied in dactylitic digits. Outcome measures for dactylitis range from dichotomous documentation to the Leeds dactylometer. Imaging outcome tools utilizing magnetic resonance imaging or ultrasound are under development. CONCLUSION: Dactylitis, which is associated with more erosive forms of PsA, is often the inaugural feature of PsA and may be the only feature for months to years. Early diagnosis and treatment of PsA favors better outcomes, possibly mitigating radiographic progression and destructive changes. Ultrasound and magnetic resonance imaging are useful tools that have not only shed light on the diverse tissues affected in dactylitis but can also be used to document ongoing inflammation. Ultrasound imaging dactylitis scores are being developed that will assist in diagnosing and documenting which compartments optimally respond to various treatment modalities.

6 Review Enthesitis: A hallmark of psoriatic arthritis. 2018

Kaeley, Gurjit S / Eder, Lihi / Aydin, Sibel Z / Gutierrez, Marwin / Bakewell, Catherine. ·Division of Rheumatology, University of Florida College of Medicine, Jacksonville, 653-1 West 8th St., LRC 2nd Floor L-14, Jacksonville, FL, 32209. Electronic address: Gurjit.Kaeley@jax.ufl.edu. · Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Canada. · University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. · Division of Musculoskeletal and Rheumatic Diseases, Instituto Nacional de Rehabilitación, Mexico City, Mexico. · Intermountain Healthcare, Salt Lake City, UT. ·Semin Arthritis Rheum · Pubmed #29429762.

ABSTRACT: OBJECTIVE: To describe the growing importance of enthesitis in patients with psoriatic arthritis (PsA) and discuss the advantages and disadvantages of clinical and imaging methods currently used to assess enthesitis. METHODS: PubMed literature searches were conducted using the terms psoriatic arthritis, entheses, enthesitis, pathology, imaging, ultrasound, magnetic resonance imaging, clinical, and indices. Articles were deemed relevant if they provided insight into the pathology, monitoring, and/or diagnosis of enthesitis in PsA, or if they discussed clinical or imaging indices used to assess enthesitis. RESULTS: Enthesitis is an early manifestation of PsA that is associated with increased disease activity and reduced quality of life. A variety of clinical indices exist to assess enthesitis in PsA; however, the Leeds Enthesitis Index and Maastricht Ankylosing Spondylitis Enthesitis Score index have been the most frequently used indices in recent clinical trials. Limitations of these indices include an inability to discern structural involvement, risk of missing subclinical enthesitis, and lack of sensitivity in detecting enthesitis, especially in patients with central sensitization and/or pain amplification. Such limitations have led to the emergent importance of imaging techniques in the assessment of enthesitis. Although there have been recent advances in magnetic resonance imaging, ultrasound (US) appears to be the preferred method for detecting enthesitis because it allows for accurate assessment of the soft-tissue components of entheses and also for new bone formation. Hypoechogenicity, increased thickness of tendon insertion, calcifications, enthesophytes, erosions, and Doppler activity have been identified as important US characteristics of enthesitis. CONCLUSION: Enthesitis is thought to be integrally involved in the pathogenesis of PsA and is associated with worse prognostic outcomes in patients with PsA. A validated US index with entheses that are less confounded by mechanical factors and obesity would be the most effective measure of enthesitis in PsA. As imaging techniques continue to advance, our understanding of enthesitis and its involvement in PsA will also improve.

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

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

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

8 Review The Challenge of Managing Psoriasis: Unmet Medical Needs and Stakeholder Perspectives. 2016

Feldman, Steven R / Goffe, Bernard / Rice, Gary / Mitchell, Matthew / Kaur, Mandeep / Robertson, Debbie / Sierka, Debra / Bourret, Jeffrey A / Evans, Tamara S / Gottlieb, Alice. ·Professor of Dermatology, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC. · Dermatologist, Dermatology Associates, and Division of Dermatology, University of Washington, Seattle. · Senior Vice President, Diplomat Specialty Pharmacy, Flint, MI. · Director, Pharmacy Services, SelectHealth, Murray, UT. · Senior Medical Director, Pfizer, Collegeville, PA. · Senior Director of Medical Affairs, Pfizer. · Director of Medical Affairs, Pfizer. · Senior Director, North America Medical Affairs, and Medical Lead, Specialty Payer & Channel Customer Strategy, Pfizer. · Field Medical Director, Pfizer, Indianapolis, IN. · Professor of Dermatology, Department of Dermatology, New York Medical College, Valhalla, NY. ·Am Health Drug Benefits · Pubmed #28465778.

ABSTRACT: BACKGROUND: Psoriasis is a debilitating chronic inflammatory autoimmune disease affecting approximately 7.4 million adults in the United States. Plaque psoriasis is the most common form, affecting 80% to 90% of patients. OBJECTIVES: To describe the impact and challenges that psoriasis presents for various stakeholders, and to provide nondermatologist healthcare decision makers with information to enhance their contributions to drug and pharmacy benefit design discussions. DISCUSSION: Psoriasis carries an increased risk for early mortality and an increased prevalence of comorbidities, including psoriatic arthritis, cardiovascular disease, and diabetes. It is also associated with anxiety, depression, and social isolation, and can negatively impact patients' relationships, productivity, and careers. The physical, psychologic, social, and economic impact of psoriasis, plus the associated stigma, result in cumulative impairment over a patient's lifetime. The current treatments for moderate-to-severe psoriasis include topical therapy, phototherapy, and systemic drugs (nonbiologic and biologic); however, patient satisfaction remains low, combination therapy and treatment switching are common, and many patients remain untreated or undertreated. Clinicians should consider the patient holistically, and should select treatment based on a range of factors, including disease severity (with physical and psychosocial manifestations), susceptibility to cumulative life-course impairment (considering personality, behavior, and cognition), comorbidities, concomitant medication, and patient preference. It is estimated that the total annual direct cost of treating psoriasis in the United States in 2015 exceeded $12.2 billion. CONCLUSION: Psoriasis is a complex disease, and appropriate management is correspondingly complex. Newer psoriasis treatments provide improved efficacy and safety versus traditional treatments, but challenges remain in ensuring patients access to these medications. An improved understanding of the barriers to appropriate treatment is needed, as well as clear and accessible information for payers and clinicians on current treatment options, to ensure that decision makers can control costs while providing patients with optimal care.

9 Review microRNAs in Psoriasis. 2016

Hawkes, Jason E / Nguyen, Giang Huong / Fujita, Mayumi / Florell, Scott R / Callis Duffin, Kristina / Krueger, Gerald G / O'Connell, Ryan M. ·Department of Dermatology, University of Utah, Salt Lake City, Utah, USA. · Department of Dermatology, University of Colorado, Aurora, Colorado, USA. · Department of Pathology, University of Utah, Salt Lake City, Utah, USA. Electronic address: ryan.oconnell@path.utah.edu. ·J Invest Dermatol · Pubmed #26802234.

ABSTRACT: Psoriasis is a chronic inflammatory skin condition resulting from a complex interplay among the immune system, keratinocytes, susceptibility genes, and environmental factors. However, the pathogenesis of psoriasis is not completely elucidated. microRNAs represent a promising class of small, noncoding RNA molecules that function to regulate gene expression. Although microRNA research in psoriasis and dermatology is still relatively new, evidence is rapidly accumulating for the role of microRNAs in the pathogenesis of psoriasis and other chronic inflammatory conditions. In this article, we present a comprehensive review of what is known about microRNAs and their role in the pathogenesis of psoriasis.

10 Review FOCUS ON PSORIASIS: A REPORT FROM THE 73RD ANNUAL MEETING OF THE AMERICAN ACADEMY OF DERMATOLOGYPsoriasis-related topics included targeted therapies, safety of biologies, comorbidities. 2015

Donigan, Jessica M. ·Contributing writer Dr. Jessica Donigan recently completed a one-year clinical research fellowship under the supervision of Dr. Alexa Kimball at the Massachusetts General Hospital and is now a first-year dermatology resident at the University of Utah. She earned a Bachelor of Science degree in environmental science from the University of Redlands and received her Doctor of Medicine degree from the University of Hawaii John A. Burns School of Medicine. ·J Clin Aesthet Dermatol · Pubmed #26240675.

ABSTRACT: -- No abstract --

11 Review Effect of tonsillectomy on psoriasis: a systematic review. 2015

Rachakonda, Tara D / Dhillon, Jaskaran S / Florek, Aleksandra G / Armstrong, April W. ·Department of Internal Medicine, University of Utah, Salt Lake City, Utah. · Department of Dermatology, University of California at Davis School of Medicine, Sacramento, California. · Department of Dermatology, University of Colorado at Denver, Anschutz Medical Campus, Aurora, Colorado. · Department of Dermatology, University of Colorado at Denver, Anschutz Medical Campus, Aurora, Colorado. Electronic address: aprilarmstrong@post.harvard.edu. ·J Am Acad Dermatol · Pubmed #25455609.

ABSTRACT: BACKGROUND: Streptococcal infection is associated with psoriasis onset in some patients. Whether tonsillectomy decreases psoriasis symptoms requires a systematic review of the literature. OBJECTIVE: We sought to determine whether tonsillectomy reduces psoriasis severity through a comprehensive search of over 50 years of literature. METHODS: We searched MEDLINE, CINAHL, Cochrane, EMBASE, Web of Science, and OVID databases (from August 1, 1960, to September 12, 2013) and performed a manual search of selected references. We identified observational studies and clinical trials examining psoriasis after tonsillectomy. RESULTS: We included data from 20 articles from the last 53 years with 545 patients with psoriasis who were evaluated for or underwent tonsillectomy. Of 410 reported cases of patients with psoriasis who underwent tonsillectomy, 290 experienced improvement in their psoriasis. Although some patients who underwent tonsillectomy experienced sustained improvement in psoriasis, others experienced psoriasis relapse after the procedure. LIMITATIONS: Fifteen of 20 publications were case reports or series that lacked control groups. Publication bias favoring reporting improved cases needs to be considered. CONCLUSION: Tonsillectomy may be a potential option for patients with recalcitrant psoriasis associated with episodes of tonsillitis. Studies with long-term follow-up are warranted to determine more clearly the extent and persistence of benefit of tonsillectomy in psoriasis.

12 Review Definitions and outcome measures for mucous membrane pemphigoid: recommendations of an international panel of experts. 2015

Murrell, Dedee F / Marinovic, Branka / Caux, Frederic / Prost, Catherine / Ahmed, Razzaque / Wozniak, Katarzyna / Amagai, Masayuki / Bauer, Johann / Beissert, Stefan / Borradori, Luca / Culton, Donna / Fairley, Janet A / Fivenson, David / Jonkman, Marcel F / Marinkovich, M Peter / Woodley, David / Zone, John / Aoki, Valeria / Bernard, Philippe / Bruckner-Tuderman, Leena / Cianchini, Giuseppe / Venning, Vanessa / Diaz, Luis / Eming, Rudiger / Grando, Sergei A / Hall, Russell P / Hashimoto, Takashi / Herrero-González, Josep E / Hertl, Michael / Joly, Pascal / Karpati, Sarolta / Kim, Jaehwan / Chan Kim, Soo / Korman, Neil J / Kowalewski, Cezary / Lee, Sang Eun / Rubenstein, David R / Sprecher, Eli / Yancey, Kim / Zambruno, Giovanna / Zillikens, Detlef / Doan, Serge / Daniel, Benjamin S / Werth, Victoria P. ·Department of Dermatology at St George Hospital, University of New South Wales, Sydney, Australia. Electronic address: d.murrell@unsw.edu.au. · Department of Dermatology and Venereology, Zagreb University Hospital Center and School of Medicine, Zagreb, Croatia. · Department of Dermatology, Avicenne Hospital, University Paris 13, Bobigny, France. · Department of Dermatology, Department of Histology, Reference Center for Autoimmune Bullous Diseases, Avicenne Hospital, University Paris 13, Bobigny, France. · Center For Blistering Diseases, Boston, Massachusetts. · Department of Dermatology and Immunodermatology, Medical University of Warsaw, Warsaw, Poland. · Department of Dermatology, Keio University School of Medicine, Tokyo, Japan. · Division of Molecular Dermatology, Department of Dermatology, Paracelsus Medical University Salzburg, Salzburg, Austria. · Department of Dermatology, University of Dresden, Dresden, Germany. · Department of Dermatology, University Hospital of Bern, Bern, Switzerland. · Department of Dermatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. · Department of Dermatology, University of Iowa, Iowa City, Iowa; Department of Veterans Affairs Medical Center, Iowa City, Iowa. · St Joseph Mercy Health System, Department of Dermatology, Ann Arbor, Michigan. · University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. · Department of Dermatology, Stanford University School of Medicine, Stanford, California; Center for Clinical Sciences Research, and Division of Dermatology, Department of Veterans Affairs Palo Alto Healthcare System, Palo Alto, California. · Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California. · Department of Dermatology, School of Medicine, University of Utah, Salt Lake City, Utah. · Department of Dermatology, University of Sao Paulo, Sao Paulo, Brazil. · Department of Dermatology, Reims University Hospital, University of Champagne-Ardenne, Reims, France. · Department of Dermatology, University Freiburg Medical Center, Freiburg, Germany. · Department of Immunodermatology, Istituto Dermopatico dell'Immacolata, IRCCS, Rome, Italy; Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata, IRCCS, Rome, Italy. · Department of Dermatology, Churchill Hospital, Oxford, United Kingdom. · Department of Dermatology and Allergology, University Hospital, Philipps-Universität Marburg, Marburg, Germany. · Department of Dermatology, University of California, Irvine, California; Department of Biological Chemistry Cancer Center, University of California, Irvine, California; Research Institute, Institute for Immunology, University of California, Irvine, California. · Division of Dermatology, Duke Medical Center, Durham, North Carolina. · Kurume University School of Medicine, Kurume, Japan. · Department of Dermatology, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain. · Department of Dermatology, University Hospital, Marburg, Germany. · Clinique Dermatologique, Institut National de la Sante et de la Recherche Medicale (INSERM), INSERM U905, Rouen University Hospital, University of Rouen, Rouen, France; Dermatology Department, Rouen University Hospital, University of Rouen, Rouen, France. · Department of Dermatology, Venereology, and Dermatooncology of the Semmelweis University, Budapest, Hungary. · Department of Dermatology at St George Hospital, University of New South Wales, Sydney, Australia; Laboratory for Investigative Dermatology, Rockefeller University, New York, New York. · Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea. · Department of Dermatology and the Murdough Family Center for Psoriasis, University Hospitals Case Medical Center, Cleveland, Ohio. · Department of Dermatology, CHA Bundang Medical Center, CHA University, Seongnam, Korea. · Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. · Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas. · Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata, IRCCS, Rome, Italy. · Department of Dermatology, University of Lubeck, Lubeck, Germany. · Department of Ophthalmology, Hopital Bichat, Paris, France; Fondation A de Rothschild, Paris, France. · Department of Dermatology at St George Hospital, University of New South Wales, Sydney, Australia. · Philadelphia Department of Veterans Affairs Medical Center, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania. ·J Am Acad Dermatol · Pubmed #25443626.

ABSTRACT: Mucous membrane pemphigoid encompasses a group of autoimmune bullous diseases with a similar phenotype characterized by subepithelial blisters, erosions, and scarring of mucous membranes, skin, or both. Although knowledge about autoimmune bullous disease is increasing, there is often a lack of clear definitions of disease, outcome measures, and therapeutic end points. With clearer definitions and outcome measures, it is possible to directly compare the results and data from various studies using meta-analyses. This consensus statement provides accurate and reproducible definitions for disease extent, activity, outcome measures, end points, and therapeutic response for mucous membrane pemphigoid and proposes a disease extent score, the Mucous Membrane Pemphigoid Disease Area Index.

13 Review Diet and psoriasis, part III: role of nutritional supplements. 2014

Millsop, Jillian W / Bhatia, Bhavnit K / Debbaneh, Maya / Koo, John / Liao, Wilson. ·Department of Dermatology, University of California, San Francisco, California; University of Utah School of Medicine, Salt Lake City, Utah. · Department of Dermatology, University of California, San Francisco, California; Rush Medical College, Rush University Medical Center, Chicago, Illinois. · Department of Dermatology, University of California, San Francisco, California; University of California, Irvine, School of Medicine, Irvine, California. · Department of Dermatology, University of California, San Francisco, California. · Department of Dermatology, University of California, San Francisco, California. Electronic address: LiaoWi@derm.ucsf.edu. ·J Am Acad Dermatol · Pubmed #24780177.

ABSTRACT: Patients with psoriasis are increasingly turning to the use of alternative and complementary medicine to manage their psoriasis. Patients often inquire about what dietary supplements may be beneficial, including the use of oral vitamin D, vitamin B12, selenium, and omega-3 fatty acids in fish oils. In this review we examine the extent to which each of these common nutritional interventions has been studied for the treatment of psoriasis. We weighed evidence from both controlled and uncontrolled prospective trials. The evidence of benefit was highest for fish oils. For other supplements, there is need for additional large, randomized clinical trials to establish evidence of efficacy.

14 Review Diet and psoriasis, part II: celiac disease and role of a gluten-free diet. 2014

Bhatia, Bhavnit K / Millsop, Jillian W / Debbaneh, Maya / Koo, John / Linos, Eleni / Liao, Wilson. ·Department of Dermatology, University of California, San Francisco, California; Rush Medical College, Rush University Medical Center, Chicago, Illinois. · Department of Dermatology, University of California, San Francisco, California; University of Utah School of Medicine, Salt Lake City, Utah. · Department of Dermatology, University of California, San Francisco, California; University of California, Irvine, School of Medicine, Irvine, California. · Department of Dermatology, University of California, San Francisco, California. · Department of Dermatology, University of California, San Francisco, California. Electronic address: liaowi@derm.ucsf.edu. ·J Am Acad Dermatol · Pubmed #24780176.

ABSTRACT: Patients with psoriasis have been shown to have a higher prevalence of other autoimmune diseases including celiac disease, a condition marked by sensitivity to dietary gluten. A number of studies suggest that psoriasis and celiac disease share common genetic and inflammatory pathways. Here we review the epidemiologic association between psoriasis and celiac disease and perform a meta-analysis to determine whether patients with psoriasis more frequently harbor serologic markers of celiac disease. We also examine whether a gluten-free diet can improve psoriatic skin disease.

15 Review Updated Physician's Guide to the Off-label Uses of Oral Isotretinoin. 2014

Nickle, Steven Brandon / Peterson, Nathan / Peterson, Michael. ·Broward Medical Center, Fort Lauderdale, Florida; · Aspen Dermatology Residency Program, Spanish Fork, Utah; · Aspen Dermatology, Spanish Fork, Utah. ·J Clin Aesthet Dermatol · Pubmed #24765227.

ABSTRACT: While oral isotretinoin is renowned for its ability to treat acne vulgaris, many of its off-label uses continue to go underappreciated. Since the last review on the unapproved indications of isotretinoin, relevant publications have surfaced with new recommendations. This article attempts to provide physicians with the latest information regarding successful and unsuccessful use of isotretinoin as an effective treatment for dermatological conditions, such as rosacea, psoriasis, pityriasis rubra pilaris, condyloma acuminatum, granuloma annulare, Darier's disease, systemic cutaneous lupus erythematosus, nonmelanoma skin cancer, and hidradenitis suppurativa. Variations in dosage regimens and isotretinoin viability as an alternative to other standard treatments are also discussed in relation to these conditions.

16 Review Psoriasis and risk of venous thromboembolism: a systematic review and meta-analysis. 2014

Ungprasert, Patompong / Sanguankeo, Anawin / Upala, Sikarin / Suksaranjit, Promporn. ·From the Department of Medicine, Faculty of Medicine Siriraj Hospital, Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang road, Bangkok, 10700, Thailand and Department of Cardiology, University of Utah, School of Medicine, 30 N 1900 E, Salt Lake City, Utah, 84132, USA patompong.ungprasert@bassett.org. · From the Department of Medicine, Faculty of Medicine Siriraj Hospital, Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang road, Bangkok, 10700, Thailand and Department of Cardiology, University of Utah, School of Medicine, 30 N 1900 E, Salt Lake City, Utah, 84132, USA. ·QJM · Pubmed #24713224.

ABSTRACT: BACKGROUND: Several chronic inflammatory disorders, such as rheumatoid arthritis and systemic lupus erythematosus, have been shown to increase venous thromboembolism (VTE) risk but the data on psoriasis is unclear. METHODS: We conducted a systematic review and meta-analysis of observational studies that reported odds ratio, relative risk, hazard ratio or standardized incidence ratio comparing VTE risk in patients with psoriasis vs. non-psoriasis participants. Pooled risk ratio and 95% confidence intervals were calculated using a random effect, generic inverse variance method. RESULT: Four studies were identified and included in our data analysis. The pooled risk ratio of VTE in patients with psoriasis was 1.46 (95% CI, 1.29-1.66). The statistical heterogeneity of this meta-analysis was high with an I(2) of 86%. CONCLUSION: Our study demonstrated a statistically significant increased VTE risk among patients with psoriasis.

17 Review Diet and psoriasis, part I: Impact of weight loss interventions. 2014

Debbaneh, Maya / Millsop, Jillian W / Bhatia, Bhavnit K / Koo, John / Liao, Wilson. ·Department of Dermatology, University of California, San Francisco, California; University of California, Irvine, School of Medicine, Irvine, California. Electronic address: Maya.debbaneh@gmail.com. · Department of Dermatology, University of California, San Francisco, California; University of Utah School of Medicine, Salt Lake City, Utah. · Department of Dermatology, University of California, San Francisco, California; Rush Medical College, Rush University Medical Center, Chicago, Illinois. · Department of Dermatology, University of California, San Francisco, California. ·J Am Acad Dermatol · Pubmed #24709272.

ABSTRACT: One of the most frequently asked questions by patients with psoriasis is whether dietary changes can improve their condition. Included in this discussion is whether dietary weight loss can benefit their skin disease. Obesity has been associated with a proinflammatory state and several studies have demonstrated a relationship between body mass index and psoriasis severity. However, the question of whether weight loss interventions can impact psoriasis outcome is less clear. Here, we review the literature to examine the efficacy of weight loss interventions, both dietary and surgical, on psoriasis disease course.

18 Review Development of a disease activity and responder index for psoriatic arthritis--report of the Psoriatic Arthritis Module at OMERACT 11. 2014

Coates, Laura C / FitzGerald, Oliver / Mease, Philip J / Gladman, Dafna D / Strand, Vibeke / Goel, Niti / Campbell, Ina / Krueger, Gerald / McHugh, Neil J / Helliwell, Philip S. ·From the Division of Rheumatic and Musculoskeletal Disease, University of Leeds, UK; Department of Rheumatology, St. Vincent's University Hospital and Conway Institute, University College Dublin, Dublin, Ireland; Seattle Rheumatology Associates, Swedish Medical Center, University of Washington School of Medicine, Seattle, Washington, USA; Division of Rheumatology, Department of Medicine, University of Toronto, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario, Canada; Division of Immunology/Rheumatology, Stanford University, Palo Alto, California; Division of Rheumatology, Department of Medicine, Duke University Medical Center, Durham, and General Medicine Therapeutic Delivery Unit, Quintiles, Morrisville, North Carolina; Department of Dermatology, University of Utah, Salt Lake City, Utah, USA; Royal National Hospital for Rheumatic Diseases and University of Bath, Bath, UK. ·J Rheumatol · Pubmed #24488420.

ABSTRACT: This module reflected work within the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) to develop and validate composite disease activity measures in psoriatic arthritis (PsA). At the Outcome Measures in Rheumatology (OMERACT) 8 Meeting, a core set of domains to be assessed in randomized controlled trials (RCT) and longitudinal observational studies of PsA was agreed upon. At OMERACT 10, 5 proposed composite responder definitions for PsA were reviewed and discussed, including new data from the GRACE (GRAppa Composite Exercise) study. At OMERACT 11, ongoing retrospective analyses of RCT data using the 3 proposed measures (Composite Psoriatic Disease Activity Index, Psoriatic Arthritis Disease Activity Score, and Arithmetic Mean of the Desirability Function) were discussed in detail. There was agreement that developing composite outcome measures for use in RCT and longitudinal observational studies in PsA was important. Concerns were expressed regarding development of a single measure that encompassed diverse domains, such as joint counts, quality of life (QOL), and disability measures. It was emphasized that the use of any composite measure should include the ability to differentiate between activity in individual domains, such as enthesitis or psoriasis, such that the effect of each could be assessed independently. It was also agreed that patients would be systematically involved in further development and refinement of composite measures. Future plans include qualitative work with patients to explore their experience of disease activity and statistical modeling to explore how each of the proposed measures will perform in different disease subgroups.

19 Review Ustekinumab: a review in the treatment of plaque psoriasis and psoriatic arthritis. 2012

Zaghi, Daniel / Krueger, Gerald G / Callis Duffin, Kristina. ·Department of Dermatology, School of Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, USA. daniel.zaghi@hsc.utah.edu ·J Drugs Dermatol · Pubmed #22270196.

ABSTRACT: Psoriasis is a complex, multigenic immune/inflammatory-mediated disorder that variably affects the skin, nails, and joints. In September 2009, ustekinumab (Stelara®), a monoclonal antibody that targets interleukin 12 (IL-12) and 23 (IL-23), was approved in the United States for treatment of moderate-to-severe plaque psoriasis. The drug's mechanism of action is derived from extensive immunologic and genomic research identifying IL-12 and IL-23 of the Th1 and Th17 inflammatory pathways, respectively, as key mediators of psoriasis. Ustekinumab is a completely human monoclonal antibody to the shared p40 subunit of IL-12 and IL-23. The drug has demonstrated efficacy, short-term safety, and convenience of use in the treatment of plaque psoriasis and psoriatic arthritis. Though long-term safety concerns remain, ustekinumab adds to the current treatment armamentarium and holds promise to improve quality of life. This is a concise and current review of ustekinumab in the treatment of plaque psoriasis and psoriatic arthritis, with focus on data from the seven published clinical trials.

20 Clinical Trial Efficacy of certolizumab pegol with and without concomitant use of disease-modifying anti-rheumatic drugs over 4 years in psoriatic arthritis patients: results from the RAPID-PsA randomized controlled trial. 2018

Walsh, J A / Gottlieb, A B / Hoepken, B / Nurminen, T / Mease, P J. ·Division of Rheumatology, University of Utah School of Medicine, Salt Lake City, UT, USA. jessica.walsh@hsc.utah.edu. · Department of Dermatology, New York Medical College, Metropolitan Hospital, New York, NY, USA. · UCB Pharma, Monheim, Germany. · Swedish Medical Center and University of Washington, Seattle, WA, USA. ·Clin Rheumatol · Pubmed #30191421.

ABSTRACT: To report long-term efficacy of certolizumab pegol (CZP) treatment with and without concomitant DMARDs in patients with psoriatic arthritis (PsA). RAPID-PsA (NCT01087788) was double-blind and placebo-controlled to week 24, dose-blind to week 48, and open-label to week 216. Patients had active PsA with ≥ 1 failed DMARD. At baseline, patients were randomized 1:1:1 to CZP 200 mg every 2 weeks: CZP 400 mg every 4 weeks: placebo. CZP-randomized patients continued their dose into open-label. Observed case efficacy data are reported to week 216 for week 0 CZP-randomized patients (dose combined) with and without baseline DMARD use (DMARD+/DMARD-). Dactylitis (tenderness and ≥ 10% difference in swelling between affected and opposite digits) and enthesitis were measured using Leeds Dactylitis Index (LDI) and Leeds Enthesitis Index (LEI). 273/409 randomized patients received CZP from baseline: 199/273 (72.9%) DMARD+ and 74/273 (27.1%) DMARD- patients. 141/199 (70.9%) DMARD+ and 42/74 (56.8%) DMARD- patients completed Week 216. DMARD+ (79.7%) and 83.3% of DMARD- patients achieved ACR20 response at week 216; 79.2 and 78.1% achieved 75% improvement from baseline in Psoriasis Area and Severity Index (PASI75). High proportions of DMARD+/DMARD- patients with extra-articular manifestations at baseline reported total resolution at week 216; dactylitis 91.4% of DMARD+ and 93.3% of DMARD- patients, enthesitis 74.4% of DMARD+ and 87.5% of DMARD- patients. Long-term improvements in PsA symptoms were observed with CZP monotherapy or concomitant DMARDs, across important psoriatic disease domains, including joint disease, psoriasis, nail disease, dactylitis, and enthesitis.Trial registration: NCT01087788.

21 Clinical Trial Efficacy and safety of ixekizumab in a randomized, double-blinded, placebo-controlled phase IIIb study of patients with moderate-to-severe genital psoriasis. 2018

Ryan, C / Menter, A / Guenther, L / Blauvelt, A / Bissonnette, R / Meeuwis, K / Sullivan, J / Cather, J C / Yosipovitch, G / Gottlieb, A B / Merola, J F / Callis Duffin, K / Fretzin, S / Osuntokun, O O / Burge, R / Naegeli, A N / Yang, F E / Lin, C-Y / Todd, K / Potts Bleakman, A / Anonymous3821597. ·Department of Dermatology, Blackrock Clinic, Dublin, Ireland. · Department of Dermatology, Baylor University Medical Center, Dallas, TX, U.S.A. · Guenther Dermatology Research Centre, London, ON, Canada. · Oregon Medical Research Center, Portland, OR, U.S.A. · Innovaderm Research, Montreal, QC, Canada. · Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands. · Kingsway Dermatology, Miranda, NSW, Australia. · Modern Research Associates, Dallas, TX, U.S.A. · Department of Dermatology and Itch Center, University of Miami School of Medicine, Miami, FL, U.S.A. · Department of Dermatology, New York Medical College at Metropolitan Hospital, New York, NY, U.S.A. · Department of Dermatology and Medicine, Division of Rheumatology, Harvard Medical School Brigham and Women's Hospital, Boston, MA, U.S.A. · Department of Dermatology, University of Utah School of Medicine, Salt Lake City, UT, U.S.A. · Dawes Fretzin Dermatology Group, Indianapolis, IN, U.S.A. · Eli Lilly and Company, Indianapolis, IN, U.S.A. ·Br J Dermatol · Pubmed #29747232.

ABSTRACT: BACKGROUND: Genital psoriasis (GenPs) is a common, debilitating and difficult-to-treat manifestation of plaque psoriasis. However, few controlled, interventional studies of GenPs exist. OBJECTIVES: To determine the efficacy of ixekizumab vs. placebo in patients with moderate-to-severe GenPs with ≥ 1% involved body surface area (BSA). METHODS: Patients with moderate-to-severe GenPs, defined as a baseline static Physician's Global Assessment of Genitalia (sPGA-G) score of ≥ 3, with BSA ≥ 1% were randomized 1 : 1 to receive placebo (n = 74) or the recommended dosing of ixekizumab (n = 75). Major outcomes included the percentage of patients achieving 0 or 1 scores on the sPGA-G (primary end point), overall sPGA, GenPs Sexual Frequency Questionnaire (GenPs-SFQ) item 2, and ≥ 3-point improvement from baseline on the GenPs itch numerical rating scale. RESULTS: At week 12, ixekizumab was superior to placebo for sPGA-G 0/1 (73% vs. 8%, P < 0·001), overall sPGA 0/1 (73% vs. 3%, P < 0·001), GenPs-SFQ item 2 score of 0 or 1 (78% vs. 21%, P < 0·001) and genital itch (60% vs. 8%, P < 0·001). No candidiasis was reported, no deaths occurred and one (1%) serious adverse event was reported in a patient receiving placebo. CONCLUSIONS: Ixekizumab was superior to placebo for the treatment of moderate-to-severe GenPs with BSA ≥ 1%. The safety profile of ixekizumab was consistent with previous studies in moderate-to-severe plaque psoriasis.

22 Clinical Trial Longitudinal Study of the Psoriasis-Associated Skin Microbiome during Therapy with Ustekinumab in a Randomized Phase 3b Clinical Trial. 2018

Loesche, Michael A / Farahi, Kamyar / Capone, Kimberly / Fakharzadeh, Steven / Blauvelt, Andrew / Duffin, Kristina Callis / DePrimo, Samuel E / Muñoz-Elías, Ernesto J / Brodmerkel, Carrie / Dasgupta, Bidisha / Chevrier, Marc / Smith, Kevin / Horwinski, Joseph / Tyldsley, Amanda / Grice, Elizabeth A. ·Departments of Dermatology and Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. · Dermatology Medical Group, Janssen Research & Development, Horsham, Pennsylvania, USA; Dermatology Medical Group, Janssen Research & Development, Spring House, Pennsylvania, USA; Dermatology Medical Group, Janssen Research & Development, Titusville, New Jersey, USA. · Emerging Science & Innovation, Johnson & Johnson Consumer, Skillman, New Jersey, USA. · Oregon Medical Research Center, Portland, Oregon, USA. · Department of Dermatology, University of Utah, Salt Lake City, Utah, USA. · Immunology Biomarkers, Janssen Research & Development, San Diego, California, USA; Immunology Biomarkers, Janssen Research & Development, Spring House, Pennsylvania, USA. · Lupus Strategy, Janssen Research & Development, Spring House, Pennsylvania, USA. · Departments of Dermatology and Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Electronic address: egrice@pennmedicine.upenn.edu. ·J Invest Dermatol · Pubmed #29559344.

ABSTRACT: Plaque psoriasis, a chronic inflammatory disease primarily affecting the skin, is thought to have a multifactorial etiology, including innate immune system dysregulation, environmental triggers, and genetic susceptibility. We sought to further understand the role of skin microbiota in psoriasis pathogenesis, as well as their response to therapy. We systematically analyzed dynamic microbiota colonizing psoriasis lesions and adjacent nonlesional skin in 114 patients prior to and during ustekinumab treatment in a phase 3b clinical trial. By sequencing the bacterial 16S ribosomal RNA gene from skin swab samples obtained at six anatomical sites, we identified minor, site-specific differences in microbial diversity and composition between pretreatment lesional and nonlesional skin. During therapy, microbial communities within lesional and nonlesional skin diverged, and body-site dispersion increased, reflecting microbial skin site-specificity. Microbiota demonstrated greater pretreatment heterogeneity in psoriatic lesions than in nonlesional skin, and variance increased as treatment progressed. Microbiota colonizing recurrent lesions did not overlap with pretreatment lesional microbiota, suggesting colonization patterns varied between initial and recurrent psoriatic lesions. While plaque psoriasis does not appear to be associated with specific microbes and/or microbial diversity, this large dataset provides insight into microbial variation associated with (i) disease in different body locations, (ii) initial versus recurrent lesions, and (iii) anti-IL12/23 therapy.

23 Clinical Trial Early and sustained efficacy with apremilast monotherapy in biological-naïve patients with psoriatic arthritis: a phase IIIB, randomised controlled trial (ACTIVE). 2018

Nash, Peter / Ohson, Kamal / Walsh, Jessica / Delev, Nikolay / Nguyen, Dianne / Teng, Lichen / Gómez-Reino, Juan J / Aelion, Jacob A / Anonymous3041016. ·Department of Medicine, University of Queensland, Brisbane, Queensland, Australia. · Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. · Department of Internal Medicine, Division of Rheumatology, University of Utah School of Medicine, Salt Lake City, Utah, USA. · Celgene Corporation, Summit, New Jersey, USA. · Hospital Clínico Universitario, Santiago, Spain. · West Tennessee Research Institute, Jackson, Tennessee, USA. ·Ann Rheum Dis · Pubmed #29343507.

ABSTRACT: OBJECTIVE: Evaluate apremilast efficacy across various psoriatic arthritis (PsA) manifestations beginning at week 2 in biological-naïve patients with PsA. METHODS: Patients were randomised (1:1) to apremilast 30 mg twice daily or placebo. At week 16, patients whose swollen and tender joint counts had not improved by ≥10% were eligible for early escape. At week 24, all patients received apremilast through week 52. RESULTS: Among 219 randomised patients (apremilast: n=110; placebo: n=109), a significantly greater American College of Rheumatology 20 response at week 16 (primary outcome) was observed with apremilast versus placebo (38.2% (42/110) vs 20.2% (22/109); P=0.004); response rates at week 2 (first assessment) were 16.4% (18/110) versus 6.4% (7/109) (P=0.025). Improvements in other efficacy outcomes, including 28-joint count Disease Activity Score (DAS-28) using C reactive protein (CRP), swollen joint count, Health Assessment Questionnaire-Disability Index (HAQ-DI), enthesitis and morning stiffness severity, were observed with apremilast at week 2. At week 16, apremilast significantly reduced PsA disease activity versus placebo, with changes in DAS-28 (CRP) (P<0.0001), HAQ-DI (P=0.023) and Gladman Enthesitis Index (P=0.001). Improvements were maintained with continued treatment through week 52. Over 52 weeks, apremilast's safety profile was consistent with prior phase 3 studies in psoriasis and PsA. During weeks 0-24, the incidence of protocol-defined diarrhoea was 11.0% (apremilast) and 8.3% (placebo); serious adverse event rates were 2.8% (apremilast) and 4.6% (placebo). CONCLUSIONS: In biological-naïve patients with PsA, onset of effect with apremilast was observed at week 2 and continued through week 52. The safety profile was consistent with previous reports. TRIAL REGISTRATION NUMBER: NCT01925768; Results.

24 Clinical Trial Assessing clinical response and defining minimal disease activity in plaque psoriasis with the Physician Global Assessment and body surface area (PGA × BSA) composite tool: An analysis of apremilast phase 3 ESTEEM data. 2017

Gottlieb, Alice B / Merola, Joseph F / Chen, Rongdean / Levi, Eugenia / Duffin, Kristina Callis. ·New York Medical College, Valhalla, New York. Electronic address: alicegottliebderm@gmail.com. · Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. · Celgene Corporation, Summit, New Jersey. · University of Utah, Salt Lake City, Utah. ·J Am Acad Dermatol · Pubmed #29132853.

ABSTRACT: -- No abstract --

25 Clinical Trial The effect of secukinumab on moderate-to-severe scalp psoriasis: Results of a 24-week, randomized, double-blind, placebo-controlled phase 3b study. 2017

Bagel, Jerry / Duffin, Kristina Callis / Moore, Angela / Ferris, Laura K / Siu, Kimberly / Steadman, Jennifer / Kianifard, Farid / Nyirady, Judit / Lebwohl, Mark. ·Psoriasis Treatment Center of Central New Jersey, East Windsor, New Jersey. Electronic address: dreamacres1@aol.com. · Department of Dermatology, University of Utah, Salt Lake City, Utah. · Arlington Research Center, Arlington, Texas; Baylor Medical Center, Dallas, Texas. · Department of Dermatology, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania. · Novartis Pharmaceuticals Corporation, East Hanover, New Jersey. · Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York. ·J Am Acad Dermatol · Pubmed #28780364.

ABSTRACT: BACKGROUND: Moderate-to-severe scalp psoriasis has not been evaluated in prospective trials of patients without moderate-to-severe body psoriasis. OBJECTIVE: Evaluate the efficacy and safety of secukinumab in moderate-to-severe scalp psoriasis. METHODS: In this 24-week, double-blind, phase 3b study, 102 patients were randomized 1:1 to subcutaneous secukinumab 300 mg or placebo at baseline, weeks 1, 2, and 3, and then every 4 weeks from week 4 to 20. The primary efficacy variable was 90% improvement of Psoriasis Scalp Severity Index (PSSI 90) score from baseline to week 12. RESULTS: At week 12, PSSI 90 (secukinumab 300 mg vs placebo, 52.9% vs 2.0%) and Investigator's Global Assessment modified 2011 scalp responses of 0 or 1 (secukinumab 300 mg vs placebo, 56.9% vs 5.9%) were significantly greater with secukinumab 300 mg than placebo (P < .001 for both). In addition, significantly more patients achieved complete clearance of scalp psoriasis at week 12 with secukinumab 300 mg than placebo (35.3% vs 0%; P < .001). The median time to 50% reduction in PSSI score was 3.29 weeks with secukinumab 300 mg. The safety profile of secukinumab was consistent with previous phase 3 studies. LIMITATIONS: There was no active comparator arm. CONCLUSION: Secukinumab is efficacious and well-tolerated for patients with extensive moderate-to-severe scalp psoriasis.

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