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Psoriasis: HELP
Articles from Rockville
Based on 13 articles published since 2010
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These are the 13 published articles about Psoriasis that originated from Rockville during 2010-2020.
 
+ Citations + Abstracts
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 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2015 Treatment Recommendations for Psoriatic Arthritis. 2016

Coates, Laura C / Kavanaugh, Arthur / Mease, Philip J / Soriano, Enrique R / Laura Acosta-Felquer, Maria / Armstrong, April W / Bautista-Molano, Wilson / Boehncke, Wolf-Henning / Campbell, Willemina / Cauli, Alberto / Espinoza, Luis R / FitzGerald, Oliver / Gladman, Dafna D / Gottlieb, Alice / Helliwell, Philip S / Husni, M Elaine / Love, Thorvardur J / Lubrano, Ennio / McHugh, Neil / Nash, Peter / Ogdie, Alexis / Orbai, Ana-Maria / Parkinson, Andrew / O'Sullivan, Denis / Rosen, Cheryl F / Schwartzman, Sergio / Siegel, Evan L / Toloza, Sergio / Tuong, William / Ritchlin, Christopher T. ·Leeds Institute of Rheumatic and Musculoskeletal Medicine and University of Leeds, Leeds, UK. · University of California at San Diego. · Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington. · Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. · University of Southern California, Keck School of Medicine, Los Angeles. · Hospital Militar Central and Universidad Militar Nueva Grenada, Bogotá, Colombia. · Geneva University Hospital, Geneva, Switzerland. · Toronto Western Hospital, Toronto, Ontario, Canada. · University of Cagliari, Monserrato Campus, Cagliari, Italy. · Louisiana State University Health Sciences Center, New Orleans. · St. Vincent's University Hospital, The Conway Institute for Biomolecular Research, and University College Dublin, Dublin, Ireland. · University of Toronto and Toronto Western Research Institute, Toronto, Ontario, Canada. · Tufts Medical Center, Boston, Massachusetts. · Leeds Institute of Rheumatic and Musculoskeletal Medicine and University of Leeds, Leeds, UK, and Bradford Hospitals NHS Foundation Trust, Bradford, UK. · Cleveland Clinic Foundation, Cleveland, Ohio. · University of Iceland and Landspitali University Hospital, Reykjavik, Iceland. · University of Molise, Campobasso, Italy. · Royal National Hospital for Rheumatic Diseases, Bath, UK. · University of Queensland, Brisbane, Queensland, Australia. · University of Pennsylvania, Philadelphia. · Johns Hopkins University School of Medicine, Baltimore, Maryland. · Chapel Allerton Hospital, Leeds, UK. · St. Vincent's University Hospital, Dublin, Ireland. · Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada. · Hospital for Special Surgery, New York, New York. · Arthritis and Rheumatism Associates, Rockville, Maryland. · Ministry of Health, San Fernando del Valle de Catamarca, Argentina. · University of California, Davis. · University of Rochester Medical Center, Rochester, New York. ·Arthritis Rheumatol · Pubmed #26749174.

ABSTRACT: OBJECTIVE: To update the 2009 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) treatment recommendations for the spectrum of manifestations affecting patients with psoriatic arthritis (PsA). METHODS: GRAPPA rheumatologists, dermatologists, and PsA patients drafted overarching principles for the management of PsA, based on consensus achieved at face-to-face meetings and via online surveys. We conducted literature reviews regarding treatment for the key domains of PsA (arthritis, spondylitis, enthesitis, dactylitis, skin disease, and nail disease) and convened a new group to identify pertinent comorbidities and their effect on treatment. Finally, we drafted treatment recommendations for each of the clinical manifestations and assessed the level of agreement for the overarching principles and treatment recommendations among GRAPPA members, using an online questionnaire. RESULTS: Six overarching principles had ≥80% agreement among both health care professionals (n = 135) and patient research partners (n = 10). We developed treatment recommendations and a schema incorporating these principles for arthritis, spondylitis, enthesitis, dactylitis, skin disease, nail disease, and comorbidities in the setting of PsA, using the Grading of Recommendations, Assessment, Development and Evaluation process. Agreement of >80% was reached for approval of the individual recommendations and the overall schema. CONCLUSION: We present overarching principles and updated treatment recommendations for the key manifestations of PsA, including related comorbidities, based on a literature review and consensus of GRAPPA members (rheumatologists, dermatologists, other health care providers, and patient research partners). Further updates are anticipated as the therapeutic landscape in PsA evolves.

3 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.

4 Review Nonalcoholic fatty liver disease in patients with psoriasis: a consequence of systemic inflammatory burden? 2018

Prussick, R B / Miele, L. ·Washington Dermatology Center, Rockville, MD, U.S.A. · Department of Dermatology, George Washington University, Washington, DC, U.S.A. · Institute of Internal Medicine, Catholic University of Sacred Heart of Rome, Rome, Italy. · Gastroenterological Area, Gastroenterology and Endocrine-Metabolic Sciences Department, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy. ·Br J Dermatol · Pubmed #29235656.

ABSTRACT: Patients with psoriasis are at an increased risk for nonalcoholic fatty liver disease (NAFLD) compared with the general population. However, the pathophysiology underlying this comorbidity and elucidation of effective treatment strategies are unclear. This review provides insights into the possible role of chronic, low-grade inflammation in the pathogenesis of NAFLD in patients with psoriasis. Both conditions are associated with increased levels of proinflammatory adipokines (such as tumour necrosis factor-α and interleukin-6) and hepatokines, and decreased levels of adiponectin, an anti-inflammatory adipokine. This imbalance in inflammatory mediators could result in insulin resistance and, thereby, facilitate the occurrence and progression of NAFLD in a multistep manner. All patients with psoriasis should, therefore, be considered candidates for NAFLD screening and managed accordingly. Given the common aetiology of inflammation between these conditions, it is hypothesized that biological therapies for psoriasis may attenuate the systemic inflammatory process and progression of NAFLD in patients with psoriasis.

5 Review Systematic review of treatment effectiveness and outcome measures for enthesitis in psoriatic arthritis. 2014

Orbai, Ana-Maria / Weitz, Joshua / Siegel, Evan L / Siebert, Stefan / Savage, Laura J / Aydin, Sibel Z / Luime, Jolanda J / Elkayam, Ori / Neerinckx, Barbara / Urbancek, Slavo / de Vlam, Kurt / Ritchlin, Christopher T / Anonymous5650810. ·From Johns Hopkins Arthritis Center, Baltimore, Maryland; Dermatology Associates of Rochester, Rochester, New York; Arthritis and Rheumatism Associates, Rockville, Maryland, USA; Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Department of Rheumatology, Koc University, Faculty of Medicine, Istanbul, Turkey; Department of Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Rheumatology, Tel Aviv Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; University Hospital Leuven, Leuven, Belgium; Department of Dermatology, F.D. Roosevelt Hospital, Banska Bystrica, Slovakia; and Allergy, Immunology, and Rheumatology Division, University of Rochester Medical Center, Rochester, New York, USA.A.M. Orbai, MD, MHS, Johns Hopkins Arthritis Center; J. Weitz, MD, Dermatology Associates of Rochester; E.L. Siegel, MD, Arthritis and Rheumatism Associates; S. Siebert, MD, Institute of Infection, Immunity and Inflammation, University of Glasgow; L.J. Savage, MD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; S.Z. Aydin, Department of Rheumatology, Koc University Faculty of Medicine; J.J. Luime, PhD, Department of Rheumatology, Erasmus Medical Center; O. Elkayam, MD, Department of Rheumatology, Tel Aviv Medical Center and Sackler Faculty of Medicine; B. Neerinckx, MD, University Hospital Leuven; S. Urbancek, MD, PhD, Department of Dermatology, F.D. Roosevelt Hospital; K. de Vlam, MD, PhD, University Hospital Leuven; C.T. Ritchlin, MD, MPH, Allergy, Immunology, and Rheumatology Division, University of Rochester Medical Center. ·J Rheumatol · Pubmed #25362713.

ABSTRACT: Enthesitis is a characteristic feature of psoriatic arthritis (PsA) and is important in disease pathogenesis and classification. Use of clinical outcome measures for enthesitis is heterogeneous, and only 1 measure has been specifically developed and validated in PsA. Ultrasound and magnetic resonance imaging assessments of enthesitis may have advantages over clinical examination but are insufficiently studied. As part of an update of treatment recommendations by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), we performed a systematic literature review and identified randomized controlled trials with enthesitis outcomes in PsA. For each treatment agent we calculated treatment effect sizes (where applicable) and graded the level of evidence.

6 Review Biological products for the treatment of psoriasis: therapeutic targets, pharmacodynamics and disease-drug-drug interaction implications. 2014

Wang, Jie / Wang, Yow-Ming C / Ahn, Hae-Young. ·Division of Clinical Pharmacology III, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, Maryland, 20993, USA. ·AAPS J · Pubmed #24993574.

ABSTRACT: Psoriasis is a chronic inflammatory skin disease condition that involves altered expression of a broad spectrum of proinflammatory cytokines which are associated with activation of T cells and proliferation of keratinocytes. Currently approved biological products for psoriasis treatment fall into two main classes: cytokine modulators and biologics targeting T cells. In psoriatic patients, elevated levels of proinflammatory cytokines are observed. Elevated proinflammatory cytokines can suppress some cytochrome P450 (CYP) enzymes, and the treatment of psoriasis with biological products can reduce proinflammatory cytokine levels. Therefore, the exposure of CYP substrate drugs is anticipated to be affected by the psoriasis disease resulting in a higher exposure than in healthy state (named disease-drug interaction) as well as by the biological treatments due to disease improvements resulting in a decrease in exposure (named disease-drug-drug interaction, disease-DDI). However, the quantitative impact on CYP substrate exposure due to disease or due to treatment with biological products remains to be evaluated. The objective of the current review is to provide an overview of the therapeutic targets and cytokine-related pharmacodynamic effects of biological products in psoriasis treatment with a particular focus on their implications for disease-DDI. The clinical study design considerations for psoriasis disease-DDI evaluation are also discussed.

7 Article Reconsideration of 2008 decision: Food and Drug Administration approval of etanercept for systemic treatment of moderate to severe pediatric psoriasis. 2018

Gatti, Jasmine / Lindstrom, Jill A / Beitz, Julie. ·Office of New Drugs, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA. ·Pediatr Dermatol · Pubmed #30066378.

ABSTRACT: Although systemic etanercept was approved in 2004 for adults, the Food and Drug Administration (FDA) denied approval for use in children with psoriasis in 2008. Revision of the FDA's risk-benefit assessment in response to understanding of disease burden, unmet medical need, and the effect of off-label use in children with psoriasis led to the 2016 approval as the first systemic biologic product for the treatment of children aged 4-17 with moderate to severe psoriasis. This article delineates the thinking that led to this reconsideration. The underlying thinking paved the way to inform current pediatric drug development as the FDA continues to bring needed medical products to children.

8 Article Dietary Recommendations for Adults With Psoriasis or Psoriatic Arthritis From the Medical Board of the National Psoriasis Foundation: A Systematic Review. 2018

Ford, Adam R / Siegel, Michael / Bagel, Jerry / Cordoro, Kelly M / Garg, Amit / Gottlieb, Alice / Green, Lawrence J / Gudjonsson, Johann E / Koo, John / Lebwohl, Mark / Liao, Wilson / Mandelin, Arthur M / Markenson, Joseph A / Mehta, Nehal / Merola, Joseph F / Prussick, Ronald / Ryan, Caitriona / Schwartzman, Sergio / Siegel, Evan L / Van Voorhees, Abby S / Wu, Jashin J / Armstrong, April W. ·Keck School of Medicine, University of Southern California, Los Angeles. · National Psoriasis Foundation, Portland, Oregon. · Psoriasis Treatment Center of Central New Jersey, East Windsor. · Department of Dermatology, University of California San Francisco. · Department of Pediatrics, University of California San Francisco. · Department of Dermatology, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York. · New York Medical College at Metropolitan Hospital, New York. · Hudson Dermatology, Somers, New York. · Department of Dermatology, George Washington University School of Medicine, Washington, DC. · Department of Dermatology, University of Michigan, Ann Arbor. · Icahn School of Medicine at Mount Sinai, New York, New York. · Northwestern University Feinberg School of Medicine, Chicago, Illinois. · Hospital for Special Surgery, Weill Medical College of Cornell University, New York-Presbyterian Hospital, New York. · National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland. · Brigham and Women's Hospital, Harvard University, Boston, Massachusetts. · Blackrock Clinic, Dublin, Ireland. · Arthritis and Rheumatism Associates, PC, Rockville, Maryland. · Georgetown University School of Medicine, Washington, DC. · Department of Dermatology, Eastern Virginia Medical School, Norfolk. · Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California. ·JAMA Dermatol · Pubmed #29926091.

ABSTRACT: Importance: Psoriasis is a chronic, inflammatory skin disease and has significant associated morbidity and effect on quality of life. It is important to determine whether dietary interventions help reduce disease severity in patients with psoriatic diseases. Objective: To make evidence-based dietary recommendations for adults with psoriasis and/or psoriatic arthritis from the Medical Board of the National Psoriasis Foundation. Evidence Review: We used literature from prior systematic reviews as well as additional primary literature from the MEDLINE database from January 1, 2014, to August 31, 2017, that evaluated the impact of diet on psoriasis. We included observational and interventional studies of patients with psoriasis or psoriatic arthritis. The quality of included studies was assessed using the Newcastle-Ottawa scale for observational studies and the Cochrane Risk of Bias Tool for interventional studies. We made evidence-based dietary recommendations, which were voted on by the National Psoriasis Foundation Medical Board. Findings: We identified 55 studies meeting the inclusion criteria for this review. These studies represent 77 557 unique participants of which 4534 have psoriasis. Based on the literature, we strongly recommend dietary weight reduction with a hypocaloric diet in overweight and obese patients with psoriasis. We weakly recommend a gluten-free diet only in patients who test positive for serologic markers of gluten sensitivity. Based on low-quality data, select foods, nutrients, and dietary patterns may affect psoriasis. For patients with psoriatic arthritis, we weakly recommend vitamin D supplementation and dietary weight reduction with a hypocaloric diet in overweight and obese patients. Dietary interventions should always be used in conjunction with standard medical therapies for psoriasis and psoriatic arthritis. Conclusions and Relevance: Adults with psoriasis and/or psoriatic arthritis can supplement their standard medical therapies with dietary interventions to reduce disease severity. These dietary recommendations from the National Psoriasis Foundation Medical Board will help guide clinicians regarding the utility of dietary interventions in adults with psoriatic diseases.

9 Article Anti-inflammatory therapy with tumour necrosis factor inhibitors is associated with reduced risk of major adverse cardiovascular events in psoriasis. 2018

Wu, J J / Joshi, A A / Reddy, S P / Batech, M / Egeberg, A / Ahlehoff, O / Mehta, N N. ·Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA. · National Heart, Lung, and Blood Institute, National Institutes of Health, Rockville, MD, USA. · University of Illinois at Chicago College of Medicine, Chicago, IL, USA. · Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA. · Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. · Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark. · Department of Cardiology, Odense University Hospital, Odense, Denmark. ·J Eur Acad Dermatol Venereol · Pubmed #29573294.

ABSTRACT: BACKGROUND: Psoriasis is a systemic chronic inflammatory condition associated with increased risk of cardiovascular disease. Data demonstrating that decreased skin inflammation reduces cardiovascular events in patients with psoriasis may be generalizable to other chronic inflammatory states with heightened cardiovascular risk. OBJECTIVE: To determine whether tumour necrosis factor inhibitor (TNFi) therapy is associated with decreased major adverse cardiovascular events (MACE) in patients with psoriasis. METHODS: In this retrospective cohort study using the KPSC health plan, patients had at least three ICD-9 codes for psoriasis and no antecedent MACE codes. Propensity score-adjusted multivariable Cox regression assessed hazard ratios (HR) of MACE associated with TNFi use. RESULTS: After adjusting for cardiovascular risk factors, the TNFi cohort had significantly lower MACE HR compared with the topical cohort (HR, 0.80; 95% CI, 0.66-0.98). The oral/phototherapy cohort had similar MACE HR compared with the topical cohort (HR, 1.19 (95% CI, 0.99-1.42)). CONCLUSIONS: We observed significantly lower MACE risk in patients with psoriasis receiving TNFi compared to topical or oral/phototherapy agents. TNFi therapy may have benefits beyond skin disease in mitigating cardiovascular event risk.

10 Article Association of Tumor Necrosis Factor Inhibitor Treatment With Reduced Indices of Subclinical Atherosclerosis in Patients With Psoriatic Disease. 2018

Eder, Lihi / Joshi, Aditya A / Dey, Amit K / Cook, Richard / Siegel, Evan L / Gladman, Dafna D / Mehta, Nehal N. ·Women's College Hospital and University of Toronto, Toronto, Ontario, Canada. · National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland. · University of Waterloo, Waterloo, Ontario, Canada. · Arthritis and Rheumatism Associates, Rockville, Maryland. · University of Toronto and Toronto Western Hospital, Toronto, Ontario, Canada. ·Arthritis Rheumatol · Pubmed #29088580.

ABSTRACT: OBJECTIVE: To assess the effect of tumor necrosis factor inhibitors (TNFi) on subclinical cardiovascular disease in patients with psoriatic disease. METHODS: We performed a 2-stage study. In stage 1, carotid total plaque area was assessed in patients with psoriasis or psoriatic arthritis (PsA) (n = 319) by ultrasound at baseline and after 2-3 years. The annual progression rate of atherosclerosis was the outcome of interest. In stage 2, PsA patients receiving TNFi (n = 21) and age- and sex-matched PsA patients not receiving any biologic agent (n = 13) underwent RESULTS: In stage 1, men had significantly higher atherosclerosis progression than women (P < 0.001). TNFi was associated with reduced atherosclerosis progression in men after controlling for cardiovascular risk and use of statins (adjusted β = -2.20 [95% confidence interval -3.41, -1.00], P < 0.001). There was no association between TNFi and atherosclerosis progression in women (P = 0.74). In stage 2, patients receiving TNFi had reduced TBR at 1 year (P = 0.03). Those not receiving TNFi had no significant change in TBR (P = 0.32). The improvement in aortic vascular inflammation in the TNFi group was independent of cardiovascular risk factors (adjusted β = -0.41 [95% confidence interval -0.74, -0.08], P = 0.02). CONCLUSION: Our findings indicate that TNFi treatment is associated with reduced progression of carotid plaques in men and improvement in vascular inflammation in both men and women with psoriatic disease.

11 Article Secukinumab improves scalp pain, itching, scaling and quality of life in patients with moderate-to-severe scalp psoriasis. 2017

Feldman, Steven R / Green, Lawrence / Kimball, Alexa B / Siu, Kimberly / Zhao, Yang / Herrera, Vivian / Nyirady, Judit / Alexis, Andrew F. ·a Department of Dermatology , Wake Forest Baptist Medical Center , Winston-Salem , NC , USA. · b George Washington University School of Medicine , Rockville , MD , USA. · c Harvard Medical School, Beth Israel Deaconess Medical Center , Boston , MA , USA. · d Novartis Pharmaceuticals Corporation , East Hanover , NJ , USA. · e Icahn School of Medicine at Mount Sinai and Mount Sinai St. Luke's , New York , NY , USA. ·J Dermatolog Treat · Pubmed #28737440.

ABSTRACT: INTRODUCTION: Scalp psoriasis adversely affects patients' lives and is often resistant to treatment; however, it has not been a major focus of a clinical study. This analysis assessed the effect of secukinumab on patient-reported outcomes (PRO) of scalp psoriasis. METHODS: A randomized, double-blind, placebo-controlled, multicenter study was conducted in 102 adult patients with moderate-to-severe scalp psoriasis. Patients were randomized 1:1 to secukinumab 300 mg or placebo. Patients rated their scalp-related pain, itching and scaling using a 0-10 numeric rating scale (higher scores indicate greater severity). Scalp dermatitis-related quality of life (QOL) was assessed at baseline and then every 4 weeks using the Scalpdex. Analysis of covariance models examined PRO effect up to 12 weeks. RESULTS: Baseline scalp pain, itching and scaling mean (SD) values were 3.1 (3.00), 6.7 (2.60) and 7.3 (2.02) and similar for both treatment groups. At week 12, patients treated with secukinumab reported greater reduction in scalp pain (-1.98 vs. 0.61), itching (-4.07 vs. -0.04) and scaling (-5.76 vs. -0.95) as well as greater improvements in Scalpdex total scores (-39.62 vs. -7.91) compared with placebo (all p < .001). DISCUSSION/CONCLUSIONS: Secukinumab in moderate-to-severe scalp psoriasis reduces scalp pain, itching, and scaling and improves patients' QOL.

12 Article Severity of Psoriasis Associates With Aortic Vascular Inflammation Detected by FDG PET/CT and Neutrophil Activation in a Prospective Observational Study. 2015

Naik, Haley B / Natarajan, Balaji / Stansky, Elena / Ahlman, Mark A / Teague, Heather / Salahuddin, Taufiq / Ng, Qimin / Joshi, Aditya A / Krishnamoorthy, Parasuram / Dave, Jenny / Rose, Shawn M / Doveikis, Julia / Playford, Martin P / Prussick, Ronald B / Ehrlich, Alison / Kaplan, Mariana J / Lockshin, Benjamin N / Gelfand, Joel M / Mehta, Nehal N. ·From the Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute (H.B.N., B.N., E.S., H.T., T.S., Q.N., A.A.J., J.D., S.M.R., J.D., M.P.P., N.N.M.), Dermatology Branch, Center for Cancer Research, National Cancer Institute (H.B.N.), Molecular Biomedical Imaging Laboratory (M.A.A.), and Systemic Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases (M.J.K.), National Institutes of Health, Bethesda, MD · Englewood Hospital, NJ (P.K.) · The Washington Dermatology Center, Rockville, MD (R.B.P.) · Department of Dermatology, George Washington Hospital, Washington DC (R.B.P., A.E.) · DermAssociates, Silver Spring, MD (B.N.L.) · and Department of Dermatology, Department of Biostatistics and Epidemiology, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia (J.M.G.). ·Arterioscler Thromb Vasc Biol · Pubmed #26449753.

ABSTRACT: OBJECTIVE: To understand whether directly measured psoriasis severity is associated with vascular inflammation assessed by (18)F-fluorodeoxyglucose positron emission tomography computed tomography. APPROACH: In-depth cardiovascular and metabolic phenotyping was performed in adult psoriasis patients (n=60) and controls (n=20). Psoriasis severity was measured using psoriasis area severity index. Vascular inflammation was measured using average aortic target-to-background ratio using (18)F-fluorodeoxyglucose positron emission tomography computed tomography. RESULTS: Both the psoriasis patients (28 men and 32 women, mean age 47 years) and controls (13 men and 7 women, mean age 41 years) were young with low cardiovascular risk. Psoriasis area severity index scores (median 5.4; interquartile range 2.8-8.3) were consistent with mild-to-moderate skin disease severity. Increasing psoriasis area severity index score was associated with an increase in aortic target-to-background ratio (β=0.41, P=0.001), an association that changed little after adjustment for age, sex, and Framingham risk score. We observed evidence of increased neutrophil frequency (mean psoriasis, 3.7±1.2 versus 2.9±1.2; P=0.02) and activation by lower neutrophil surface CD16 and CD62L in blood. Serum levels of S100A8/A9 (745.1±53.3 versus 195.4±157.8 ng/mL; P<0.01) and neutrophil elastase-1 (43.0±2.4 versus 30.8±6.7 ng/mL; P<0.001) were elevated in psoriasis. Finally, S100A8/A9 protein was related to both psoriasis skin disease severity (β=0.53; P=0.02) and vascular inflammation (β=0.48; P=0.02). CONCLUSIONS: Psoriasis severity is associated with vascular inflammation beyond cardiovascular risk factors. Psoriasis increased neutrophil activation and neutrophil markers, and S100A8/A9 was related to both skin disease severity and vascular inflammation.

13 Article Progressive multifocal leukoencephalopathy associated with efalizumab use in psoriasis patients. 2011

Kothary, Namita / Diak, Ida-Lina / Brinker, Allen / Bezabeh, Shewit / Avigan, Mark / Dal Pan, Gerald. ·Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland. Electronic address: namita.kothary@fda.hhs.gov. · Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland. ·J Am Acad Dermatol · Pubmed #21514689.

ABSTRACT: BACKGROUND: Progressive multifocal leukoencephalopathy (PML), a rare, potentially fatal demyelinating disease, affects primarily immunocompromised individuals. The Food and Drug Administration (FDA) received reports of PML associated with efalizumab (Raptiva), a biologic agent approved for psoriasis. In July 2009, efalizumab was voluntarily withdrawn from the US market because of the risk of PML. OBJECTIVE: To describe 3 cases of PML in psoriasis patients treated with efalizumab. METHODS: The FDA's Adverse Event Reporting System (AERS) database was searched for post-marketing reports of PML associated with biologic agents that are FDA approved for psoriasis (adalimumab, alefacept, efalizumab, etanercept, infliximab) from market approval to January 30, 2009. RESULTS: Twelve cases suggestive of PML were identified: adalimumab (1), efalizumab (4), etanercept (3), and infliximab (4). Efalizumab was the only drug with cases reporting PML in the setting of psoriasis. All cases of PML in efalizumab-treated patients presented 3 years or more after treatment initiation and resulted in death. Cases of PML in patients treated with adalimumab, etanercept, or infliximab occurred in patients treated for conditions other than psoriasis and were confounded by the use of other immunosuppressive therapies or were not confirmed PML cases. LIMITATIONS: AERS data are limited because of an underreporting of spontaneous post-marketing adverse events and variable quality and quantity of information provided. CONCLUSIONS: These cases suggest that prolonged efalizumab therapy is a risk factor for PML. Although the cases reported treatment for longer than 3 years, a specific treatment duration that does not place patients at risk for PML has not been defined.