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HIV-associated psoriasis: Epidemiology, pathogenesis, and management. Ceccarelli M et al. Dermatol Ther. (2018)

JAK-STAT inhibitors for the treatment of immunomediated diseases. Serra López-Matencio JM et al. Med Clin (Barc). (2018)

The discovery and synthesis of the nutritional factor vitamin D. Jones G et al. Int J Paleopathol. (2018)

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Items: 1 to 10 of 49995

1.
Br J Dermatol. 2019 Jan 19. doi: 10.1111/bjd.17643. [Epub ahead of print]

A novel approach to outpatient clinic management.

Author information

1
Chelsea and Westminster Hospital, Fulham Road, London, SW10 9NH.

Abstract

I read with great interest the study by Khoury et al1 in the BJD on the safety of patient-initiated care consultations (PICC) for psoriasis patients, though has wider implications for all patients with chronic conditions. There are over 15 million people in England with chronic conditions, accounting for 64% of outpatient appointments, and with future trends suggesting a further increase. This article is protected by copyright. All rights reserved.

KEYWORDS:

NHS ; Clinical efficiency; Outpatient clinic management; Patient-initiated care consultations

PMID:
30659593
DOI:
10.1111/bjd.17643
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2.
Curr Drug Saf. 2019 Jan 18. doi: 10.2174/1574886314666190119115632. [Epub ahead of print]

A Novel Desensitization Protocol for Infliximab hypersensitivity in a 13-Year Old Patient with Pustular Psoriasis.

Author information

1
Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, (JIPMER), Puducherry. India.
2
Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry. India.
3
Department of Dermatology & STD, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry. India.
4
Department of Pharmacology, Sri Ramachandra Institute of Higher Education and Research, Chennai. India.

Abstract

BACKGROUND:

Drug hypersensitivity reactions to infliximab have been reported in pediatric patients. At times, these patients may need infliximab administration in spite of hypersensitivity. However, only a few reports of desensitization protocols are available in the literature in pediatric patients.

CASE REPORT:

We report a case of immediate hypersensitivity reaction to intravenous infliximab in a 13-year-old child suffering from pustular psoriasis who eventually underwent a 14 step desensitization protocol for the administration of infliximab in a pediatric intensive care unit.

CONCLUSION:

Although our desensitization protocol was safe and effective, we recommend the entire desensitization procedure to be performed under supervision of experienced personnel in a pediatric intensive care unit. Future studies with larger sample size are needed to confirm our findings.

KEYWORDS:

Desensitization; infliximab; monoclonal antibody; pediatric; psoriasis

3.
J Clin Med. 2019 Jan 17;8(1). pii: E110. doi: 10.3390/jcm8010110.

MiR-146a-5p Expression in Peripheral CD14⁺ Monocytes from Patients with Psoriatic Arthritis Induces Osteoclast Activation, Bone Resorption, and Correlates with Clinical Response.

Lin SH1,2,3, Ho JC4,5, Li SC6, Chen JF7, Hsiao CC8,9, Lee CH10.

Author information

1
Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan. hong51@cgmh.org.tw.
2
Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan. hong51@cgmh.org.tw.
3
Division of Basic Medical Sciences, Department of Nursing, Chang Gung University of Science and Technology-Chiayi Campus, Chiayi County 613, Taiwan. hong51@cgmh.org.tw.
4
Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan. jichenho@cgmh.org.tw.
5
Department of Dermatology, Chai-Yi Chang Gung Memorial Hospital, Chiayi 613, Taiwan. jichenho@cgmh.org.tw.
6
Genomics and Proteomics Core Laboratory, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan. raymond.pinus@gmail.com.
7
Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan. uporchidjfc@gmail.com.
8
Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan. cchsiao@mail.cgu.edu.tw.
9
Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan. cchsiao@mail.cgu.edu.tw.
10
Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan. dermlee@gmail.com.

Abstract

In psoriatic arthritis (PsA), progressive bone destruction is mediated by monocyte-derived osteoclasts. MicroRNAs (miRNAs) regulate many pathophysiological processes; however, their function in PsA patient monocytes has not been examined. This study aims to address whether specific miRNAs in CD14⁺ monocytes and monocyte-derived osteoclasts cause active osteoclastogenesis in PsA patients. Candidate miRNAs related to monocyte activation (miR-146a-5p, miR-146b-5p and miR-155-5p) were measured in circulatory CD14⁺ monocytes collected from 34 PsA patients, 17 psoriasis without arthritis (PsO) patients, and 34 normal controls (NCs). CD14⁺ monocytes were cultured with media containing TNF-α and RANKL to differentiate into osteoclasts. Osteoclast differentiation and bone resorption were measured by TRAP immunostaining and dentin slice resorption, respectively. The results showed that the miR-146a-5p expression was higher in PsA patient-derived CD14⁺ monocytes compared to PsO and NCs. Activation and bone resorption were selectively enhanced in osteoclasts from PsA patients, but both were abrogated by RNA interference against miR-146a-5p. More importantly, after clinical improvement using biologics, the increased miR-146a-5p expression in CD14⁺ monocytes from PsA patients was selectively abolished, and associated with blood CRP level. Our findings indicate that miR-146a-5p expression in CD14⁺ monocytes derived from PsA patients correlates with clinical efficacy, and induction of osteoclast activation and bone resorption.

KEYWORDS:

miR-146a-5p; osteoclast; psoriatic arthritis

4.
Rev Prat. 2017 Mar 20;67(3):297-298.

Living with psoriasis

[Article in French]

Author information

1
France Psoriasis, Paris, France

KEYWORDS:

psoriasis; association of patients

PMID:
30657295

Conflict of interest statement

R. Aubert déclare n’avoir aucun lien d’intérêts.

5.
Life Sci. 2019 Jan 15. pii: S0024-3205(19)30029-3. doi: 10.1016/j.lfs.2019.01.019. [Epub ahead of print]

Hesperidin inhibits keratinocyte proliferation and imiquimod-induced psoriasis-like dermatitis via the IRS-1/ERK1/2 pathway.

Author information

1
Beijing Institute of Traditional Chinese Medicine, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China; Beijing Key Laboratory of Clinic and Basic Research with Traditional Chinese Medicine on Psoriasis, Beijing 100010, China; Beijing University of Chinese Medicine, Beijing 100029, China. Electronic address: 619365198@qq.com.
2
Beijing Institute of Traditional Chinese Medicine, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China; Beijing Key Laboratory of Clinic and Basic Research with Traditional Chinese Medicine on Psoriasis, Beijing 100010, China.
3
Beijing Institute of Traditional Chinese Medicine, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China; Beijing Key Laboratory of Clinic and Basic Research with Traditional Chinese Medicine on Psoriasis, Beijing 100010, China; Beijing University of Chinese Medicine, Beijing 100029, China.

Abstract

AIMS:

To evaluate the therapeutic benefits of Hesperidin (Hes) using an imiquimod (IMQ)-induced psoriasis-like mouse model and human immortalized keratinocytes (HaCaT) cells stimulated with lipopolysaccharide (LPS).

METHODS:

Mice were treated with IMQ and orally administered Hes (125-500 mg/kg/day), methotrexate (MTX) 1 mg/kg/day or distilled water. HaCaT cells were stimulated with LPS (1 μg/mL) and relevant indices were measured after administration with different concentrations of Hes (5-20 μg/mL) for 24 h. Inflammatory skin lesions in IMQ mice were evaluated using the psoriasis area severity index (PASI) and pathological staining. Proteins in the IRS-1/ERK1/2 pathway and inflammatory factors were assessed using western blotting or quantitative real-time PCR. In addition, factors related to IRS-1 secretion levels were assessed by enzyme-linked immunosorbent assays. Extracellular flux (XF) analysis was used to assess cellular metabolic levels.

KEY FINDINGS:

Hes significantly improved psoriasis-like skin lesions of IMQ-treated mice and inhibited LPS-induced HaCaT cell proliferation. In addition, Hes remarkably decreased PASI scores, reduced epidermal thickness, decreased proliferation and differentiation of epidermal cells, inhibited mRNA expression of inflammatory factors, reduced local skin lesions and serum insulin and glucose levels. Furthermore, Hes modulated the secretion levels of serum Leptin, Adiponectin and Resistin, and inhibited the activation of the IRS-1/ERK1/2 signaling pathway and regulated HaCaT cells metabolism.

SIGNIFICANCE:

This study demonstrated that Hes administration could have significant therapeutic value for the prevention and clinical treatment of psoriasis.

KEYWORDS:

Hesperidin; IRS-1; Imiquimod; Psoriasis

6.
Br J Dermatol. 2019 Jan 18. doi: 10.1111/bjd.17642. [Epub ahead of print]

Severe disseminated Nocardia infection associated with ustekinumab treatment for psoriasis.

Author information

1
Université de Sherbrooke, Medical microbiology and infectious diseases department, Sherbrooke, Québec, Canada.
2
Hôpital Maisonneuve-Rosemont, Medical microbiology and infectious diseases department, affiliated to Université de Montréal,, Montréal, Québec, Canada.
3
Dermatology department, Université de Montréal, Montréal, Québec, Canada.
4
Infectious Disease susceptibility program, McGill Université Health Centre (MUHC) and Research Institute-MUHC (RI-MUHC), Montréal, Québec, Canada.
5
Urology department, Université de Sherbrooke, Sherbrooke, Québec, Canada.

Abstract

Ustekinumab is one of the newer biologic agents on the market, and most clinical experience associated with this agent has been accumulated with the treatment of psoriasis. It exerts its effect through IL-12/IL-23p40 antagonism. This immune signaling pathway is associated with Mendelian Susceptibility to Mycobacterial Disease, a genetic condition predisposing to opportunistic infections with mycobacteria and other select organisms. Nonetheless, clinical trial safety data for this agent has suggested its safety, with very few case reports of severe opportunistic infections. It is sometimes considered to be associated with a lesser infectious risk compared to some other biologic agents such as tumor necrosis factor inhibitors. We report a 56-year-old patient presenting with an unusually severe disseminated Nocardia farcinica infection associated with ustekinumab treatment: sustained bacteremia, disseminated skin lesions, large renal abscess, septic renal vein thrombosis and pulmonary and cerebral lesions . To our knowledge, this is the first report of disseminated nocardiosis associated with this monoclonal antibody. This article is protected by copyright. All rights reserved.

PMID:
30657168
DOI:
10.1111/bjd.17642
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7.
Adv Rheumatol. 2018 Oct 22;58(1):33. doi: 10.1186/s42358-018-0036-6.

The effects of cultural background on patient-perceived impact of psoriatic arthritis - a qualitative study conducted in Brazil and France.

Author information

1
Serviço de Reumatologia, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos Street 2350, Porto Alegre, Zip code 90035903, Brazil. penelopepalominos@gmail.com.
2
Programa de Pós Graduação em Ciências Médicas, Universidade Federal do Rio Grande do Sul (UFRGS), Ramiro Barcelos 2400, Porto Alegre, Zip code 90035903, Brazil. penelopepalominos@gmail.com.
3
Institut Pierre Louis d'Epidémiologie et de Santé Publique. Pitié-Salpetrière Hospital, AP-HP, Rheumatology Department, Sorbonne Universités, UPMC Univ Paris 6, GRC-08, 83 Boulevard de l'Hôpital, 75013, Paris, France.
4
Faculdade de Medicina, Departamento de Medicina Interna, Universidade Federal do Rio Grande do Sul (UFRGS), Ramiro Barcelos 2400, Porto Alegre, Zip code 90035903, Brazil.
5
Serviço de Reumatologia, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos Street 2350, Porto Alegre, Zip code 90035903, Brazil.
6
Programa de Pós Graduação em Ciências Médicas, Universidade Federal do Rio Grande do Sul (UFRGS), Ramiro Barcelos 2400, Porto Alegre, Zip code 90035903, Brazil.
7
Patient Research Partner, Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), University Health Network, Toronto Western Hospital, 399 Street Toronto, Bathurst, ON, M5T 2S8, Canada.
8
Department of Medical Humanities, Patient Research Partner, VU University Medical Centre, de Boelenlaan 1089a, 1081 HV, Amsterdam, Netherlands.
9
Patient Research Partner; Advisory Services, Quintiles; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina, 27705, USA.

Abstract

BACKGROUND:

In psoriatic arthritis (PsA) almost all qualitative studies have been performed in European populations. This work aimed to evaluate the impact of PsA in Brazilian and French subjects, as well as to explore cultural differences in the experience of disease and to recognize domains important for patients living with PsA outside Europe.

METHODS:

A qualitative study was conducted in two university hospitals in Brazil and France; outpatients fulfilling Classification Criteria for PsA participated in individual interviews regarding the impact of PsA; interviews were conducted in the local language. The sample size was defined by saturation; interviews were recorded and transcribed and content analysis was performed.

RESULTS:

Fifteen patients were interviewed in Brazil and 13 in France. Mean disease duration was 16.5 ± 12.5 years (range: 8 months to 47 years) and 14.4 ± 8.4 years (range 12 months to 29 years) for Brazilian and French subjects, respectively. A broad impact was perceived: 67 codes emerged from the interviews and were grouped in 41 categories. Although 2/3 of categories were common to both nationalities, some important health domains from the perspective of PsA patients from a non-European background were brought to light including sexual dysfunction, emotional impact of psoriasis and impact of prejudice on social and professional life.

CONCLUSIONS:

This study highlights the importance of assessing the impact of PsA on a national level, emphasizing the common cross-cultural aspects but also revealing domains of interest for patients with PsA living outside Europe which merit further study.

KEYWORDS:

Disease burden; Psoriatic arthritis; Qualitative research; Quality of life

8.
Adv Rheumatol. 2018 Aug 3;58(1):22. doi: 10.1186/s42358-018-0016-x.

Evaluation of the safety and satisfaction of rheumatic patients with accelerated infliximab infusion.

Author information

1
SOS Vida, Rheumatology Unit, Salvador, Bahia, Brazil. jotafc@gmail.com.
2
Institute of Health Sciences, Universidade Federal da Bahia (Federal University of Bahia), Salvador, Bahia, Brazil. jotafc@gmail.com.
3
SOS Vida, Rheumatology Unit, Salvador, Bahia, Brazil.
4
Institute of Health Sciences, Universidade Federal da Bahia (Federal University of Bahia), Salvador, Bahia, Brazil.

Abstract

INTRODUCTION:

Infliximab infusion generally occurs in 2-4 h. Recent studies have suggested the possibility of accelerated infusion (1 h) of this drug.

OBJECTIVE:

To evaluate the safety of accelerated infliximab infusion in patients with rheumatic diseases. In addition, patient satisfaction was also assessed.

METHODS:

A prospective, single-center, non-randomized study with 34 patients with rheumatic diseases was conducted from July to November 2016. Patients with the following were excluded: history of allergic reaction to biologics, asthma or severe atopy. All patients previously received a 2- to 3-h infliximab infusion. The infusion rate was accelerated to 1 h, and premedication was excluded. The infusion was monitored in all patients.

RESULTS:

A total of 34 patients were included in the study [rheumatoid arthritis (n = 16), ankylosing spondylitis (n = 15), psoriatic arthritis (n = 2) and enteropathic arthropathy (n = 1)], with an average age of 48.7 ± 18.6 years; 55.5% of the patients were female, and 29.4% were white. The duration of disease was 9.5 ± 9.2 years, and the duration of infliximab use was 38.9 ± 27.6 months, with a mean dose per infusion of 414.2 ± 158.1 (range, 200-800) mg. The mean infliximab infusion time prior to the study was 2.2 ± 0.4 h. A total of 6 (17.6%) patients received premedication. The premedication was suspended. There were no adverse effects during or after infusion. Ninety-seven percent of the patients and 100% of the health workers were satisfied with the accelerated infusion.

CONCLUSION:

Our data support the safe use of accelerated infliximab infusion in rheumatic patients, with high satisfaction among patients and health workers.

KEYWORDS:

Ankylosing spondylitis; Immunobiologics; Infliximab; Infusion; Psoriatic arthritis; Rheumatoid arthritis; Spondyloarthritis

9.
Clin Exp Dermatol. 2019 Jan 17. doi: 10.1111/ced.13901. [Epub ahead of print]

Psoriasis induced by dupilumab therapy.

Author information

1
Department of Dermatology, Centre Hospitalier de Saint-Brieuc, 10, rue Marcel Proust, 22000, Saint-Brieuc, France.
2
Ouest Pathologie Laboratory, Rennes, France.
PMID:
30656722
DOI:
10.1111/ced.13901
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10.
Cochrane Database Syst Rev. 2019 Jan 18;1:CD012722. doi: 10.1002/14651858.CD012722.pub2. [Epub ahead of print]

Methotrexate for psoriatic arthritis.

Author information

1
Department of Rheumatology, Royal Adelaide Hospital and University of Adelaide, Port Rd, Adelaide, South Australia, Australia, 5000.

Abstract

BACKGROUND:

Psoriatic arthritis is an inflammatory disease associated with joint damage, impaired function, pain, and reduced quality of life. Methotrexate is a disease-modifying anti-rheumatic drug (DMARD) commonly prescribed to alleviate symptoms, attenuate disease activity, and prevent progression of disease.

OBJECTIVES:

To assess the benefits and harms of methotrexate for psoriatic arthritis in adults.

SEARCH METHODS:

We searched CENTRAL, MEDLINE, Embase, the WHO International Clinical Trials Registry Platform, and www.clinicaltrials.gov for relevant records. We searched all databases from inception to 29 January 2018. We handsearched included articles for additional records and contacted study authors for additional unpublished data. We applied no language restrictions.

SELECTION CRITERIA:

We included all randomised controlled trials (RCTs) and quasi-RCTs that compared methotrexate versus placebo, or versus another DMARD, for adults with psoriatic arthritis. We reported on the following major outcomes: disease response (measured by psoriatic arthritis response criteria (PsARC)), function (measured by the Health Assessment Questionnaire for Rheumatoid Arthritis (HAQ)), health-related quality of life, disease activity (measured by disease activity score (28 joints) with erythrocyte sedimentation rate (DAS28-ESR)), radiographic progression, serious adverse events, and withdrawals due to adverse events.

DATA COLLECTION AND ANALYSIS:

Two review authors independently reviewed search results, assessed risk of bias, extracted trial data, and assessed the quality of evidence using the GRADE approach. We undertook meta-analysis only when this was meaningful.

MAIN RESULTS:

We included in this review eight RCTs conducted in an outpatient setting, in Italy, the United Kingdom, the United States of America, China, Russia, and Bangladesh. Five studies compared methotrexate versus placebo, and four studies compared methotrexate versus other DMARDs. The average age of participants varied across studies (26 to 52 years), as did the average duration of psoriatic arthritis (one to nine years). Doses of methotrexate varied from 7.5 mg to 25 mg orally per week, but most studies administered approximately 15 mg or less orally per week. Risk of bias was generally unclear or high across most domains for all studies. We considered only one study to have low risk of selection and detection bias. The main study informing results of the primary comparison (methotrexate vs placebo up to six months) was at low risk of bias for all domains except attrition bias and reporting bias.We restricted reporting of results to the comparison of methotrexate versus placebo for up to six months. Low-quality evidence (downgraded due to bias and imprecision) from a single study (221 participants; methotrexate dose 15 mg orally or less per week) informed results for disease response, function, and disease activity. Disease response, measured by the proportion who responded to treatment according to PsARC (response indicates improvement), was 41/109 in the methotrexate group and 24/112 in the placebo group (risk ratio (RR) 1.76, 95% confidence interval (CI) 1.14 to 2.70). This equates to an absolute difference of 16% more responders with methotrexate (4% more to 28% more), and a number needed to treat for an additional beneficial outcome (NNTB) of 6 (95% CI 5 to 25). Mean function, measured by the HAQ (scale 0 to 3; 0 meaning no functional impairment; minimum clinically important difference 0.22), was 1.0 points with placebo and 0.3 points better (95% 0.51 better to 0.09 better) with methotrexate; absolute improvement was 10% (3% better to 17% better), and relative improvement 30% (9% better to 51% better). Mean disease activity as measured by the DAS28-ESR (scale of 0 to 10; lower score means lower disease activity; minimum clinically important difference unknown) was 3.8 points in the methotrexate group and 4.06 points in the placebo group; mean difference was -0.26 points (95% CI -0.65 to 0.13); absolute improvement was 3% (7% better to 1% worse), and relative improvement 6% (16% better to 3% worse).Low-quality evidence (downgraded due to risk of bias and imprecision) from three studies (n = 293) informed our results for serious adverse events and withdrawals due to adverse events. Due to low event rates, we are uncertain if methotrexate results show increased risk of serious adverse events or withdrawals due to adverse events compared to placebo. Results show 1/141 serious adverse events in the methotrexate group and 4/152 in the placebo group: RR 0.26 (95% CI 0.03 to 2.26); absolute difference was 2% fewer events with methotrexate (5% fewer to 1% more). In all, 9/141 withdrawals in the methotrexate group were due to adverse events and 7/152 in the placebo group: RR 1.32 (95% CI 0.51 to 3.42); absolute difference was 1% more withdrawals (4% fewer to 6% more).One study measured health-related quality of life but did not report these results. No study measured radiographic progression.

AUTHORS' CONCLUSIONS:

Low-quality evidence suggests that low-dose (15 mg or less) oral methotrexate might be slightly more effective than placebo when taken for six months; however we are uncertain if it is more harmful. Effects of methotrexate on health-related quality of life, radiographic progression, enthesitis, dactylitis, and fatigue; its benefits beyond six months; and effects of higher-dose methotrexate have not been measured or reported in a randomised placebo-controlled trial.

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