Psoriasis is a systemic chronic skin disorder characterized by excessive keratinocyte proliferation that results into thickened scaly plaques, itching and inflammatory changes in the epidermis and dermis. It is transmitted genetically but can be provoked by environmental factors.
It is found in approximately 2% of the population that primarily affects the skin and joints.
It is associated with other inflammatory disorders and autoimmune diseases (eg psoriatic arthritis, inflammatory bowel disease, coronary artery disease).
Generally, it begins as red scaling papules that coalesce to form round-to-oval plaques. The rashes are often pruritic and may be painful.
The risk of new-onset inflammatory bowel disease (IBD) among patients with psoriasis exposed to interleukin-17 inhibitor (IL-17i) appears to be comparable to that among unexposed individuals, suggests a study. In addition, the incidence of IBD in exposed patients is low.
Brodalumab, risankizumab, and ixekizumab rank as the top three best performing biologic drugs for psoriasis, yielding the highest rates of complete clearance of lesions and scoring a high probability of being the most effective in the induction treatment phase, according to the results of a network meta-analysis.
The oral TYK2/JAK1 inhibitor PF-06700841 appears to be effective in the treatment of patients with moderate-to-severe plaque psoriasis, with a tolerable safety profile, according to the results of a phase IIa study.
The use of fish oil and its components may yield favourable effects on psoriasis and its comorbidities, namely obesity, cardiovascular disease and metabolic disease, when combined with conventional treatments, as reported in a recent study.
Treatment with tumour necrosis factor-alpha (TNFα) inhibitor may likely lead to an increase in body weight and body mass index (BMI) in patients with psoriasis, whereas treatment with anti-interleukin (IL)-12/23 and IL-17 biologics does not, results of a recent systematic review and meta-analysis have shown.
Biologic therapies for psoriasis may need to be switched between classes to increase drug survival in patients, suggest a recent study. Ad hoc retrospective studies are needed to confirm the benefits of this switching strategy.
The first-in-class interleukin (IL)-17A monoclonal antibody secukinumab is a safe and effective treatment for moderate-to-severe plaque psoriasis, with efficacy rates similar to those found in its phase III studies and enduring up to a year from start of treatment.
The risk of serious infection* among patients receiving systemic therapy for psoriasis differs by treatment, with apremilast, etanercept, and ustekinumab associated with a reduced risk of serious infection than methotrexate, according to an observational study.
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.