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Background: Efficacy of tildrakizumab for plaque psoriasis was demonstrated in randomized, placebo‐controlled trials. Objective: To consolidate tildrakizumab efficacy results by pooling data. Methods: Data (N = 2081) from tildrakizumab 100 mg, tildrakizumab 200 mg and placebo groups in three trials were pooled. Results: Proportions of Psoriasis Area and Severity Index (PASI) 75 responders at week 12 were better with tildrakizumab 100 mg (62.3%) and tildrakizumab 200 mg (64.8%) vs. placebo (5.6%; P < 0.0001) and for PASI 90, PASI 100 and Physician's Global Assessment (PGA) 'clear' or 'minimal' vs. placebo (P < 0.0001). Responses increased from weeks 12 to 28. Week 12 PASI and PGA responses to tildrakizumab vs. placebo were numerically greater in patients with lower vs. higher bodyweight and were better with tildrakizumab 200 mg than tildrakizumab 100 mg for patients with higher bodyweight. Week 12 PASI 75 responses vs. placebo with tildrakizumab 100 mg were similar between patients with (55.0%) or without (56.7%) prior biologics. PASI 90, PASI 100 and PGA responses were generally higher in patients without prior biologics. Week 8 PASI 50 response predicted PASI 90 response. Conclusion: Pooled data confirmed the efficacy of tildrakizumab for moderate‐to‐severe plaque psoriasis. [ABSTRACT FROM AUTHOR]

Background: Apremilast, an oral phosphodiesterase 4 inhibitor, has an acceptable safety profile and is effective for treatment of plaque psoriasis and psoriatic arthritis. Objectives: To evaluate the impact of apremilast on health‐related quality of life (HRQOL), general functioning and mental health using patient‐reported outcome (PRO) assessments among patients with moderate to severe plaque psoriasis in the ESTEEM 1 and 2 trials. Methods: A total of 1255 patients were randomized (2 : 1) to apremilast 30 mg BID or placebo for 16 weeks; all received apremilast through Week 32. PRO assessments included the Dermatology Life Quality Index (DLQI), 36‐Item Short‐Form Health Survey version 2 mental/physical component summary scores (SF‐36v2 MCS/PCS), Patient Health Questionnaire‐8 (PHQ‐8), EuroQol‐5D (EQ‐5D) and Work Limitations Questionnaire‐25 (WLQ‐25). Post hoc analyses examined relationships between Psoriasis Area and Severity Index (PASI) scores and PHQ‐8 in the apremilast‐treated population at Week 16. Results: Treatment with apremilast improved all HRQOL PROs at Week 16 (vs. placebo), except the SF‐36v2 PCS, and improvements were sustained through Week 32. Mean DLQI and SF‐36v2 MCS improvements exceeded minimal clinically important differences. Changes at Week 16 in PHQ‐8 and PASI were weakly correlated, and only 35.8% of patients who achieved a ≥75% reduction from baseline in PASI score (PASI‐75) with apremilast treatment also achieved PHQ‐8 scores of 0–4. Conclusions: Apremilast led to improvements in HRQOL PROs vs. placebo in patients with moderate to severe plaque psoriasis.

The article discusses research on the safety and efficacy of topical treatment with BL-5010, a novel combination of aqueous trichloroacetic acid (TCA) and formic acid, to remove benign skin lesions. Topics covered include the effectiveness of BL-5010 as a treatment for seborrhoeic keratosis (SK) lesions, adverse events reported by patients, and the safety profile and clinical data associated with BL-5010.

A letter to the editor is presented which discusses a case study of a successful pregnancy in a Crohn's disease (CD) and paradoxical psoriasis patient under ustekinumab treatment.

Abstract: Background: Though psoriasis poses a substantial chronic socio‐economic burden, few studies have addressed the economic impact in Germany. Objectives: The objective was to evaluate the annual costs of psoriasis in Germany from the societal perspective. Methods: A cross‐sectional study was performed in randomly selected German dermatology practices and clinics in 2013/2014 using standardized questionnaires of illness‐related costs. Costs were grouped by perspective and category as well as analysed by sex and age. Group differences were tested by non‐parametric tests. Results: Complete data were obtained from 1158 patients in 132 centres. Annual average costs for patients with psoriasis: total costs € 5543 ± € 8044, systemic treatment costs (paid by the statutory health insurances [SHI]) € 3733 ± € 7322, out‐of‐pocket costs € 224 ± € 406, total SHI costs € 4940 ± € 7533, direct costs € 5164 ± € 7581 and indirect costs € 379 ± € 2087. Significant higher costs in male and significant lower costs in 65+‐year‐old patients were found. Conclusions: Psoriasis induces a considerable economic burden. Between 2003 and 2014, costs have markedly shifted from hospital, out‐of‐pocket and indirect costs towards systemic drug costs. [ABSTRACT FROM AUTHOR]

Background Psoriasis has a negative impact on patient's' quality of life, which may reflect the physical and psychosocial impact of the disease. However, little is known about the perceived burden of disease. Pictorial Representation of Illness and Self Measure (PRISM), a pictorial tool, was developed to measure this global suffering. Capturing quality of life impairments in psoriasis is an integral part of assessing the overall disease severity and planning effective treatment strategies. Objective To validate Pictorial Representation of Illness and Self Measure (PRISM) in psoriasis patients. Methods An investigator initiated, prospective cohort study was performed in 108 outpatients with psoriasis to validate PRISM as an appropriate tool; Reliability was assessed in a cohort with controlled stable disease, repeated after 1 hour and after a 3-month follow-up phase; Convergent validity determined by correlation against measures of life quality (DLQI) and reported severity of psoriasis (PASI, PGA and BSA) was performed. Results For PRISM, we found a high reliability for short-term measurements (ICC = 0.98, P < 0.001) and for follow-up assessments at 3 months (ICC = 0.76, P < 0.001). Our investigation showed significant differences between patients with clear to minimal (PGA 0, 1), mild (PGA 2) and moderate-to-severe disease (PGA 3, 4) and significant (P < 0.001) correlation with DLQI, PGA, PASI and BSA (ρ = -0.62, -0.54, -0.44 and -0.39 respectively). Conclusion PRISM is a highly reliable tool and new approach to assess perceived burden of patients with psoriasis. It is easy to use and we recommend the application as an additional outcome measure in clinical trial settings. [ABSTRACT FROM AUTHOR]

The German Psoriasis Registry PsoBest was conducted in 2008 in order to investigate the long-term outcomes and safety of systemic treatments for moderate-to-severe psoriasis. Safety analysis of antipsoriatic drugs with special focus on serious adverse events (SAE) for infections, malignancies and major cardiac events (MACE) was done. Nationwide non-interventional patient treatment registry conducted in 251 active dermatology centers. Until June 2012, n = 2444 patients [40 % female; mean age 47.3 (SD 14.1) years; mean duration of disease 18.2 (SD 14.7) years] were recruited, including n = 1791 patients (3842 patient years) with conventional systemic drugs and n = 908 (3442 patient years) with biological drugs. Mean PASI (Psoriasis Area and Severity Index) at inclusion was 14.7, mean DLQI (Dermatology Life Quality Index) 11.1, mean BMI (Body Mass Index) 28.2. The overall rate of SAE per 100 patient years were 1.3 (SD 0.9) per 100 patient years in conventional systemic and 1.5 (SD 1.2) in biologics ( p > 0.5, no significant difference). The rates per 100 patient years for single severe adverse events were as follows (systemic/biologics): serious infections, 0.33/0.65 [CI (confidence interval) 0.13-0.54/0.35-0.98]; MACE, 0.56/0.77 (CI 0.29-0.97/0.41-1.31); malignancies (except non-melanoma skin cancer), 0.46/0.49 (CI 0.22-0.84/0.21-0.97). There were no significant differences between single drugs in any of the safety parameters. The conventional systemic and biologic drugs for psoriasis show satisfying safety under routine psoriasis care in Germany with respect to infections, MACE and malignancies. [ABSTRACT FROM AUTHOR]

Background Tofacitinib is an oral Janus kinase inhibitor being investigated for psoriasis. Objectives To determine the 16-week efficacy and safety of two oral tofacitinib doses vs. placebo in patients with moderate-to-severe chronic plaque psoriasis. Methods Patients in two similarly designed phase III studies ( OPT Pivotal 1, NCT01276639, n = 901; OPT Pivotal 2, NCT01309737, n = 960) were initially randomized 2 : 2 : 1 to tofacitinib 10 or 5 mg or placebo, twice daily. Coprimary efficacy end points (week 16) included the proportion of patients achieving Physician's Global Assessment ( PGA) of 'clear' or 'almost clear' ( PGA response) and the proportion achieving ≥ 75% reduction in Psoriasis Area and Severity Index ( PASI 75). Results Across OPT Pivotal 1 and OPT Pivotal 2, 745 patients received tofacitinib 5 mg, 741 received tofacitinib 10 mg and 373 received placebo. At week 16, a greater proportion of patients achieved PGA responses with tofacitinib 5 and 10 mg twice daily vs. placebo ( OPT Pivotal 1, 41·9% and 59·2% vs. 9·0%; OPT Pivotal 2, 46·0% and 59·1% vs. 10·9%; all P < 0·001). Higher PASI 75 rates were observed with tofacitinib vs. placebo ( OPT Pivotal 1, 39·9%, 59·2% and 6·2%, respectively, for tofacitinib 5 and 10 mg twice daily and placebo; OPT Pivotal 2, 46·0%, 59·6% and 11·4%; all P < 0·001 vs. placebo). Adverse event ( AE) rates appeared generally similar across groups; rates of serious AEs, infections, malignancies and discontinuations due to AEs were low. Twelve patients reported herpes zoster across the tofacitinib treatment groups in both studies vs. none in the respective placebo groups. The most common AE across groups was nasopharyngitis. Conclusions Oral tofacitinib demonstrated significant efficacy vs. placebo during the initial 16 weeks of treatment in patients with moderate-to-severe psoriasis. Safety findings were consistent with prior studies. [ABSTRACT FROM AUTHOR]

Background: Vitiligo is an autoimmune disease, characterized by specific destruction of melanocytes. While associations with numerous comorbid conditions, which potentially increase the risk of cardiovascular diseases have been described, data on the risk for cardiovascular disease is inconclusive. To address this relevant knowledge gap, this study aims to identify the risk of cardiovascular disease in vitiligo., Methods: The US Collaborative Network was accessed using the TriNetX platform, allowing retrospective data retrieval from electronic health records (EHRs) from 57 US based health care organizations (HCOs). Patients with vitiligo and controls were identified by their respective ICD10 codes. Risk of onset of several cardiovascular diseases was determined in patients within 15 years after diagnoses., Findings: A total of 94 diagnoses with a prevalence of ≥1% in both cohorts, which consisted of 96,581 individuals per group after propensity-score-matching, were identified. Of those, 54 displayed an increased risk in vitiligo. None of the cardiovascular diseases investigated were associated with a decreased risk in patients with vitiligo. Specifically, cerebral infarction occurred in 1.3% of patients with vitiligo, and 1.0% in controls. This difference translated into a hazard ratio (HR) of 1.21 (95% confidence interval [CI] 1.11-1.32, p adj  < 0.001). Venous thromboembolism was recorded in 1.34% of cases and 1.02% of controls without vitiligo, resulting in an increased HR of 1.27 (95% CI 1.171-1.38, p adj  < 0.001). Further, major adverse cardiovascular events (MACE) as a composite endpoint was evaluated. The risk for MACE was increased following a vitiligo diagnosis (HR 1.28, 95% CI 1.22-1.35, p adj  < 0.001), which persisted in both sensitivity analyses., Interpretation: Patients with vitiligo display an increased risk of onset of cardiovascular diseases as compared to healthy individuals. Thus, vitiligo might require more precise monitoring and systemic treatment., Funding: This research was supported by the Schleswig-Holstein Excellence-Chair Program from the State of Schleswig Holstein, by the Excellence Cluster Precision Medicine in Chronic Inflammation (DFG, EXC 2167), and by DFG Individual Grant LU 877/25-1., Competing Interests: Declaration of interests AO-S has received honoraria or fees for serving on advisory boards, as a speaker, as a consultant from AbbVie, Allergan, Almirall, Janssen, Leo Pharma, Lilly, Medac, Novartis, Sandoz, Sanofi, Sunpharm. RJL has received honoraria for speaking or consulting or has obtained research grants from Monasterium Laboratories, Novartis, Lilly, Bayer, Dompe, Synthon, Argen-X, and Incyte during the last 3 years. GH is an employee of TriNetX. SS has received honoraria for speaking or consulting from AbbVie, Bristol-Myers Squibb, Janssen-Cilag, Pfizer and UCB. DT has received honoraria or fees for serving on advisory boards, as a speaker, as a consultant from AbbVie, Amgen, Almirall, Bristol-Meiers-Squibb, Boehringer Ingelheim, Celltrion, Galderma, Leo Pharma, Lilly, New Bridge, Novartis, Janssen-Cilag, Pfizer, Regeneron, Sanofi, l, Sun Pharmaceuticals, and UCB and grants from AbbVie, Leo Pharma and Novartis. HZ has received support for attending meetings and/or travel from Pfizer, UCB Pharma, Almirall, Janssen, TriNetX. All other authors declare no conflict of interest., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Chronic inflammatory diseases (immune-mediated inflammatory diseases, IMID) can overlap or occur simultaneously due to clinical similarities. The resulting utilization of heathcare structures has not yet been investigated across disciplines but is of potential importance for optimizing the treatment of patients with IMID., Aim of the Work: Analysis of epidemiological data including utilization of care services in patients with selected IMIDs: psoriasis, psoriatic arthritis (PsA), rheumatoid arthritis (RA), ankylosing spondylitis, ulcerative colitis, Crohn's disease and connective tissue disease., Material and Methods: In a retrospective cross-sectional analysis based on health insurances accounting data with a sample of approximately 4 million insured persons, the prevalence of the abovementioned IMID and the frequency of IMID combinations were analyzed based on documented diagnoses (ICD-10 GM). The frequency of hospitalizations and utilization of outpatient physician contacts was recorded in predefined specialist disciplines (general medicine, dermatology, gastroenterology, rheumatology) and compared with an age-adjusted and gender-adjusted reference population., Results: A total of 188,440 patients had at least 1 of the IMID diagnoses analyzed (4.7%), with an age peak of 61-70 years. The highest prevalence was observed for psoriasis (1.85%), followed by rheumatoid arthritis (1.38%). Combinations with at least one other IMID were relatively common (29%), with this being most common in patients with psoriatic arthritis (82.9%, of which 68.2% had psoriasis), followed by ankylosing spondylitis (27.5%) and Crohn's disease (21.6%). Compared to the reference population, patients with IMID were hospitalized more often and more frequently utilized the outpatient disciplines., Discussion: The study results describe that IMIDs occur in combination and that the patients make comparatively more use of care structures of different disciplines. A multidisciplinary approach could increase the efficiency of care; an evaluation is still pending., (© 2023. The Author(s).)