scholarly journals THE CASE OF PSORIATIC ERYTHRODERMA AND SEVERE COMORBID PSORIATIC ARTHRITIS

2019 ◽  
Vol 22 (1-2) ◽  
pp. 15-23
Author(s):  
O. Yu Olisova ◽  
N. G Kochergin ◽  
T. A Belousova ◽  
Victoria O. Nikuradze ◽  
V. V Gudova
Keyword(s):  
Psoriatic Arthritis ◽  
Early Diagnosis ◽  
Disease Progression ◽  
Systemic Therapy ◽  
Biological Agents ◽  
Severe Psoriasis ◽  
Early Initiation ◽  
Main Role ◽  
Treatment And Prevention ◽  
Timely Treatment

Early diagnosis of psoriatic arthritis (PsA) is necessary for timely treatment and prevention of the disease progression with destruction of the joints. In most patients, comorbid PsA develops many years after the debut of the skin process. Consequently, the main role in timely diagnosis of PsA is played by a dermatologist, who is able to identify its initial signs and refer the patient to a rheumatologist. Early initiation of systemic therapy with the use of modern biological agents for progressive psoriatic arthritis and severe psoriasis can prevent the development of irreversible disability.

scholarly journals Draft interdisciplinary guidelines for diagnosis, methods for estimation of the degree of activity, for evaluation of therapeutic efficacy, and for use of biological agents in patients with concomitant immunoinflammatory diseases (psoriasis, psoriatic arthritis, Crohn's disease)

2018 ◽  
Vol 12 (3) ◽  
pp. 4-18 ◽  
Author(s):  
D. I. Abdulganieva ◽  
A. L. Bakulev ◽  
E. А. Belousova ◽  
L. F. Znamenskaya ◽  
T. V. Korotaeva ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Psoriatic Arthritis ◽  
High Risk ◽  
Crohn's Disease ◽  
Early Diagnosis ◽  
Russian Federation ◽  
Therapeutic Efficacy ◽  
Working Group ◽  
Biological Agents ◽  
The Russian Federation

Due to that one patient may be at high risk for developing several immunoinflammatory diseases (psoriasis, psoriatic arthritis (PsA), and Crohn's disease (CD)), their early diagnosis and adequate therapy are extremely relevant. The Interdisciplinary Working Group that includes experts in rheumatology, gastroenterology and dermatology has developed draft guidelines for early diagnosis, methods for activity assessments and for indications for the use of biological agents in patients with concomitant immunoinflammatory diseases (psoriasis, PsA, and CD). In accordance with the decision adopted by the Council of Experts and with the results of a discussion with experts from different regions of the Russian Federation, further steps will be undertaken to validate the guidelines.

scholarly journals Difficulties in choosing a biologic disease-modifying anti-rheumatic drug for the treatment of psoriasis and psoriatic arthritis

2019 ◽  
Vol 57 (1) ◽  
pp. 111-115
Author(s):  
I. M. Marusenko ◽  
N. N. Vezikova ◽  
S. N. Kondrichin ◽  
N. D. Silvestrov
Keyword(s):  
Psoriatic Arthritis ◽  
Systemic Therapy ◽  
Clinical Observation ◽  
Severe Psoriasis ◽  
Disease Modifying Therapy ◽  
Disease Modifying ◽  
Rheumatic Drug

The article presents a clinical observation of a patient with severe psoriasis and psoriatic arthritis. Due to insufficient efficacy of systemic therapy of psoriasis biologic disease-modifying therapy was started, but it was associated with difficulties. Development of erythrodermic form of psoriasis was observed during treatment with infliximab and abatacept was successfully used though it is not registered inRussiafor the treatment of psoriasis.

scholarly journals Disease burden of psoriasis associated with psoriatic arthritis in Hungary

2014 ◽  
Vol 155 (48) ◽  
pp. 1913-1921 ◽  
Author(s):  
Fanni Rencz ◽  
Valentin Brodszky ◽  
Márta Péntek ◽  
Orsolya Balogh ◽  
Éva Remenyik ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psoriatic Arthritis ◽  
Systemic Therapy ◽  
Biological Therapy ◽  
Indirect Costs ◽  
Severe Psoriasis ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Introduction: Psoriasis is a frequent, chronic, systemic immune-mediated disease mainly affecting the skin and joints. Aim: To assess health related quality of life and cost-of-illness in moderate to severe psoriasis associated with psoriatic arthritis. Method: A cross-sectional questionnaire survey was conducted at two academic dermatology clinics in Hungary. Results: Fifty-seven patients (65% males) completed the survey with a mean age of 54.3±11.6 years and mean EQ-5D score of 0.48±0.4. Mean annual total cost was €8,977 per patient, of which 71% occurred due to biological therapy and 21% were indirect costs, respectively. Permanent work disability due to psoriasis accounted for €1,775 (95% of the indirect costs). Per patient costs of subgroups not receiving systemic therapy (21%), traditional systemic therapy (32%), and biological systemic therapy (47%) amounted to the sum of €1,729, €1,799, and €16,983, respectively. Conclusions: Patients on biological therapy showed significantly better health related quality of life. As for health economics, the efficacy of systemic treatments is appropriate to be assessed together in patients with moderate to severe psoriasis associated with psoriatic arthritis, since actual health gain might exceed that reported in psoriasis or psoriatic arthritis separately. Orv. Hetil., 2014, 155(48), 1913–1921.

scholarly journals Combination therapy of recalcitrant severe psoriasis with psoriatic arthritis, diabetes nephropathy, and liver cirrhosis

2021 ◽  
Author(s):  
Sebastian Zimmer ◽  
Mohamad Goldust ◽  
Shashank Bhargava ◽  
Joanna Wegner ◽  
Stephan Grabbe ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Psoriatic Arthritis ◽  
Combination Therapy ◽  
Severe Psoriasis ◽  
Diabetes Nephropathy

scholarly journals Patterns of Progression in Metastatic Estrogen Receptor Positive Breast Cancer: An Argument for Local Therapy

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Patrick Kelly ◽  
Zhe Ma ◽  
Said Baidas ◽  
Rebecca Moroose ◽  
Nikita Shah ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Disease Progression ◽  
Systemic Therapy ◽  
Local Therapy ◽  
Disease Course ◽  
Mechanisms Of Resistance ◽  
Diffuse Disease ◽  
Estrogen Receptor Positive ◽  
Positive Breast Cancer

Purpose. Despite advances in endocrine therapy (ET), metastatic estrogen receptor positive breast cancer (BrCA) remains incurable. Though the mechanisms of resistance to ET have been studied extensively, the anatomic pattern of disease progression remains poorly characterized. The purpose of this study was to characterize the pattern of progression for patients receiving ET for metastatic BrCA. Methods. The records of 108 patients with metastatic BrCA who progressed on ET were reviewed. Progression was characterized as follows: diffuse progression, progression in greater than 3 sites; oligoprogression, progression in fewer than 3 sites with prior diffuse metastases; and oligometastatic disease with progression, progression in 3 or fewer sites with prior limited metastases. Results. Seventy-four patients (69%) displayed only diffuse disease progression. Conversely, 23 patients (21%) displayed oligoprogression and 11 patients (10%) displayed oligometastases with progression at least once in their disease course. Further analysis of the patients with oligoprogression suggested that in 14 patients the sites of progression would have been amenable to local therapy. Conclusion. Oligoprogressive disease occurs in a significant subset of patients with metastatic BrCA treated with ET. These patients with oligoprogressive disease may be eligible for local therapy, potentially obviating the need to change of systemic therapy.

scholarly journals The Risk of Mortality among Psoriatic Patients with Varying Severity: A Nationwide Population-Based Cohort Study in Taiwan

2018 ◽  
Vol 15 (12) ◽  
pp. 2622 ◽  
Author(s):  
Ying-Xiu Dai ◽  
Ming-Chun Hsu ◽  
Hsiao-Yun Hu ◽  
Yun-Ting Chang ◽  
Tzeng-Ji Chen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Psoriatic Arthritis ◽  
Mortality Risk ◽  
Psoriasis Patient ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Severe Psoriasis ◽  
Control Group ◽  
Research Database ◽  
Control Subjects

Background: Previous studies showed conflicting results regarding the mortality risk in psoriasis patients with respect to disease severity and presence of psoriatic arthritis. This study aimed to determine the mortality risk in patients with mild and severe psoriasis and patients with psoriatic arthritis (PsA). Methods: A nationwide population-based cohort study was conducted based on data from the Taiwan National Health Insurance Research Database between 2002 and 2012. Incident psoriasis subjects were classified into two groups: psoriasis without arthritis and psoriasis with arthritis. Patients who had received systemic therapy and/or phototherapy were classified as having severe psoriasis; otherwise, patients were classified as having mild psoriasis. Control subjects without psoriasis were selected to match each psoriasis patient from the database within the same observational period. Cox proportional hazards analysis was used to compare the hazard ratio (HR) of time to death. Results: A total of 106,701 patients with psoriasis were included in this study. After controlling for demographics and comorbidities, psoriasis patients had a higher mortality risk compared with the control group (HR 1.41; 95% confidence interval (CI) 1.36 to 1.46). Compared with psoriasis alone, the mortality risk was not increased for PsA (HR = 1.01; 95% CI 0.93 to 1.10). Besides, severe psoriasis did not increase mortality risk compared with mild psoriasis (HR = 1.0; 95% CI 0.95 to 1.06). Conclusions: Patients with psoriasis had a higher mortality risk compared with control subjects, whereas psoriasis severity and presence of PsA had no impact on mortality risk in psoriasis patients.

scholarly journals Recent advances in understanding and managing psoriatic arthritis

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2670 ◽  
Author(s):  
Dafna D. Gladman
Keyword(s):  
Psoriatic Arthritis ◽  
Early Diagnosis ◽  
Clinical Laboratory ◽  
Joint Damage ◽  
Screening Tools ◽  
Therapeutic Interventions ◽  
Joint Disease ◽  
New Therapeutic Approaches ◽  
Recent Advances ◽  
And Function

This article reviews recent advances in psoriatic arthritis (PsA) over the past several years with emphasis on early diagnosis, better understanding of pathogenesis, and new therapeutic approaches. Early diagnosis is important, since people who present late do not fare as well. There are a number of clinical, laboratory, and ultrasound features that can help identify patients destined to develop PsA, and several screening tools have been developed. It is recognized that genetic and epigenetic factors, as well as T cells and cytokines, play a role in the pathogenesis of PsA, and several targets have been identified for therapeutic interventions. New therapies have been developed and tested in PsA and have been found to be highly effective for both skin and joint manifestations of the disease. The expectation is that, in the future, PsA patients will be treated early and more aggressively and that there will not be significant progression of joint damage. Moreover, with effective treatment of the skin and joint disease and management of risk factors for the comorbidities, we can expect to reduce their occurrence and further reduce the excess mortality and reduced quality of life and function in these patients.

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