INTRODUCTION: Psoriatic arthritis (PsA) affects 10-30% of individuals with psoriasis. Early detection of PsA is crucial to prevent potential irreversible joint damage. The Psoriasis Epidemiology Screening Tool (PEST) has proven to be an effective tool in daily clinical practice, but limited data is available on the analysis of positive responses. Our study aimed to determine the combination of positive responses to individual questions and characterize patients with positive PEST results based on specific anatomical sites of psoriasis, duration of the disease, and epidemiological parameters that could potentially predict PEST positivity. METHODS: The PEST questionnaire was randomly administered to patients with psoriasis without psoriatic arthritis attending the outpatient unit for psoriasis treatment. A total of 351 patients completed the PEST questionnaire over a 24-month period. Patients undergoing various types of therapy were included. Each patient completed the PEST questionnaire once, and epidemiological data (such as age, weight, height, body mass index, smoking status, age of disease onset, disease duration, and family history of psoriasis) were collected, as well as types of therapy. RESULTS: We included 242 men and 109 women with an average age of 49.4 years and duration of psoriasis of 23.3 years. A positive PEST questionnaire result was found in 28.5% of patients; 13.1% had a score of 3, 8.0% a score of 4 and 7.4% a score of 5. Nail psoriasis, higher age, and therapy with biological/targeted therapy were associated with PEST positivity. The most frequently observed positive response was nail involvement. CONCLUSION: The PEST questionnaire is a well-established screening tool for identifying patients at risk of having undiagnosed psoriatic arthritis in daily dermatological practice. Patients with nail involvement, higher age, or treated with modern systemic therapy should be closely monitored, as these factors indicate a higher risk of a positive PEST result and consequently higher risk of having psoriatic arthritis.
- Publikační typ
- časopisecké články MeSH
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- MeSH
- komorbidita MeSH
- lidé MeSH
- nádory prsu terapie MeSH
- psoriáza * farmakoterapie MeSH
- senioři MeSH
- ustekinumab farmakologie terapeutické užití MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Psoriasis vulgaris is a chronic immune-mediated inflammatory disease of the skin. Biologic therapy has been available for more than 10 years and has become one of the standard treatments for patients with moderate to severe psoriasis. Initially, only biologics against tumour necrosis factor alpha (TNF-α) were used, and only later did drugs against different interleukins (ILs), including IL-17 or IL-23, became available. The side effects of biologic therapy include paradoxical adverse events (PAEs), such as palmoplantar pustular reaction, especially with anti-TNF-α drugs. We present the case of a 49-year-old female patient with diabetes and psoriasis and psoriatic arthritis treated with an adalimumab biosimilar who developed a severe PAE of the palmoplantar pustular type. Treatment with adalimumab was stopped and the patient switched to ixekizumab which was successful. When a paradoxical reaction develops during biologic therapy, especially when it is severe as in our patient, switching to another class of biologics is advised.
- Publikační typ
- časopisecké články MeSH
Pacienti s psoriázou jsou vystaveni zvýšenému riziku aterosklerózy, která je charakterizovaná endotelovou dysfunkcí spojenou se systémovým zánětem. Zdá se, že léčba anti-tumor nekrotizujícím faktorem alfa (anti-TNF-a) může toto riziko snížit. Účelem studie bylo změřit hladiny sérových markerů asociovaných se systémovým zánětem u pacientů s psoriázou v porovnaní se zdravými jedinci a dále zhodnotit změnu jejich hladin po 3 měsících a 2 letech při léčbě anti-TNF alfa adalimumabem. Zkoumali jsme čtyři biomarkery: vysoce senzitivní C-reaktivní protein (hsCRP), oxidovaný lipoprotein s nízkou hustotou (OxLDL), E-selektin a Interleukin 22 (IL-22). Tyto markery byly stanoveny u zdravých dobrovolníků a u 28 pacientů se středně těžkou až těžkou psoriázou před léčbou a po 3 a 24 měsících léčby adalimumabem. Pacienti s psoriázou měli zvýšené hladiny markerů ve srovnání s kontrolní skupinou. Po 3 měsících léčby významně poklesl E-selektin (p < 0,001), stejně tak IL-22 (p < 0,001). HsCRP pokleslo také, ale statisticky nevýznamně, OxLDL byl lehce vyšší než původně. Po 24 měsících bylo 17 pacientů stále léčeno adalimumabem. U těchto pacientů hsCRP (p < 0,05), E-selektin (p < 0,001) a IL-22 (p < 0,001) byly signifikantně snížené. Hodnota OxLDL zůstala zvýšena. Stabilní pokles E-selektinu, hsCRP a IL-22 po 24 měsících potvrzuje, že adalimumab potlačuje systémový zánět.
Patients with psoriasis are at increased risk of atherosclerosis, which is characterized by endothelial dysfunction associated with systemic inflammation. It appears that anti-tumor necrosis alpha treatment may reduce this risk. The purpose of this study was to measure serum marker levels associated with systemic inflammation in patients with psoriasis compared to healthy subjects and to further evaluate the change in their levels after 3 months and 2 years of treatment with adalimumab. We investigated four biomarkers: highly sensitive C-reactive protein (hsCRP), oxidized low density lipoproteins (OxLDL), E-selectin and Interleukin 22 (IL-22). These markers were determined in healthy volunteers and in 28 patients with moderate to severe psoriasis before and after 3 and 24 months of adalimumab treatment. Patients with psoriasis had elevated markers levels compared to controls. After 3 months of treatment, E-selectin decreased significantly (p < 0.001), same as IL-22 (p < 0.001). HsCRP also decreased, but statistically insignificantly, OxLDLs were slightly higher than originally. After 24 months, 17 patients were still treated with adalimumab. In these patients, HsCRP (p < 0.05), E-selectin (p < 0.001) and IL-22 (p < 0.001) were significantly reduced. The OxLDL value remained elevated. A steady decrease in E-selectin, hsCRP and IL-22 after 24 months confirms that adalimumab suppresses systemic inflammation.
- MeSH
- adalimumab * aplikace a dávkování terapeutické užití MeSH
- biologické markery krev MeSH
- klinické zkoušky jako téma MeSH
- lidé MeSH
- psoriáza * farmakoterapie krev patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- MeSH
- adherence k farmakoterapii * MeSH
- bezpečnost pacientů * MeSH
- biologické přípravky škodlivé účinky terapeutické užití MeSH
- COVID-19 epidemiologie MeSH
- dospělí MeSH
- imunosupresiva škodlivé účinky terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- pandemie MeSH
- průzkumy a dotazníky MeSH
- psoriáza farmakoterapie psychologie MeSH
- SARS-CoV-2 MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- úzkost epidemiologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- dopisy MeSH
- multicentrická studie MeSH
- Geografické názvy
- Česká republika MeSH
