INTRODUCTION: Understanding how different comorbidities and epidemiological factors are related to psoriasis severity can help us estimating patients' clinical outcome. AIM: Establish possible prognostic factors of severe psoriasis. METHODS: Three groups of patients were included: 118 were on topical therapy, 83 used conventional systemic drugs, and 112 were treated with biological agents. Based on the fact that patients on topical therapy have a lower grade of disease severity than patients treated systemically, we compared a variety of comorbidities and epidemiological parameters between the three groups. RESULTS: Patients treated more aggressively have an increased risk of cardiovascular disease (p = .044), suffer more from depression (p = .020), hyperuricemia (p = .031) and nonspecific noninfectious liver disease (p = .005). Male gender (p < .001), increased height (p < .001), early age of disease onset (p < .001), viral upper respiratory infections (p = .049) and periods of hormonal changes (p = .045) are associated with these therapies. CONCLUSION: Psoriasis severity is directly related to an increased risk of cardiovascular disease, depression, hyperuricemia and nonspecific noninfectious liver disease. Male gender, increased height, early age of disease onset, viral upper respiratory infections and periods of hormonal changes seem to be prognostic of higher degrees of psoriasis severity. We are pioneering the use of increased height and puberty, menopause/andropause as independent prognostic factors of psoriasis severity.

• Klíčová slova
• Psoriasis, high-need psoriasis, psoriasis prognostic factors, psoriasis trigger factors,
• MeSH
• biologické faktory terapeutické užití   MeSH
• dermatologické látky * terapeutické užití   MeSH
• hyperurikemie * farmakoterapie   MeSH
• infekce dýchací soustavy * farmakoterapie   MeSH
• kardiovaskulární nemoci * epidemiologie   MeSH
• lidé MeSH
• nemoci jater * farmakoterapie   MeSH
• psoriáza * farmakoterapie   epidemiologie   MeSH
• stupeň závažnosti nemoci MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• biologické faktory MeSH
• dermatologické látky * MeSH

BACKGROUND: Drug survival analysis of biologic agents in psoriasis is of extreme importance, as it allows not only the evaluation of objective clinical outcomes (such as effectiveness and safety) but also of factors that are associated with patients' adherence to treatment. The aim of this study was to evaluate and compare the drug survival of the most recent biologic agents approved for the treatment of moderate-to-severe psoriasis-ustekinumab, secukinumab, ixekizumab, brodalumab, guselkumab, and risankizumab-and to identify clinical predictors that can influence the drug survival of these drugs. METHODS: This retrospective multicentric cohort study from 16 dermatology centers in Portugal, Spain, Italy, Switzerland, Czech Republic, Canada, and the United States included patients that started IL-12/23, IL-17 (IL-17A and IL-17R) and IL-23 inhibitors for the treatment of psoriasis between January 1, 2012 and December 31, 2019. Survival analysis was performed using a Kaplan-Meier estimator, to obtain descriptive survival curves, and proportional hazard Cox regression models. RESULTS: A total of 3312 treatment courses (total patients: 3145) were included in the study; 1118 (33.8%) with an IL-12/23 inhibitor (ustekinumab), 1678 (50.7%) with an IL-17 inhibitor [911 (27.5%) on secukinumab, 651 (19.7%) on ixekizumab, 116 (3.5%) on brodalumab], and 516 (15.5%) with an IL-23 inhibitor [398 (12.0%) on guselkumab, 118 (3.5%) on risankizumab]. At 18 months, the cumulative probability of survival was 96.4% for risankizumab, 91.1% for guselkumab, 86.3% for brodalumab, 86.1% for ustekinumab, 82.0% for ixekizumab, and 79.9% for secukinumab. Using ustekinumab as reference, drug survival of guselkumab was higher (HR 0.609; 95% CI 0.418-0.887) and that of secukinumab was lower (HR 1.490; 95% CI 1.257-1.766). In the final multivariable model, secukinumab, female sex, higher BMI, and prior exposure to biologic agents significantly increased the risk of drug discontinuation, whereas risankizumab was protective. CONCLUSION: In this multinational cohort with 8439 patient-years of follow-up, the cumulative probability of drug survival for all drugs was >79% at 18 months. Prescribed biologic, female sex, higher BMI, and previous exposure to biologic agents were predictors of drug discontinuation. Drug survival of guselkumab and risankizumab was higher than that of ustekinumab, and secukinumab was lower.

• MeSH
• biologické přípravky farmakologie   terapeutické užití   MeSH
• časové faktory MeSH
• dermatologické látky farmakologie   terapeutické užití   MeSH
• dospělí MeSH
• indukce remise metody   MeSH
• interleukin-12 antagonisté a inhibitory   imunologie   MeSH
• interleukin-17 antagonisté a inhibitory   imunologie   MeSH
• interleukin-23 antagonisté a inhibitory   imunologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• psoriáza farmakoterapie   imunologie   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• srovnávací studie MeSH
• Názvy látek
• biologické přípravky MeSH
• dermatologické látky MeSH
• interleukin-12 MeSH
• interleukin-17 MeSH
• interleukin-23 MeSH

BACKGROUND: Insights into the real-world treatment paradigm and long-term burden of atopic dermatitis (AD) are needed to inform clinical and health policy decisions. METHODS: The prospective, observational EUROSTAD study enrolled adults with moderate-to-severe AD starting or switching systemic therapy (51 sites in 10 European countries). We report the baseline characteristics, treatment patterns, and outcomes of these patients using descriptive statistics. RESULTS: A 12-month enrollment period of EUROSTAD was completed and 308 patients were enrolled: average age 37 years, AD duration 25 years, 43% were female. Most patients reported use of systemic therapy (93%) and ≥1 atopic comorbidity (82%). Mean [standard deviation] disease severity/burden measures were high: Investigator's Global Assessment (3.1 [0.8]), Eczema Area and Severity Index (16.2 [10.9]), Peak Pruritus Numerical Rating Scale (5.5 [2.5]), sleep impairment Visual Analog Scale (49.8 [31.6]) scores, and time lost from work (4.1 [13.7] days/year) or usual activities (16.8 [38.7] days/year). Most patients showed borderline or clinical levels of anxiety (59%) and/or depression (63%) using the Hospital Anxiety and Depression Scale. CONCLUSIONS: Adults with moderate-to-severe AD starting/switching systemic treatment enrolled in EUROSTAD have a high burden of longstanding disease despite continuous use of topical drugs, emollients, and systemic therapies.

• Klíčová slova
• Atopic dermatitis, patient-reported outcomes, quality of life, systemic therapy,
• MeSH
• atopická dermatitida farmakoterapie   epidemiologie   patologie   MeSH
• cyklosporin terapeutické užití   MeSH
• dermatologické látky terapeutické užití   MeSH
• dospělí MeSH
• hormony kůry nadledvin terapeutické užití   MeSH
• komorbidita MeSH
• kvalita života MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• osobní újma zaviněná nemocí * MeSH
• prevalence MeSH
• prospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stupeň závažnosti nemoci MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• Názvy látek
• cyklosporin MeSH
• dermatologické látky MeSH
• hormony kůry nadledvin MeSH

BACKGROUND: Acne vulgaris (acne), a common inflammatory skin disorder, has its peak incidence between 14 and 19 years of age, with girls frequently developing acne earlier than boys. Over recent years, persistent acne is becoming more prevalent in adult women. OBJECTIVES: This review and panel discussion addresses challenges in acne management, particularly in adult women. The role which nonprescription acne treatment can play is explored when used as monotherapy or as an adjunctive treatment for acne of all severity. METHODS: The best available evidence on nonprescription acne treatment was coupled with the opinion of an international expert panel of dermatologists to adopt statements and recommendations discussed in this review. RESULTS: All severity of acne has a significant burden on patients. Addressing environmental factors that are important for the individual with acne may help to educate, prevent, effectively manage, and maintain acne, as per the panel. They agreed that the adult female acne population has unique needs because of their aging skin and social environment. Nonprescription acne treatment products may help to balance the efficacy and tolerability of prescription acne treatment. Currently, there are no specific guidelines for how to use nonprescription acne treatment products in these patients. CONCLUSION: The panel agreed that guidelines including nonprescription acne treatment either as monotherapy for mild acne or in combination with prescription treatments for more severe acne would address a significant unmet need.

• Klíčová slova
• acne in adult women, acne vulgaris, adjunctive treatment, dermocosmetics, monotherapy,
• MeSH
• acne vulgaris * farmakoterapie   MeSH
• dermatologické látky * terapeutické užití   MeSH
• dospělí MeSH
• kůže MeSH
• lidé MeSH
• stárnutí kůže * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• dermatologické látky * MeSH

• MeSH
• adalimumab farmakologie   terapeutické užití   MeSH
• dermatologické látky farmakologie   terapeutické užití   MeSH
• hidradenitis suppurativa diagnóza   farmakoterapie   imunologie   MeSH
• humanizované monoklonální protilátky farmakologie   terapeutické užití   MeSH
• hýždě MeSH
• interleukin-17 imunologie   metabolismus   MeSH
• léková rezistence MeSH
• lidé středního věku MeSH
• lidé MeSH
• receptory interleukinu-17 antagonisté a inhibitory   metabolismus   MeSH
• stupeň závažnosti nemoci MeSH
• TNF-alfa antagonisté a inhibitory   imunologie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• adalimumab MeSH
• brodalumab MeSH Prohlížeč
• dermatologické látky MeSH
• humanizované monoklonální protilátky MeSH
• IL17RA protein, human MeSH Prohlížeč
• interleukin-17 MeSH
• receptory interleukinu-17 MeSH
• TNF protein, human MeSH Prohlížeč
• TNF-alfa MeSH

The authors present two cases of severe atopic dermatitis with extremely elevated IgE levels treated with omalizumab. The effect of this treatment was completely unconvincing in both patients, most likely because of extremely elevated IgE values, which could not be eliminated by omalizumab. Our observation is consistent with earlier published literature reporting that omalizumab as a treatment for atopic dermatitis seems to work better in patients with lower levels of IgE antibodies.

• MeSH
• atopická dermatitida farmakoterapie   imunologie   MeSH
• dermatologické látky terapeutické užití   MeSH
• dospělí MeSH
• imunoglobulin E imunologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• omalizumab terapeutické užití   MeSH
• vztah mezi dávkou a účinkem léčiva MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• přehledy MeSH
• Názvy látek
• dermatologické látky MeSH
• imunoglobulin E MeSH
• omalizumab MeSH

BACKGROUND: EGALITY was a phase III confirmatory efficacy and safety study conducted in patients with plaque-type psoriasis as a part of totality of evidence gathered during the development of GP2015, an etanercept biosimilar. OBJECTIVE: To demonstrate equivalent efficacy and comparable safety and immunogenicity of GP2015 and the etanercept originator product (ETN, Enbrel® ) and evaluate effects of repeated switching between GP2015 and ETN. Results for efficacy, safety and immunogenicity during treatment period (TP) 2 (TP2) are presented pooling the two continued treatment arms (pooled continued) versus the two treatment arms with repeated switches (pooled switched). METHODS: Patients (n = 531) were randomized 1:1 to self-administer GP2015 or ETN twice-weekly subcutaneously during TP1. Patients with a ≥50% improvement in Psoriasis Area and Severity Index (PASI 50) at week 12 were re-randomized for TP2 to continue the same treatment at once-weekly dosing or to undergo three consecutive treatment switches between GP2015 and ETN until week 30. Patients continued the last-assigned treatment during TP2, until week 52. RESULTS: Mean (standard deviation [SD]) PASI scores at baseline were similar in patients who underwent multiple switches compared to those with continued treatments during TP2. During TP2, PASI 50, PASI 75 and PASI 90 response rates, percent change from baseline in PASI scores and all other efficacy parameters were similar between the pooled switched and pooled continued treatment groups at all time points. The incidence of treatment-emergent adverse events including injection site reactions was comparable between the pooled switched (36.7%) and pooled continued (34.9%) groups. None of the patients in either treatment group were positive for binding anti-drug antibodies in TP2. CONCLUSION: Treatment efficacy, safety and immunogenicity were similar between the pooled continued and pooled switched treatments during TP2, indicating that there are no effects in the short term on clinical data of multiple switches between GP2015 and ETN.

• MeSH
• biosimilární léčivé přípravky aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• chronická nemoc MeSH
• dermatologické látky aplikace a dávkování   škodlivé účinky   imunologie   terapeutické užití   MeSH
• dospělí MeSH
• dvojitá slepá metoda MeSH
• etanercept aplikace a dávkování   škodlivé účinky   analogy a deriváty   terapeutické užití   MeSH
• injekce subkutánní MeSH
• lidé středního věku MeSH
• lidé MeSH
• protilátky imunologie   MeSH
• psoriáza farmakoterapie   imunologie   MeSH
• rozvrh dávkování léků MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze III MeSH
• multicentrická studie MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• biosimilární léčivé přípravky MeSH
• dermatologické látky MeSH
• etanercept MeSH
• GP2015 MeSH Prohlížeč
• protilátky MeSH

BACKGROUND: Biologics have greatly improved psoriasis management. However, primary and secondary non-response to treatment requires innovative strategies to optimize outcomes. OBJECTIVE: To describe the use of combined treatment of biologics with conventional systemic agents or phototherapy in daily clinical practice. METHODS: We collected data on frequency of use, demographics, treatment characteristics and drug survival of biologics combined with conventional systemic agents or phototherapy in five PSONET registries. RESULTS: Of 9922 biologic treatment cycles, 982 (9.9%) were identified as combination treatment. 72.9% of treatment cycles concerned concomitant use of methotrexate, 25.3% concerned concomitant UVB therapy, acitretin or cyclosporin and 1.8% concerned combined treatment with PUVA, fumaric acids or a second biologic. Substantial variation was detected in type and frequency of combination treatments prescribed across registries. Patients initiated on combined treatment had generally severe disease and were affected with psoriasis for many years. The extent to which patients had been priory treated with biologic monotherapy and the proportion of patients affected with psoriatic arthritis differed between registries. Survival rates for etanercept, adalimumab, infliximab and ustekinumab with methotrexate ranged between 43 and 92%, 28 and 83%, 65 and 87% and 53 and 77%, respectively, across registries after one year with no consistent superior survival for a particular biologic. Longest survival on a biologic combined with methotrexate, acitretin or cyclosporin was 103, 78 and 34 months, respectively. CONCLUSION: Methotrexate was the most commonly used concomitant treatment for patients on a biologic. Wide geographical variations in treatment selection and persistence of combination treatment exist. Data derived from ongoing studies may help to determine whether combined treatment is superior to biologic monotherapy.

• MeSH
• acitretin terapeutické užití   MeSH
• adalimumab terapeutické užití   MeSH
• biologické přípravky terapeutické užití   MeSH
• cyklosporin terapeutické užití   MeSH
• dermatologické látky terapeutické užití   MeSH
• etanercept terapeutické užití   MeSH
• fumaráty terapeutické užití   MeSH
• infliximab terapeutické užití   MeSH
• Kaplanův-Meierův odhad MeSH
• kombinovaná farmakoterapie MeSH
• kombinovaná terapie MeSH
• lidé středního věku MeSH
• lidé MeSH
• methotrexát terapeutické užití   MeSH
• psoriáza terapie   MeSH
• PUVA terapie * MeSH
• registrace MeSH
• stupeň závažnosti nemoci MeSH
• ustekinumab terapeutické užití   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Itálie MeSH
• Izrael MeSH
• Nizozemsko MeSH
• Rakousko MeSH
• Názvy látek
• acitretin MeSH
• adalimumab MeSH
• biologické přípravky MeSH
• cyklosporin MeSH
• dermatologické látky MeSH
• etanercept MeSH
• fumaráty MeSH
• fumaric acid MeSH Prohlížeč
• infliximab MeSH
• methotrexát MeSH
• ustekinumab MeSH

Psoriasis is a chronic systemic immune-mediated inflammatory dermatosis associated with several comorbidities. Psoriasis patients are at increased risk of developing cardiovascular diseases (CVD), namely, coronary heart disease, stroke or peripheral vascular disease, and psoriasis seems to be an independent cardiovascular risk factor. Antipsoriatic systemic therapy, especially anti-tumor necrosis factor (TNF)-α, seems to exert a beneficial effect on these comorbidities. The purpose of this study was: (i) to measure the level of cardiovascular serum markers in psoriasis patients in comparison with healthy volunteers; and (ii) to compare the serum level of the same markers in patients before and 3 months after adalimumab therapy. We investigated six biomarkers connected to CVD: C-reactive protein (measured high sensitively, hsCRP), oxidized low-density lipoproteins (oxLDL), oxLDL/β-glycoprotein I complex (oxLDL/β2GPI), vascular endothelial adhesion molecule 1 (VCAM-1), E-selectin and interleukin (IL)-22. These biomarkers were measured in 21 patients with moderate/severe psoriasis before and after treatment with adalimumab and in healthy volunteers. hsCRP (P < 0.05), oxLDL-β2GPI complex (P < 0.05), E-selectin (P < 0.001) and IL-22 (P < 0.001) were significantly increased in comparison with healthy controls, whereas oxLDL and VCAM-1 were also higher in psoriasis patients but the difference did not reach statistical significance. A decrease of E-selectin (P < 0.001) and IL-22 (P < 0.001) was observed after 3 months of adalimumab therapy. Inhibition of TNF-α seems to not only improve psoriasis but also decreases serum cardiovascular biomarkers. E-selectin and IL-22 could serve for monitoring of the efficacy of antipsoriatic systemic therapy on cardiovascular risk.

• Klíčová slova
• adalimumab, atherosclerosis, biomarkers, cardiovascular, psoriasis,
• MeSH
• adalimumab aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• beta-2-glykoprotein I krev   MeSH
• biologické markery krev   MeSH
• C-reaktivní protein analýza   MeSH
• cévní buněčněadhezivní molekula-1 krev   MeSH
• dermatologické látky aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• dospělí MeSH
• E-selektin krev   MeSH
• interleukin 22 MeSH
• interleukiny krev   MeSH
• kardiovaskulární nemoci krev   komplikace   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lipoproteiny LDL krev   MeSH
• pilotní projekty MeSH
• psoriáza krev   komplikace   farmakoterapie   MeSH
• rizikové faktory MeSH
• TNF-alfa antagonisté a inhibitory   MeSH
• zdraví dobrovolníci pro lékařské studie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Názvy látek
• adalimumab MeSH
• beta-2-glykoprotein I MeSH
• biologické markery MeSH
• C-reaktivní protein MeSH
• cévní buněčněadhezivní molekula-1 MeSH
• dermatologické látky MeSH
• E-selektin MeSH
• interleukiny MeSH
• lipoproteiny LDL MeSH
• oxidized low density lipoprotein MeSH Prohlížeč
• SELE protein, human MeSH Prohlížeč
• TNF-alfa MeSH

BACKGROUND: BIOREP is a Czech registry of psoriatic patients on biological treatment in a clinical setting. We describe the characteristics of patients with psoriasis at the time of enrollment and present comparisons with published data from other national registries. METHODS: We analyzed the cohort of patients treated with biologics between May 2005 and May 2015. Demographic data, previous therapies, comorbidities, and severity of psoriasis were compared with data from other registries - DERMBIO, BIOBADADERM, BADBIR, and PSOBEST. RESULTS: A total of 1412 psoriatic patients initiating biological treatment were included with a predominance of males (63.4%). The mean patient age was 50.2 years, and approximately 70.5% of patients were either overweight or obese. The mean baseline Psoriasis Area and Severity Index was 19.8, and the Dermatology Life Quality Index was 16.6. More than one-third of patients (41.0%) reported a history of psoriatic arthritis, and a high proportion of patients (49.5%) with cardiovascular risk factors (hypertension [35.2%], hyperlipidemia [27.7%], diabetes mellitus [11.4%], coronary heart disease [4.9%], and obesity [15.2%]) were observed. Most of the patients had been previously treated with phototherapy (85.4%), acitretin (74.0%), methotrexate (65.7%), or cyclosporine (53.1%). CONCLUSION: BIOREP is one of the first registries of patients with psoriasis treated with biologics in Central and Eastern Europe. Our results found a similar or higher prevalence of comorbidities, long disease duration, and high impact on the quality of life among patients included in Western European registries.

• MeSH
• acitretin terapeutické užití   MeSH
• biologické přípravky terapeutické užití   MeSH
• cyklosporin terapeutické užití   MeSH
• dermatologické látky terapeutické užití   MeSH
• diabetes mellitus epidemiologie   MeSH
• dospělí MeSH
• fototerapie MeSH
• hyperlipidemie epidemiologie   MeSH
• hypertenze epidemiologie   MeSH
• index tělesné hmotnosti MeSH
• keratolytika terapeutické užití   MeSH
• komorbidita MeSH
• koronární nemoc epidemiologie   MeSH
• kvalita života MeSH
• lidé středního věku MeSH
• lidé MeSH
• methotrexát terapeutické užití   MeSH
• obezita epidemiologie   MeSH
• opakovaná terapie MeSH
• prevalence MeSH
• psoriáza farmakoterapie   epidemiologie   terapie   MeSH
• registrace MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• stupeň závažnosti nemoci MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• acitretin MeSH
• biologické přípravky MeSH
• cyklosporin MeSH
• dermatologické látky MeSH
• keratolytika MeSH
• methotrexát MeSH