Background Few systematic data on sex-related treatment responses exist for psoriasis. Objectives To evaluate sex differences with respect to systemic antipsoriatic treatment. Methods Data from patients with moderate-to-severe psoriasis in the PsoBest or Swiss Dermatology Network of Targeted Therapies (SDNTT) registries were analysed. Treatment response was defined as achieving a >= 75% reduction in Psoriasis Area and Severity Index (PASI 75) or PASI <= 3 at treatment months 3, 6 and 12, supplemented by patient-reported outcomes [i.e. Dermatology Life Quality Index (DLQI) <= 1 and delta DLQI >= 4]. Results In total, 5346 patients registered between 2007 and 2016 were included (PsoBest, n = 4896; SDNTT, n = 450). The majority received nonbiological treatment (67.3% male, 69.8% female). Women showed slightly higher PASI response rates after 3 (54.8% vs. 47.2%; P <= 0.001), 6 (70.8% vs. 63.8%; P <= 0.001) and 12 months (72.3% vs. 66.1%; P <= 0.004). A significantly higher proportion of women achieved a reduction in DLQI >= 4 [month 3: 61.4% vs 54.8% (P <= 0.001); month 6: 69.6% vs. 62.4% (P <= 0.001); month 12: 70.7% vs. 64.4% (P <= 0.002)]. Regarding PASI <= 3, women on biologics showed a significantly superior treatment response compared with men at 3 (57.8% vs. 48.5%; P <= 0.004) and 6 months (69.2% vs. 60.9%; P <= 0.018). Women in the nonbiological treatment group had a significantly better treatment response (PASI response, PASI 75 and PASI <= 3) over 12 months compared with men. Conclusions We provide evidence that women experience better treatment outcomes with systemic antipsoriatic therapy than men.

Due to the increasing incidence of skin cancer, programmes for the prevention of skin cancer have been developed and implemented in Germany. However, utilization of skin cancer screenings shows marked regional differences. Reasons and predictors of such variations are unclear.

Effects of a Protein Optimized Diet Combined with Moderate Resistance Training on the Postoperative Course in Older Patients with Hip Fracture

Methotrexate (MTX) remains one of the most frequently used first-line systemic treatment options in patients with plaque-type psoriasis [1]. Direct head-to-head trials against adalimumab, infliximab and ixekizumab [2] as well as indirect comparisons [3] indicate lower efficacy compared to biologic therapies. The comparator studies were conducted with oral MTX which may be suboptimal compared to subcutaneous (SC) administration due to the generation of lower levels of biologically active MTX polyglutamate [4]. A clinical trial with SC MTX suggested improved long-term disease control compared to oral MTX in previous studies, but a direct head-to-head comparison was not performed [5, 6]. The route of administration did not influence response rates in a recent real-life study [7]. Here we report the effectiveness of oral versus subcutaneous MTX in the German psoriasis registry PsoBest.

这项研究由一组来自曼彻斯特和汉堡的皮肤科研究者执行。它使用来自德国银屑病登记数据库和英国皮肤病学会生物干预登记数据库(或 BADBIR,旨在采集用于银屑病的新型生物制剂相关使用和结局的信息)的信息。该团队开发并评估了一个模型,用于预测哪些银屑病患者最可能在开始系统接受治疗(即作用于全身的治疗,而非只是外用于皮肤上)后一年内发生严重感染。评估的治疗范围包括从口服药物的老方法(如甲氨蝶呤或环孢素)到较新的注射生物制剂治疗(如依那西普或优特克单抗)。评估小组就待调查的潜在风险因素(如年龄、性别、疾病严重程度和初始治疗以及其他)达成了一致。这类严重感染是指在患者开始这些治疗后一年内导致患者长时间住院、接受抗生素静脉注射治疗或者死亡的感染。1.7% 的 BADBIR 和德国患者发生了重度感染。严重感染可能性增高的风险因素包括性别为女性、其他潜在疾病(如慢性肺病)、酒精摄入较多和接受生物制剂利妥昔单抗治疗。令人感兴趣的是,年龄本身不会导致感染风险增高。这项研究将被证实极其有助于帮助皮肤科医生决定治疗哪些患者、使用何种药物,以及就饮酒等生活方式选择为患者提供建议。

Several treatment options are currently available for the treatment of psoriasis.

This study was carried out by a group of investigators from dermatology departments in Manchester and Hamburg. It used information from the German Psoriasis Registry and also the British Association of Dermatologists Biologic Interventions Register, or BADBIR, which collects information on the use and outcomes of new biologic drugs used for psoriasis. The team developed and then assessed a model for predicting which patients with psoriasis were most likely to develop severe infection within one year of starting systemically administered treatment (i.e. treatment that works on the whole body, rather than being applied just to the skin). The treatments assessed ranged from older methods where the drug is taken by mouth, such as methotrexate or ciclosporin, to the newer injected biologic therapies, such as etanercept or ustekinumab. Potential risk factors to be investigated, such as age, gender, disease severity and initial therapy, amongst others, were agreed by the assessment group. These serious infections were those where patients had prolonged admissions to hospital, were treated with intravenous antibiotics or where they died, within one year of starting these therapies. 1.7 % of both BADBIR and German patients developed a severe infection. Risk factors for a higher likelihood of serious infections included female gender, other underlying illnesses such as chronic lung disease, higher alcohol intake, and treatment with the biologic, infliximab. Interestingly age did not, by itself, pose a higher risk of infection. This work will prove very useful in helping dermatologists to decide which patients to treat, and with what drug, and to advise patients of lifestyle choices such as drinking alcohol.