Psoriasis (PsO) has been associated with a range of psychiatric disorders, yet the availability of national-level data remains limited and outdated. This study utilzied the 2023 National Health Interview Survey recent data to elucidate the psychological impact of PsO. This cross-sectional study compared participants with self-reported PsO to those without using Wilcoxon rank sum and chi-square tests. Adjusted logistic regression models assessed odds for life satisfaction, depression, anxiety, and use of medication/therapy for mental health reasons. Weighted analysis demonstrated 7,424,788 participants with self-reported PsO of which 51
Biologic dosing frequency is a key concern among psoriasis (PsO) patients and physicians, yet dosing optimization remains a challenge. This study evaluates patient dosing preferences for IL-17 and IL-23 inhibitors, risankizumab (RZB) every 12 weeks, guselkumab (GUS) every 8 weeks, and ixekizumab (IXE) every 4 weeks, in managing PsO. This phone survey study evaluated 87 adults on RZB (n = 29), GUS (n = 35), or IXE (n = 23) from 2019 onward at two clinical sites. Patients were assessed for baseline PsO bothersome severity, current dosing frequency satisfaction, frequency of PsO flares, and preferred dosing frequency. Most patients were males (57.5%) with an average age of 54.1 years and an average treatment duration of 19.0 months. At baseline before treatment, 87% were 'very bothered' by their PsO. After treatment, 86% were either '3-somewhat' or '4-very satisfied' with their current dosing schedule, with no significant differences between each drug (P = 0.7). Across all biologics the majority of participants (62% with RZB, 57% with GUS, and 48% with IXE) preferred maintaining their current dosing frequency. No statistically significant differences were observed in dosing frequency preference between treatment groups, suggesting dosing schedule is not a primary concern for most patients. This aligns with previous research demonstrating effective disease control is the most important factor for patient satisfaction; however, tailoring dosing regimens to individual patient needs can also strengthen long-term adherence, as demonstrated in recent studies.
Meta-analyses reporting patient adherence to prescribed psoriasis (Pso) and psoriatic arthritis (PsA) biologic therapy range from 61% to 70%, with limited data elucidating reasons for non-adherence. Our study's objective was to characterize patient-reported factors associated with adherence among IL-23 inhibitors in Pso and PsA patients treated at a single clinic at our institution from 2019 onwards. Patient-reported therapy satisfaction was assessed using an adapted Treatment Satisfaction Questionnaire for Medication (TSQM-9), a validated instrument (from 0 to 100) used to assess patient satisfaction with medication across three domains: effectiveness, convenience, and global satisfaction. Medication non-adherence was defined as at least one missed injection over the study period. Exploratory factor loading was conducted to identify specific attributes of therapy associated with adherence. The mean treatment duration from drug initiation to the study period was 14.1 months ± 10.0, with 22 patients prescribed risankizumab and 15 patients prescribed guselkumab. In our cohort, 32% of patients reported at least one missed dose, and 5% of patients reported multiple missed doses. The overall TSQM-9 scores were as follows: effectiveness 93.4 ± 7.9, convenience 93.4 ± 9.1, and global satisfaction 89.6 ± 15.9. Mean scores for TSQM-9 statistically differed (p < 0.05) between fully compliant patients and non-compliant patients for convenience (96.5 ± 5.4 vs. 87.6 ± 11.8). There were no intra-drug differences in satisfaction or adherence despite variations in dosing regimens. Factor loading revealed medication planning, medication administration, and side effects as the top three variables responsible for satisfaction variance between groups.
Introduction: Biologic therapies such as JAK-inhibitors (Abrocitinib, Upadicitinib), IL-4 (Tralokinumab), and IL-13 (Dupilumab) antagonists have recently been approved by the FDA for moderate-to-severe atopic dermatitis (AD). Given these advances and limited understanding of the comparative drug efficacy, we sought to summarize and evaluate drug efficacy, safety, and monitoring requirements by patient profile to optimize outcomes.
Background:Despite recent advances in biologics, there is a lack of significant evidence regarding the comparative efficacy of biologics in treating more resistant features of psoriasis, namely nail psoriasis. A systematic review synthesizing data from multiple studies is efficacious in assessing the comparative efficacy among biologics for the treatment of nail psoriasis. Objective:To evaluate and compare the efficacy of biologics for the treatment of nail psoriasis. Methods:Utilizing PRISMA guidelines, a systematic literature review was conducted using the Pubmed database on November 16, 2022. Studies selected were phase 3 or 4 randomized clinical trials, clinical studies, or other randomized trials with data on the treatment with biologics for adults with nail psoriasis. Results:Sixteen studies meeting inclusion criteria were included for analysis. At 24 weeks, the highest mean NAPSI percent improvement achieved at week 24 was by brodalumab (76.9%) followed by etanercept (74%) and ixekizumab (70.5%) while the biologics achieving the greatest proportion of NAPSI 0 were adalimumab (44.6%) and ixekizumab (41%). Conclusions:This study helps elucidate the comparative efficacy of biologics for the treatment of nail psoriasis. This review suggests that brodalumab and etanercept are associated with the highest percent improvement in nail psoriasis while adalimumab and ixekizumab are associated with the greatest probability of complete nail resolution.
Background: The Monkeypox virus (MPX) has been detected in multiple non-endemic countries since May 2022. Although there are no approved treatments for MPX, three antivirals (brincidofovir, cidofovir, tecovirimat) have been utilized based on data from animal studies. The objective of our study was to conduct a systematic review to summarize and evaluate antiviral therapy efficacy for MPX among human patients.
BACKGROUND:The Monkeypox virus (MPX) has been detected in multiple non-endemic countries since May 2022. The cutaneous manifestations of MPX can have multiple distinct presentations, including pustular and vesicular. Although there are no approved treatments, three antivirals (brincidofovir, cidofovir, tecovirimat) have been utilized. The objective of our study was to conduct a systematic review to evaluate antiviral efficacy (first aim) and cutaneous manifestations of MPX (second aim).METHODS:Utilizing PRISMA guidelines, we searched PubMed and SCOPUS databases to identify studies utilizing antiviral treatment in human subjects for MPX and studies reporting cutaneous characteristics of MPX lesions.RESULTS:For our first aim, six articles met inclusion criteria. For our second aim, 27 met inclusion criteria. Eighty-eight percent had complete resolution with tecovirimat (n=28) which was well tolerated, and decreased hospitalization time (10 days) compared to brincidofovir (29 days). Forty-four percent of patients had <10 cutaneous lesions and 36% had 10-100 lesions. The most common lesion type was pustular (32%, n=380).CONCLUSION:This limited sample of studies suggests that tecovirimat is well tolerated and may be an effective antiviral for MPX treatment. Further studies are required to better understand the role of antivirals for MPX treatment among human patients. J Drugs Dermatol. 2023;22(3): doi:10.36849/JDD.7263.
Cutaneous reactions have been commonly associated with the Moderna messenger RNA (mRNA) COVID-19 vaccine. Among the reported cutaneous side effects, there have not been any associations reported yet regarding keratoacanthoma development after COVID-19 mRNA vaccination. We report a novel case of an 86-year-old man who experienced an eruption of multiple keratoacanthomas 2 weeks after inoculation with the Moderna mRNA-1273 vaccine that resolved following treatment with intralesional 5-fluorouracil.
