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Patel S, Mehren MV, Reed D, Agulnik M, Kaiser P, Charlson J, Kraft A, Hamm J, Karnad A, Ryan C, Rushing D, Meyer C, Khokhar N, McCarthy S, Park Y, Knoblauch R, Parekh T, Maki R, Demetri G. 3403 Final overall survival (OS) analysis of the randomized phase 3 study of trabectedin (T) or dacarbazine (D) for the treatment of patients (pts) with advanced leiomyosarcoma (LMS) or liposarcoma (LPS). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31878-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Campa M, Ryan C, Menter A. An overview of developing TNF-α targeted therapy for the treatment of psoriasis. Expert Opin Investig Drugs 2015; 24:1343-54. [PMID: 26289788 DOI: 10.1517/13543784.2015.1076793] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Three biologic drugs targeting TNF-α are approved to treat moderate-to-severe cutaneous psoriasis. These are adalimumab, etanercept and infliximab. These drugs are given by subcutaneous injection or intravenous infusion, and while generally safe and effective, they are expensive with potential for side effects. Thus, numerous new drug candidates are under development that also target TNF-α. AREAS COVERED In this review, the authors detail several drugs under development that target TNF-α, focusing on those drugs in preclinical, Phase I and II trials. The authors describe emerging biologic psoriasis therapies, including biosimilars and novel biologics, in addition to several synthetic and naturally derived small-molecule drug candidates. EXPERT OPINION The currently approved TNF-α antagonists benefit from over 10 years of safety and efficacy data. The expense and method of administration of these biologics, however, can be cumbersome, and less expensive alternatives have the potential to benefit patients with psoriasis. It is inevitable, despite the introduction of new anti-IL-17 therapies, that established TNF-α targeted therapies, as well as newcomers targeting TNF-α, will continue to play an important role in the lifelong management of psoriasis.
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Ryan C, Barbour A, Burke L, Sheppard MN. Non-infectious aortitis of the ascending aorta: a histological and clinical correlation of 71 cases including overlap with medial degeneration and atheroma—a challenge for the pathologist. J Clin Pathol 2015; 68:898-904. [DOI: 10.1136/jclinpath-2015-203061] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 06/11/2015] [Indexed: 12/15/2022]
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Mooney K, Ryan C, Downey D. ePS03.5 Adherence monitoring in cystic fibrosis centres: Current practice and pharmacists’ perspectives. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30150-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ryan C, Sadlier M, De Vol E, Patel M, Lloyd AA, Day A, Lally A, Kirby B, Menter A. Genital psoriasis is associated with significant impairment in quality of life and sexual functioning. J Am Acad Dermatol 2015; 72:978-83. [DOI: 10.1016/j.jaad.2015.02.1127] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 02/17/2015] [Accepted: 02/18/2015] [Indexed: 02/08/2023]
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Böttcher M, Neumann J, Falkenhagen D, Holtz M, Schmicker R, Ryan C, Klinkmann H. Five-sixths nephrectomy and extracorporeal detoxification in the conscious rat. CONTRIBUTIONS TO NEPHROLOGY 2015; 60:245-51. [PMID: 3345673 DOI: 10.1159/000414809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Wangnapi RA, Soso S, Unger HW, Sawera C, Ome M, Umbers AJ, Ndrewei N, Siba P, Li Wai Suen CSN, Vallely A, Wapling J, Ryan C, Mueller I, Rogerson SJ. Prevalence and risk factors for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis infection in pregnant women in Papua New Guinea. Sex Transm Infect 2014; 91:194-200. [PMID: 25313204 DOI: 10.1136/sextrans-2014-051670] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Accepted: 09/21/2014] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To determine the prevalence of, and risk factors associated with, Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis infection in pregnant women in Madang, Papua New Guinea (PNG). METHODS A cross-sectional survey was conducted among 400 pregnant women presenting to antenatal clinics. Sociodemographic and behavioural data were collected and real-time PCR diagnostic methods were used to detect the presence of chlamydia, gonorrhoea and trichomonas in self-collected vaginal swabs. The relationships between symptoms, sociodemographic and behavioural factors and infection were assessed. RESULTS The prevalence of C. trachomatis was 11.1%, N. gonorrhoeae was 9.7% and T. vaginalis was 21.3%. One-third of women (33.7%) had at least one infection. The most common symptom was abdominal pain (48.0%), but only abnormal vaginal discharge was consistently associated with infection (p<0.001). Women diagnosed with vaginal discharge syndrome were more likely to have at least one treatable infection (50.0% (47/94) vs 26.8% (68/254), p<0.001), yet 59.1% of women with infection would have been missed by the current clinically-based syndromic diagnosis. Risk factors included having a partner at perceived risk of infection, maternal extramarital intercourse, early sexual debut, lack of formal education, urban residence and smoking. 78.8% of women reported never using condoms. CONCLUSIONS The prevalences of T. vaginalis, C. trachomatis and N. gonorrhoeae were high among pregnant women in coastal PNG. The poor performance of clinically based syndromic diagnosis suggests that alternative strategies are urgently required to improve detection and reduce the burden of sexually transmitted infections and their associated adverse pregnancy outcomes in this population.
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Kivelevitch DN, Ryan C, Menter A. The use of tumor necrosis factor inhibitors in pregnancy: what is the evidence? J Am Acad Dermatol 2014; 71:829-31. [PMID: 25219705 DOI: 10.1016/j.jaad.2014.04.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 04/24/2014] [Indexed: 10/24/2022]
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Patel M, Freeman NR, Dhaliwal S, Wright N, Daoud Y, Ryan C, Dibella AV, Menter A. The prevalence of Dupuytren contractures in patients with psoriasis. Clin Exp Dermatol 2014; 39:894-9. [DOI: 10.1111/ced.12424] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2014] [Indexed: 12/15/2022]
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Abstract
To be, or not to be, that is the question - Whether 'tis nobler in the mind to suffer The slings and arrows of outrageous fortune, Or to take arms against a sea of troubles, And by opposing end them? To die, to sleep; … Hamlet, III i Hamlet's soliloquy is surely the most famous expression of suicidal ideation in English literature. However, by the end of the play, it is not Hamlet, but Ophelia who has taken her own life, even though she gave no prior hint of self-destruction.
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Ryan C, Kelleher J, Fagan MF, Rogers S, Collins P, Barker JNWN, Allen M, Hagan R, Renfro L, Kirby B. Genetic markers of treatment response to tumour necrosis factor-α inhibitors in the treatment of psoriasis. Clin Exp Dermatol 2014; 39:519-24. [DOI: 10.1111/ced.12323] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2014] [Indexed: 02/01/2023]
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Cecconi M, Ryan C, Dawson D, Di Tomasso N, McAnulty G, Philips B, Rhodes A. Glycaemia and critical care outcomes. Crit Care 2014. [PMCID: PMC4069443 DOI: 10.1186/cc13631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Ryan C, McHugh B, Boyle B, McGovern E, Bérubé M, Lopez-Suárez P, Elfes CT, Boyd DT, Ylitalo GM, Van Blaricom GR, Clapham PJ, Robbins J, Palsbøll PJ, O’Connor I, Berrow SD. Levels of persistent organic pollutants in eastern North Atlantic humpback whales. ENDANGER SPECIES RES 2013. [DOI: 10.3354/esr00545] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Ryan P, Schlidt A, Ryan C. The impact of osteoporosis prevention programs on calcium intake: a systematic review. Osteoporos Int 2013; 24:1791-801. [PMID: 23314270 DOI: 10.1007/s00198-012-2259-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 08/28/2012] [Indexed: 11/25/2022]
Abstract
Little is known about the dimensions of osteoporosis prevention programs essential to changing health behaviors. The purpose of this review was to determine the impact of select characteristics of structured osteoporosis prevention programs on calcium intake in women. This systematic review included 12 experimental and quasi-experimental studies conducted internationally with adult women participants. Studies were more likely to demonstrate differences when they were conducted outside the U.W.; participants had lower baseline calcium intake; and interventions were multi-dimensional and included factual information, skill training, and social contact delivered dynamically over time. The results document extensive variability across participants, programs, and measures. There is a need to document the source (total and sub-total) of calcium intake, to provide the necessary data to calculate effect sizes to enable comparison across studies, and to identify those moderating factors (such as menopausal status) that affect the ability to determine differences between sub-groups. Results indicate health behavior change is more likely to occur when patient-centered interventions designed to increase knowledge and health beliefs, skills and abilities, and social facilitation are delivered over time. There is an urgent need for the development and testing of new health behavior change theories, prevention programs, and delivery media to support and complement health care providers in the prevention and management of this common, debilitating condition.
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Ryan C, Shaw RE, Cockerell CJ, Hand S, Ghali FE. Novel sodium hypochlorite cleanser shows clinical response and excellent acceptability in the treatment of atopic dermatitis. Pediatr Dermatol 2013; 30:308-15. [PMID: 23617366 PMCID: PMC3666086 DOI: 10.1111/pde.12150] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The intermittent use of dilute sodium hypochlorite "bleach baths" has shown efficacy as adjunctive therapy for atopic dermatitis (AD). This feasibility study evaluated the clinical response and patient acceptability of treatment with a cleansing body wash containing sodium hypochlorite in children with AD. This was a 12-week open-label feasibility study of 18 children with AD conducted in a pediatric dermatology outpatient clinic between May 2011 and July 2012. Children with moderate to severe AD, defined as an Investigator Global Assessment (IGA) score of at least 3 on a 5-point scale, who were age 6 months and older and had lesional cultures positive for Staphylococcus aureus at baseline were included. Patients were instructed to wash 3 days/week for 12 weeks with the sodium hypochlorite-containing cleansing body wash. During the study period, patient's individualized topical and systemic treatment regimens were continued. Clinical response to treatment was measured using an IGA score and the percentage of body surface area (BSA) affected. Parents were also administered a retrospective questionnaire evaluating acceptability of the product. There was a statistically significant reduction in IGA score at all time points, with an overall mean reduction from baseline to final measurement using the last observation carried forward in all patients of 1.0 (p = 0.001, n = 18). Similarly the mean reduction of BSA affected was 14.8% (p = 0.005, n = 18). Parents reported that the body wash was significantly easier to use than traditional bleach baths (p < 0.001). The significant reductions in clinical disease severity scores with use of this formulation are encouraging.
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Abstract
Levamisole-contaminated cocaine is an increasingly reported cause of a syndrome characterized by vasculitic skin lesions and immunologic abnormalities. With approximately 70% of cocaine in the United States now contaminated with levamisole, the incidence of this syndrome is likely to increase. We report two cases of this syndrome and review its clinical presentation, course, and prognosis.
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McDermott RL, Hutchinson B, Ryan C, Conneely JB, Latif A, Maguire D, Sheahan K. Mesenteric lipodystrophy - An unusual intraabdominal mass. Int J Surg Case Rep 2013; 4:232-4. [PMID: 23291330 DOI: 10.1016/j.ijscr.2012.11.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 11/23/2012] [Accepted: 11/23/2012] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION We report the case of a 21 year old female with underlying facial lipodystrophy who presented with left lower abdominal pain, weight gain and altered bowel habit. PRESENTATION OF CASE Subsequent investigation showed a large (21cm×18cm×8cm) intraabdominal mass. At laparotomy, it was completely excised and was seen to arise from the transverse mesocolon and following histology revealed it to be mesenteric lipodystrophy. DISCUSSION Mesenteric lipodystrophy is a rare clinical entity, and part of a spectrum of disorders of sclerosing mesenteritis. This is the first reported case in a patient with pre-existing facial lipodystrophy. CONCLUSION Herein we describe a case of mesenteric lipodystrophy, discuss its management and review of the literature.
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Bayley PJ, Isaac L, Kong JY, Adamson MM, Ashford JW, Mahoney LA, Beltran M, Brown-Elhillali A, Held A, Ajayi A, Belcher H, Bond A, Mason H, Lemaster C, Shaw S, Mullin C, Holick E, Saper R, Braun TD, Riley KE, Park CL, Trehern AE, Davis MB, Mastronardi EL, Butzer B, Khalsa SBS, Shorter SM, Reinhardt KM, Cope S, Cheung C, Justice C, Wyman J, Cook-Cottone CP, Daly LA, Haden SC, Hagins M, Danhauer SC, Griffin LP, Avis NE, Sohl SJ, Lawrence J, Jesse MT, Addington EL, Messino MJ, Giguere JK, Lucas SL, Wiliford SK, Shaw E, de Manincor M, Bensoussan A, Smith C, Fahey P, Bourchier S, Desrochers DIM, Viswanathan S, Partharasathy BR, Doherty K, Moye J, Walsh C, Pokaski-Azar J, Gosian J, Chapman J, King K, Sohl S, Danhauer S, Dunbar E, Gabriel MG, Huebner M, Hofmann SG, Khalsa SBS, Gaskins RB, Jennings E, Thind H, Fava JL, Hartman S, Bock BC, Gramann P, Haaz S, Bingham CO, Bartlett SJ, Hagins M, States R, Selfe T, Innes K, Harris AR, Jennings PA, Abenavoli RM, Katz DA, Hudecek KM, Greenberg MT, Jeter PE, Nkodo AF, Haaz S, Dagnelie G, Keosaian JE, Lemaster CM, Chao M, Saper RB, King KD, Gosian J, Doherty K, Walsh C, Pokaski Azar J, Chapman J, Danhauer SC, Moye J, Kinser P, Bourguignon C, Taylor A, Mahoney LA, Bayley PJ, Collery LM, Menzies-Toman D, Nilsson M, Frykman V, Noggle JJ, Braun T, Khalsa SBS, Nosaka M, Okamura H, Fukatu N, Potts A, Weidknecht K, Coulombe S, Davies B, Ryan C, Day D, Reale J, Staples JK, Knoefel J, Herman C, Riley KE, Park CL, Bedesin EY, Stewart VM, Riley KE, Braun TD, Park CL, Pescatello LS, Davis MB, Trehern AE, Mastronardi EL, Rioux J, Rosen RK, Thind H, Gaskins R, Jennings E, Morrow K, Williams D, Bock B, Rousseau D, Jackson E, Schmid AA, Miller KK, Van Puymbroeck M, Debaun EL, Schalk N, Dierks TD, Altenburger P, Damush T, Williams LS, Selman L, Citron T, Howie-Esquivel J, McDermott K, Milic M, Donesky D, Shook A, Ruzic R, Galloway F, Van Puymbroeck M, Miller KK, Schalk N, Schmid AA, Ward LJ, Stebbings S, Sherman K, Cherkin D, Baxter GD, West JI, Duffy N, Liang B. 2013 SYR Accepted Poster Abstracts. Int J Yoga Therap 2013; 23:32-53. [PMID: 24016822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Krawczyk J, Maguire S, Sandys N, Kelly J, Ryan C, O'Marcaigh A, Storey L, Rooney S, Phillips C, Smith OP. In search of Pinkel's children: unravelling the biological heterogeneity of childhood acute lymphoblastic leukaemia by genotype and treatment molecular response. Ir J Med Sci 2012; 182:377-82. [PMID: 23242576 DOI: 10.1007/s11845-012-0892-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 12/04/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Acute lymphoblastic leukaemia (ALL), the commonest childhood malignancy has seen remarkable progress since the 1960s with cure rates now approaching 85%. To achieve this patients undergo intensive treatment that usually takes 2.5-3.5 years involving on average 15 different chemotherapeutic drugs. In 1971, Donald Pinkel reported Total Therapy-Protocol V that used 5 drugs and cranial radiation therapy over a similar time period. Today, one half of these patients (Pinkel's children) remain alive and free of leukaemia. AIM The aim of this study was to evaluate the impact post-induction minimal residual disease (MRD) levels had on survival and its relationship with the more established clinical and biological prognostic predictors of outcome in the hope of identifying a subgroup of patients that are at very low risk of failure. METHODS A retrospective review of 250 Irish children with ALL was carried out. MRD status after 28 days of induction chemotherapy and other known predictors of outcome were correlated with 5 year event-free survival (EFS). RESULTS MRD status was the strongest predictor of outcome with 5 year EFS rates greater that 90% seen in those patients with low-risk MRD and this was associated with TEL/AML1 rearrangement, high hyperdiploidy (HH) karyotype and female gender. CONCLUSION Both MRD and karyotype are powerful determinants of outcome in childhood ALL. Therefore, it is reasonable to conclude that the majority of children cured by Pinkel et al. in the late 1960s were most likely composed of low-risk MRD, TEL/AML1 and HH patients.
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McClure CP, Bowman CA, Geary I, Ryan C, Ball JK, Eley A. HIV-1 co-receptor expression and epithelial immune cells of the cervix in asymptomatic women attending a genitourinary medicine clinic. HIV Med 2012; 14:108-14. [PMID: 23171088 DOI: 10.1111/hiv.12002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of the study was to qualitatively and semiquantitatively characterize the expression of the principal HIV co-receptors chemokine (C-C motif) receptor 5 (CCR5) and chemokine (C-X-C motif) receptor 4 (CXCR4) on susceptible CD4 T-helper cell, monocyte/macrophage and Langerhans dendritic cell populations within the cervical epithelia of asymptomatic women attending a genitourinary medicine clinic. METHODS Of 77 asymptomatic women recruited, 35 were excluded: 21 because they were found to have bacterial vaginosis, eight because they were found to have candida and six for other reasons. Cervical cytobrush samples from 11 women with Chlamydia trachomatis infection and 31 women without any detectable genital infection were stained with fluorescently labelled antibodies specific for cell surface CCR5, CXCR4, CD4, CD3, CD1a and CD19 expression, then analysed by flow cytometry. RESULTS CD4/CD3 T-helper cells (84%), CD1a Langerhans dendritic cells (75%) and CD4/CD14 monocytes/macrophages (59%) were detected in the samples. CCR5 and CXCR4 HIV co-receptor expression was observed on 46-86% of the above subsets. CD1a cells exhibited significantly higher CCR5 and CXCR4 positivity and median fluorescence than CD4 cells and higher CXCR4 positivity and median fluorescence than CD14 cells (P < 0.05 or less). Increased detection of CCR5 over CXCR4 was seen in CD14 cells (P < 0.05). No significant differences in CCR5 or CXCR4 expression were found in samples from asymptomatic women with or without chlamydial infection. CONCLUSIONS Co-receptor expression confirms the potential for CD1a Langerhans cells, monocytes/macrophages and T-helper cells in the cervix as primary targets for HIV infection. Previously observed selective transmission of CCR5-tropic isolates cannot be accounted for by a lack of CXCR4-expressing CD4 cervical immune cells. We were unable to identify any specific impact of chlamydial infection on co-receptor expression in this study.
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Friedlander T, Ngo V, Doty S, Zhao Q, Dong H, Ryan C, Chen W, Paris P. 490 Detection and Genomic Interrogation of Circulating Tumor Cells (CTCs) and Circulating Tumor Stem Cells (CTSCs) From Men with Metastatic Castration-resistant Prostate Cancer (mCRPC). Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72288-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Koch E, Ryan C, Leitch M, Del Piero F, Boyle A. Magnetic resonance imaging of a solid, multilobular ameloblastoma in the mandible of a pony. EQUINE VET EDUC 2012. [DOI: 10.1111/j.2042-3292.2012.00456.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lloyd P, Ryan C, Menter A. Psoriatic arthritis: an update. ARTHRITIS 2012; 2012:176298. [PMID: 23209897 PMCID: PMC3504365 DOI: 10.1155/2012/176298] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 10/13/2012] [Indexed: 02/08/2023]
Abstract
Psoriatic arthritis is a debilitating condition, which affects approximately one-quarter of psoriasis patients. Recent findings have furthered our understanding of the complex pathophysiology of PsA. There have been major advances in the identification of genes associated with joint involvement but not with cutaneous disease alone. The elucidation of key immunologic pathways has allowed the development of novel targeted therapies that are in the research pipeline. Currently, good screening tests and biomarkers to diagnose early PsA and to guide therapy are limited. In this paper, we present recent findings with regard to the immunopathogenesis and genetics of PsA, biomarkers, and screening tools and review the targeted therapies currently in clinical trials.
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