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Campione E, Zarabian N, Cosio T, Borselli C, Artosi F, Cont R, Sorge R, Shumak RG, Costanza G, Rivieccio A, Gaziano R, Bianchi L. Apremilast as a Potential Targeted Therapy for Metabolic Syndrome in Patients with Psoriasis: An Observational Analysis. Pharmaceuticals (Basel) 2024; 17:989. [PMID: 39204094 PMCID: PMC11357209 DOI: 10.3390/ph17080989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 07/19/2024] [Accepted: 07/23/2024] [Indexed: 09/03/2024] Open
Abstract
Psoriasis (PsO) is a chronic inflammatory dermatosis that often presents with erythematous, sharply demarcated lesions. Although psoriasis is primarily a dermatological disease, its immune-mediated pathogenesis produces systemic effects and is closely associated with various comorbid conditions such as cardiovascular disease (CVD), metabolic syndrome (MetS), and diabetes mellitus type II (DMII). Apremilast, an oral phosphodiesterase 4 (PDE-4) inhibitor, has shown promise in treating moderate-to-severe psoriasis and is associated with potential cardiometabolic benefits. In a 12-month prospective observational study involving 137 patients with moderate-to-severe psoriasis, we assessed changes in psoriasis clinimetric scores and metabolic profiles from baseline (T0) to 52 weeks (T1) to evaluate the efficacy of apremilast. After 52 weeks of apremilast treatment, we documented a statistically significant decrease in low-density lipoprotein (LDL) and total cholesterol, triglycerides, and glucose levels. Our findings even suggest a potential synergistic effect among patients treated with apremilast, alongside concomitant statin and/or insulin therapy. Although the results of our study must be validated on a larger scale, the use of apremilast in the treatment of psoriatic patients with cardio-metabolic comorbidities yields promising results.
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Affiliation(s)
- Elena Campione
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (C.B.); (F.A.); (R.C.); (R.G.S.); (A.R.); (L.B.)
| | - Nikkia Zarabian
- School of Medicine and Health Sciences, George Washington University, 2300 I St NW, Washington, DC 20052, USA;
| | - Terenzio Cosio
- Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (T.C.); (R.G.)
- Dynamyc Research Team 7380, Université de Paris-Est-Créteil, 94000 Créteil, France
| | - Cristiana Borselli
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (C.B.); (F.A.); (R.C.); (R.G.S.); (A.R.); (L.B.)
| | - Fabio Artosi
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (C.B.); (F.A.); (R.C.); (R.G.S.); (A.R.); (L.B.)
| | - Riccardo Cont
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (C.B.); (F.A.); (R.C.); (R.G.S.); (A.R.); (L.B.)
| | - Roberto Sorge
- Laboratory of Biometry, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Ruslana Gaeta Shumak
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (C.B.); (F.A.); (R.C.); (R.G.S.); (A.R.); (L.B.)
| | - Gaetana Costanza
- Unit of Virology, Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy;
| | - Antonia Rivieccio
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (C.B.); (F.A.); (R.C.); (R.G.S.); (A.R.); (L.B.)
| | - Roberta Gaziano
- Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (T.C.); (R.G.)
| | - Luca Bianchi
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, 00133 Rome, Italy; (C.B.); (F.A.); (R.C.); (R.G.S.); (A.R.); (L.B.)
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Hwang JK, Ricardo JW, Lipner SR. Efficacy and Safety of Nail Psoriasis Targeted Therapies: A Systematic Review. Am J Clin Dermatol 2023; 24:695-720. [PMID: 37209391 DOI: 10.1007/s40257-023-00786-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 05/22/2023]
Abstract
INTRODUCTION Nail changes are frequent clinical findings in patients with cutaneous psoriasis and psoriatic arthritis, often causing significant impairments in quality of life. Numerous targeted therapies have been previously studied for treatment of nail psoriasis, however, newer agents have not been captured in prior systematic reviews. With over 25 new studies published since 2020, the landscape of nail psoriasis systemic treatments is rapidly evolving, warranting analysis of recently approved therapies. METHODS An updated systematic review of all PubMed and OVID database studies assessing efficacy and safety of targeted therapies for nail psoriasis was performed, with the goal of incorporating clinical data of recent trials and newer agents, namely brodalumab, risankizumab, and tildrakizumab. Eligibility criteria included clinical human studies reporting at least one of the nail psoriasis clinical appearance outcomes (Nail Psoriasis Severity Index, modified Nail Psoriasis Severity Index). RESULTS A total of 68 studies on 15 nail psoriasis targeted therapeutic agents were included. Biological agents and small molecule inhibitors included TNF-alpha inhibitors (adalimumab, infliximab, etanercept, certolizumab, golimumab), IL-17 inhibitors (ixekizumab, brodalumab, secukinumab), IL-12/23 inhibitors (ustekinumab), IL-23 inhibitors (guselkumab, risankizumab, tildrakizumab), PDE-4 inhibitors (apremilast), and JAK inhibitors (tofacitinib). These agents all demonstrated statistically significant improvements in nail outcome scores, compared with placebo or with baseline values, at weeks 10-16 and weeks 20-26, with some studies assessing efficacy up to week 60. Safety data for these agents were acceptable and consistent with known safety profiles within these timepoints, with nasopharyngitis, upper respiratory tract infections, injection site reactions, headache, and diarrhea being the most reported adverse events. Specifically, the newer agents, brodalumab, risankizumab, and tildrakizumab, showed promising outcomes for treatment of nail psoriasis on the basis of current data. CONCLUSION Numerous targeted therapies have shown significant efficacy in improving nail findings in patients with psoriasis and psoriatic arthritis. Data from head-to-head trials have shown greater efficacy of ixekizumab over adalimumab and ustekinumab, as well as brodalumab over ustekinumab, while prior meta-analyses have demonstrated superiority of ixekizumab and tofacitinib to other included agents at various assessed timepoints. Further studies on the long-term efficacy and safety of these agents, as well as randomized controlled trials involving comparison with placebo arms, are needed to fully analyze differences in efficacy of newer agents compared with previously established therapies.
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Affiliation(s)
- Jonathan K Hwang
- Weill Cornell Medicine, Department of Dermatology, 1305 York Avenue, New York, NY, 10065, USA
| | - Jose W Ricardo
- Weill Cornell Medicine, Department of Dermatology, 1305 York Avenue, New York, NY, 10065, USA
| | - Shari R Lipner
- Weill Cornell Medicine, Department of Dermatology, 1305 York Avenue, New York, NY, 10065, USA.
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Kang Q, Chen JS, Yang H. Efficacy and safety profile of phosphodiesterase 4 inhibitor in the treatment of psoriasis: A systematic review and meta-analysis of randomized controlled trials. Front Immunol 2022; 13:1021537. [PMID: 36300119 PMCID: PMC9589065 DOI: 10.3389/fimmu.2022.1021537] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/22/2022] [Indexed: 11/18/2022] Open
Abstract
Background Systemic therapy is an important treatment for psoriasis. Phosphodiesterase 4 (PDE4) inhibitors are new candidates for psoriasis therapy. Objectives To evaluate the efficacy and safety of PDE4 inhibitors in psoriasis. Method Randomized clinical trials with PDE4 inhibitors vs placebos in patients with psoriasis were identified from MEDLINE, Embase, Cochrane Controlled Register of Trials, ClinicalTrials.gov, from inception to July 14, 2022. The study was registered in PROSPERO (CRD42022345700). Results 18 studies were identified, 9 of which included moderate-to-severe plaque psoriasis, 2 mild-to-moderate plaque psoriasis, and 7 psoriatic arthritis. A total of 6036 patients were included. Only one oral PDE4 inhibitor, apremilast, met the inclusion criteria. Overall, compared with the placebo, apremilast was associated with higher response rates in PASI-75 (RR, 3.22; 95% CI, 2.59-4.01), ScPGA of 0 or 1 (RR, 2.21; 95% CI, 1.69-2.91), PPPGA of 0 or 1 (RR 2.33; 95%CI, 1.16-4.66), and a significant decrease in NPASI (SMD, -0.46; 95% CI, -0.58 to -0.33). There were no significant differences in serious adverse events. Subgroup analyses showed that significantly more patients achieved PASI-75 after 16 weeks of therapy with apremilast of 20 mg bid (RR, 2.82; 95% CI, 2.01-3.95) and 30 mg bid (RR, 4.08; 95% CI, 3.12-5.33). Heterogeneity was not significant across studies. Conclusion Apremilast is a safe and effective treatment for plaque psoriasis and psoriatic arthritis, especially for difficult-to-treat sites. Systematic review registration https://www.crd.york.ac.uk/prospero, identifier (CRD42022345700).
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Affiliation(s)
- Qin Kang
- Department of Health Statistics and Information Management, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Jing-si Chen
- Department of Dermatology, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- China International Science and Technology Cooperation Base of Child development and Critical Disorders, Chongqing, China
| | - Huan Yang
- Department of Dermatology, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
- *Correspondence: Huan Yang,
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Alnaqbi KA, Hannawi S, Namas R, Alshehhi W, Badsha H, Al‐Saleh J. Consensus statements for pharmacological management, monitoring of therapies, and comorbidity management of psoriatic arthritis in the United Arab Emirates. Int J Rheum Dis 2022; 25:1107-1122. [PMID: 35916205 PMCID: PMC9804226 DOI: 10.1111/1756-185x.14406] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 06/28/2022] [Accepted: 07/17/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Psoriatic arthritis (PsA), a chronic inflammatory disease characterized by heterogeneous clinical manifestations, substantially impacts the quality of life of affected individuals. This article aims at developing consensus recommendations for the management of PsA and associated comorbidities and screening and monitoring requirements of PsA therapies in the United Arab Emirates (UAE) population. METHODS An extensive review of present international and regional guidelines and publications on the pharmacological management, monitoring of therapies in the context of PsA was performed. Key findings from guidelines and literature were reviewed by a panel of experts from the UAE at several meetings to align with current clinical practices. Consensus statements were formulated based on collective agreement of the experts and members of Emirates Society for Rheumatology. RESULTS The consensus recommendations were developed to aid practitioners in clinical decision-making with respect to dosage recommendations for pharmacological therapies for PsA, including conventional drugs, non-biologic, and biologic therapies. Consensus recommendations for therapeutic options for the treatment of PsA domains, including peripheral arthritis, axial disease, enthesitis, dactylitis, psoriasis, and nail disease, were developed. The panel emphasized the importance of monitoring PsA therapies and arrived at a consensus on monitoring requirements for PsA therapies. The expert panel proposed recommendations for the management of common comorbidities associated with PsA. CONCLUSION These consensus recommendations can guide physicians and healthcare professionals in the UAE in making proper treatment decisions, as well as efficiently managing comorbidities and monitoring therapies in patients with PsA.
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Affiliation(s)
- Khalid A. Alnaqbi
- Department of RheumatologyTawam HospitalAl AinUAE
- College of Medicine and Health SciencesUAE UniversityAl AinUAE
| | - Suad Hannawi
- Emirates Health Services (EHS)DubaiUAE
- Ministry of Health and PreventionDubaiUAE
| | - Rajaie Namas
- Division of Rheumatology, Department of Internal MedicineCleveland Clinic Abu DhabiUAE
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Tsentemeidou A, Sotiriou E, Sideris N, Bakirtzi K, Papadimitriou I, Lallas A, Ioannides D, Vakirlis E. Apremilast in Psoriasis Patients With Serious Comorbidities: a Case Series and Systematic Review of Literature. Dermatol Pract Concept 2022; 12:e2022179. [PMID: 36534526 PMCID: PMC9681161 DOI: 10.5826/dpc.1204a179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2022] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Patients with serious comorbidities are traditionally excluded from clinical trials. Apremilast is not contraindicated in active infections, malignancy and serious hepatic or renal impairment, but real-life data is needed to support this recommendation. OBJECTIVES The aim of this paper is to present our personal as well as literature-sourced real-world evidenced on apremilast use in psoriasis patients with serious baseline comorbidities. METHODS A case-series and systematic literature review were performed. The psoriasis archives of a tertiary-care hospital, four electronic databases (MEDLINE, ScienceDirect, Cochrane Library, Google scholar) and other sources were searched (January 2014 - July 2021). Identified records were considered eligible, if they reported on the use of apremilast monotherapy in psoriasis patients with chronic infections, history of malignancy, serious liver, renal, psychiatric, or other disease(s). RESULTS At least 841 psoriasis patients with serious baseline diseases received apremilast. Only 3 cases of cancer progression and no infection reactivations or worsening of other diseases were documented. No increased frequency/severity of adverse events or reduced drug efficacy were noted. Main limitations of this study are the exclusion of a few reports due to inappropriately documented data and the fact that at least some patients might have been counted more than once. CONCLUSIONS Apremilast is a safe and adequately efficacious option for psoriasis that cannot be treated/is challenging to treat with classic systemic agents and/or biologics.
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Affiliation(s)
- Aikaterini Tsentemeidou
- First Department of Dermatology and Venereology, School of Medicine, Aristotle University, Thessaloniki, Greece
| | - Elena Sotiriou
- First Department of Dermatology and Venereology, School of Medicine, Aristotle University, Thessaloniki, Greece
| | - Nikolaos Sideris
- First Department of Dermatology and Venereology, School of Medicine, Aristotle University, Thessaloniki, Greece
| | - Katerina Bakirtzi
- First Department of Dermatology and Venereology, School of Medicine, Aristotle University, Thessaloniki, Greece
| | - Ilias Papadimitriou
- First Department of Dermatology and Venereology, School of Medicine, Aristotle University, Thessaloniki, Greece
| | - Aimilios Lallas
- First Department of Dermatology and Venereology, School of Medicine, Aristotle University, Thessaloniki, Greece
| | - Dimitrios Ioannides
- First Department of Dermatology and Venereology, School of Medicine, Aristotle University, Thessaloniki, Greece
| | - Efstratios Vakirlis
- First Department of Dermatology and Venereology, School of Medicine, Aristotle University, Thessaloniki, Greece
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Gao JC, Wu AG, Contento MN, Maher JM, Cline A. Apremilast in the Treatment of Plaque Psoriasis: Differential Use in Psoriasis. Clin Cosmet Investig Dermatol 2022; 15:395-402. [PMID: 35300435 PMCID: PMC8921676 DOI: 10.2147/ccid.s266036] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/03/2022] [Indexed: 12/15/2022]
Abstract
Small molecule medications like apremilast are emerging as promising options for patients with psoriasis and other inflammatory conditions. Apremilast was approved by the Food and Drug Administration in 2014 for the management of both psoriasis and psoriatic arthritis. Apremilast inhibits phosphodiesterase-4, which increases the intracellular levels of cyclic AMP, thereby reducing inflammatory cytokine production. This review aims to discuss the published evidence and evaluate the differential use of apremilast in plaque psoriasis of the body and scalp, nail psoriasis, and palmoplantar psoriasis. In clinical trials, apremilast effectively reduced the severity of different dermatological manifestations of psoriasis and improved patients' quality of life. It has an acceptable safety profile and is generally well-tolerated. Oral medications like apremilast offer an alternative route of administration which can be more convenient and appropriate for some patients. Additionally, pharmacoeconomic analyses of available anti-psoriatic systemic agents favor apremilast as a cost-effective therapeutic option.
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Affiliation(s)
- Jia C Gao
- School of Medicine, New York Medical College, Valhalla, NY, USA
| | - Albert G Wu
- School of Medicine, New York Medical College, Valhalla, NY, USA
| | | | | | - Abigail Cline
- Department of Dermatology, New York Medical College, New York, NY, USA
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Campione E, Cosio T, Di Prete M, Lanna C, Dattola A, Bianchi L. Experimental Pharmacological Management of Psoriasis. J Exp Pharmacol 2021; 13:725-737. [PMID: 34345187 PMCID: PMC8323855 DOI: 10.2147/jep.s265632] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/30/2021] [Indexed: 01/26/2023] Open
Abstract
Psoriasis is a chronic, relapsing, immune-mediated systemic disease. Its pathogenesis is complex and not fully understood yet. Genetic and epigenetic factors interact with molecular pathways involving TNF-α, IL-23/IL-17 axis, and peculiar cytokines, as IL-36 or phosphodiesterase 4. This review discusses the mechanisms involved in the development of the disease, as well as the therapeutic options proposed following the investigation of the inflammatory psoriatic pathways. We performed a comprehensive search using the words “psoriasis” and the newest molecules currently under investigation and approval. From these data, a new scenario in psoriasis is occurring to personalize the therapies - especially systemic ones and those using small molecules – and avoid topical and injectable drugs. We reported the newest therapeutic opportunities, including the inhibitors of Janus kinase/tyrosine kinase 2, phosphodiesterase-4 and IL-36 receptor. Today, more than 20 molecules are under investigation for the treatment of cutaneous psoriasis. Most of them are constituted by small molecules or biologic therapies. This underlines how psoriasis needs systemic therapies, due to its complex pathogenesis and multisystemic involvement.
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Affiliation(s)
- Elena Campione
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, 00133, Italy
| | - Terenzio Cosio
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, 00133, Italy
| | - Monia Di Prete
- Anatomic Pathology, University of Rome Tor Vergata, Rome, 00133, Italy
| | - Caterina Lanna
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, 00133, Italy
| | - Annunziata Dattola
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, 00133, Italy
| | - Luca Bianchi
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, 00133, Italy
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Hadeler E, Mosca M, Hong J, Brownstone N, Bhutani T, Liao W. Nail Psoriasis: A Review of Effective Therapies and Recommendations for Management. Dermatol Ther (Heidelb) 2021; 11:799-831. [PMID: 33978917 PMCID: PMC8163925 DOI: 10.1007/s13555-021-00523-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Indexed: 11/24/2022] Open
Abstract
Nail psoriasis has a prevalence that ranges from 10 to 82% and can significantly impact the quality of life of patients. Nail psoriasis is one of the most challenging areas to treat, and multiple therapies have been explored. Topical and injectable therapies are recommended for few-nail disease. Systemic therapies, including biologics, can be considered for patients with multiple and resistant nail disease, impaired quality of life, and severe skin and joint involvement, due to their long-term efficacy. Although outcome data are difficult to compare, interleukin (IL)-17 inhibitors may have superior short-term efficacy when compared to IL-23 inhibitors and tumor necrosis factor (TNF)-alpha inhibitors, although long-term efficacy is similar to TNF-alpha inhibitors. IL-23 inhibitors and TNF-alpha inhibitors have a similar efficacy for nail psoriasis.
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Affiliation(s)
- Edward Hadeler
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA.
| | - Megan Mosca
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Julie Hong
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Nicholas Brownstone
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Tina Bhutani
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
| | - Wilson Liao
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, 515 Spruce Street, San Francisco, CA, 94118, USA
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Ultrasound Evaluation of the Effectiveness of the Use of Acitretin in the Treatment of Nail Psoriasis. J Clin Med 2021; 10:jcm10102122. [PMID: 34068890 PMCID: PMC8157176 DOI: 10.3390/jcm10102122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 05/10/2021] [Accepted: 05/12/2021] [Indexed: 12/22/2022] Open
Abstract
The study aimed to evaluate the effect of retinoid treatment on the morphological changes in the nail apparatus in patients with nail psoriasis. Material and methods: 41 patients aged 32 to 64 with nail psoriasis, without clinical signs of psoriatic arthritis, started on acitretin 0.6 to 0.8 mg kg b.w./d, for six months and 28 people in the control group were included in the study. Both groups had ultrasound examination of fingernails and digital extensor tendon in the distal interphalangeal joints. In psoriatic patients, US examination was conducted before starting the treatment and after six months. A total of 685 nails were examined. Results: After six months of treatment, there was a reduction in the thickness of the nail bed and nail matrix (p = 0.046 and p = 0.031, respectively). The thickness of the nail plates decreased, although it was statistically insignificant (p = 0.059) and it was higher than in the control group (p = 0.034). The reduced severity of clinical nail changes after six months of retinoid treatment did not correlate with the reduction in extensor tendon thickness in any group of patients. Conclusions: In patients with nail psoriasis, acitretin treatment resulted in a rapid decrease in the thickness of the nail bed and matrix, but it did not affect the thickness of the nail plate after six months. There was no effect of acitretin on the digital extensor tendon thickness or the increased blood supply to the tendon area. The results of the study may indicate the usefulness of ultrasound nail examinations in patients with nail psoriasis not only to assess the advancement of morphological changes and response to treatment, but also to choose the potential treatment.
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Wang B, Sun W, Bi K, Li Y, Li F. Apremilast prevents IL‑17‑induced cellular senescence in ATDC5 chondrocytes mediated by SIRT1. Int J Mol Med 2021; 47:12. [PMID: 33448323 PMCID: PMC7834959 DOI: 10.3892/ijmm.2021.4845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/30/2020] [Indexed: 11/18/2022] Open
Abstract
Osteoarthritis is the most prevalent joint degenerative disease and has been considered a major cause of severe joint pain and physical disability in the elderly. The chondrocyte is the only cell type found in articular cartilage and chondrocyte senescence plays a pivotal role in the pathogenesis of osteoarthritis. Apremilast is an oral PDE4 inhibitor and has been used for the treatment of patients with active psoriatic arthritis. In the present study, the biological function of apremilast was examined in an interleukin (IL)-17-treated chondrocyte model. Expression levels of target genes and proteins were measured using reverse transcription-quantitative PCR, ELISA, and western blotting, respectively. ROS levels in chondrocytes were examined using the fluorescent dye DCFH-DA. Cellular senescence was determined using senescence-associated-β-galactosidase staining. The profile of cell cycle phases was analyzed via flow cytometry. It was revealed that treatment with apremilast reduced the expression of IL-1β, MCP-1, and the production of ROS. SA-β-gal staining results indicated that the presence of apremilast suppressed IL-17-induced cellular senescence. Furthermore, apremilast prevented IL-17-induced G0/G1 phase cell cycle arrest. In addition, it was demonstrated that apremilast suppressed IL-17-induced expression of p21 and PAI-1. Notably, the silencing of sirtuin 1 (SIRT1) abolished the protective effect of apremilast against IL-17-induced cellular senescence, suggesting that the action of apremilast in chondrocytes is dependent on SIRT1. In conclusion, the present results revealed that apremilast exerted a beneficial effect, thereby protecting chondrocytes from senescence induced by IL-17.
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Affiliation(s)
- Benlong Wang
- Department of Sports Medicine of Zaozhuang Municipal Hospital, Zaozhuang, Shandong 277000, P.R. China
| | - Wei Sun
- Department of Sports Medicine of Zaozhuang Municipal Hospital, Zaozhuang, Shandong 277000, P.R. China
| | - Kunwei Bi
- Department of Sports Medicine of Zaozhuang Municipal Hospital, Zaozhuang, Shandong 277000, P.R. China
| | - Yong Li
- Department of Sports Medicine of Zaozhuang Municipal Hospital, Zaozhuang, Shandong 277000, P.R. China
| | - Feng Li
- Department of Sports Medicine of Zaozhuang Municipal Hospital, Zaozhuang, Shandong 277000, P.R. China
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