Psoriasis Review

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Pulsed Dye Laser Therapy May Effectively Treat Plaque Psoriasis  

A recent study found that pulsed dye laser (PDL) therapy was safe and effective for treating chronic plaque psoriasis. The study included 20 participants with plaque psoriasis. Plaques on the right side received PDL treatment and a plaque of similar size and severity on the left side was left untreated. Participants underwent 3 to 4 sessions of PDL 595 nm and were followed for 3 months. Changes in human beta defensin-2 expression (HBD-2) was assessed at baseline and after treatment.

Compared with untreated plaques, treated plaques showed significant decreases in HBD-2 expression, with statistically significant differences between the untreated and treated plaques. In addition, participants did not experience recurrence during follow up.

“[PDL] is safe, effective, and tolerable treatment for resistant stable localized plaque psoriasis with minimal side effects and prolonged recurrence period,” the researchers concluded. 

Reference

Elwan NM, Gheida SF, Hawwam SA, Ahmed AH. Evaluation of the effect of pulsed dye laser on chronic psoriatic plaque [published online April 18, 2018]. J Dermatolog Treat. doi:10.1080/09546634.2018.1466025

Phase 3 Trial Shows Promising Results for Psoriasis Therapy

Results from a phase 3 trial demonstrated that certolizumab (Cimzia) improved psoriasis severity compared with placebo and was noninferior to etanercept (Enbrel). 

In the study, participants with moderate to severe plaque psoriasis were randomized to either 400 mg of certolizumab, 200 mg of certolizumab, or placebo taken every 2 weeks for 16 weeks or 50 mg of etanercept taken 2 times per week for 12 weeks. At week 16, participants who received certolizumab and achieved a 75% or more reduction in Psoriasis Area and Severity Index (PASI) at week 16 were re-randomized to certolizumab or placebo for 32 weeks. 

The primary endpoint included the responder rate of certolizumab, defined as a 75% or greater reduction in PASI, compared with placebo and etanercept at week 12. Secondary endpoints included responder rates on other disease measures compared with placebo at week 12, 16, and 48. Treatment-emergent adverse events were assessed throughout the study period.

Overall, certolizumab showed significantly superior response rates on disease measures compared with placebo, with the greatest response seen among those who received 400 mg of certolizumab. While 200 mg of certolizumab was noninferior to etanercept, 400 mg of certolizumab was superior. In addition, adverse events observed in the study were consistent with the antitumor necrosis factor class.

“Both certolizumab regimens improved psoriasis symptoms with greater response at the higher dose,” the researchers concluded. “No new safety signals were observed.” 

Reference

Lebwohl M, Blauvelt A, Paul C, et al. Certolizumab pegol for the treatment of chronic plaque psoriasis: results through 48 weeks of a phase 3, multicenter, randomized, double-blinded, etanercept- and placebo-controlled study (CIMPACT) [published online April 13, 2018]. J Am Acad Dermatol. doi:10.1016/j.jaad.2018.04.013

Vitamin D Levels and Psoriasis Severity

Vitamin D levels could be associated with psoriasis severity, according to the findings of a recent study. However, vitamin D supplementation did not appear to benefit individuals with psoriasis.

The randomized, double-blind, placebo-controlled trial included 101 participants with psoriasis who were grouped by severity. For 12 months, 67 participants received 100,000 IU vitamin D3 after an initial 200,000 IU dose at baseline and 34 participants received placebo. Serum 25 (OH) concentrations and Psoriasis Area Severity Index (PASI) were measured every 3 months. The researchers assessed changes in PASI between groups over time, as well as the relationship between 25(OH)D levels and PASI.

Although PASI did not differ between groups during the study, the researchers observed increases in 25(OH)D levels in both groups, rendering their findings inconclusive.

However, they found a significant inverse relationship between PASI and 25(OH)D, with an elevation of 25(OH)D by up to 125 nmol/L associated with mild decreases in PASI.

“A direct benefit of vitamin D3 supplementation for psoriasis could not be determined,” the researchers concluded. “However, these findings suggest a relationship between 25(OH)D and psoriasis severity, at least in some subgroups.” 

Reference

Ingram MA, Jones MB, Stonehouse W, et al. Oral vitamin D3 supplementation for chronic plaque psoriasis: a randomized, double-blind, placebo-controlled trial [published online March 22, 2018]. J Dermatol Treat. doi:10.1080/09546634.2018.1444728 

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