麻豆传媒

PARIS -- The European Academy of Dermatology and Venereology congress included more than 2,000 poster presentations; the following were among the few selected for brief oral summaries.

Comorbidity Profile in Kids with Psoriasis

Pediatric patients with psoriasis have a distinct comorbidity profile as compared with children who have atopic dermatitis, according to a review of medical records for 300,000 children and adolescents in Germany.

Among 1,313 pediatric patients with psoriasis, the most common comorbidities were allergic rhinitis (15.16%), bronchial asthma (12.19%), and obesity (7.08%). Obesity was more prevalent as compared with 30,354 children who had atopic dermatitis (4.11%). Hyperlipidemia (1.14%), arterial hypertension (0.91%), and diabetes mellitus (0.61%) occurred more often in children with psoriasis than in children with atopic dermatitis and in all children without psoriasis. Psoriasis also conferred a high relative risk of arthritis (RR 15.3) and iridocyclitis (9.3) as compared with all children without psoriasis.

The findings support the importance of early diagnosis and treatment of psoriasis and its comorbidities, concluded Marc Radtke, MD, of the University of Hamburg, and colleagues. They urged similar diligence toward pediatric atopic dermatitis, which was associated with high prevalences of allergic rhinitis (19.64%) and bronchial asthma (19.04%) and high relative risks for impetigo and vitiligo.

Long-Term Radiographic Control of Psoriatic Arthritis with Adalimumab

Patients with psoriatic arthritis had a significantly lower rate of radiographic progression after 12 years of follow-up if they were treated with adalimumab (Humira) than with placebo, results from an open-label extension of a randomized trial showed.

Overall, 52% of placebo-treated patients had an increase in Total Sharp Score (TSS) >0.5 versus 48% of patients treated with adalimumab. The corresponding proportions with joint space narrowing (JSN) >0.5 were 53.5% and 46.5%, and the proportions with change in erosion score >0.5 were 50.7% and 49.3%, Pranav Sheth, MD, of Group Health Associates and Trihealth in Cincinnati, and colleagues reported. The mean change in TSS from baseline to week 144 was 2.91 with placebo versus 0.85 with adalimumab (P<0.01), 0.98 versus 0.46 for JSN (NS), and 2.40 versus 0.76 for erosion score (P<0.01).

Radiographic progression occurred more often in patients who had radiographic evidence of joint damage at baseline, which in turn was seen more often in patients who had psoriatic arthritis duration ≥2 years. Prevalence of radiographic damage at baseline was 83% in patients with ≥2 years disease duration and 72% in those with shorter disease duration. Among patients with radiographic damage at baseline, 82% with disease duration ≥2 years had progression at 144 weeks, as did 79% of those with disease duration <2 years.

The findings came from an analysis of 285 patients (from a total of 289) who completed the 24-week randomized ADEPT trial and entered a 120-week open-label extension study.

Anti-IL-23 Inhibition Tops Conventional Systemic Therapy for Psoriasis

The anti-interleukin-23 antibody guselkumab (Tremfya) led to significantly better psoriasis control as compared with the most widely used first-line conventional systemic therapy in Germany, a randomized, multicenter trial showed.

After 24 weeks of treatment, 87.6% of patients assigned to guselkumab had at least 90% improvement in the Psoriasis Area and Severity Index (PASI 90) as compared with 22.2% of patients randomized to fumaric acid esters (P<0.0001). The PASI 75 response rates were 96.6% with guselkumab and 46.3% with fumaric acid esters (P<0.0001). The proportion of patients achieving a Dermatology Life Quality Index (DLQI) score of 0/1 was 66.9% with the anti-IL-23 antibody and 28.2% among patients treated with fumaric acid esters (P<0.0001).

For the PASI 90 (primary endpoint), PASI 75, and DLQI, guselkumab demonstrated a more rapid onset of action and consistent superiority over the control therapy beginning with follow-up visits at 4 and 8 weeks, reported Diamant Thaçi, MD, of the Comprehensive Center for Inflammation Medicine in Lübeck. Guselkumab was associated with a more favorable adverse event profile, and the only patients who discontinued treatment because of adverse events were in the control group.

The findings came from part 1 of the ongoing POLARIS trial, involving a total of 119 patients with moderate or severe psoriasis (baseline PASI score >10). Treatment will continue until week 64 and follow-up, until week 100.