Patients with moderate to severe plaque psoriasis (considered here as psoriasis involving more than 5 to 10 percent of the body surface a. Treatment selection for moderate to severe plaque psoriasis in special populations. Because the risks associated with treatment may be altered by the presence of additional medical disorders, treatment selection must involve consideration of the patient s underlying diseases. Treatment Goals for Moderate to Severe Psoriasis. United States for the treatment of moderate to severe plaque psoriasis in January 2015. Although the selection of one therapy over another is a complex topic that is beyond the scope of this review, any change in therapy will signal a heightened attention to monitoring for both efficacy and side effects. For special populations, searches of the published literature and input from colleagues from other fields should help guide decisions. Describe the treatment modalities for moderate or severe psoriasis. Note: Total credit is subject to change based on topic selection and article length.
The most common type, chronic plaque psoriasis, shows well demarked plaques covered by silver scales which are often located symmetrically and bilaterally. Therefore, further studies need to evaluate if there is a possible limitation to the improvement of the disease after several courses of alefacept treatment and if it would be helpful to select only responders for the treatment, and, if so, which read-out parameters for the selection of responders and differentiation from non-responders would be the best in order to save time and costs by not treating non-responders for a long time. Management of psoriasis in special populations is discussed. MANAGEMENT OF MODERATE TO SEVERE PLAQUE PSORIASIS SPECIAL POPULATIONS AND CIRCUMSTANCES CONCLUSIONS ARTICLE INFORMATION REFERENCES. Selected Topics in Dermatology for Primary Care. A 37-Year-Old Woman with Moderate-to-Severe Plaque Psoriasis. He also discusses how to select treatments based on symptom severity, and which treatments to avoid in special populations, such as pregnant women and those with renal insufficiency.
Patients with moderate-to-severe plaque psoriasis suffer from a decreased quality of life as well as comorbidities. In a Phase I clinical trial, treatment with ixekizumab resulted in both clinical and histopathologic improvement of psoriasis, which suggests that IL-17 may be a key driver in the pathogenesis of psoriasis. Relevant articles were selected from the PubMed database using individual or combinations of search terms such as: ixekizumab, LY2439821, IL-17, plaque psoriasis, psoriasis vulgaris, comorbidity, quality of life, epidemiology, cost, biologic, adalimumab, etanercept, infliximab, ustekinumab, brodalumab, adverse effect, and efficacy. However, researchers might consider these special populations as avenues for future research and as a potential way for ixekizumab to distinguish itself from the other biological agents. To build our model, we used a purposeful selection approach in which all covariates thought to be clinically important a priori as well as any covariates with significance at P Figures. This article addresses some of those challenges in two special populations: children and women of childbearing potential. 1 Guttate psoriasis is characterized by red, teardrop-shaped lesions that often progress to plaque psoriasis. In selecting treatment for psoriasis in children, safety is a primary concern, given the potential expo sure to medications across the life span. Ziv M. Pregnancy outcomes in women with moderate-to-severe psoriasis.
The Safety And Efficacy Of Alefacept In The Treatment Of Chronic Plaque Psoriasis
An estimated 7.5 million Americans (2.2 of the population) have psoriasis. Treatment options for moderate to severe psoriasis include topical and systemic medications, phototherapy, and excimer laser, Combination therapies are often more effective than one treatment alone. Plaque psoriasis leads to skin patches that start off in small areas, about 1/8 of an inch wide. T cells have special receptors attached to their surface that recognize the specific antigen. Special Populations: Renal Function Impairment. The AUC and Cmax of apremilast increased by 88 and 42, respectively, in patients with severe renal impairment. Psoriasis: Treatment of patients with moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy.