Journal of Clinical and Aesthetic Dermatology • Hot Topics in Psoriasis February 2024 • Journal Watch

Bimekizumab for the treatment of moderate-to-severe plaque psoriasis: a meta-analysis of randomized clinical trials

Summary. In this meta-analysis of five trials, Wang et al found that rates of 90-percent or greater reduction in Psoriasis Area and Severity Index score (PASI90) and PASI100 were higher among patients with psoriasis treated with bimekizumab, compared to placebo and active comparator. Bimekizumab was also associated with a higher proportion of patients achieving Investigator’s Global Assessment (IGA) 0/1, compared to placebo or active comparator. There were no significant differences in PASI90, PASI 100, and IGA 0/1 between bimekizumab dosage every four weeks or every eight weeks.

Efficacy and safety of vitamin D supplementation on psoriasis: a systematic review and meta-analysis

Summary. Analysis of pooled results from several studies showed that vitamin D supplementation did not affect the change in PASI values after three months of supplementation or at the end of follow-up. The effects of vitamin D supplementation on changes in Psoriasis Disability Index, Dermatology Life Quality Index (DLQI), or C-reactive protein (CRP) levels were not significant. The rate of adverse events (AEs) was low.

Evaluation of sleep quality and pruritus severity in patients with psoriasis and their impact on quality of life: a cross section correlational study

Summary. Among 200 patients with psoriasis, 32 (16%) had poor sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI). Patients with plaque psoriasis had significantly worse sleep efficiency, compared to patients with scalp or palmoplantar psoriasis. There was a significant association between longer disease duration and lower sleep quality. Global PSQI was significantly associated with PASI score, pruritus severity, and psoriasis disability.

Association between psoriasis and serum apolipoprotein A1 and B: a systematic review and meta-analysis Wang F, Wang Y, Kong X, et al. Heliyon. 2023;9(10):e21168.

Summary. Analyzing 14 studies with data on serum apolipoprotein A1, the authors identified a pooled weighted mean difference (WMD) of –9.05, indicating that psoriasis is associated with decreased serum apolipoprotein A1 levels. For serum apolipoprotein B, the pooled WMD of 15 studies was 11.68, indicating an association between psoriasis and increased serum apolipoprotein B levels. Subgroup analyses based on body mass index (BMI) and presence/ absence of psoriatic arthritis demonstrated similar results.

Evaluation of plasma concentrations of galectins-1, 2 and 12 in psoriasis and their clinical implications

Nowowiejska J, Baran A, Hermanowicz JM, et al. Biomolecules. 2023;13(10):1472.

Summary. Compared to healthy controls (n=30), patients with psoriasis (n=60) had significantly higher plasma concentrations of galectin (gal)-1, gal-2, and gal-12. Gal-1 and gal-12 had a significant, negative correlation with glomerular filtration rate (GFR). There was a positive correlation between gal-12 and fasting glucose as well. Gal-2 had a significant positive correlation with CRP and negative correlation with high-density lipoprotein (HDL).

Circulating inflammatory cytokines and psoriasis risk: a systematic review and meta-analysis

Summary. Evaluating the role of circulating inflammatory cytokine in psoriasis, Liu et al found that risk of psoriasis was significantly associated with interleukin (IL)-2, IL-18, IL-17, and interferon (IFN)-γ. There was significant heterogeneity between studies. Regression analysis indicated that age might be a significant source of heterogeneity for serum levels of IL-17. One study was identified as the main source of heterogeneity for IL-18.

Impact of mental state on the severity of psoriasis symptoms: a study on patient’s emotional well-being

Wojciechowska M, McFarlane O, Betyna-Białek M. Med Sci Monit. 2023;29:e941636.

Summary. Among 70 patients with moderate-to-severe psoriasis, 60 percent reported moderate depressive symptoms, measured by the Beck Depression Inventory (BDI). Pathological anxiety and depression were each present in 18.6 percent of patients, measured by the Hospital Anxiety and Depression Scale-Anxiety (HADS-A) and HADS-Depression (HADS-D). Disease duration was significantly, positively associated with HADS-A. There was a positive correlation between PASI and both HADS-A and HADS-D.

Matwiejuk M, Myśliwiec H, Lukaszuk B, et al. Int J Mol Sci. 2023;24(19):14872.

Summary. Evaluating samples from 20 patients with plaque psoriasis and 28 controls, Matwiejuk et al found that ceramide, sphingosine-1-phosphate (S1P), sphinganine (SFA), sphinganine-1-phosphate (SFA1P), and sphingosine (SFO) were significantly increased in psoriatic lesional skin, compared to psoriatic nonlesional skin and control skin. Serum levels of S1P, SFA, and SFA1P were significantly elevated in patients with psoriasis, compared to controls. There were significant associations between serum ceramide and lesional tissue ceramide, SFO, and SFA in patients with psoriasis. Both serum SFO and SFA were negatively associated with nonlesional tissue ceramide and SFO in psoriasis.

Psoriasis severity classification based on adaptive multi-scale features for multi-severity disease

Summary. Moon et al developed a multiscale deformable attention module (MS-DAM) to improve classification of psoriasis severity. Incorporating MS-DAM with EfficientNetB1 resulted in the best classification performance, with an F1 score of 0.93. Compared to six other self-attention methods, MS-DAM showed improved psoriasis severity detection and classification.

Association between poor sleep and myocardial infarction in patients with psoriasis: findings from a cross-sectional study with the National Psoriasis Foundation

Spencer RK, Jin JQ, Elhage KG, et al. Dermatol Ther (Heidelb). 2023;13(11):2903–2909.

Summary. Analyzing survey data from individuals with psoriasis, Spencer et al identified a significant association between sleep quantity and history of myocardial infarction, when adjusting for covariates. Significant predictors of myocardial infarction included male sex and older age. Psoriasis severity, sleep apnea, and traditional myocardial infarction risk factors were not significant predictors.

Impact of maternal psoriasis on adverse maternal and neonatal outcomes: a systematic review and meta-analysis

Rahmati S, Moameri H, Mohammadi NM, et al. BMC Pregnancy Childbirth. 2023;23(1):703.

Summary. Rahmati et al found that psoriasis in pregnant individuals was associated with greater odds of cesarean delivery, preeclampsia, and preterm birth, though study heterogeneity was substantial, moderate, and high, respectively. Psoriasis was linked to gestational hypertension, with low heterogeneity among studies. In terms of neonatal outcomes, psoriasis was associated with increased odds of small for gestational age, low birth weight, and stillbirth; studies exhibited moderate heterogeneity, which was nonsignificant for stillbirth studies.

RESEARCH BITE—Comparing vitamin D level between patients with psoriasis and healthy individuals: a systematic review and meta-analysis

Among 19 studies, which included data from 1,387 patients with psoriasis and 6,939 controls, 13 compared levels of serum vitamin D between patients with psoriasis and controls. Compared to controls, patients with psoriasis had lower levels of vitamin D (pooled odds ratio: 3.07). Combining results from all studies, pooled standard mean difference of serum vitamin D level between the two groups was –0.92.

Source: Moosazadeh M, Damiani G, Khademloo M, et al. Comparing vitamin D level between patients with psoriasis and healthy individuals: a systematic review and meta-analysis. J Evid Based Integr Med. 2023;28:2515690X231211663.

RESEARCH BITE—Interleukin levels and non-alcoholic fatty liver disease in chronic plaque psoriasis: an analytical case control study

Twenty-eight of 50 patients with psoriasis (56%) had nonalcoholic fatty liver disease (NAFLD), compared to only two of 30 controls (6.6%); this difference was significant. In patients with psoriasis, NAFLD was significantly associated with various factors, including body mass index of 23kg/m2 or greater, increasing disease duration, and body surface area involved. There was a nonsignificant association between NAFLD and increased interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, fasting blood sugar, and Psoriasis Area Severity Index.

Source: Yadav V, Mendiratta V, Agrawal A, et al. Interleukin levels and non-alcoholic fatty liver disease in chronic plaque psoriasis: an analytical case control study. Indian J Dermatol. 2023;68(4):377–384.