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The Impact of Innovative Biologic Drugs in the Management of Psoriatic Patients
Current Issue
Volume 3, 2015
Issue 5 (October)
Pages: 43-49   |   Vol. 3, No. 5, October 2015   |   Follow on         
Paper in PDF Downloads: 58   Since Sep. 3, 2015 Views: 2158   Since Sep. 3, 2015
Alessandra Bettiol, Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy.
Roberta Pirolo, Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy; Local Health Authority No. 9, Treviso, Italy.
Jenny Bolcato, Local Health Authority No. 9, Treviso, Italy.
Giulia Franchin, Local Health Authority No. 9, Treviso, Italy.
Paola Deambrosis, Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy.
Pietro Giusti, Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy.
Alessandro Chinellato, Local Health Authority No. 9, Treviso, Italy.
Purpose: Psoriasis is an immune-mediated dermatosis affecting 2% of the world population. Based on severity, different therapies are indicated: systemic drugs (cyclosporine (CsA) and methotrexate (Mtx)) are administered in severe cases; in patients that do not respond or do not tolerate these molecules, biologic drugs (Etanercept, Infliximab, Adalimumab, and Ustekinumab) are used as well. However, an appropriate management of patients still remains a critical goal still. This retrospective observational study investigated the effectiveness of systemic therapies in the treatment of severe psoriatic patients of the Local Health Authority (LHA) of Treviso, focusing on biologic vs synthetic drugs. Methods: The analysis was performed on the databases of territorial and hospital prescriptions, therapeutic plans, exemption code, blood laboratory tests and hospitalizations. Results: The analysis allowed the identification of a cohort of 871 psoriatic patients. Among them, articular, cardiovascular and immune-mediated complications are frequent comorbidities, sharing with psoriasis a similar genetic predisposition and inflammatory basis. In the LHA of Treviso, 11% of identified psoriatic patients were treated with biologics. Considering blood inflammatory parameters (C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)), the study revealed that the association of biologic and synthetic therapies (methotrexate) significantly reduces patient inflammatory state (mean CRP value <0.5 mg/100mL; mean ESR value<15mm/hour for men and <20mm/hour for women). Conclusions: The obtained results show clearly that innovative therapies represent a real contribution in the treatment of both psoriasis and its well-known comorbidities. An effective management will therefore require a systemic holistic approach, targeting the psoriatic pathology beyond skin.
Severe Psoriasis, Immune-Mediated Comorbidities, Biologic Drugs, Inflammatory Parameters
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