tbuckley/cabot-search huggingface dataset:
P118 Palmoplantar psoriasis: association with comorbidities
Journal: British Journal of Dermatology (2024)

Abstract Introduction Palmo-plantar psoriasis (PP) is a localized form of psoriasis that can affect only palms and/or soles in the absence of psoriatic lesions in any other parts of the body or may accompany psoriatic lesions elsewhere. Term ‘Psoriatic disease’ refers reveals systemic impact of the disease. Some publications reveal correlation between psoriasis severity and affected area (BSA) with higher risk of comorbidities. The aim of this study was to reveal comorbidities in palmoplantar psoriasis patients with relatively low BSA percentage, but still high disease burden. Materials and Methods Data was collected from October 2022 till January 2024. Forty-five patients with isolated palmoplantar psoriasis were included into study if complete medical documentation was available and histological diagnosis of PP was approved. Paediatric patients were excluded from the study. Results A total of 45 patients with PP were included into research. Thirty patients (66.66%) had at least one comorbidity with the disease duration from 1 to 4 years. From 30 patients with comorbidities 53.3% had primary arterial hypertension (35.5% in total). 20% had gastrointestinal disease [incl. ulcerative colitis, hepatic steatosis, gastroduodenal ulcer, GERD (13.3% in total)]. Dyslipidaemia was present in 16.6% in this group (11.1% in total) ; bronchial asthma in 13.3% (8.8% in total); and diabetes mellitus second type, haemolytic anaemia, psoriatic arthritis, neurologic disorders (incl. insomnia, anxiety, depression: each in 6.66% (4.4% in total). Autoimmune thyroiditis was revealed in 3.3% from PP patients with comorbidities and 2.2% in total. Conclusions The obtained results are consistent with literature data on the association between psoriasis and arterial hypertension. Palmoplantar psoriasis patients with relatively low percentage of affected skin area reveals most concomitant associated diseases—cardiovascular, gastrointestinal, neurological etc. The risk of developing hypertension is elevated in patients not only with severe psoriasis, but also in PP. Further investigation should be performed to determine association with metabolic syndrome and disease duration as well as comprehensive cardiovascular risk assessment in this population.
P43 Correlation of SF-36v2 score with disease burden and patient background in Japanese patients with psoriasis vulgaris
Journal: British Journal of Dermatology (2024)

Abstract Psoriasis vulgaris is a chronic inflammatory skin disease that accounts for 0.3–0.4% of the Japanese population and is known to reduce the QoL of affected individuals. However, there are few evaluations of Japanese patients with psoriasis in general health-related quality of life indices such as short form (SF)-36v2. The Western Japan Psoriasis Registry is a prospective cohort conducted by the Western Japan Inflammatory Skin Disease Research Group and currently enrols around 2600 patients. QoL of psoriasis vulgaris patients enrolled in this registry were assessed using a questionnaire including SF36v2. Objective severity of the skin symptom was evaluated by board-certified dermatologists. The study was authorized by the internal review board of each facility and was conducted with the patient’s written consent. A total of 1065 PsV patients (765 males and 300 females) were enrolled. The mean age was 60.3 years; the mean physical component summary (PCS) of SF-36v2 in PsV patients was 47.9, lower than the national average. The scores were significantly lower in items physical functioning and general health. When stratified with demographics, women and those aged over 60 years had lower scores in almost all items. In contrast, habitual drinkers had higher scores on all items. In terms of comorbidities, patients with hypertension and diabetes had lower PCS than those who do not have such comorbidities, while having hyperlipidaemia or hyperuricaemia did not make any difference in scores. Regarding Physical Functioning, scores were higher overall in patients with a current lesion area of &amp;lt;3% and patients with a PGA score of 2 or less. For patients who have lesions on the head/neck and extremities, the scores were lower overall than those who do not have lesions in such areas. In correlation with other patient-reported outcomes, SF-36v2 scores were lower in the group with DLQI &amp;gt;10 than in those with DLQI ≦10. Similar results were found for the patient’s global assessment of severity and Itch NRS. In conclusion, women, older age, non-drinking, concomitant diabetes, objective severity, lesions on the head and neck, extremities, and itching were found to be factors that reduced quality of life in patients with PsV. This study was conducted by the members of the nonprofit organization Western Japan Inflammatory Skin Disease Research Group, and this work is partially supported by Boehringer Ingelheim.
FC15 Psoriasis in skin of colour patients: where are we now?
Journal: British Journal of Dermatology (2024)

Abstract Psoriasis is a chronic immune-mediated inflammatory disease affecting individuals across all races and ethnicities with reports of varying prevalence in different populations. Apart from similarities, there are nuances in various aspects of psoriasis in populations with skin of colour (SOC) as well as disparities in access to care and research.1 Our objective was to further understand the unique characteristics of plaque psoriasis in SOC patients. A literature search from January 2018 until August 2023 in Pubmed/MEDLINE and Cochrane Library was performed. Level of evidence for each study was assessed using the Oxford Centre for Evidence-Based Medicine recommendations and only studies with a level of evidence of I–III were included. The prevalence of plaque psoriasis is higher in White populations compared with those with SOC, although the disease is more severe, with higher body surface area affected and with a greater impact on quality of life in the latter group. The clinical picture in SOC patients may vary as lesions can appear as violaceous/grey and postinflammatory pigmentary alteration is a common associated feature. High-impact site involvement might be more common and more severe in patients with SOC. In terms of management, disparities in care have been reported. Data about the use of biologics or oral small molecules have shown similar efficacy and safety profiles across self-identified racial and ethnic groups. Psoriasis has been shown to have a greater impact on quality of life (QoL) in patients with SOC and new QoL tools that are more culturally appropriate for SOC patients may be required for use in global populations. Historically, access to clinical care and research has been more limited in people with SOC due to multiple factors. Inclusion of representative patient populations in registration trials has not changed significantly over the last years; however, postmarketing studies specifically involving SOC populations in North America have recently emerged. A limitation of our study is the lack of a universal definition and use of terms, such as ethnicity, race and SOC. In conclusion, racial and ethnic variations in epidemiology, clinical presentation, access to care, and QoL impact in psoriasis have been reported. However, data involving global populations with SOC are limited. This study raises awareness about the need to better understand psoriasis in patients with SOC so as to improve patient care globally.
P29 Frequency of HLA-C*06:02 in a multiracial population in Brazil: a comparison between psoriasis patients and healthy controls
Journal: British Journal of Dermatology (2024)

Abstract Psoriasis is a chronic, inflammatory, systemic and genetic-based disease with prevalences varying from 0.09 and 11.43% around the world. In Brazil, the overall prevalence is 1.31%, although there are significant differences among regions. The genetic background is still a matter of study, and many genes and loci of susceptibility have been identified. PSORS1 is the most important locus related to the risk of the disease, and inside it, HLA-C*06:02 is the main gene related to psoriasis. When two copies of this gene are carried by an individual, it increases 50-fold odds of developing the disease. It also participates in the clinical presentation, because the presence of HLA-C*06:02 is related to the early development of symptoms (Type 1 psoriasis), higher incidence of the Koebner phenomenon, and higher response to streptococcal throat infection as a trigger to the disease. Moreover, it is related to the response to treatment. The population in Brazil differs from the rest of Latin America, because colonization involved Portuguese, native Brazilians and African population. On the other hand, in the rest of Latin America miscegenation occurred between Spanish, native people from America (distinct from the ones in Brazil) and different degrees of participation of African population. Inside Brazil, which is a continental country, there are also significant differences between populations of distinct regions and, therefore, possibly diverse genetics. In Brazil, the last studies were performed before the last update in nomenclature, and none of them showed results regarding HLA-C*06:02. Our research has typified 40 patients with psoriasis and 104 healthy patients for HLA*C06:02 from the Southeast region of Brazil. The frequency of HLA-C*06:02 (allele G) in the group of patients was 27.78% and in controls was 14.44% (odds ratio 2.28; confidence interval 1.5–3.47), P = 0.00011. The Bonferroni correction was applied, and P-value was adjusted (P = 0.004). Also, when the patients were divided between mild and moderate to severe disease, there was no difference in frequency of this allele between the two groups (P = 0.48377). This study was funded by FAPERJ, www.faperj.br.
P16 Journey of psoriasis registry in Nigeria (prince study)
Journal: British Journal of Dermatology (2024)

Abstract The prevalence of Psoriasis in African populations ranges from 0.05 to 1%, compared with 2–3% reported in Caucasian populations.1,2 Some postulate that the low prevalence in African studies may be due to missed or misdiagnoses as tinea corporis or non-specific dermatitis by non-dermatologists due to a scarcity of dermatologists and dermatopathologists.1,2 Information on psoriasis in Nigerians is needed, being the most populous dark-skinned nation in the world, as clinical and genetic variations could influence therapeutic approaches to its management. This project was to develop a psoriasis registry, the first in Nigeria, that will document psoriasis patients’ clinical, epidemiological and biochemical characteristics. Our Roadmap included developing the Psoriasis Registry team, writing the proposal, and seeking ethics clearance from the National Human Research and Ethics Committee of Nigeria and the committees at the participating centres. Investigators were trained on diagnosis, assessment, and instruments, including PASI, DLQI, and body surface area, as well as datasheets and protocols and data entry into the website https://psoriasis.org.ng. Bimonthly meetings are held to assess the challenges and progress. This collaborative effort comprised the principal investigator (PI), three co-PIs, and over 60 co-investigators from Dermatology clinics across Nigeria’s six geopolitical regions. The proposal and protocols have received approval from the National Human Research and Ethics Committee of Nigeria (NHREC/01/01/2007 – 08/11/202333). Data entry started in January, and we are about 6 months into the project. Preliminary results show about equal frequencies of psoriasis in both males and females. Chronic plaque psoriasis is the most common clinical type, and all the clinical types have been documented. This study, with the cohort developed, will form the foundation for further studies of psoriasis in Nigeria, particularly genetic studies. It will potentially improve the understanding and management of psoriasis across Nigeria’s six geopolitical zones and the skin of colour population.
FC06 Genetic liability to psoriasis predicts severe disease outcomes in a cohort study of four population-based biobanks
Journal: British Journal of Dermatology (2024)

Abstract Psoriasis is a common inflammatory skin disease with heterogeneous presentation. Up to 30% of affected individuals have severe disease with a greater surface area of skin involvement, co-morbidity burden and impact on quality of life. Prognostic biomarkers of psoriasis severity could improve the allocation of clinical resources and enable earlier intervention to prevent disease progression, and a genetic biomarker would be cost-effective, stable over time, and unaffected by treatment or comorbidity. Psoriasis severity was studied in four European population-based biobanks and classified based on the level of clinical intervention received, with criteria for severe disease including hospitalization due to psoriasis, use of systemic immunomodulating therapy or phototherapy. Common genetic variants, polygenic risk scores and established epidemiological risk factors were tested for association with severe psoriasis in each of the constituent biobanks and combined through meta-analysis. The distribution of psoriasis polygenic risk was also evaluated in an independent cohort of 4151 participants in the UK-based severe psoriasis registry, BSTOP. In the population-based datasets, 9738 of 44 904 individuals with psoriasis (21.7%) were classified as having severe disease. Genetic variants within the major histocompatibility complex and the TNIP1 and IL12B psoriasis susceptibility loci were associated with severe disease at genome-wide significance (P &amp;lt; 5.0 × 10−8). Furthermore, a strong positive correlation was observed between psoriasis susceptibility and severity effect sizes across all psoriasis susceptibility loci. An individual’s genetic liability to psoriasis as measured with a polygenic risk score (PRS) strongly associated with disease severity, with a magnitude of effect comparable to established severity risk factors such as obesity and smoking. The top 5% of psoriasis cases by genetic liability were 1.23–2.00 times as likely than the average psoriasis case to have severe disease. Psoriasis cases in the BSTOP severe disease registry were 3.10-fold enriched for a PRS that exceeded the 95th percentile established among UK Biobank psoriasis cases. The psoriasis susceptibility PRS demonstrates utility and may be as effective as established epidemiological factors, as a stratification tool to identify those individuals that are at the greatest risk of severe disease. Further work is needed to determine whether high-risk individuals may benefit most from early intervention.
P106 Genome-Wide Association Study of a rare papulosquamous disease: pityriasis rubra pilaris
Journal: British Journal of Dermatology (2024)

Abstract Pityriasis rubra pilaris (PRP) is a rare chronic skin disorder that causes persistent inflammation, thickening and shedding of the skin. In terms of classification, it is a papulosquamous disease and its clinical features that have the closest overlap with psoriasis. Genetic studies have thus far identified variants in the CARD14 gene that contribute to the susceptibility of PRP, but a genome-wide association study (GWAS) has not yet been conducted. Therefore, it was our aim to perform a GWAS using the genotype data of nearly 200 000 individuals available from the Estonian Biobank database (EstBB). The patients included 100 EstBB participants who had a registered ICD-10 diagnosis code for PRP–L44.0. The control group consisted of 199 647 individuals who did not have the L44.0 diagnosis. An additive GWAS was performed using the SAIGE program adjusting for age, sex, and the first 10 genetic principal components. Since the group of patients was smaller than typically used in GWAS, we lowered the threshold for statistical significance to P &amp;lt; 5 × 10−7. The FUMA platform was used for functional annotation of association signals. Significant associations appeared in genomic regions of chromosome 4 [single nucleotide polymorphism (SNP) rs115367424, P = 2.08 × 10−7], chromosome 6 (lead SNP rs142103230, P = 5.71 × 10−8) and chromosome 14 (lead SNP rs8012648, P = 2.44 × 10−7). The nearest gene to rs115367424 is CCSER1, which has been associated with poor melanoma survival. The candidate SNPs of chromosome 6 are situated within an intron of PRKN gene that functions as a modulator of innate immunity to infectious agents and its genetic variants have been associated with susceptibility to leprosy. Chromosome 14 candidate SNPs are intronic variants of FBLN5 gene that can promote dermal wound healing and attenuate burn injury-induced inflammatory responses. The results presented here require confirmation in future studies, and the identification of possible functional variants in the three discussed genomic regions calls for further investigation. Genetic research on PRP is challenging due to its very rare occurrence, but considering the severity of the disease, this scientific attention is still very much needed.
P70 The 1-year all-cause drug survival of bimekizumab compared with other biologics in psoriasis: a nationwide real-world cohort study
Journal: British Journal of Dermatology (2024)

Abstract Bimekizumab was approved by the European Medicines Agency for the treatment of moderate-to-severe plaque psoriasis in August 2021. Bimekizumab is the only biologic that exerts specific inhibition of interleukin (IL)-17A and IL-17F. Few real-world studies have assessed the drug survival of bimekizumab. We assessed the 1-year all-cause drug survival of the tumour necrosis factor (TNF)-α inhibitor adalimumab, the IL-12/23 inhibitor ustekinumab, the IL-17 inhibitors secukinumab, ixekizumab, brodalumab, and bimekizumab, and the IL-23 inhibitor guselkumab. We used data on adult patients with psoriasis that were extracted from a nationwide prospective psoriasis database in February 2024. Survival functions were estimated using the Kaplan–Meier method. Hazard ratios (HRs) were estimated using a Cox proportional hazards model adjusted for the a priori-defined covariates age, sex, body weight, psoriatic arthritis (PsA), and previous number of biologics. Proportional hazards and linearity were assessed using the cumulative residuals. If the proportionality assumption was violated, we explored the time-varying effects of covariates. We included 4165 patients with 6554 treatment series. There were 3064 treatment series with adalimumab, 1498 with ustekinumab, 856 with secukinumab, 555 with ixekizumab, 195 with brodalumab, 192 with bimekizumab, and 194 with guselkumab. The crude 1-year all-cause drug survival was highest for bimekizumab (83.7%) followed by ustekinumab (79.2%), guselkumab (76.5%), ixekizumab (73.9%), adalimumab (71.4%), secukinumab (70.1%), and brodalumab (60.3%). In the Cox proportional hazards model, we found that bimekizumab had a significantly lower discontinuation hazard than all the other investigated biologics except guselkumab [HR, 1.26; 95% confidence interval (CI), 0.76–2.09]. Compared with bimekizumab, the HR was 1.55 (95% CI, 1.00–2.39) for ixekizumab, 1.56 (95% CI, 1.03–2.38) for ustekinumab, 2.25 (95% CI, 1.48–3.43) for secukinumab, 2.61 (95% CI, 1.65–4.13) for brodalumab, and 2.65 (95% CI, 1.75–4.01) for adalimumab. The analysis found that sex and PsA had time-varying effects. The hazard was 135% higher for females compared with males (HR, 2.35; 95% CI, 1.95–2.84) in the first 100 days and, among those still on treatment after 100 days, the HR decreased to 1.57 (95% CI, 1.40–1.78). In the first 100 days, PsA was protective (HR, 0.69; 95% CI, 0.56–0.86) but PsA had no protective effect for those still on treatment after 100 days (HR, 0.98; 95% CI, 0.86–1.11). In conclusion, bimekizumab had the highest 1-year all-cause drug survival compared with adalimumab, ustekinumab, secukinumab, ixekizumab, and brodalumab but not guselkumab. Data on the long-term drug survival of bimekizumab, as well as the drug survival associated with effectiveness and safety, are needed.
P52 Efficacy of guselkumab in bionaive psoriatic arthritis patients with severe disease activity: <i>post hoc</i> analysis of Phase 3, randomized, double-blind, placebo-controlled study
Journal: British Journal of Dermatology (2024)

Abstract The efficacy and safety of guselkumab, a fully human IL-23p19-subunit inhibitor, has been established in DISCOVER-1 and -2 studies. This post hoc analysis evaluates guselkumab efficacy through Week (W)100 in Bionaive psoriatic arthritis (PsA) patients with severe disease activity (DA) based on a range of composite and patient-reported outcomes. In DISCOVER-2, Bionaive adults with active PsA (≥5 swollen and ≥5 tender joints, CRP ≥0.6 mg/dL) received (1:1:1) guselkumab 100 mg every 4W (Q4W); guselkumab 100 mg at W0, W4, Q8W; or placebo with crossover to guselkumab Q4W at W24. Severe DA was defined by clinical DA Index for PsA (cDAPSA &amp;gt;27), PsA DA Score (PASDAS ≥5.4), and patient global assessment (PtGA ≥80 mm) criteria. Least square mean (LSM) changes from baseline were estimated with mixed models for repeated measures, adjusted for treatment group, baseline outcome levels, and study stratification factors (baseline csDMARD use, high-sensitivity serum CRP). Among 739 DISCOVER-2 patients, 648 (88%), 639 (86%), and 218 (29%) met cDAPSA (mean = 49.5), PASDAS (mean = 6.8), and PtGA (mean = 89.0) criteria for severe DA. Baseline characteristics and treatment groups were generally consistent across severe DA cohorts, except guselkumab Q4W group had a higher proportion of males and dactylitis than placebo. In multivariate analyses, irrespective of the severe DA cohort, significantly greater improvements were observed in guselkumab-treated patients vs. placebo in all evaluated endpoints (largest effect observed in severe PtGA cohort). Guselkumab showed clinically meaningful improvements at W2 for cDAPSA (guselkumab Q4W: −5.9; Q8W: −7.2; placebo: −5.0) and W8 for PASDAS (guselkumab Q4W: −1.5; Q8W: −1.5; placebo: −0.9) and PtGA (guselkumab Q4W: −30.0; Q8W: −32.1; placebo: −17.4). The LSM differences between guselkumab Q4W/Q8W and placebo were enhanced through W24 across severe DA cohorts, at which time further improvements with guselkumab occurred, resulting in significant (P &amp;lt; 0.001) differences of −9.8/−9.0 for cDAPSA, −1.1/−1.1 for PASDAS, and −24.0/−20.2 for PtGA. Further improvements were observed through 2 years of guselkumab treatment in all evaluated outcomes (LSM difference from BL: ΔcDAPSA, ∼−36; ΔPASDAS, ∼−3.6; ΔPtGA, ∼−56) representing ∼73%, ∼53%, and ∼63% improvements in joint DA, PsA activity across domains, and patient-reported overall DA. Guselkumab demonstrated rapid (W2 for joint and W8 for overall DA) and clinically meaningful improvements in DA in Bionaive PsA patients with severe DA in a range of joint-focused and multi-domain outcomes; these improvements were further enhanced by W24 and sustained through 2 years. Overall, findings support the use of guselkumab in PsA patients with severe DA.