Early intervention in psoriasis: Where do we go from here?
Patients with psoriasis often have comorbidities and are at increased risk of developing several complications compared with the general population. Knowledge on the role of immune mediators and systemic inflammation in psoriasis has led to the hypothesis that early intervention with systemic therap...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.1027347/full |
| _version_ | 1811321420601360384 |
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| author | Paulo Antônio Oldani Felix Ana Luisa Sampaio Bruno Leonardo Silva Analia Luiza Porto Viana |
| author_facet | Paulo Antônio Oldani Felix Ana Luisa Sampaio Bruno Leonardo Silva Analia Luiza Porto Viana |
| author_sort | Paulo Antônio Oldani Felix |
| collection | DOAJ |
| description | Patients with psoriasis often have comorbidities and are at increased risk of developing several complications compared with the general population. Knowledge on the role of immune mediators and systemic inflammation in psoriasis has led to the hypothesis that early intervention with systemic therapy has the potential to modify the course of the disease and reduce the risk of long-term adverse outcomes. In this article, we address some potential issues that need to be considered before early intervention can be implemented routinely. The first is determining what constitutes “early” intervention for psoriasis. A second point is whether the intervention should be considered for patients with early disease or for selected subsets based on risk stratification. A third important consideration is defining success for early intervention. Finally, adoption of early and effective intervention should be based on high-level evidence. Ideally, randomized trials would be the best strategy to compare early vs. late systemic treatment in patients with psoriasis, probably using the frequency of long-term outcomes as primary endpoint, with cutaneous and pharmacoeconomic outcomes assessed secondarily. |
| first_indexed | 2024-04-13T13:17:23Z |
| format | Article |
| id | doaj.art-7c76828c48584339922e2cda5fa864de |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-13T13:17:23Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-7c76828c48584339922e2cda5fa864de2022-12-22T02:45:25ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-12-01910.3389/fmed.2022.10273471027347Early intervention in psoriasis: Where do we go from here?Paulo Antônio Oldani Felix0Ana Luisa Sampaio1Bruno Leonardo Silva2Analia Luiza Porto Viana3Dermatology Department, Hospital Federal dos Servidores do Estado, Rio de Janeiro, BrazilDermatology Department, Hospital Universitário Pedro Ernesto, Rio de Janeiro State University, Rio de Janeiro, BrazilAbbVie Brazil Medical Department, São Paulo, BrazilAbbVie Brazil Medical Department, São Paulo, BrazilPatients with psoriasis often have comorbidities and are at increased risk of developing several complications compared with the general population. Knowledge on the role of immune mediators and systemic inflammation in psoriasis has led to the hypothesis that early intervention with systemic therapy has the potential to modify the course of the disease and reduce the risk of long-term adverse outcomes. In this article, we address some potential issues that need to be considered before early intervention can be implemented routinely. The first is determining what constitutes “early” intervention for psoriasis. A second point is whether the intervention should be considered for patients with early disease or for selected subsets based on risk stratification. A third important consideration is defining success for early intervention. Finally, adoption of early and effective intervention should be based on high-level evidence. Ideally, randomized trials would be the best strategy to compare early vs. late systemic treatment in patients with psoriasis, probably using the frequency of long-term outcomes as primary endpoint, with cutaneous and pharmacoeconomic outcomes assessed secondarily.https://www.frontiersin.org/articles/10.3389/fmed.2022.1027347/fullsystemic treatmentmethotrexatepsoriasisearly interventionrisk stratificationtherapeutic success |
| spellingShingle | Paulo Antônio Oldani Felix Ana Luisa Sampaio Bruno Leonardo Silva Analia Luiza Porto Viana Early intervention in psoriasis: Where do we go from here? Frontiers in Medicine systemic treatment methotrexate psoriasis early intervention risk stratification therapeutic success |
| title | Early intervention in psoriasis: Where do we go from here? |
| title_full | Early intervention in psoriasis: Where do we go from here? |
| title_fullStr | Early intervention in psoriasis: Where do we go from here? |
| title_full_unstemmed | Early intervention in psoriasis: Where do we go from here? |
| title_short | Early intervention in psoriasis: Where do we go from here? |
| title_sort | early intervention in psoriasis where do we go from here |
| topic | systemic treatment methotrexate psoriasis early intervention risk stratification therapeutic success |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.1027347/full |
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