Metabolic abnormalities associated with initiation of systemic treatment for psoriasis: evidence from the Italian Psocare Registry.

Objective To evaluate variations in laboratory parameters and diagnoses of selected clinical conditions up to16 weeks after starting a new systemic psoriasis treatment for Psocare Registry enrollees.Design Prospective cohort study.Setting Italian public referral centres for psoriasis treatment.Patients First-time recipients (n = 10,539) of continuous systemic psoriasis treatment for at least 16 weeks.Main outcome measure Mean variations in (weeks 8 and 16) and proportions of patients reaching a clinicallymeaningful increase in serum levels (week 16) of total and low-density lipoprotein cholesterol, triglycerides, aspartateamino transferase, alanine amino transferase and creatinine, as well as week-16 cumulative incidences of newdiagnoses of diabetes mellitus and arterial hypertension.Results Mean cholesterol and triglyceride levels significantly increased in patients treated with acitretin orcyclosporine. Mean triglyceride levels also increased in efalizumab- and etanercept-treated patients. Meantransaminase values increased in methotrexate-treated patients, and mean aspartate amino transferase levelsincreased in infliximab-treated patients. The average serum creatinine value increased in cyclosporine-treatedpatients. Acitretin and cyclosporine were associated with risk of hypercholesterolaemia (odds ratios 1.51 and 1.34)and acitretin with risk of hypertriglyceridaemia (odds ratio 1.43). Methotrexate and infliximab were associated withrisk of more than doubling the upper normal aspartate amino transferase (odds ratios 2.06 and 1.87) and alanineamino transferase (odds ratios 2.38 and 1.74) values. The relative risk of developing arterial hypertension anddiabetes was increased for patients receiving cyclosporine (odds ratios 3.31 and 2.88).Conclusion Systemic treatments for psoriasis resulted in heterogeneous effects on the parameters analysed.Received: 1 September 2011; Accepted: 12 January 201

Latent tuberculosis infection in patients with chronic plaque psoriasis: evidence from the Italian Psocare Registry

The nationwide prevalence of latent tuberculosis infection (LTBI) in Italian patients with psoriasis has never been investigated

Latent tubercolosis infection in patients with chronic plaque psoriasis: from the Italian Psocare registry

BACKGROUND: The nationwide prevalence of latent tuberculosis infection (LTBI) in Italian patients with psoriasis has never been investigated. OBJECTIVES: To estimate the nationwide prevalence of LTBI in Italian patients with psoriasis who are candidates for systemic treatment. METHODS: Data were obtained from the Psocare Registry on those patients (n = 4946) with age > 18 years, systemic treatment at entry specified and tuberculin skin test (TST) performed according to the Mantoux method. LTBI diagnosis was based on a positive TST result in the absence of any clinical, radiological or microbiological evidence of active tuberculosis. RESULTS: Latent tuberculosis infection was diagnosed in 8\ub73% of patients with psoriasis (409 of 4946). The prevalence of LTBI was lower in patients on biologics than in those on conventional systemic treatments, ranging from 4\ub73% (19 of 444) of patients on adalimumab to 31% (eight of 26) of those on psoralen-ultraviolet A (P < 0\ub705). Independent factors associated with LTBI were male sex [odds ratio (OR) 1\ub730, 95% confidence interval (CI) 1\ub704-1\ub762; P = 0\ub702], age over 55 years (OR 2\ub793, 95% CI 2\ub718-3\ub793; P < 0\ub7001) and being entered into a conventional treatment (OR 3\ub783, 95% CI 3\ub710-4\ub774; P < 0\ub7001). Positive history of tuberculosis was seen in 1% of patients (n = 49). CONCLUSIONS: The nationwide prevalence of LTBI in Italian patients with psoriasis candidate to systemic treatment is high, and screening is recommended prior to biological treatment

Metabolic abnormalities associated with initiation of systemic treatment for psoriasis: evidence from the Italian Psocare Registry.

Objective To evaluate variations in laboratory parameters and diagnoses of selected clinical conditions up to16 weeks after starting a new systemic psoriasis treatment for Psocare Registry enrollees.Design Prospective cohort study.Setting Italian public referral centres for psoriasis treatment.Patients First-time recipients (n = 10,539) of continuous systemic psoriasis treatment for at least 16 weeks.Main outcome measure Mean variations in (weeks 8 and 16) and proportions of patients reaching a clinicallymeaningful increase in serum levels (week 16) of total and low-density lipoprotein cholesterol, triglycerides, aspartateamino transferase, alanine amino transferase and creatinine, as well as week-16 cumulative incidences of newdiagnoses of diabetes mellitus and arterial hypertension.Results Mean cholesterol and triglyceride levels significantly increased in patients treated with acitretin orcyclosporine. Mean triglyceride levels also increased in efalizumab- and etanercept-treated patients. Meantransaminase values increased in methotrexate-treated patients, and mean aspartate amino transferase levelsincreased in infliximab-treated patients. The average serum creatinine value increased in cyclosporine-treatedpatients. Acitretin and cyclosporine were associated with risk of hypercholesterolaemia (odds ratios 1.51 and 1.34)and acitretin with risk of hypertriglyceridaemia (odds ratio 1.43). Methotrexate and infliximab were associated withrisk of more than doubling the upper normal aspartate amino transferase (odds ratios 2.06 and 1.87) and alanineamino transferase (odds ratios 2.38 and 1.74) values. The relative risk of developing arterial hypertension anddiabetes was increased for patients receiving cyclosporine (odds ratios 3.31 and 2.88).Conclusion Systemic treatments for psoriasis resulted in heterogeneous effects on the parameters analysed.Received: 1 September 2011; Accepted: 12 January 201

Metabolic abnormalities associated with initiation of systemic treatment for psoriasis:evidence from the Italian Psocare Registry

OBJECTIVE: To evaluate variations in laboratory parameters and diagnoses of selected clinical conditions up to 16 weeks after starting a new systemic psoriasis treatment for Psocare Registry enrollees. DESIGN: Prospective cohort study. SETTING: Italian public referral centres for psoriasis treatment. PATIENTS: First-time recipients (n = 10,539) of continuous systemic psoriasis treatment for at least 16 weeks. MAIN OUTCOME MEASURE: Mean variations in (weeks 8 and 16) and proportions of patients reaching a clinically meaningful increase in serum levels (week 16) of total and low-density lipoprotein cholesterol, triglycerides, aspartate amino transferase, alanine amino transferase and creatinine, as well as week-16 cumulative incidences of new diagnoses of diabetes mellitus and arterial hypertension. RESULTS: Mean cholesterol and triglyceride levels significantly increased in patients treated with acitretin or cyclosporine. Mean triglyceride levels also increased in efalizumab- and etanercept-treated patients. Mean transaminase values increased in methotrexate-treated patients, and mean aspartate amino transferase levels increased in infliximab-treated patients. The average serum creatinine value increased in cyclosporine-treated patients. Acitretin and cyclosporine were associated with risk of hypercholesterolaemia (odds ratios 1.51 and 1.34) and acitretin with risk of hypertriglyceridaemia (odds ratio 1.43). Methotrexate and infliximab were associated with risk of more than doubling the upper normal aspartate amino transferase (odds ratios 2.06 and 1.87) and alanine amino transferase (odds ratios 2.38 and 1.74) values. The relative risk of developing arterial hypertension and diabetes was increased for patients receiving cyclosporine (odds ratios 3.31 and 2.88). CONCLUSION: Systemic treatments for psoriasis resulted in heterogeneous effects on the parameters analysed

Metabolic abnormalities associated with initiation of systemic treatment for psoriasis: Evidence from the Italian Psocare Registry

To evaluate variations in laboratory parameters and diagnoses of selected clinical conditions up to 16 weeks after starting a new systemic psoriasis treatment for Psocare Registry enrollees

Latent tuberculosis infection in patients with chronic plaque psoriasis: evidence from the Italian Psocare Registry

The nationwide prevalence of latent tuberculosis infection (LTBI) in Italian patients with psoriasis has never been investigated

Metabolic abnormalities associated with initiation of systemic treatment for psoriasis: evidence from the Italian Psocare Registry

OBJECTIVE: To evaluate variations in laboratory parameters and diagnoses of selected clinical conditions up to 16 weeks after starting a new systemic psoriasis treatment for Psocare Registry enrollees. DESIGN: Prospective cohort study. SETTING: Italian public referral centres for psoriasis treatment. PATIENTS: First-time recipients (n = 10,539) of continuous systemic psoriasis treatment for at least 16 weeks. MAIN OUTCOME MEASURE: Mean variations in (weeks 8 and 16) and proportions of patients reaching a clinically meaningful increase in serum levels (week 16) of total and low-density lipoprotein cholesterol, triglycerides, aspartate amino transferase, alanine amino transferase and creatinine, as well as week-16 cumulative incidences of new diagnoses of diabetes mellitus and arterial hypertension. RESULTS: Mean cholesterol and triglyceride levels significantly increased in patients treated with acitretin or cyclosporine. Mean triglyceride levels also increased in efalizumab- and etanercept-treated patients. Mean transaminase values increased in methotrexate-treated patients, and mean aspartate amino transferase levels increased in infliximab-treated patients. The average serum creatinine value increased in cyclosporine-treated patients. Acitretin and cyclosporine were associated with risk of hypercholesterolaemia (odds ratios 1.51 and 1.34) and acitretin with risk of hypertriglyceridaemia (odds ratio 1.43). Methotrexate and infliximab were associated with risk of more than doubling the upper normal aspartate amino transferase (odds ratios 2.06 and 1.87) and alanine amino transferase (odds ratios 2.38 and 1.74) values. The relative risk of developing arterial hypertension and diabetes was increased for patients receiving cyclosporine (odds ratios 3.31 and 2.88). CONCLUSION: Systemic treatments for psoriasis resulted in heterogeneous effects on the parameters analysed

Efficacy of switching between tumor necrosis factor-alfa inhibitors in psoriasis: results from the Italian Psocare registry

Some studies have shown that switching patients from one tumor necrosis factor (TNF)-alfa inhibitor to another may be beneficial when they have an inadequate response or an adverse event