Psoriasis: systematic review finds that therapies offer efficacy in older patients

  • van Winden MEC & al.
  • JAMA Dermatol
  • 19.08.2020

  • von Brian Richardson, PhD
  • Clinical Essentials
Der Zugang zum gesamten Inhalt dieser Seite ist nur Angehörigen medizinischer Fachkreise vorbehalten. Der Zugang zum gesamten Inhalt dieser Seite ist nur Angehörigen medizinischer Fachkreise vorbehalten.

Takeaway

  • Available therapies for psoriasis are associated with clinical efficacy according to rates of ≥75% improvement in the Psoriasis Area and Severity Index (PASI 75) at weeks 12-16 in patients aged 65 years and older.

Why this matters

  • The effectiveness of psoriasis treatments in elderly patients has not previously been systematically assessed.

Key results

  • Rates of PASI-75 at weeks 12-16 in patients age ≥65 years were as follows:
    • 49% of methotrexate sodium users.
    • 46%-52.6% of cyclosporine users.
    • 27%-47.8% of acitretin users.
    • 15.6%-64% of etanercept users.
    • 66.7%-93% of infliximab users.
    • 60.7%-65% of adalimumab users.
    • 56.5% of ustekinumab users.
    • 86.4% of secukinumab users.
  • Older age was significantly associated with renal function deterioration in cyclosporine users (P=.03) and with lymphopenia in fumaric acid ester users (HR, 2.42; P<.001>

Study design

  • 31 unique articles with 39,561 patients.
  • Funding: Almirall SA; Radboud University Medical Center Nijmegen.

Limitations

  • Heterogeneity among included studies.
  • No meta-analysis performed.
  • Baseline comorbidities were often not reported.