Treatment protocols may differ in early and late onset psoriasis

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Treatment protocols may differ in early and late onset psoriasis

Patients with early-onset psoriasis are less likely than those with late-onset psoriasis to respond to systemic psoriasis treatments, a scientific review shows.

Patients with early-onset psoriasis are less likely than those with late-onset psoriasis to respond to systemic psoriasis treatments, a scientific review shows.

The review, published in the September 2018 issue of the American Journal of Clinical Dermatology, shows that patients who develop psoriasis before 40 years old are less likely than those who develop psoriasis after 40 years to respond to TNF inhibitors, IL-12/23 inhibitors and methotrexate.

The review adds real-world clinical data to previous observations that early and late onset patients respond differently to treatment, said lead author Sanminder Singh, M.D., an internal medicine resident at the University of California Los Angeles.

“The past few years have been marked with great innovation and the development of multiple highly effective treatment options for psoriasis. Given our expanded repository of biologic and oral systemic treatment options, it’s important to examine differences in efficacy in certain subsets of patients,” the authors wrote.

These differences in treatment response were first documented in 1985 in the Journal of the American Academy of Dermatology in which investigators documented differences in disease severity and relapse frequency.

The new analysis shows that patients with late-onset psoriasis had a better response to treatment with etanercept than did patients with early-onset psoriasis.” This pattern persisted whether researchers looked at outcomes in terms of physician global assessment (PGA) scores or body surface area measurements, Dr. Singh said.

“This does not necessarily mean that etanercept is an inappropriate choice for certain patients with early-onset psoriasis. The results from this real-world data suggest that some patients with early-onset psoriasis may respond better to other agents,” he said.

09 Read on: Treatment protocols may differ in early and late onset psoriasis

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