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      S3-Leitlinie zur Therapie der Psoriasis vulgaris Update - Kurzfassung Teil 1 - Systemische Therapie : S3-Leitlinie Psoriasis

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          European S3-Guideline on the systemic treatment of psoriasis vulgaris - Update Apremilast and Secukinumab - EDF in cooperation with EADV and IPC.

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            S3 - Guidelines on the treatment of psoriasis vulgaris (English version). Update.

            Psoriasis vulgaris is a common and often chronic inflammatory skin disease. The incidence of psoriasis in Western industrialized countries ranges from 1.5% to 2%. Patients afflicted with severe psoriasis vulgaris may experience a significant reduction in quality of life. Despite the large variety of treatment options available, surveys have shown that patients still do not received optimal treatments. To optimize the treatment of psoriasis in Germany, the Deutsche Dermatologi sche Gesellschaft (DDG) and the Berufsverband Deutscher Dermatologen (BVDD) have initiated a project to develop evidence-based guidelines for the management of psoriasis. They were first published in 2006 and updated in 2011. The Guidelines focus on induction therapy in cases of mild, moderate and severe plaque-type psoriasis in adults including systemic therapy, UV therapy and topical therapies. The therapeutic recommendations were developed based on the results of a systematic literature search and were finalized during a consensus meeting using structured consensus methods (nominal group process).
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              Which antipsoriatic drug has the fastest onset of action? Systematic review on the rapidity of the onset of action.

              The time necessary for a treatment to become effective is crucial for patients and physicians but has been largely neglected in the reporting and comparison of clinical trials in dermatology. The aim of this systematic review is to determine the time until the onset of action (TOA) of systemic agents approved for moderate-to-severe psoriasis. Primary outcome is the TOA defined as the weighted mean time until 25% of the patients achieved a psoriasis area and severity index (PASI) 75 response. Among the biologics, infliximab has the shortest TOA (3.5 weeks), followed by ustekinumab (high dose 4.6/low dose 5.1 weeks/not weight adapted), adalimumab (4.6 weeks), etanercept (high dose 6.6/low dose 9.5 weeks), and alefacept (high dose 15.4 weeks/low dose: no data). Among the conventional treatments, good data are available for cyclosporine A (CsA; TOA: 6.0 weeks) and limited data are found for methotrexate (MTX; TOA: high dose 3.2/low dose 9.9 weeks). No data are available for fumaric acid esters and retinoids. This systematic review provides clinically relevant information on the onset of action of antipsoriatic agents, although the data currently available allow only a limited assessment. Psoriasis trials should consider including TOA as an additional outcome measure.
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                Author and article information

                Journal
                JDDG: Journal der Deutschen Dermatologischen Gesellschaft
                JDDG: Journal der Deutschen Dermatologischen Gesellschaft
                Wiley
                16100379
                May 2018
                May 2018
                May 11 2018
                : 16
                : 5
                : 645-670
                Affiliations
                [1 ]Charité - Universitätsmedizin Berlin; corporate member of Freie Universität Berlin; Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Dermatology, Venereology und Allergy, Division of Evidence-Based Medicine (dEBM)
                [2 ]Fachklinik Bad Bentheim
                [3 ]Universitätsklinikum Hamburg-Eppendorf; Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen
                [4 ]Service de Dermatologie et Vénéréologie; Hôpitaux Universitaires de Genève
                [5 ]Katholisches Klinikum Mainz; Zentrum für Rheumatologische Akutdiagnostik; Klinik für Rheumatologie; Klinische Immunologie und Physikalische Therapie
                [6 ]Selbsthilfegemeinschaft Haut e. V.
                [7 ]Deutscher Psoriasis Bund e. V.
                [8 ]Psoriasis-Zentrum; Klinik für Dermatologie; Venerologie; Allergologie; Universitätsklinikum Schleswig-Holstein; Campus Kiel
                [9 ]Haut- und Allergieklinik; Klinikum Hanau
                [10 ]Charité - Universitätsmedizin Berlin; corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Dermatology; Venereology und Allergy, Psoriasisstudienzentrum
                [11 ]Dermatologikum Hamburg
                [12 ]Niedergelassener Dermatologe; Osnabrück
                [13 ]Privatpraxis Rzany & Hund; Berlin
                [14 ]Niedergelassener Dermatologe; Oldenburg
                [15 ]Berolina Klinik; Löhne
                [16 ]Niedergelassener Dermatologe; Mahlow
                [17 ]Niedergelassener Dermatologe; Selters
                [18 ]Klinik für Dermatologie; Venerologie und Allergologie; Universitätsklinikum Frankfurt; Frankfurt/Main und Arbeitsgruppe EbM Frankfurt; Institut für Allgemeinmedizin; Goethe-Universität Frankfurt; Frankfurt/Main
                Article
                10.1111/ddg.13516_g
                29750455
                838592aa-7df6-445d-b158-ec3e5be33f77
                © 2018

                http://doi.wiley.com/10.1002/tdm_license_1.1

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