Title
Evidence-based modalities in the management of Psoriasis and Psoriatic arthritis
Authors
Francesco Chiappelli
Affiliation
Corresponding author: Francesco Chiappelli Ph.D., Dr. End. (h.c.), Professor Emeritus, Center for the Health Sciences, UCLA, Los Angeles, CA; Dental Group of Sherman Oaks, CA 91403.
Article Type
Editorial
Date
Received June 1, 2023; Revised June 30, 2023; Accepted June 30, 2023, Published June 30, 2023
Abstract
Psoriasis is a waxing and waning skin disorder, often associated with a plethora of co-morbidities, including psoriatic arthritis (PsA), a severe form of chronic inflammatory arthritis. All forms of psoriasis and PsA are immune-mediated diseases where the patient's immune system is overactive in the production of certain factors that stimulate and activate the function of certain immune cells. Recent evidence has uncovered an important role for cell-mediated immunity in the aetiology and course of psoriasis and PsA, with a critical role played by the pro-inflammatory IL-23/TH17 axis. Taken together, these new lines of evidence suggest new and improved therapeutic interventions for patients with psoriasis and PsA. The hypothesis-driven process of inquiry of the best available evidence and its implication, application and evaluation in the context of clinical practice pertains to the meta-science of evidence-based health care (EBHC). EBHC consists in the initial step of research synthesis and generation of the systematic review of the best available evidence, estimated both qualitatively and quantitatively (i.e., meta-analysis). Evidence-based decision-making, a process driven and controlled by the expertise of the clinician and by the clinical needs and personal wants of the patient, is the principal, most timely and critical aspect of evidence-based practice. Recent and systematic reviews for the treatment of psoriasis and PsA consistently updated for emerging new and revised data (i.e., living systematic reviews) confirm the efficacy and the effectiveness of methotrexate (MTX) in containing and controlling psoriasis. The outcomes of MTX intervention for PsA remain mixed and inconclusive.
Keywords
Evidence-based healthcare, Systematic review, Metascience, PICO(TS) question, Bibliome, Research synthesis, Translational evidence-based intervention, Psoriasis, Psoriatic arthritis (PsA), Methotrexate (MTX)
Citation
Chiappelli, Bioinformation 19(6): 679-684 (2023)
Edited by
P Kangueane
ISSN
0973-2063
Publisher
License
This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.
