PMID- 37480749
OWN - NLM
STAT- MEDLINE
DCOM- 20230825
LR  - 20230825
IS  - 1878-1705 (Electronic)
IS  - 1567-5769 (Linking)
VI  - 122
DP  - 2023 Sep
TI  - Efficacy and safety of biological agents to treat patients with palmoplantar 
      pustulosis: A systematic scoping review.
PG  - 110553
LID - S1567-5769(23)00876-7 [pii]
LID - 10.1016/j.intimp.2023.110553 [doi]
AB  - BACKGROUND: Palmoplantar pustulosis (PPP), a chronic, recurrent pustular 
      dermatosis associated with erythema, scales, and sterile pustules on the palms 
      and soles, is commonly encountered in dermatology clinics. Whether PPP is a 
      variant of psoriasis or a distinct condition is still debated. Although 
      biological agents have been successfully used to treat moderate-to-severe 
      psoriasis, existing literature on PPP is limited to case reports or small case 
      series. The lack of well-documented clinical studies makes it difficult to select 
      the ideal treatment for this condition. This review aims to discuss the efficacy 
      and safety of biological agents in PPP treatment based on randomized controlled 
      trials with the hope of inspiring dermatologist clinicians to propose new 
      therapeutic approaches. OBJECTIVES: This review aims to obtain high-level 
      evidence to assess the efficacy and safety of biological agents in the treatment 
      of patients with PPP. METHODS: We searched the PubMed, Embase, and Cochrane 
      databases up to May 18, 2023, for high-quality randomized controlled trials that 
      reported at least one adverse event after PPP treatment with biological agents in 
      patients > 18 years of age. RevMan 5.3 software was used for the meta-analysis. 
      RESULTS: Nine trials involving 799 participants were included in the analysis. We 
      used ppPASI 75 as the primary efficacy measure. Anti-IL-23 and anti-IL-17A agents 
      afforded 4.14-fold and 1.95-fold better outcomes than placebo treatment at weeks 
      16 and 12, respectively (P-value = 0.009, RR = 4.14, 95% confidence interval [CI; 
      1.43-11.98]; P-value = 0.02, RR = 1.95, 95% CI [1.11-3.42]). Moreover, anti-IL-23 
      agents at a dose of 100 mg were more effective than at 200 mg, indicating that 
      100 mg may be the best dose for anti-IL-23 agents. Next, we investigated the 
      safety of biological agents for PPP treatment. The incidence of total adverse 
      events (AEs) was 1.25 times higher for biological agents than for controls, 
      indicating a good safety profile (RR = 1.25, P-value ＜ 0.00001, 95% CI [1.13, 
      1.37]). Additionally, we divided the common AEs into 16 categories and found that 
      anti-IL-23 agents were more likely to induce infections. In conclusion, we 
      evaluated safety and efficacy in a comprehensive comparison and found that 
      anti-IL-23 agents conferred good clinical efficacy with a low incidence of AEs 
      and could be recommended with caution. LIMITATIONS: Only a few relevant, 
      high-quality, randomized controlled trials were included in the study. 
      CONCLUSION: This study showed that biological agents can be used to treat 
      patients with PPP with good efficacy; however, AEs cannot be ignored. 
      Multi-center, high-quality clinical studies with large sample sizes are needed to 
      further evaluate the effects and safety of biological agents in PPP treatment.
CI  - Copyright (c) 2023 Elsevier B.V. All rights reserved.
FAU - Zhang, Miao
AU  - Zhang M
AD  - Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and 
      Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 
      200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese 
      Medicine, Shanghai 201203, China.
FAU - Hua, Liang
AU  - Hua L
AD  - Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and 
      Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 
      200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese 
      Medicine, Shanghai 201203, China.
FAU - Hong, Seokgyeong
AU  - Hong S
AD  - Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, 
      Shanghai 201203, China.
FAU - Sun, Xiaoying
AU  - Sun X
AD  - Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, 
      Shanghai 201203, China.
FAU - Zhou, Yaqiong
AU  - Zhou Y
AD  - Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, 
      Shanghai 201203, China.
FAU - Luo, Ying
AU  - Luo Y
AD  - Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, 
      Shanghai 201203, China.
FAU - Liu, Liu
AU  - Liu L
AD  - Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and 
      Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 
      200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese 
      Medicine, Shanghai 201203, China.
FAU - Wang, Jiao
AU  - Wang J
AD  - Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and 
      Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 
      200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese 
      Medicine, Shanghai 201203, China.
FAU - Wang, Chunxiao
AU  - Wang C
AD  - Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and 
      Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 
      200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese 
      Medicine, Shanghai 201203, China.
FAU - Lin, Naixuan
AU  - Lin N
AD  - Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and 
      Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 
      200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese 
      Medicine, Shanghai 201203, China.
FAU - Li, Xin
AU  - Li X
AD  - Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and 
      Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 
      200437, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese 
      Medicine, Shanghai 201203, China. Electronic address: 13661956326@163.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20230720
PL  - Netherlands
TA  - Int Immunopharmacol
JT  - International immunopharmacology
JID - 100965259
RN  - 0 (Biological Factors)
SB  - IM
MH  - Humans
MH  - Biological Factors
MH  - *Psoriasis/drug therapy
MH  - Acute Disease
MH  - Chronic Disease
MH  - Databases, Factual
MH  - *Primary Immunodeficiency Diseases
MH  - Randomized Controlled Trials as Topic
OTO - NOTNLM
OT  - Biological factors
OT  - Drug-related side effects and adverse reactions
OT  - Psoriasis
OT  - Systematic review
OT  - Treatment outcome
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2023/07/23 01:11
MHDA- 2023/08/25 06:42
CRDT- 2023/07/22 18:06
PHST- 2023/02/16 00:00 [received]
PHST- 2023/06/02 00:00 [revised]
PHST- 2023/06/20 00:00 [accepted]
PHST- 2023/08/25 06:42 [medline]
PHST- 2023/07/23 01:11 [pubmed]
PHST- 2023/07/22 18:06 [entrez]
AID - S1567-5769(23)00876-7 [pii]
AID - 10.1016/j.intimp.2023.110553 [doi]
PST - ppublish
SO  - Int Immunopharmacol. 2023 Sep;122:110553. doi: 10.1016/j.intimp.2023.110553. Epub 
      2023 Jul 20.