title: Efficacy and safety of systemic treatments for psoriasis in elderly patients.
abstract: Management of psoriasis in elderly patients can be challenging, because of the impairment of immune system efficiency and the presence of comorbidities that contra-indicate systemic therapies. We studied the safety and efficacy of systemic traditional and biological treatments in 187 consecutive psoriatic patients aged > 65 years. At week 12 of therapy, Psoriasis Area and Severity Index 75 was achieved by 49%, 27%, 46% and 31% of patients who received methotrexate, acitretin, cyclosporine or PUVA, and 64.1%, 64.7%, 93.3%, 57.1% and 100% of patients who received etanercept, adalimumab, infliximab, efalizumab and ustekinumab. The rate of adverse events was 0.12, 0.32, 1.4 and 0.5 per patient-year in the methotrexate, acitretin, cyclosporine and PUVA groups and 0.11, 0.35, 0.19, 0.3 and 0.26 in the etanercept, adalimumab, infliximab, efalizumab and ustekinumab groups. Traditional drugs were less effective than biologics in our elderly population. Etanercept was associated with a lower rate of adverse events compared with other treatments.
authors.affiliation: Dermatology Unit, University of Padua Via Cesare Battisti 206, IT-35128 Padua, Italy. stefano.piaserico@unipd.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Piaserico
authors.forename: Andrea
authors.initials: A
authors.lastname: Conti
authors.forename: Francesco
authors.initials: F
authors.lastname: Lo Console
authors.forename: Clara
authors.initials: C
authors.lastname: De Simone
authors.forename: Francesca
authors.initials: F
authors.lastname: Prestinari
authors.forename: Annamaria
authors.initials: A
authors.lastname: Mazzotta
authors.forename: Giulio
authors.initials: G
authors.lastname: Gualdi
authors.forename: Claudio
authors.initials: C
authors.lastname: Guarneri
authors.forename: Stefania
authors.initials: S
authors.lastname: Borsari
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Cassano
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001688:Biological Products / Q000009:adverse effects / Q000627:therapeutic use*; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D011565:Psoriasis / Q000175:diagnosis / Q000188:drug therapy*; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D001688:Biological Products; D003879:Dermatologic Agents