Management of Systemic Anti‑psoriatic Drugs in Psoriasis Patients with Concurrent Paraplegia or Tetraplegia: Insights From a 6‑Year Multicenter, Retrospective Observational Study

Dermatol Ther (Heidelb), 2025 · DOI: https://doi.org/10.1007/s13555-025-01338-w · Published: January 24, 2025

Simple Explanation

Patients with psoriasis and spinal cord injuries may have a higher risk of infections, making treatment with immunosuppressants challenging. This study aimed to evaluate the rate of infections in psoriasis patients with spinal cord injuries treated with systemic immunosuppressants. The study found that certain anti-psoriatic drugs (Methotrexate and TNF alpha inhibitors) were associated with higher infection rates compared to others (interleukin-17/23i).

Study Duration

5 years

Participants

23 patients with SCI (16 with paraplegia and 7 with tetraplegia)

Evidence Level

Retrospective observational study

Key Findings

1
Patients with SCI treated with MTX had higher infection rates compared to those treated with biologics.
2
Patients with paraplegia had lower infection rates compared to those with tetraplegia during anti-psoriatic therapies.
3
Those treated with TNFi had greater rates of infection than those treated with IL-17i/IL-23i.

Research Summary

This study evaluated the rate of infections in patients with psoriasis and spinal cord injuries treated with systemic immunosuppressants over a 5-year period. The results showed that methotrexate was associated with higher infection rates compared to biologics, and TNF inhibitors had higher infection rates than IL-17/IL-23 inhibitors. The study suggests that IL-17/IL-23 inhibitors should be considered as first-line therapy in patients with psoriasis and concurrent traumatic spinal cord injury.

Practical Implications

Treatment Choice

IL-17i/IL-23i should be considered as first-line therapy for psoriasis patients with traumatic SCI to minimize infection risk.

Monitoring and Diagnosis

Increased monitoring for PsA is needed in SCI patients due to difficulties in self-reporting pain and stiffness, potentially using imaging tools and lab tests.

Guideline Updates

Clinical guidelines should address the management of psoriasis in special populations, such as patients with paraplegia and tetraplegia.

Management of Systemic Anti‑psoriatic Drugs in Psoriasis Patients with Concurrent Paraplegia or Tetraplegia: Insights From a 6‑Year Multicenter, Retrospective Observational Study

Simple Explanation

Key Findings

Research Summary

Practical Implications

Treatment Choice

Monitoring and Diagnosis

Guideline Updates

Study Limitations

Your Feedback

Was this summary helpful?

Management of Systemic Anti‑psoriatic Drugs in Psoriasis Patients with Concurrent Paraplegia or Tetraplegia: Insights From a 6‑Year Multicenter, Retrospective Observational Study

Simple Explanation

Key Findings

Research Summary

Practical Implications

Treatment Choice

Monitoring and Diagnosis

Guideline Updates

Study Limitations

Your Feedback

Was this summary helpful?