Gene/Protein Disease Symptom Drug Enzyme Compound
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Psoriasis and psoriatic arthritis are serious autoimmune diseases requiring lifelong management and support. Uncontrolled psoriatic disease wields a significant impact on the lives of those affected, resulting in lowered quality of life, disability, depression, increased risk of related illnesses (eg, heart disease, diabetes), and early mortality. In National Psoriasis Foundation (NPF) surveys, roughly two-thirds of patients with psoriasis and/or psoriatic arthritis said their disease made them feel angry, frustrated, and/or helpless, and more than half said psoriasis interfered with their ability to enjoy life. The economic burden of psoriasis is equally daunting, and NPF surveys consistently report cost to be a significant barrier to treatment. This challenge is one of many reasons the NPF launched an aggressive strategic plan in 2014 intended to: 1) cut in half the number of patients who report that their condition is a problem in everyday life, 2) increase by 50% the number of patients receiving the right treatment, and 3) double the number of healthcare providers effectively managing patients with psoriasis and psoriatic arthritis. The NPF has launched several large-scale projects-including the development and implementation of solutions that reduce high out-of-pocket costs-intended to significantly increase the number of people with psoriatic disease who are effectively managing their condition.
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PMID:National Psoriasis Foundation: a patient-centric approach to improve access to psoriatic disease treatment. 2727 Jan 54

The chronic and systemic nature of psoriasis has a significant impact on direct costs, indirect costs, and patient quality of life. Psoriasis is associated with comorbid conditions that add to the burden of the disease, especially in moderate to severe disease. The total estimated annual healthcare burden of psoriasis may be as high as $35.2 billion, with $12.2 billion in direct costs and $23 billion in indirect costs (attributed to reduced health-related quality of life and lost productivity). These costs vary based on the severity of the disease; pharmacy costs account for the majority of the burden, especially in severe disease. Biologic therapies are largely responsible for the pharmacy costs. Approval of biosimilar products in the near future may ease some of this burden for payers and patients, although new agents have also been recently approved, with more in the pipeline. The healthcare costs of psoriasis management substantially increase with comorbid conditions, such as heart disease, hyperlipidemia, hypertension, diabetes, and lung disease. These comorbidities also include psychiatric conditions, such as social stigmatization, depression, and suicide. The overall costs associated with comorbidities are estimated to be an additional $22,713 per patient per year. Appropriate treatment selection and timing may curtail the progression of psoriasis, and, as a result, can decrease the economic burden. As treatment options vary based on comorbidities, long-term remission goals, and medication costs, conducting a comprehensive patient assessment is imperative. Drug utilization reviews steered by specialty pharmacists may help reduce costs and improve outcomes by providing treatment monitoring and patient education.
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PMID:Managed care aspects of psoriasis and psoriatic arthritis. 2735 95

Psoriatic arthritis (PsA) is chronic inflammatory arthropathy of peripheral joints and axial skeleton, occurring in 7% to 42% of patients with psoriasis. Arthritis might precede skin psoriatic lesion lesion in 13% to 17% cases. Patients present with pain and stiffness of the affected joins. A genetic factors play an important role (B27 has been associated with axial form, and DR4 with peripheral polyarticular form of PsA). Enthesopathy is a hallmark feature of PsA. It is an inflammation at the sites where tendons and ligaments attach to the bone. Extra-articular manifestations of disease are conjunctivitis and uveitis (occur in up to 1/3 of patients with PsA), heart disorder (aortic insufficiency), gut inflammation, urogenital inflammation. Treatment of PsA includes therapies for boths the skin and the joint disease. The treatment for the joint disease includes using NSAR (nonsteroidal anti-inflammatory drugs), DMARDs (disease-Modifying Antirheumatic Drugs) such as methotrexate (MTX), leflunomid, sulfasalasin and biological agents. Second-line therapy are: systemic glucocorticoids, retinoic acid derivatives/etretinate, photochemoterapy with MTX, physical therapy as an adjunct to drug therapy, and reconstructive surgery. The most important is that rheumatologist and dermatologist need to have some approach in management of PsA for optimal results.
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PMID:[WHAT SHOULD BE KNOWN ABOUT PSORIATIC ARTHRITIS]? 2907 11

Overweight and obesity are defined as an unnecessary accumulation of fat, which poses a risk to health. It is a well-identified risk factor for increased mortality due to heightened rates of heart disease, certain cancers, musculoskeletal disorders, and bacterial, protozoan and viral infections. The increasing prevalence of obesity is of concern, as conventional pathogenesis may indeed be increased in obese hosts rather than healthy hosts, especially during this COVID-19 pandemic. COVID-19 is a new disease and we do not have the luxury of cumulative data. Obesity activates the development of gene induced hypoxia and adipogenesis in obese animals. Several factors can influence obesity, for example, stress can increase the body weight by allowing people to consume high amounts of food with a higher propensity to consume palatable food. Obesity is a risk factor for the development of immune-mediated and some inflammatory-mediated diseases, including atherosclerosis and psoriasis, leading to a dampened immune response to infectious agents, leading to weaker post-infection impacts. Moreover, the obese host creates a special microenvironment for disease pathogenesis, marked by persistent low-grade inflammation. Therefore, it is advisable to sustain healthy eating habits by increasing the consumption of various plant-based and low-fat foods to protect our bodies and decrease the risk of infectious diseases, especially COVID-19.
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PMID:Factors Associated with Increased Morbidity and Mortality of Obese and Overweight COVID-19 Patients. 3291 25


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