27 August 2020

Much research has been done on the effectiveness and safety of systemic antipsoriasis therapies in general, but the effectiveness in specifically older adults psoriasis patients has never been systematically assessed. 

Led by Satish Lubeek of the Department of Dermatology (photo), physician-researchers Marieke van Winden and Lara van der Schoot - together with other researchers - have conducted research into the effectiveness and safety of systemic anti-psoriasis therapies in patients over 65 years of age.

Findings

It seems that the effectiveness of treatment with acitretin, etanercept, adalimumab and secukinumab is not affected by advanced age. Studies of other systemic anti-psoriasis drugs have not made age group comparisons. Older age was significantly associated with impairment of renal function in users of ciclosporin and lymphopenia in users of fumaric acid. Infections were the most frequently reported side effect in patients over 65 years of age using biologics; no significant association with age was found.

Conclusions and relevance

Based on the very limited relevant studies available, age alone should not be a limiting factor in the treatment of psoriasis. Awareness of other medical conditions and concomitant medication use is very important in older adults, as well as possible dosage adjustments and frequent laboratory and clinical monitoring.
  
More research from daily practice, as well as (sub)analyses of prospective cohort studies on the effectiveness and safety of systemic therapies in older adults, are crucial for optimizing personalized, effective and safe anti-psoriasis treatments in this growing patient group.

The research was recently published in the scientific medical journal Journal of the American Medical Association: Jama Dermatology. It is also discussed in the corresponding editorial.

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