Perelman School of Medicine at the University of Pennsylvania

Gelfand Clinical Research Lab

Research

LITE Study

Light Treatment Effectiveness Study

PI: Dr. Joel M. Gelfand, MD, MSCE

 

The LITE Study is a joint effort of academic investigators(PI: Dr. Joel Gelfand and Co-PI Dr. Kristina Callis Duffin) and the National Psoriasis Foundation with input and active involvement by patients, dermatologists, health insurance providers/payers, and other stakeholders.

For more information please visit the PCORI website and LITE Study website

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Cardiovascular Disease Prevention for Psoriasis and Psoriatic Arthritis (CP3)

PIs: Joel Gelfand MD, MSCE and Nehal Mehta MD MSCE   


 

Check out our April 9th,2021: CP3 meeting 

Psoriasis and psoriatic arthritis (PsA) are associated with major medical comorbidity and premature death. Psoriasis is viewed as a cardiovascular (CV) risk enhancer warranting earlier use of statins for primary prevention of cardiovascular diseases (CVD) and mortality.   However, despite the increased risk of CVD in people with psoriasis, they are more likely to have undiagnosed or inadequately managed dyslipidemia and other major CV risk factors. Funded by   the National Psoriasis Foundation’s Psoriasis Prevention Initiative (PPI) the goal of CP3, is to shift screening for, and management of, dyslipidemia to specialists who mostly care for patients with psoriasis (rheumatologists and dermatologists) with a focus on use of statins per the new guidelines from the American Academy of Dermatology (AAD)/National Psoriasis Foundation (NPF) and the American Heart Association(AHA)/American College of Cardiology(ACC) which target psoriasis patients as a population  enhanced CVD prevention efforts.     

CP3 includes a multi-disciplinary and institutional team of investigators. Along with Dr. Gelfand, Dr. Nehal Mehta, MD, MSCE (Preventative Cardiologist, National Heart, Lung, Blood Institute) will serve as a PI. Our co-principal investigators include April Armstrong (Professor of Dermatology University of Southern California, expert in pragmatic trials and telemedicine), Rinad Beidas, PhD (Associate Professor of Psychiatry, Medical Ethics & Health Policy at Penn, expert in implementation science), Alexis Ogdie, MD MSCE (Associate Professor of Medicine (rheumatology) and Epidemiology at PENN, expert in psoriatic arthritis, clinical epidemiology, and trials).   

 In collaboration with the ARCH Lab (Accelerating Research-to-Practice in Community Health) and the National Psoriasis Foundation, we will conduct qualitative interviews and preference elicitation surveys of four stakeholder groups:

 

 1. Dermatologists who treat patients with psoriasis

2. Rheumatologists who treat patients with psoriatic arthritis

3. PsA patients ages 40-75, treated by rheumatologists

4. Psoriasis patients ages 40-75, treated by dermatologists

 

 The interviews and surveys will help us identify the facilitators and barriers to implementation of cardiovascular prevention care in psoriatic disease. These findings will inform the design and plan of a clinical trial that will determine the impact of dermatologist or rheumatologist screening and management of dyslipidemia on successful achievement of CV guideline-based treatment goals of statin utilization in patients with psoriatic disease compared to usual care.

If you are a rheumatologist or dermatologist or a patient with psoriatic disease and would like to learn more about the study please contact us at skinvip@upenn.edu.

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Vascular Inflammation in Psoriasis (VIP) Trials

PI: Joel M. Gelfand, MD, MSCE

In 2006 Gelfand and his team were the first to demonstrate that psoriasis, especially when severe, may be an independent risk factor for myocardial infarction. The purpose of the VIP trials is to determine the impact of psoriasis treatment on key markers of cardiovascular risk such as lipid metabolism (HDL function) and aortic inflammation measured by 18-FDG-PET/CT. 

A Trial to Determine the Effect of Psoriasis Treatment on Cardiometabolic Disease

The purpose of this study is to assess the effect of adalimumab (Humira), when compared to NB-UVB (narrow-band ultraviolet B) phototherapy or placebo (an inactive substance that may resemble an active substance but has no medical value) injection. The study will compare the effects of each on systemic inflammation and cardiovascular disease risk factors in subjects diagnosed with moderate to severe psoriasis.

This study will look for systemic vascular inflammation in subjects with a test called FDG-PET/CT (Fluorodeoxyglucose-positron emission tomography/computed tomography). The study will also look for cardio metabolic (heart disease and metabolic factors such as diabetes) identifiers in the blood. A blood sample will be taken that will look for these markers identifying high cholesterol, cholesterol efflux function (the ability of cholesterol to move in the body), metabolic factors, and inflammation.

This study will also assess the effect of adalimumab (Humira), when compared to NB-UVB phototherapy or placebo injection on psoriasis activity and severity. The study will also compare the safety of adalimumab (Humira) to NB-UVB phototherapy or placebo injection. This study will also evaluate subjects' reported outcomes through a questionnaire that will assess quality-of-life in subjects living with psoriasis. 

To learn more about the VIP study, please refer to this link


A Phase IV, Open Label Study of the Effects of Apremilast on Vascular Inflammation and Cardiometabolic function in Psoriasis

Vascular Inflammation in Psoriasis - Apremilast (VIP-A)

The purpose of this study is to assess the effect of apremilast (Otezla), an FDA-approved medication for the treatment of psoriasis, on systemic inflammation and cardiovascular disease risk factors in people diagnosed with moderate to severe psoriasis.

This study will look for systemic vascular inflammation with a test called FDG-PET/CT (Fluorodeoxyglucose-positron emission tomography/computed tomography). A description of an FDG-PET/CT scan is included below. The study will also look for cardiometabolic (heart disease and metabolic factors such as types of blood fats) identifiers in the blood. A blood sample will be taken that will look for these markers identifying high cholesterol, cholesterol efflux function (the ability of cholesterol to move in the body), metabolic factors, and inflammation.

This study will also compare subject-reported outcomes with a questionnaire that will assess quality-of-life for people living with psoriasis.

To learn more about the VIP-A Study, please refer to this link.



Selected Publications

High-density lipoprotein cholesterol function improves after successful treatment of psoriasis: a step forward in the right direction.

Mehta NNGelfand JM.

J Invest Dermatol. 2014 Mar;134(3):592-5. doi: 10.1038/jid.2013.447.

PMID: 23925466

Abnormal lipoprotein particles and cholesterol efflux capacity in patients with psoriasis.

Mehta NN, Li R, Krishnamoorthy P, Yu Y, Farver W, Rodrigues A, Raper A, Wilcox M, Baer A, DerOhannesian S, Wolfe M, Reilly MP, Rader DJ, VanVoorhees A, Gelfand JM

Atherosclerosis. 2012 Sep;224(1):218-21. doi: 10.1016/j.atherosclerosis.2012.06.068. Epub 2012 Jul 21.

PMID: 22858285

Systemic and vascular inflammation in patients with moderate to severe psoriasis as measured by [18F]-fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT): a pilot study.

Mehta NN, Yu Y, Saboury B, Foroughi N, Krishnamoorthy P, Raper A, Baer A, Antigua J, Van Voorhees AS, Torigian DA, Alavi A, Gelfand JM.

Arch Dermatol. 2011 Sep;147(9):1031-9. doi: 10.1001/archdermatol.2011.119. Epub 2011 May 16.

PMID: 21576552

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Incident Health Outcomes and Psoriasis Events

iHOPE

A population-based, cross sectional study using The Health Improvement Network (THIN), a large (7.5 million patients from 415 general practices) electronic medical records database maintained by general practitioners (GPs), broadly representative of the United Kingdom (UK) was conducted. 



Psoriasis and the risk of diabetes: A prospective population-based cohort study

Wan MT, Noe MH, Hubbard RA, Shin DB, Mehta NN, Gelfand JM.

J Am Acad Dermatol. 2018 Feb;78(2):315-322.e1. doi: 10.1016/j.jaad.2017.10.050. Epub 2017 Nov 8.

PMID: 29128465

Objective Measures of Psoriasis Severity Predict Mortality: A Prospective Population-Based Cohort Study.

Noe MH, Wan MT, Shin DB, Gelfand JM.

J Invest Dermatol. 2018 Apr;138(4):998. doi: 10.1016/j.jid.2018.02.006.

PMID: 28843488

Effect of psoriasis severity on hypertension control: a population-based study in the United Kingdom.

Takeshita J, Wang S, Shin DB, Mehta NN, Kimmel SE, Margolis DJ, Troxel AB, Gelfand JM.

JAMA Dermatol. 2015 Feb;151(2):161-9. doi: 10.1001/jamadermatol.2014.2094.

PMID: 25322196

Risk of moderate to advanced kidney disease in patients with psoriasis: population based cohort study.

Wan J, Wang S, Haynes K, Denburg MR, Shin DB, Gelfand JM.

BMJ. 2013 Oct 15;347:f5961. doi: 10.1136/bmj.f5961.

PMID: 24129480

Psoriasis severity and the prevalence of major medical comorbidity: a population-based study.

Yeung H, Takeshita J, Mehta NN, Kimmel SE, Ogdie A, Margolis DJ, Shin DB, Attor R, Troxel AB,Gelfand JM.

JAMA Dermatol. 2013 Oct;149(10):1173-9. doi: 10.1001/jamadermatol.2013.5015.

PMID: 23925466

Prevalence of metabolic syndrome in patients with psoriasis: a population-based study in the United Kingdom.

Langan SM, Seminara NM, Shin DB, Troxel AB, Kimmel SE, Mehta NN, Margolis DJ, Gelfand JM.

J Invest Dermatol. 2012 Mar;132(3 Pt 1):556-62. doi: 10.1038/jid.2011.365. Epub 2011 Nov 24.

PMID: 22113483

The risk of fracture among patients with psoriatic arthritis and psoriasis: a population-based study

Alexis Ogdie, Lauren Harter, Daniel Shin, Joshua Baker, Junko Takeshita, Hyon K Choi, Thorvardur Jon Love, Joel M Gelfand.

Ann Rheum Dis. 2017 Jan 16. pii: annrheumdis-2016-210441. doi: 10.1136/annrheumdis-2016-210441.

PMID: 28093419

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