Exploration of Musculoskeletal Diseases

From: How should we do in the selection and follow-up of systemic conventional treatments in psoriasis?

Table 2. Recommendations according to comorbidities in patients with psoriasis

Comorbidities	Strong recommendation in favour (Will likely be beneficial)	Weak recommendation in favour (Might be beneficial)	No recommendation (Insufficient evidence)	Weak recommendation against (Will likely not help but cause no harm)	Strong recommendation against (Likely to cause harm)
Psoriatic arthritis	MTX	Cyclosporin	Acitretin, fumarates	-	-
Chronic inflammatory bowel disease: Crohn’s disease	-	Acitretin (especially cases with mild paradoxical psoriasis), MTX	Cyclosporin, fumarates	-	-
Chronic inflammatory bowel disease: ulcerative colitis	-	Acitretin (especially cases with mild paradoxical psoriasis), cyclosporin (2nd choice oral treatment)	MTX, fumarates	-	-
Psychiatric disorders	MTX, acitretin, cyclosporin, fumarates	-	-	-	-
Metabolic syndrome	Fumarates	Acitretin, cyclosporin, MTX	-	-	-
Diabetes mellitus/insulin resistance	Acitretin, fumarates	Cyclosporin, MTX	-	-	-
Dyslipidaemia	-	-	MTX, cyclosporin, fumarates	Acitretin	-
Obesity	Fumarates	-	-	Acitretin, cyclosporin, MTX	-
Cardiovascular risk factors	MTX, fumarates	-	-	Acitretin, cyclosporin	-
Advanced heart failure	-	Acitretin, MTX	Fumarates	Cyclosporin	-
Ischemic heart disease	-	MTX	Fumarates	Acitretin, cyclosporin	-
Cancer history	-	Acitretin, MTX	Fumarates	Cyclosporin	-
Chronic kidney disease	Stage 1/2 renal insufficiency: use MTX with standard dose	Mild-moderate renal impairment (eGFR ≥ 30 mL/min per 1.73 m²). Acitretin, MTX, fumarates (carefull dosing/reduced dose)	-	-	Severe renal impairment (eGFR < 30 mL/min per 1.73 m²), cyclosporin, MTX, fumarates
Demyelinating diseases	Fumarates	MTX	Cyclosporin	Acitretin	-
Concomitant treated tuberculosis	-	Acitretin, fumarates	Cyclosporin, MTX	-	-
Latent tuberculosis	-	Acitretin, fumarates	-	Cyclosporin, MTX	-
HIV with undetectable viral load	-	Acitretin	-	Cyclosporin, MTX, fumarates	-
HIV with detectable viral load	-	Acitretin	-	-	Cyclosporin, MTX, fumarates
Hepatitis C	-	-	Fumarates	Cyclosporin	Acitretin, MTX
Hepatitis B	-	Acitretin, cyclosporin	Fumarates	-	MTX
Solid cancer	-	Acitretin, MTX, cyclosporin, fumarates	-	-	-
Hematological cancer	-	Acitretin, MTX, fumarates	Cyclosporin	-	-
Non-melanoma skin cancer	Acitretin	Fumarates	-	Cyclosporin, MTX	-
Melanoma	-	Acitretin, MTX, fumarates	-	-	Cyclosporin

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eGFR: estimated glomerular filtration rate

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Author contributions

SA: Conceptualization, Writing—original draft, Writing—review & editing.

Conflicts of interest

The author declares there is no conflicts of interest.

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