Psoriasis (Pso) is a chronic, immune-mediated inflammatory disease (IMID) characterised by skin manifestations including but not limited to red, well-demarcated, endured and scaly plaques. The prevalence ranges between 0.09% and 11.43%, with higher numbers reported in Northern Europe. Approximately 64,6 million individuals are affected worldwide, with rising global incidence seen in the last 30 years. In approximately one-third of patients, more than 10% of the body is affected, and this is termed moderate-to-severe psoriasis. As there still is no cure for psoriasis until now, the need for treatment is typically lifelong and is mainly focused on disease remission.
Luckily, with the advent of newer and more effective therapies such as biologicals, the treatment goal has evolved towards (near) complete skin clearance, resulting in a new gold standard in clinical practice. Nevertheless, selecting the right biologic for an individual patient from the start remains challenging for the physician. Finding the best biologic for each patient is currently based on a process of ‘trial and error’, steered by clinical aspects, physicians’ expertise and patient characteristics e.g. baseline severity of disease, comorbidities, impairment of life quality, compliance profile, pregnancy wish, age and degree of professional activity.
Seeking a solution
The EPIPSORA trial will be carried out as part of the METHYLOMIC project. This study will investigate whether it is possible to develop and validate an epigenetic biomarker that predicts treatment success for rheumatoid arthritis and psoriasis. This would allow personalized management of the disease, and improve the patient’s quality of life. The study will investigate the treatment response of the commonly used drugs: adalimumab, ustekinumab and secukinumab. Approximately 200 patients will be included.