Emerging evidence has suggested a link between new-onset psoriasis and both COVID-19 infection and vaccination, though findings have been limited by small case numbers and lack of adequate control groups. This retrospective cohort study used electronic health records from the US Collaborative Network of TriNetX from January 2020 to January 2025 to compare the risk of developing new-onset psoriasis in individuals with confirmed COVID-19 infection and no vaccination history vs those vaccinated without prior infection. Propensity score matching was applied to balance demographics, comorbidities, and psoriasis risk factors. The primary outcome was a new diagnosis of psoriasis (ICD10-CM: L40.0-5) within 3 months following infection or vaccination. Subgroup analyses assessed the specific codes L40.0-5 separately. Kaplan-Meier survival analysis and Cox proportional hazards models were used to compare outcomes. Patients with COVID-19 infection had a significantly higher risk of developing psoriasis compared with vaccinated individuals (HR 1.30; 95% CI, 1.14-1.49; p < 0.001). Increased risks were also observed for psoriatic arthritis and pustulosis palmaris et plantaris. These findings suggest a potential triggering role of infection in psoriasis pathogenesis and support the safety profile of vaccination. Further studies are needed to confirm causality and guide clinical decision-making.

Palmoplantar pustulosis (PPP) is a difficult-to-treat chronic dermatitis with limited treatment options. To report results from a Phase 3 study of apremilast in patients with moderate to severe PPP (NCT05174065). In this randomized, placebo-controlled, double-blind, confirmatory study, Japanese adults with PPP Area and Severity Index (PPPASI) total score ≥12, PPPASI pustules/vesicles severity score ≥2 and inadequate response to topicals were randomly assigned (1:1) to apremilast or placebo for 16 weeks, followed by an active treatment phase where all patients received apremilast through Week 52. The primary endpoint was a ≥50% reduction in PPPASI total score (PPPASI-50) at Week 16, evaluated in all randomized patients. Safety outcomes were assessed in all patients who received ≥1 dose of the study drug. Between March 8, 2022 to April 28, 2023, 176 patients (141 [80%] women, 35 [20%] men) were randomly assigned to apremilast (n = 88 [50%]) or placebo (n = 88 [50%]). Mean (SD) PPPASI total score at baseline was 22.1 (8.1) in the apremilast group and 22.0 (8.4) in the placebo group. A significantly greater proportion of patients achieved PPPASI-50 at Week 16 with apremilast versus placebo (60 of 88 [68%] vs. 31 of 88 [35%]; treatment difference: 32.6% [95% CI: 18.7, 46.5], p < 0.0001). Improvements were maintained through Week 52. The most common adverse events (≥10% of patients) during the double-blind phase in patients receiving apremilast were diarrhea (placebo: n = 3 [3%]; apremilast: n = 17 [19%]), feces soft (placebo: n = 1 [1%]; apremilast: n = 15 [17%]), headache (placebo: n = 2 [2%]; apremilast: n = 10 [11%]) and nausea (placebo: n = 1 [1%]; apremilast: n = 10 [11%]). There were no events of depression or fatal adverse events. In this Phase 3 trial, apremilast was effective in Japanese patients with moderate to severe PPP. Adverse events were consistent with the known safety profile of apremilast. gov: NCT05174065.

Anlotinib, a novel multitarget kinase inhibitor of VEGFR, FGFR, PDGFR and c-Kit, has proven to be effective and safe for refractory soft tissue sarcoma patients, but has not been examined in recurrent or metastatic primary malignant bone tumors in a clinical trial setting. This is a multicenter single-arm trial. Patients with pathologically proven recurrent or metastatic primary malignant bone tumors were eligible. Anlotinib was administered orally at 12 mg per day. Each cycle consisted of 2 weeks of treatment followed by 1-week off-treatment. The primary endpoint was progression-free survival (PFS), as assessed in the intention-to-treat (ITT) population. Secondary endpoints included objective response rate (ORR), disease control rate (DCR) and overall survival (OS). Adverse events (AEs) were assessed per NCI CTCAE version 4.03. A total of 42 patients were enrolled. Median PFS was 5.3 months (95% CI 3.5-8.4 months) in the overall analysis, 4.8 months (95%CI 3.5-7.1 months) in osteosarcoma patients and 2.8 months [95%CI 1.3 months to not reached (NR)] in chondrosarcoma patients. The median OS was 11.4 months (95% CI 10.1 months to NR) in the overall analysis, not reached (95% CI, NR, NR) in osteosarcoma patients and 11.4 months (95% CI 1.8 to 21.1 months) in chondrosarcoma patients. The ORR was 9.52% and DCR was 78.57%. Grade 3 or above AEs occurred in 54.76% of the patients, and included hypertension (19.05%), hypertriglyceridemia (9.52%) and pustulosis palmaris et plantaris (7.14%). No treatment-related death was reported. Anlotinib demonstrated promising antitumor activities in recurrent or metastatic primary malignant bone tumors with manageable AEs.