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Lee H, Patel K, Singam V, Rastogi S, Silverberg J. Associations of cutaneous and extracutaneous infections with hidradenitis suppurativa in U.S. children and adults. Br J Dermatol 2019; 182:327-334. [DOI: 10.1111/bjd.18093] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2019] [Indexed: 12/29/2022]
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Rastogi S, Sadowsky L, Thiede R, Erickson T, Hua T, Kosche C, Rastogi A, Patel K, Miller C, Schlosser B. 596 Global sex differences in initial treatment for genital extramammary Paget’s disease: a systematic review. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rastogi S, Shastry J, Kong B, Park J, Patel K, Hua T, Singam V, Lee H, Fuertes E, Silverberg J. 183 Association of atopic dermatitis, ultraviolet radiation and climate factors: a systematic review and ecological meta-analysis. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Patel K, Lee H, Rastogi S, Vakharia P, Hua T, Chhiba K, Singam V, Silverberg J. 219 A systematic review and meta-analysis of the association between hidradenitis suppurativa, depression, suicidal ideation, and anxiety. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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McMichael A, Desai SR, Qureshi A, Rastogi S, Alexis AF. Efficacy and Safety of Brodalumab in Patients with Moderate-to-Severe Plaque Psoriasis and Skin of Color: Results from the Pooled AMAGINE-2/-3 Randomized Trials. Am J Clin Dermatol 2019; 20:267-276. [PMID: 30471012 DOI: 10.1007/s40257-018-0408-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Data on treatment outcomes in patients with psoriasis who have skin of color are limited. Brodalumab has shown efficacy in patients with moderate-to-severe plaque psoriasis. OBJECTIVE Our objective was to evaluate the efficacy, safety, and health-related quality of life associated with brodalumab in patients with skin of color participating in two phase III, multicenter, randomized, double-blind, placebo- and active comparator-controlled studies (AMAGINE-2/-3). METHODS Patients were self-categorized into racial subgroups (black, Asian, or white) or the non-mutually exclusive ethnic subgroup Hispanic/Latino. Patients were randomized to receive brodalumab 210 mg every 2 weeks (Q2W) or ustekinumab (45 mg in patients weighing ≤ 100 kg and 90 mg in patients weighing > 100 kg) for 52 weeks. Skin clearance was monitored using the Psoriasis Area and Severity Index (PASI) and Static Physician's Global Assessment (sPGA). Treatment-emergent adverse events (TEAEs) were summarized by treatment and racial and ethnic subgroup. Health-related quality of life was assessed using the Dermatology Life Quality Index (DLQI). RESULTS During the 12-week induction phase, 613 patients received ustekinumab (black, n = 20; Asian, n = 24; white, n = 551; Hispanic/Latino, n = 68) and 1236 patients received brodalumab 210 mg Q2W (black, n = 36; Asian, n = 39; white, n = 1116; Hispanic/Latino, n = 132). At week 52, a total of 590 patients received continuous ustekinumab (black, n = 19; Asian, n = 23; white, n = 532; Hispanic/Latino, n = 64) and 339 patients were re-randomized to continue receiving brodalumab 210 mg Q2W (black, n = 10; Asian, n = 7; white, n = 308; Hispanic/Latino, n = 40). Among patients who received brodalumab 210 mg Q2W, skin clearance response rates were similar across racial and ethnic subgroups at week 12 and week 52; rates of 75%, 90%, and 100% improvement in PASI from baseline were also higher, as was sPGA score ≤ 1, than in patients who received ustekinumab across all racial and ethnic subgroups. Rates of TEAEs and ≥ 5-point improvement in DLQI score were similar across racial and ethnic subgroups. CONCLUSIONS Brodalumab 210 mg Q2W is well tolerated and efficacious across diverse racial and ethnic subgroups in patients with psoriasis, including black, Asian, white, and Hispanic/Latino patients. TRIAL REGISTRY ClinicalTrials.gov identifier NCT01708603 (AMAGINE-2); NCT01708629 (AMAGINE-3).
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Patel K, Rastogi S, Singam V, Lee H, Amin A, Silverberg J. Association between hidradenitis suppurativa and hospitalization for psychiatric disorders: a cross‐sectional analysis of the National Inpatient Sample. Br J Dermatol 2019; 181:275-281. [DOI: 10.1111/bjd.17416] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2018] [Indexed: 01/05/2023]
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Langley R, Armstrongi A, Lebwohl M, Blauvelt A, Hsu S, Tyring S, Rastogi S, Pillai R, Israel R. Brodalumab in patients who had inadequate response to ustekinumab. Br J Dermatol 2019. [DOI: 10.1111/bjd.17471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Langley R, Armstrongi A, Lebwohl M, Blauvelt A, Hsu S, Tyring S, Rastogi S, Pillai R, Israel R. Brodalumab 用于对乌司奴单抗应答不足的患者. Br J Dermatol 2019. [DOI: 10.1111/bjd.17484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Singam V, Rastogi S, Patel KR, Lee HH, Silverberg JI. The mental health burden in acne vulgaris and rosacea: an analysis of the US National Inpatient Sample. Clin Exp Dermatol 2019; 44:766-772. [PMID: 30706514 DOI: 10.1111/ced.13919] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Little is known about the mental health (MH) hospitalization among patients with acne and rosacea. AIMS To determine the MH disorders and cost burden associated with acne and rosacea. METHODS Data were examined from the 2002-2012 US National Inpatient Sample, comprising a sample of ~20% of all US paediatric and adult hospitalizations (n = 87 053 155 admissions). RESULTS A diagnosis of ≥ 1 MH disorder was much more common among all inpatients with vs. those without a diagnosis of acne (43.7% vs. 20.0%, respectively) and rosacea (35.1% vs. 20.0%, respectively). In multivariable logistic regression models controlling for sex, age, race/ethnicity and insurance status, acne (adjusted OR = 13.02; 95% CI 11.75-14.42) and rosacea (adjusted OR = 1.70; 95% CI 1.56-1.95) were associated with significantly higher odds of a primary admission for an MH disorder (13 and 8, respectively, of 15 MH disorders examined). Both acne and rosacea were associated with higher risk of mood, anxiety, impulse control and personality disorders, and with > $2 million of excess mean annual costs of hospitalization for MH disorders in the USA. CONCLUSION In this study, inpatients with acne or rosacea had increased odds of comorbid MH disorders. In particular, there was an increased number of hospital admissions secondary to a primary MH disorder with coexistent acne/rosacea. MH comorbidities were associated with considerable excess costs among inpatients with acne or rosacea.
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Noordzij GJ, van den Boomen YJG, Gilbert C, van Elk DJP, Roy M, Wilsens CHRM, Rastogi S. The aza-Michael reaction: towards semi-crystalline polymers from renewable itaconic acid and diamines. Polym Chem 2019. [DOI: 10.1039/c9py00463g] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This paper reports, for the first time, semi-crystalline polymers based on bis-pyrrolidone dicarboxylic acids (BPDA) obtained from the aza-Michael reaction between renewable itaconic acid and various diamines.
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Langley RG, Armstrong AW, Lebwohl MG, Blauvelt A, Hsu S, Tyring S, Rastogi S, Pillai R, Israel R. Efficacy and safety of brodalumab in patients with psoriasis who had inadequate responses to ustekinumab: subgroup analysis of two randomized phase III trials. Br J Dermatol 2018; 180:306-314. [PMID: 30328108 DOI: 10.1111/bjd.17318] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND Brodalumab, a fully human anti-interleukin-17 receptor A monoclonal antibody, has demonstrated superior efficacy and safety over ustekinumab as induction therapy for moderate-to-severe psoriasis. OBJECTIVES To evaluate the efficacy and safety of brodalumab through week 52 in patients who had inadequate responses to ustekinumab. METHODS A subgroup analysis of the phase III AMAGINE-2/-3 double-blind randomized controlled trials was performed. Participants were aged 18-75 years and had a Psoriasis Area and Severity Index (PASI) ≥ 12, static Physician's Global Assessment score ≥ 3 and involvement of ≥ 10% body surface area. The studies were registered at ClinicalTrials.gov: AMAGINE-2, NCT01708603; AMAGINE-3, NCT01708629. RESULTS At baseline, patients with or without prior biologic experience who had an adequate response at week 16 on ustekinumab or brodalumab had lower rates of involved body surface area, PASI, prior biologic use, psoriatic arthritis and body mass index than patients who experienced inadequate response at or after week 16. Among patients who experienced inadequate response to ustekinumab, those rescued with brodalumab had PASI ≥ 75%, ≥ 90% and 100% improvement response rates of 72·6%, 58·1% and 36·3%, respectively, at week 52 compared with 61·7%, 25·5% and 5·4%, respectively, in patients who continued ustekinumab. Exposure-adjusted rates of treatment-emergent adverse events were similar among patients rescued with brodalumab (377·3 adverse events per 100 patient-years) and those who remained on ustekinumab (389·9 adverse events per 100 patient-years). CONCLUSIONS Among patients who experienced inadequate responses to ustekinumab, rescue with brodalumab improved skin clearance outcomes compared with continuing ustekinumab.
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Dharmendra Kumar MG, Narayanan V, Manikandan R, Parameswaran A, Kumar P, Shree Ram Subba Reddy G, Rastogi S. Role of extra oral monofocal distractor device in the correction of the facial asymmetry, sleep apnoea, and quality of life associated with TMJ ankylosis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2018; 120:203-210. [PMID: 30513389 DOI: 10.1016/j.jormas.2018.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 10/31/2018] [Accepted: 11/25/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The purpose of this study is to evaluate the role of primary osteo-distraction prior to ankylosis release in patients, diagnosed with sleep apnoea, facial asymmetry, and reduced quality of life secondary to temporomandibular joint (TMJ) ankylosis. METHODS Ten patients in the age group of 13-40 years with TMJ ankylosis underwent primary osteo-distraction for mandibular advancement. They were evaluated pre- and post-operatively using radiographs, various questionnaires, and subjective evaluation of facial asymmetry, sleep apnoea, and quality of life (QOL). RESULTS All the ten patients showed significant improvement in their sleep apnoea symptoms with a mean of 6.20 ± 1.39 (P < 0.05). The mean advancement of the mandible in all the ten patients (both bilateral and unilateral ankylosis) was 15.8 mm (P < 0.05). The quality of life showed marked improvement from very poor to very satisfactory (P < 0.001). CONCLUSION Primary mandibular distraction is an effective method of correction of facial asymmetry, sleep apnoea, and quality of life in patients with TMJ ankylosis.
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Patel K, Immaneni S, Singam V, Rastogi S, Silverberg J. A SYSTEMATIC REVIEW AND META-ANALYSIS OF DEPRESSION AND SUICIDE IN ATOPIC DERMATITIS. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Friedman J, Rastogi S, Glaser L, Lis C, Carter I, Milad M. RCT: Tolerance of Chlorhexidine Gluconate versus Povidone-Iodine Vaginal Cleansing Solution. J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Patel K, Singam V, Rastogi S, Lee H, Silverberg N, Silverberg J. Association of vitiligo with hospitalization for mental health disorders in
US
adults. J Eur Acad Dermatol Venereol 2018; 33:191-197. [DOI: 10.1111/jdv.15255] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 09/05/2018] [Indexed: 12/20/2022]
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Tiwari A, Rastogi S, Deo S, Sharma D, Sharma M, Bakshi S. Single arm prospective study evaluating the role of neoadjuvant chemotherapy in soft tissue sarcoma. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy299.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Chaudhuri S, Goel A, Awasthi A, Gupta S, Rastogi S, Panda D, Kumar N, Aneesh P. Disparity Between Metro-Centric Cancer Care and Rural Outreach in India: Situational Analysis and Future Trends in Context of Developing Countries. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.86000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Radiation therapy is used in two-third of all patients diagnosed with cancer in any form and it has become an integral part of modern treatment strategies for many types of cancers in recent decade. Semi-urban and rural places in India lack healthcare facilities and so as the cancer care facilities. Aim: To identify the propensity of a metro-centric oncologic care in developing countries undermining the need of availability of facilities in smaller towns and cities. Methods: Data for state-wise population for 2016 and 2026 was projected using cohort component method. For the projection of cancer incidence and prevalence in 2016 and 2026, we assumed that the state-level prevalence and incidence of cancer in the year 2015 will not change over time in 2016. Data collected through telephonic interviews from the radiotherapy centers listed by Atomic Energy Regulatory Board (AERB), India. Further, we assumed few scenarios of cancer incidence and prevalence increase and projected state wise cancer burden in 2026. Results: With almost 70% population of India residing in districts and cities lacking quality health care, the situation of cancer care is much grave. India is currently equipped with only 394 RTU (Radiation Therapy Unit) against requirement of almost 1300 RTU, amounting to 0.38 RTU per million populations as per World Health Organization. The public sponsored healthcare infrastructure for cancer treatment, and research is centralized with all the resources centered in metro/major cities. Eight metro cities of India with a combined population of 140.6 million hold control of 188 RTU under their boundaries. Thus, while habitants of these eight metro cities, constituting only 10.9% of the national population, avail treatment benefit from 38% of total RTU capacity of India, rest of Indian population at 1143.8 million strengths is left prey to the wrath of cancer with just 306 machines at disposal. In comparison, the developed nations as the United States of America, Australia, and the United Kingdom fare far better in RTU availability for treatment of diagnosed cancer patients, with RTU per million population density of 12.45, 10.12 and 5.04 respectively. Similar scenario has been seen in other LMICs in world like Congo, Mongolia, Sudan, Nigeria, Nepal etc. Conclusion: We observed that wide disparity exists in India concerning RTU and cancer facility availability and density per million populations in between metro cities and rest of India and a dire need of improvement to fight against cancer which is very similar to the situation in developing countries.
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Patel K, Singam V, Vakharia P, Chopra R, Sacotte R, Rastogi S, Lee H, Patel N, Immaneni S, Kantor R, Hsu D, Silverberg J. LB1526 Comparison of DLQI, ItchyQOL, and 5-D itch scale for the assessment of the burden of atopic dermatitis in adults. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.06.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Patel K, Singam V, Rastogi S, Lee H, Silverberg J. LB1502 Vitiligo is associated with multiple mental health disorders and psychiatric emergencies in the United States. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Friedman J, Rastogi S, Glaser L, Lis C, Carter I, Milad M. RCT: tolerance of chlorhexidine gluconate versus povidone-iodine vaginal cleansing solution. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Thiede R, Rastogi S, Nardone B, West D, Rangel S, Schlosser B. LB1516 Hyperkalemia in women with acne exposed to spironolactone in a large, urban, Midwestern U.S. population: A report from the Research on Adverse Drug Events and Reports Program (RADAR). J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.06.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Singam V, Patel K, Lee H, Rastogi S, Silverberg J. LB1494 Alopecia areata is associated with a substantial mental health burden in US inpatients. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Singam V, Orrell K, Patel K, Rastogi S, Kelm R, Rangel S, Laumann A, West D, Nardone B. LB1501 Chronic exposure to statin drugs and association with melanoma: A report from the RADAR (Research on Adverse Drug Events and Reports) project. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Feldman SR, Rastogi S, Lin J. Effect of Prior Biologic Use on Cost-Effectiveness of Brodalumab vs. Ustekinumab for Treatment of Moderate-to-Severe Psoriasis in the United States. Dermatol Ther (Heidelb) 2018; 8:441-453. [PMID: 30006866 PMCID: PMC6109035 DOI: 10.1007/s13555-018-0251-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Indexed: 11/30/2022] Open
Abstract
Introduction Clinical trials have shown brodalumab to have better efficacy than ustekinumab for the treatment of moderate-to-severe psoriasis. An estimation of the cost-effectiveness of brodalumab vs. ustekinumab is warranted and may be useful for treatment decision-making processes, especially in the context of the cost considerations of the current US healthcare system. Therefore, we compared the cost-effectiveness of brodalumab with ustekinumab for treatment of moderate-to-severe psoriasis in biologic-naïve and biologic-experienced patients in the USA. Methods An Excel-based economic model was developed to estimate and compare total annual costs to health plans associated with treatment with brodalumab vs. ustekinumab per achievement of Psorasis Area and Severity Index (PASI) 75, 90, and 100 for patients with moderate-to-severe psoriasis. Results For treatment with brodalumab vs. ustekinumab, total annual treatment costs per PASI 75, 90, and 100 were $31,106, $57,776, and $163,069, respectively, lower for a patient naïve to prior biologic treatment; they were $40,535, $65,472, and $223,610, respectively, lower for a patient experienced with prior biologic treatment. In an additional analysis among patients with and without prior biologic failure, they were $52,822, $93,309, and $365,606, respectively, lower for a patient with failure and they were $31,660, $57,128, and $164,996, respectively, lower for a patient without failure. Conclusion Compared to ustekinumab, treatment with brodalumab was associated with better cost-effectiveness ratios for biologic-naïve and experienced-patients and also patients with and without prior biologic treatment failure. The greater cost-effectiveness of brodalumab was most prominent for biologic-experienced and prior biologic treatment failure patients. Funding Ortho Dermatologics.
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Papp KA, Gordon KB, Langley RG, Lebwohl MG, Gottlieb AB, Rastogi S, Pillai R, Israel RJ. Impact of previous biologic use on the efficacy and safety of brodalumab and ustekinumab in patients with moderate-to-severe plaque psoriasis: integrated analysis of the randomized controlled trials AMAGINE-2 and AMAGINE-3. Br J Dermatol 2018; 179:320-328. [PMID: 29488226 DOI: 10.1111/bjd.16464] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND Biologics are being used increasingly to treat moderate-to-severe psoriasis. Efficacy may differ in patients with previous exposure to biologics. OBJECTIVES To investigate the impact of previous biologic exposure on the efficacy and safety of brodalumab and ustekinumab in patients with moderate-to-severe plaque psoriasis. METHODS Two placebo- and ustekinumab-controlled phase III clinical trials. There was an initial 12-week induction phase where patients were treated with brodalumab [210 mg or 140 mg every 2 weeks (Q2W)], ustekinumab or placebo. Efficacy end points included ≥ 75% improvement in Psoriasis Area and Severity Index (PASI 75) and static Physician's Global Assessment (score of 0 or 1) vs. placebo, PASI 100 vs. ustekinumab, Dermatology Life Quality Index and Psoriasis Symptom Inventory. Adverse events were monitored throughout. RESULTS In total, 493 patients [334 (27%) brodalumab 210 mg Q2W and 159 (26%) ustekinumab] had received prior biologics; 150 (12%) and 62 (10%), respectively, reported previously failed treatment with a biologic. Brodalumab efficacy in patients with or without previous exposure to biologics was statistically equivalent: 40·9% and 39·5% of biologic-naive and -experienced patients achieved PASI 100 at week 12, compared with 21·1% and 17·0% with ustekinumab (both P < 0·001). In patients where prior biologics had been successful or failed, 41·7% and 32·0% achieved PASI 100, compared with 21·1% and 11·3% with ustekinumab. Tolerability was similar, and did not appear to be influenced by previous treatment with biologics. CONCLUSIONS The efficacy of brodalumab 210 mg Q2W was similar regardless of prior biological therapy (P = 0·31, 0·32 and 0·64 for PASI 75, 90 and 100, respectively). Almost twice as many patients achieved PASI 100 or complete clearance with brodalumab at week 12 compared with ustekinumab; the differences were most noticeable where previous biologics had failed. Both treatments were well tolerated.
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