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Noe MH, Wan MT, Shin DB, Armstrong AW, Duffin KC, Chiesa Fuxench ZC, Kalb RE, Menter A, Simpson EL, Takeshita J, Tyring SK, Van Voorhees AS, Mehta NN, Gelfand JM. Patient-reported outcomes of adalimumab, phototherapy, and placebo in the Vascular Inflammation in Psoriasis Trial: A randomized controlled study. J Am Acad Dermatol 2019; 81:923-930. [PMID: 31163241 DOI: 10.1016/j.jaad.2019.05.080] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/20/2019] [Accepted: 05/30/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND There are limited data about the impact of narrowband ultraviolet B phototherapy on patient-reported measures of health-related quality of life. OBJECTIVE To evaluate the impact of adalimumab and phototherapy on health-related quality of life. METHODS We examined patient-reported outcomes from a multicenter, randomized, placebo-controlled trial (ClinicalTrials.gov no. NCT01553058). The Dermatology Life Quality Index and EQ-5D-3L were evaluated every 4 weeks. RESULTS We enrolled 97 patients: 30.9% were female, mean age was 43.5 years (standard deviation, 14.0), and median Psoriasis Area and Severity Index score was 16.7 (interquartile range, 13.9-21.6). At week 12, patients being treated with adalimumab (odds ratio [OR], 2.88; 95% confidence interval [CI], 1.02-8.17) and phototherapy (OR, 8.83; 95% CI, 2.47-31.57) were more likely to achieve the minimal clinically important difference in the Dermatology Life Quality Index compared with those receiving placebo. There were higher odds of achieving the minimal clinically important difference for the EQ-5D-3L Index score when comparing phototherapy versus placebo (OR, 9.78; 95% CI, 2.99-31.95) and phototherapy versus adalimumab (OR, 4.07; 95% CI, 1.42-11.70). LIMITATIONS Small sample size, secondary analysis, generalizability. CONCLUSION Phototherapy and adalimumab both improve skin-related quality of life and overall health-related quality of life compared with placebo in patients with psoriasis; however, patients treated with phototherapy achieved more improvement in overall health-related quality of life compared with patients treated with adalimumab.
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Affiliation(s)
- Megan H Noe
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
| | - Marilyn T Wan
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Daniel B Shin
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - April W Armstrong
- Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, California
| | | | - Zelma C Chiesa Fuxench
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Robert E Kalb
- Department of Dermatology, University of Buffalo, Williamsville, New York
| | - Alan Menter
- Department of Dermatology, Baylor University Medical Center, Dallas, Texas
| | - Eric L Simpson
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon
| | - Junko Takeshita
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Stephen K Tyring
- Department of Dermatology, University of Texas, McGovern Medical School, Dallas, Texas
| | - Abby S Van Voorhees
- Department of Dermatology, Eastern Virginia Medical School, Norfolk, Virginia
| | - Nehal N Mehta
- Cardiopulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Joel M Gelfand
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
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Afifi L, Shankle L, Armstrong AW, Boas M, Bridges A, Chiguil V, Doris F, Callis Duffin K, Fielding E, Fleischmann R, Gelfand JM, Kiselica M, Kiselica C, LaFoy B, Latella JJ, Takeshita J, Truman S, Wan MT, Wilkerson V, Wu JJ, Siegel MP, Liao W. National Psoriasis Foundation Priorities for Patient-Centered Research: Proceedings from the 2016 Conference. JOURNAL OF PSORIASIS AND PSORIATIC ARTHRITIS 2017; 2:73-80. [PMID: 28825055 PMCID: PMC5562437 DOI: 10.1177/247553031700200307] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The National Psoriasis Foundation (NPF) is developing an agenda for patient-centered research to help patients and their caregivers make more informed health care decisions by engaging psoriasis patients in prioritizing comparative effectiveness research (CER) topics. The NPF has created a novel patient-centered research platform known as Citizen Pscientist (CP), allowing patients with psoriasis and psoriatic arthritis to register and contribute their health data. The CP Governance Council administered an online 23-question CER survey to the CP community and held a structured meeting on December 3, 2016, with patients and researchers to review CER survey results and discuss patient-centered research priorities. Of the 2,945 patients surveyed, 792 patients responded. Three CER topics were deemed to be of high priority for the research agenda: 1) Treat-to-target therapy for psoriasis, 2) Psoriatic arthritis screening questionnaires for early detection and treatment of psoriatic arthritis, and 3) Comparative effectiveness of home-based phototherapy for psoriasis.
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Affiliation(s)
- Ladan Afifi
- University of California, San Francisco, San Francisco, California
- Citizen Pscientist Governance Council, Portland, Oregon
| | - Lindsey Shankle
- National Psoriasis Foundation, Portland, Oregon
- Citizen Pscientist Governance Council, Portland, Oregon
| | - April W. Armstrong
- University of Southern California, Los Angeles, California
- Citizen Pscientist Governance Council, Portland, Oregon
| | - Marc Boas
- Citizen Pscientist Governance Council, Portland, Oregon
| | | | | | - Frank Doris
- Citizen Pscientist Governance Council, Portland, Oregon
| | | | | | | | - Joel M. Gelfand
- University of Pennsylvania, Philadelphia, Pennsylvania
- Citizen Pscientist Governance Council, Portland, Oregon
| | | | | | | | | | - Junko Takeshita
- University of Pennsylvania, Philadelphia, Pennsylvania
- Citizen Pscientist Governance Council, Portland, Oregon
| | - Sarah Truman
- Citizen Pscientist Governance Council, Portland, Oregon
| | - Marilyn T. Wan
- University of Pennsylvania, Philadelphia, Pennsylvania
- Citizen Pscientist Governance Council, Portland, Oregon
| | | | - Jashin J. Wu
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
- Citizen Pscientist Governance Council, Portland, Oregon
| | - Michael P. Siegel
- National Psoriasis Foundation, Portland, Oregon
- Citizen Pscientist Governance Council, Portland, Oregon
| | - Wilson Liao
- University of California, San Francisco, San Francisco, California
- Citizen Pscientist Governance Council, Portland, Oregon
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