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Perales Pascual J, Navarro Aznárez H, López Pérez A, Gracia-Cazaña T, Gilaberte Calzada Y, Abad Sazatornil MR. Psoriatic Patient-Reported Outcomes, Adherence, and Satisfaction. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00491-5. [PMID: 38857843 DOI: 10.1016/j.ad.2024.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/07/2024] [Accepted: 05/11/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Patient-reported outcomes (PROs) are outcomes evaluated by patients based on their perception of their disease and treatment. OBJECTIVES Determine antipsoriatic treatment-related adherence, quality of life (QoL) and satisfaction. MATERIALS AND METHODS We conducted an observational cross-sectional, prospective, and single-center study in which PROs surveys were conducted on adherence (Morisky-Green [MG] test), treatment satisfaction (Spanish Questionnaire of Treatment Satisfaction in Psoriasis [CESTEP]) and QoL (Skindex-29 and DLQI). Additional variables include: PASI, BSA. STATISTICAL ANALYSIS Jamovi®2.3.26. RESULTS A total of 100 surveys were conducted. Based on the MG questionnaire, we found that 75% (75/100) of patients were adherent vs 94% (94/100) from the dispensation records. Regarding CESTEP, a mean score of 7.4±7.7 (close to maximum satisfaction 0) was obtained, while DLQI yielded a score of 2.6±4.6 (indicating a small effect on QoL), and SKINDEX-29 a score of 14.6±15.4 (68% indicating mild (< 5) or very mild (6-17) impact according to Nijsten et al.). Based on CESTEP a p.Rho Spearman value of 0.338 (p=0.004) was obtained in relation to PASI when the study was conducted with a BSA of 0.255 (p=0.050), DLQI results of 0.508 (p <0.001) and Skindex-29 results of 0.397(p <0.001). At the time of the study, the correlation matrix between DLQI result and PASI was 0.365 (p=0.002) with a BSA of 0.347 (p=0.007). Skindex-29 results with PASI were 0.380 (p=0.001) and with BSA, 0.295 (p=0.022). CONCLUSIONS Patients on therapy exhibit a good QoL, high adherence and satisfaction with their treatment. A significant correlation was seen among satisfaction, QoL, and PASI-BSA at the time of the study.
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Affiliation(s)
- J Perales Pascual
- Servicio de Farmacia Hospitalaria, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - H Navarro Aznárez
- Servicio de Farmacia Hospitalaria, Hospital Universitario Miguel Servet, Zaragoza, España
| | - A López Pérez
- Servicio de Farmacia Hospitalaria, Hospital Universitario Miguel Servet, Zaragoza, España
| | - T Gracia-Cazaña
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Y Gilaberte Calzada
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Mª R Abad Sazatornil
- Servicio de Farmacia Hospitalaria, Hospital Universitario Miguel Servet, Zaragoza, España
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Guavita Falla PM, Castro Ayarza JR, Cortés Correa C, Peñaranda Contreras E. [Translated article] Evaluation of Dermatology Life Quality Index (DLQI) Scores in Patients With Psoriasis: A Cross-sectional and Correlation Study Over a 6-Year Period. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T282-T284. [PMID: 36717069 DOI: 10.1016/j.ad.2022.05.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/25/2022] [Accepted: 05/23/2022] [Indexed: 01/29/2023] Open
Affiliation(s)
- P M Guavita Falla
- Programa de Dermatología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia; Servicio de Dermatología, Hospital Universitario de La Samaritana, Bogotá, Colombia.
| | - J R Castro Ayarza
- Programa de Dermatología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia; Grupo Colombiano de Psoriasis e Inmunodermatología - COLPSOR
| | - C Cortés Correa
- Programa de Dermatología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia; Servicio de Dermatología, Hospital Universitario de La Samaritana, Bogotá, Colombia; Grupo Colombiano de Psoriasis e Inmunodermatología - COLPSOR
| | - E Peñaranda Contreras
- Programa de Dermatología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia; Servicio de Dermatología, Hospital Universitario de La Samaritana, Bogotá, Colombia; Grupo Colombiano de Psoriasis e Inmunodermatología - COLPSOR
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Guavita Falla PM, Castro Ayarza JR, Cortés Correa C, Peñaranda Contreras E. Evaluation of Dermatology Life Quality Index (DLQI) Scores in Patients With Psoriasis: a cross-sectional and correlation study over a 6-year period. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:282-284. [PMID: 36309045 DOI: 10.1016/j.ad.2022.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/25/2022] [Accepted: 05/23/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- P M Guavita Falla
- Programa de Dermatología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia; Servicio de Dermatología, Hospital Universitario de La Samaritana, Bogotá, Colombia.
| | - J R Castro Ayarza
- Programa de Dermatología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia; Grupo Colombiano de Psoriasis e Inmunodermatología - COLPSOR
| | - C Cortés Correa
- Programa de Dermatología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia; Servicio de Dermatología, Hospital Universitario de La Samaritana, Bogotá, Colombia; Grupo Colombiano de Psoriasis e Inmunodermatología - COLPSOR
| | - E Peñaranda Contreras
- Programa de Dermatología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia; Servicio de Dermatología, Hospital Universitario de La Samaritana, Bogotá, Colombia; Grupo Colombiano de Psoriasis e Inmunodermatología - COLPSOR
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Fujita H, Ohtsuki M, Morita A, Nagao R, Seko N, Matsumoto K, Tani Y, Terui T. Safety and effectiveness of secukinumab in psoriasis vulgaris and psoriatic arthritis: Real-world evidence in Japan. J Dermatol 2021; 48:175-183. [PMID: 33099791 PMCID: PMC7894540 DOI: 10.1111/1346-8138.15655] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/18/2020] [Indexed: 12/11/2022]
Abstract
Secukinumab, a fully human monoclonal antibody that selectively neutralizes interleukin-17A, has been available for the treatment of moderate to severe psoriasis and psoriatic arthritis since February 2015 in Japan. Because there was a time gap after the previous approval of biologics for psoriatic disease indication, it was suggested that patients to be treated with secukinumab at its launch might have refractory disease symptoms. In order to assess the safety and effectiveness of secukinumab in those patients, a 52-week, open-label, multicenter, observational cohort study was conducted. In total, 306 and 250 patients were included in the safety and effectiveness analysis sets, respectively. Over half of patients had previously received biologics (56.9%). Adverse events, serious adverse events and adverse reactions were reported in 41.2%, 7.2% and 24.2% of patients, respectively. The most commonly reported adverse reactions were oral candidiasis (2.9%), consistent with those reported in clinical studies. In addition, none of the patient characteristics assessed for the effect on safety of secukinumab increased the occurrence of adverse reactions. Psoriasis Area and Severity Index score (mean ± standard deviation) improved from baseline (14.7 ± 12.3) to week 12 (1.78 ± 3.3), which was maintained up to week 24 (1.59 ± 3.0). The proportion of patients with a Dermatology Life Quality Index score of 0/1 improved from baseline (2.2%) to week 12 (64.7%) and sustained up to week 24 (71.4%). In addition to the skin symptoms, improvement was observed in all psoriatic arthritis disease-related assessments. The current study reaffirmed the safety and effectiveness of secukinumab with broader patients than those in the clinical studies.
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Affiliation(s)
- Hideki Fujita
- Division of Cutaneous ScienceDepartment of DermatologyNihon University School of MedicineTokyoJapan
| | | | - Akimichi Morita
- Department of Geriatric and Environmental DermatologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | | | | | | | | | - Tadashi Terui
- Division of Cutaneous ScienceDepartment of DermatologyNihon University School of MedicineTokyoJapan
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Puig L, Fernández-Freire LR, Burgos-Pol R, Gomez I, Peral C, Gomez S, Rebollo Laserna FJ. Economic Impact of Etanercept in Patients with Psoriasis and Psoriatic Arthritis in Spain: A Systematic Review. Dermatol Ther (Heidelb) 2019; 9:479-496. [PMID: 31062222 PMCID: PMC6704195 DOI: 10.1007/s13555-019-0301-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Etanercept (ETN), a highly effective biological agent for the treatment of psoriasis (PSO) and psoriatic arthritis (PsA), is widely used in Spain. However, evidence of its economic impact is limited, indicating the need for a systematic review of the economic assessments conducted on the use of ETN in the treatment of both PSO and PsA in Spain. METHODS A systematic review was carried out in PubMed, Embase, Cochrane Library, Health Technology Assessment reports and not indexed sources up to November 2018. The inclusion criteria were economic evaluations (total and partial) and dose optimization studies published in English or Spanish on the use of ETN to treat PSO and PsA for ETN in Spain. RESULTS A total of 402 publications were identified, of which 32 were selected for inclusion in the review; of these 32 publications, 81.3% analyzed PSO (14 full economic evaluations, 5 partial economic evaluations and 7 dose optimization studies) and 18.8% analyzed PsA (1 economic analysis and 5 dose optimization studies). The perspective of the Spanish National Health Service (NHS) was used in 90.0% (n = 18) of the full and partial economic evaluations. The time horizons ranged from 12 weeks to 2 years. Reductions in the Psoriasis Area and Severity Index (PASI) of 50, 75 and 90% (PASI 50, 75 and 90, respectively) were most commonly used as efficacy outcomes in the complete evaluations. The economic impact of ETN ranged from €9110-14,337/PASI 75 at 12 weeks (50 mg/week) to €82,279/PASI 90 at 2 years, depending on the health outcome, time horizon and ETN dose used. Only one study determined the cost of using ETN for the treatment of PSO (€29,430-52,367/QALY for dose 2 × 25 mg/week or 50 mg/week, respectively). Only one partial economic evaluation on PSA was identified (NHS perspective), resulting in an ETN annual cost of €8585/patient-year. CONCLUSION Consistent evidence on the economic impact of ETN for the treatment of PSO and PSA in Spain is lacking, mainly due to the highly heterogeneous methodology used and the broad range of outcomes found in the economic evaluations published to date. FUNDING Pfizer S.L.U.
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Affiliation(s)
- Lluís Puig
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Ramón Burgos-Pol
- Pharmacoeconomics and Outcomes Research Iberia (PORIB), Madrid, Spain.
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Patient-reported outcomes assessment tools for use in psoriasis in Spain: A systematic review. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Patient-reported outcomes assessment tools for use in psoriasis in Spain: A systematic review. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:561-584. [PMID: 31101318 DOI: 10.1016/j.ad.2019.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 02/26/2019] [Accepted: 02/27/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To review the literature on validated tools for measuring patient-reported outcomes (PROs) in psoriasis in Spain. To evaluate the psychometric properties of the tools and describe the results of their practical application. MATERIAL AND METHODS Systematic review of studies validating or using instruments for assessing PROs in Spanish patients with psoriasis. Literature searches were performed in international (PubMed/Medline) and Spanish (Medes, Ibecs) databases. We also searched databases of instruments for measuring PROs (BiblioPRO, PROQOLID). The review included studies published in English or Spanish up to January 9, 2017. We also checked the reference lists of the key publications identified. The quality of the questionnaires was evaluated based on their psychometric properties (construct, transcultural adaptation, reliability, validity, feasibility, and sensitivity to change). RESULTS Eighteen publications were included. Six articles described the validation of Spanish versions of 5 PROs tools: 4 health-related quality of life (HRQoL) questionnaires specific to psoriasis and dermatologic diseases and 1 questionnaire specific to satisfaction with treatment. Our assessment of the HRQoL tools' psychometric properties showed that the PSO-LIFE questionnaire received the highest scores, although specific properties varied from instrument to instrument. The 12 remaining articles were observational studies that used the validated instruments. In use, these tools detected the high impact of psoriasis on HRQoL, especially in young female patients with severe disease. CONCLUSIONS We identified 5 specific instruments validated in Spain for scoring PROs in patients with psoriasis. The tools' psychometric properties vary, and it is essential to understand their strengths and weaknesses when selecting the right one for each situation. In use, these questionnaires are able to detect the high impact of psoriasis on patients' HRQoL. PROs provide useful information to complement routine clinical findings in psoriasis and may contribute to improving disease management.
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Zozaya N, Martínez-Galdeano L, Alcalá B, Armario-Hita JC, Carmona C, Carrascosa JM, Herranz P, Lamas MJ, Trapero-Bertran M, Hidalgo-Vega Á. Determining the Value of Two Biologic Drugs for Chronic Inflammatory Skin Diseases: Results of a Multi-Criteria Decision Analysis. BioDrugs 2018; 32:281-291. [PMID: 29808418 PMCID: PMC5990558 DOI: 10.1007/s40259-018-0284-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Multi-criteria decision analysis (MCDA) is a tool that systematically considers multiple factors relevant to health decision-making. The aim of this study was to use an MCDA to assess the value of dupilumab for severe atopic dermatitis compared with secukinumab for moderate to severe plaque psoriasis in Spain. METHOD Following the EVIDEM (Evidence and Value: Impact on DEcision Making) methodology, the estimated value of both interventions was obtained by means of an additive linear model that combined the individual weighting (between 1 and 5) of each criterion with the individual scoring of each intervention in each criterion. Dupilumab was evaluated against placebo, while secukinumab was evaluated against placebo, etanercept and ustekinumab. A retest was performed to assess the reproducibility of weights, scores and value estimates. RESULTS The overall MCDA value estimate for dupilumab versus placebo was 0.51 ± 0.14. This value was higher than those obtained for secukinumab: 0.48 ± 0.15 versus placebo, 0.45 ± 0.15 versus etanercept and 0.39 ± 0.18 versus ustekinumab. The highest-value contribution was reported by the patients' group, followed by the clinical professionals and the decision makers. A fundamental element that explained the difference in the scoring between pathologies was the availability of therapeutic alternatives. The retest confirmed the consistency and replicability of the analysis. CONCLUSIONS Under this methodology, and assuming similar economic costs per patient for both treatments, the results indicated that the overall value estimated of dupilumab for severe atopic dermatitis was similar to, or slightly higher than, that of secukinumab for moderate to severe plaque psoriasis.
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Affiliation(s)
- Néboa Zozaya
- Department of Health Economics, Weber Economía y Salud, c/Norias 123, Majadahonda, 28221, Madrid, Spain.
| | - Lucía Martínez-Galdeano
- Department of Health Economics, Weber Economía y Salud, c/Norias 123, Majadahonda, 28221, Madrid, Spain
| | - Bleric Alcalá
- Department of Health Economics, Weber Economía y Salud, c/Norias 123, Majadahonda, 28221, Madrid, Spain
| | | | - Concepción Carmona
- Department of Healthcare, Servicio Extremeño de Salud, Mérida, Badajoz, Spain
| | - Jose Manuel Carrascosa
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Pedro Herranz
- Department of Dermatology, La Paz Universitary Hospital-Carlos III, Madrid, Spain
| | - María Jesús Lamas
- Servicio de Farmacia, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, La Coruña, Spain
| | - Marta Trapero-Bertran
- Faculty of Economics and Social Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Álvaro Hidalgo-Vega
- Fundación Weber, Majadahonda, Madrid, Spain
- Universidad de Castilla-La Mancha, Campus de Toledo, Toledo, Spain
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Song HJ, Park CJ, Kim TY, Choe YB, Lee SJ, Kim NI, Cho JW, Jeon JH, Jang MS, Youn JI, Kim MH, Park J, Kim KH, Kim BS, Youn SW, Lee JH, Lee MG, Ahn SK, Won YH, Yun SK, Shin BS, Seo SJ, Lee JY, Kim KJ, Ro YS, Kim Y, Yu DY, Choi JH. The Clinical Profile of Patients with Psoriasis in Korea: A Nationwide Cross-Sectional Study (EPI-PSODE). Ann Dermatol 2017; 29:462-470. [PMID: 28761295 PMCID: PMC5500712 DOI: 10.5021/ad.2017.29.4.462] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 02/15/2017] [Accepted: 03/02/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Psoriasis is an immune-mediated, chronic inflammatory disease affecting multiple aspects of patients' lives. Its epidemiology varies regionally; however, nationwide epidemiologic data on psoriasis depicting profile of Korean patients has not been available to date. OBJECTIVE To understand nationwide epidemiologic characteristics and clinical features of adult patients with psoriasis visited university hospitals in Korea. METHODS This multicenter, non-interventional, cross-sectional study recruited 1,278 adult patients with psoriasis across 25 centers in Korea in 2013. Various clinical data including PASI, BSA, DLQI, SF-36 and PASE were collected. RESULTS A total of 1,260 patients completed the study (male:female=1.47:1). The mean age was 47.0 years with a distribution mostly in the 50s (24.9%). Early onset (<40 years) of psoriasis accounted for 53.9% of patients. The mean disease duration was 109.2 months; mean body mass index was 23.9 kg/m2; and 12.7% of patients had a family history of psoriasis. Plaque and guttate types of psoriasis accounted for 85.8% and 8.4%, respectively. Patients with PASI ≥10 accounted for 24.9%; patients with body surface area ≥10 were 45.9%. Patients with DLQI ≥6 accounted for 78.8%. Between PASI <10 and PASI ≥10 groups, significant difference was noted in age at diagnosis, disease duration, blood pressure, waist circumference of female, and treatment experiences with phototherapy, systemic agents, and biologics. CONCLUSION This was the first nationwide epidemiologic study of patients with psoriasis in Korea and provides an overview of the epidemiologic characteristics and clinical profiles of this patient population.
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Affiliation(s)
- Hae Jun Song
- Department of Dermatology, Korea University Guro Hospital, Seoul, Korea
| | - Chul Jong Park
- Department of Dermatology, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Korea
| | - Tae Yoon Kim
- Department of Dermatology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
| | - Yong Beom Choe
- Department of Dermatology, Konkuk University School of Medicine, Seoul, Korea
| | - Seok-Jong Lee
- Department of Dermatology, Kyungpook National University Hospital, Daegu, Korea
| | - Nack In Kim
- Department of Dermatology, Kyung Hee University Medical Center, Seoul, Korea
| | - Jae We Cho
- Department of Dermatology, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Jie Hyun Jeon
- Department of Dermatology, Korea University Guro Hospital, Seoul, Korea
| | - Min Soo Jang
- Department of Dermatology, Kosin University College of Medicine, Busan, Korea
| | - Jai Il Youn
- Department of Dermatology, National Medical Center, Seoul, Korea
| | - Myung Hwa Kim
- Department of Dermatology, Dankook University Hospital, Cheonan, Korea
| | - Joonsoo Park
- Department of Dermatology, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Ki Ho Kim
- Department of Dermatology, Dong-A University Hospital, Busan, Korea
| | - Byung Soo Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
| | - Sang Woong Youn
- Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Joo-Heung Lee
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Min-Geol Lee
- Department of Dermatology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Ku Ahn
- Department of Dermatology, Wonju Severance Christian Hospital, Wonju, Korea
| | - Young Ho Won
- Department of Dermatology, Chonnam National University Hospital, Gwangju, Korea
| | - Seok Kweon Yun
- Department of Dermatology, Chonbuk National University Hospital, Jeonju, Korea
| | - Bong Seok Shin
- Department of Dermatology, Chosun University Hospital, Gwangju, Korea
| | - Seong Jun Seo
- Department of Dermatology, Chung-Ang University Hospital, Seoul, Korea
| | - Ji Yeoun Lee
- Department of Dermatology, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Kwang Joong Kim
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Young Suck Ro
- Department of Dermatology, Hanyang University Medical Center, Seoul, Korea
| | | | | | - Jee-Ho Choi
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Perrone V, Sangiorgi D, Buda S, Degli Esposti L. Topical medication utilization and health resources consumption in adult patients affected by psoriasis: findings from the analysis of administrative databases of local health units. CLINICOECONOMICS AND OUTCOMES RESEARCH 2017; 9:181-188. [PMID: 28293115 PMCID: PMC5345983 DOI: 10.2147/ceor.s126975] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIM The objectives of this study were to: 1) analyze the drug utilization pattern among adult psoriasis patients who were newly prescribed with topical medication; and 2) assess their adherence to topical therapy and the possibility of switching to other strategies in the treatment process. METHODS An observational retrospective analysis was conducted based on administrative databases of two Italian local health units. All adult subjects who were diagnosed with psoriasis or who were newly prescribed for topical medication with at least one prescription between January 1, 2010, and December 31, 2014, were screened. Only patients who were "non-occasional users of topical drugs" (if they had at least two prescriptions of topical drugs in a time space of 2 years) were considered for the first and second objectives in the analysis. The date of the first prescription of topical agents was identified as the index date (ID), which was then followed for all time available from ID (follow-up period). The adherence to therapy was assessed on the basis of cycles of treatment covered in the 6 months before the end of the follow-up period. The mean health care costs in patients who switched to disease-modifying antirheumatic drugs (DMARDs) or biologics after the ID were evaluated. RESULTS A total of 17,860 patients with psoriasis who were newly prescribed for topical medication were identified. A total of 2,477 were identified as "non-occasional users of topical drugs", of whom 70.2% had a prescription for a topical fixed combination regimen at ID. Around 19% adhered to their medication, whereas 6% switched to other options of psoriasis treatment. Multivariable logistic regression model shows that patients on fixed combination treatment were less likely to be non-adherent to treatment and less likely to switch to other treatments. The annual mean pharmaceutical costs were €567.70 and €10,606.10 for patients who switched to DMARDs and biologics, respectively. CONCLUSION Our findings show that the use of fixed combination topical treatment can lead to improve the likelihood of patients being adherent to treatment and can decrease the likelihood of switching the treatment to DMARDs or biologics.
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Affiliation(s)
| | - Diego Sangiorgi
- Clicon S.r.l. Health, Economics & Outcomes Research, Ravenna, Italy
| | - Stefano Buda
- Clicon S.r.l. Health, Economics & Outcomes Research, Ravenna, Italy
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Obradors M, Blanch C, Comellas M, Figueras M, Lizan L. Health-related quality of life in patients with psoriasis: a systematic review of the European literature. Qual Life Res 2016; 25:2739-2754. [PMID: 27259580 DOI: 10.1007/s11136-016-1321-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2016] [Indexed: 01/13/2023]
Abstract
PURPOSE To summarize the data published over the last 5 years in the European Union related to the health-related quality of life (HRQoL) of patients with psoriasis and its conditioning factors. METHODS International electronic databases and gray literature were searched to identify studies conducted on patient-reported outcomes in patients with psoriasis, published in Europe between January 1, 2009 and December 31, 2013. Bibliographic references were hand-searched. Editorials, letters, commentaries, opinion papers, and studies related to specific treatments were excluded. RESULTS A total of 46 studies met the inclusion criteria, 27 of them reporting data related to HRQoL or its conditioning factors. The publications reviewed highlighted the substantial negative impact of psoriasis on patients' HRQoL. Most of the studies that analyzed the relationship between HRQoL and sociodemographic characteristics described a relation between gender (female) and age (young patients) and poorer HRQoL. An association between HRQoL impairment and visibility of skin lesions and disease activity and severity was also established. Skin discomfort and pruritus were identified as elements that negatively influenced HRQoL. Use of biological agents had a positive impact on HRQoL and on treatment satisfaction, a better HRQoL being seen in patients treated with systemic therapies and biologics. CONCLUSIONS HRQoL has been broadly addressed in patients with psoriasis in Europe. Several disease- and patient-related factors contributed to its deterioration. Therapeutic measures with proven effectiveness in controlling disease symptoms and reducing PASI should be considered in patients with a severe disease who have a poorer HRQoL.
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Kyriakou A, Patsatsi A, Vyzantiadis TA, Sotiriadis D. Serum levels of TNF-α, IL-12/23p40, and IL-17 in plaque psoriasis and their correlation with disease severity. J Immunol Res 2014; 2014:467541. [PMID: 25759829 PMCID: PMC4352416 DOI: 10.1155/2014/467541] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 07/20/2014] [Accepted: 12/03/2014] [Indexed: 11/30/2022] Open
Abstract
A case-control study was performed to assess the serum levels of TNF-α, IL-12/23p40, and IL-17 in patients with plaque psoriasis, compare them with healthy controls, and correlate them with disease severity, as represented by Psoriasis Area Severity Index (PASI). 32 consecutively selected, untreated patients with active, chronic plaque psoriasis were recruited and compared to 32 age- and sex-matched healthy controls. Serum cytokine levels were determined by solid phase sandwich enzyme linked immunosorbent assay (R&D Systems Europe, Ltd.). The mean serum levels of TNF-α were significantly higher in psoriatic patients compared to those of controls (Mann-Whitney U test; P = 0.000). However, the median serum levels of neither IL-12/23p40 nor IL-17 differ significantly between the 2 groups (Mann-Whitney U test; P = 0.968 and P = 0.311, resp.). No significant correlations were found between PASI and any of the cytokine serum levels (Spearman's rank test; P > 0.05). Despite the well-evidenced therapeutic efficacy of biologic agents targeting TNF-α, IL-12/23p40, and IL-17, serum levels of TNF-α, IL-12/23p40, and IL-17 do not seem to correlate with the severity of psoriatic skin disease in untreated patients, as represented by PASI. Further investigation may add more data on the pathogenetic cascade of psoriasis.
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Affiliation(s)
- Aikaterini Kyriakou
- 2nd Dermatology Department, Aristotle University School of Medicine, General Hospital “Papageorgiou”, Nea Efkarpia Ring Road, 564 03 Thessaloniki, Greece
| | - Aikaterini Patsatsi
- 2nd Dermatology Department, Aristotle University School of Medicine, General Hospital “Papageorgiou”, Nea Efkarpia Ring Road, 564 03 Thessaloniki, Greece
| | | | - Dimitrios Sotiriadis
- 2nd Dermatology Department, Aristotle University School of Medicine, General Hospital “Papageorgiou”, Nea Efkarpia Ring Road, 564 03 Thessaloniki, Greece
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Goldust M, Raghifar R. Clinical Trial Study in the Treatment of Nail Psoriasis with Pulsed Dye Laser. J COSMET LASER THER 2013:1-12. [PMID: 24131073 DOI: 10.3109/14764172.2013.854627] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract Objective: The treatment options for nail psoriasis have been limited, and the management of nail psoriasis has been challenging for physicians. This study aimed at evaluating the effect of different pulse durations in the treatment of nail psoriasis with the 595-nm PDL to determine the optimal pulse duration. Methods: Forty patients with bilateral fingernail psoriasis were recruited and completed a 6-month trial. PDL was applied on the proximal and lateral nailfolds based on random assignment. Eghity nails were treated with 6-millisecond pulse duration and 9 J/cm(2) whereas 80 nails were treated with 0.45-millisecond pulse duration and 6 J/cm(2). Nail Psoriasis Severity Index (NAPSI) was used to assess the clinical outcome from pretreatment and posttreatment photographs. Results: After 6 months of first treatment, there was a significant reduction in overall NAPSI, nail matrix NAPSI, and nail bed NAPSI scores from baseline in both groups; however, no significant difference was found between the two pulse duration groups. Side effects were mild including transient petechiae and hyperpigmentation. Conclusion: Both the longer 6-millisecond and shorter 0.45-millisecond pulses of PDL (595 nm) have been clinically proven to be effective for the treatment of nail matrix and nail bed psoriasis.
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Doukaki S, Caputo V, Bongiorno MR. Psoriasis and Cardiovascular Risk: Assessment by CUORE Project Risk Score in Italian Patients. Dermatol Res Pract 2013; 2013:389031. [PMID: 24082881 PMCID: PMC3780628 DOI: 10.1155/2013/389031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 08/07/2013] [Indexed: 02/03/2023] Open
Abstract
Background. Psoriasis is a common inflammatory and immune-mediated skin disease. There is growing controversy as to whether cardiovascular risk is elevated in psoriasis. A number of studies suggest a high prevalence of cardiovascular risk factors as well as cardiovascular diseases in psoriasis patients. Objective. The objective of this study was to estimate cardiovascular risk score in psoriasis patients and the relation between cardiovascular risk and psoriasis features. Cardiovascular risk was assessed by CUORE project risk score built within the longitudinal study of the Italian CUORE project and suited to populations with a low rate of coronary heart disease. Results. A case-control study in 210 psoriasis outpatients and 111 controls with skin diseases other than psoriasis was performed. CUORE project risk score was higher in patients than controls (6.80 ± 6.34 versus 4.48 ± 4.38, P < 0.001). Compared to controls, psoriasis patients have higher risk of developing major cardiovascular events. Cardiovascular risk was not related to psoriasis characteristics. Conclusion. Increased focus on identifying cardiovascular risk factors and initiation of preventive lifestyle changes or therapeutic interventions in patients with psoriasis is warranted.
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Affiliation(s)
- Spyridoula Doukaki
- Department of Dermatology, University of Palermo, Via del Vespro 131, 90123 Palermo, Italy
| | - Valentina Caputo
- Department of Dermatology, University of Palermo, Via del Vespro 131, 90123 Palermo, Italy
| | - Maria Rita Bongiorno
- Department of Dermatology, University of Palermo, Via del Vespro 131, 90123 Palermo, Italy
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