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Rahmati-Dehkordi F, Birang N, Jalalian MN, Tamtaji Z, Dadgostar E, Aschner M, Shafiee Ardestani M, Jafarpour H, Mirzaei H, Nabavizadeh F, Tamtaji OR. Can infliximab serve as a new therapy for neuropsychiatric symptoms? NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024:10.1007/s00210-024-03397-w. [PMID: 39225829 DOI: 10.1007/s00210-024-03397-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 08/17/2024] [Indexed: 09/04/2024]
Abstract
Neuropsychiatric disorders present a global challenge to public health. Mechanisms associated with neuropsychiatric disorders etiology include apoptosis, oxidative stress, and neuroinflammation. Tumor necrosis factor alpha, an inflammatory cytokine, mediates pathophysiology of neuropsychiatric disorders. Therefore, its inhibition by infliximab might afford a valuable target for intervention. Infliximab is commonly used to treat inflammatory diseases, including ulcerative colitis, Crohn's disease, and rheumatoid arthritis. Recently, it has been shown that infliximab improves cognitive dysfunction, depression, anxiety, and life quality. Here, we review contemporary knowledge supporting the need to further characterize infliximab as a potential treatment for neuropsychiatric disorders.
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Affiliation(s)
- Fatemeh Rahmati-Dehkordi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Electrophysiology Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nafiseh Birang
- Department of Physical Medicine and Rehabilitation, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Zeinab Tamtaji
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Ehsan Dadgostar
- Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Mehdi Shafiee Ardestani
- Department of Radio Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Jafarpour
- Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamed Mirzaei
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran.
| | - Fatemeh Nabavizadeh
- Electrophysiology Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Omid Reza Tamtaji
- Electrophysiology Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Assalem N, Abd-Allah H, Ragaie MH, Ahmed SS, Elmowafy E. Therapeutic potential of limonene-based syringic acid nanoemulsion: Enhanced ex-vivo cutaneous deposition and clinical anti-psoriatic efficacy. Int J Pharm 2024; 660:124376. [PMID: 38914355 DOI: 10.1016/j.ijpharm.2024.124376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 06/20/2024] [Accepted: 06/21/2024] [Indexed: 06/26/2024]
Abstract
Nanoemulsions have carved their position in topical delivery owing to their peculiar features of forming a uniform film on the skin and conquering stratum corneum barrier and hence fostering dermal penetration and retention. The present work developed syringic acid nanoemulsion (SA-NE) by spontaneous emulsification as an anti-psoriatic remedy via the dermal route. SA-NE were prepared with either lauroglycol90, limonene or their combination (oil phase) and tween80 (surfactant) with variable concentrations. The physicochemical characteristics of SA-NE were assessed together with Ex-vivo skin deposition and dermal toxicity. The effectiveness of optimal formula in psoriatic animal model and psoriatic patients was investigated using PASI scoring and dermoscope examination. Results showed that, SA-NE containing mixture of lauroglycol 90, limonene and 10 % tween80 (F5), was selected as the optimal formula presenting stable nanoemulsion for 2-month period, showing droplet size of 177.6 ± 13.23 nm, polydispersity index of 0.16 ± 0.06, zeta potential of -21.23 ± 0.41 mV. High SA% in different skin strata and no dermal irritation was noticed with limonene-based SA-NE also it showed high in-vitro anti- inflammatory potential compared to the blank and control formulations. A preclinical study demonstrated that limonene-based SA-NE is effective in alleviating psoriasis-like skin lesions against imiquimod-induced psoriasis in rats. Clinically, promising anti-psoriatic potential was asserted as all patients receiving F5 experienced better clinical improvement and response to therapy, achieving ≥ 50 % reduction in PASI scores versus only 35 % responders in the Dermovate® cream group. Collectively, the practical feasibility of limonene-based SA-NE topical delivery can boost curative functionality in the treatment of psoriatic lesions.
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Affiliation(s)
- Noor Assalem
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt, Monazzamet Elwehda Elafrikeya Street, Abbaseyya, Cairo, Egypt, P.O.B. 11566
| | - Hend Abd-Allah
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt, Monazzamet Elwehda Elafrikeya Street, Abbaseyya, Cairo, Egypt, P.O.B. 11566.
| | - Maha H Ragaie
- Department of Dermatology, STD's and Andrology, Faculty of Medicine, Minya University, Al-Minya, Egypt
| | - Shimaa S Ahmed
- Department of Dermatology, STD's and Andrology, Faculty of Medicine, Minya University, Al-Minya, Egypt
| | - Enas Elmowafy
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt, Monazzamet Elwehda Elafrikeya Street, Abbaseyya, Cairo, Egypt, P.O.B. 11566
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Vyas J, Johns JR, Ali FM, Singh RK, Ingram JR, Salek S, Finlay AY. A systematic review of 454 randomized controlled trials using the Dermatology Life Quality Index: experience in 69 diseases and 43 countries. Br J Dermatol 2024; 190:315-339. [PMID: 36971254 DOI: 10.1093/bjd/ljad079] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/31/2023] [Accepted: 03/14/2023] [Indexed: 02/18/2024]
Abstract
BACKGROUND Over 29 years of clinical application, the Dermatology Life Quality Index (DLQI) has remained the most used patient-reported outcome (PRO) in dermatology due to its robustness, simplicity and ease of use. OBJECTIVES To generate further evidence of the DLQI's utility in randomized controlled trials (RCTs) and to cover all diseases and interventions. METHODS The methodology followed PRISMA guidelines and included seven bibliographical databases, searching articles published from 1 January 1994 until 16 November 2021. Articles were reviewed independently by two assessors, and an adjudicator resolved any opinion differences. RESULTS Of 3220 screened publications, 454 articles meeting the eligibility criteria for inclusion, describing research on 198 190 patients, were analysed. DLQI scores were primary endpoints in 24 (5.3%) of studies. Most studies were of psoriasis (54.1%), although 69 different diseases were studied. Most study drugs were systemic (85.1%), with biologics comprising 55.9% of all pharmacological interventions. Topical treatments comprised 17.0% of total pharmacological interventions. Nonpharmacological interventions, mainly laser therapy and ultraviolet radiation treatment, comprised 12.2% of the total number of interventions. The majority of studies (63.7%) were multicentric, with trials conducted in at least 42 different countries; 40.2% were conducted in multiple countries. The minimal clinically importance difference (MCID) was reported in the analysis of 15.0% of studies, but only 1.3% considered full score meaning banding of the DLQI. Forty-seven (10.4%) of the studies investigated statistical correlation of the DLQI with clinical severity assessment or other PRO/quality of life tools; and 61-86% of studies had within-group scores differences greater than the MCID in 'active treatment arms'. The Jadad risk-of-bias scale showed that bias was generally low, as 91.8% of the studies had Jadad scores of ≥ 3; only 0.4% of studies showed a high risk of bias from randomization. Thirteen per cent had a high risk of bias from blinding and 10.1% had a high risk of bias from unknown outcomes of all participants in the studies. In 18.5% of the studies the authors declared that they followed an intention-to-treat protocol; imputation for missing DLQI data was used in 34.4% of studies. CONCLUSIONS This systematic review provides a wealth of evidence of the use of the DLQI in clinical trials to inform researchers' and -clinicians' decisions for its further use. Recommendations are also made for improving the reporting of data from future RCTs using the DLQI.
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Affiliation(s)
| | - Jeffrey R Johns
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Faraz M Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Ravinder K Singh
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - John R Ingram
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - Sam Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Andrew Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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Dermatology Life Quality Index in Patients with Psoriasis Treated with Biologic Versus Non-biologic Treatment in Malaysia: A Retrospective Cross-Sectional Study. Drugs Real World Outcomes 2023:10.1007/s40801-023-00359-1. [PMID: 36840826 DOI: 10.1007/s40801-023-00359-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Psoriasis imposes a substantial burden on patients' social, emotional, physical, and family life. Although psoriasis has no complete cure, various treatments are available to control its symptoms and improve a patients' quality of life. OBJECTIVE We aimed to compare the effectiveness of biologic versus non-biologic treatments on health-related quality of life among patients with psoriasis in Malaysia. METHODS This retrospective cross-sectional study evaluated data of adult patients diagnosed with psoriasis during 2007-18 from the Malaysian Psoriasis Registry. Baseline demographics, disease, and treatment characteristics were described. For a subset of patients treated with biologics and non-biologics who had baseline and 6-month follow-up data available, changes in the mean Dermatology Life Quality Index scores and the proportion of patients with a clinically relevant improvement (≥ 4 points) post-treatment were assessed. RESULTS Overall, 15,238 adult patients with psoriasis from the Malaysian Psoriasis Registry were included in the analysis. Patients receiving biologics showed a statistically significant reduction in the mean Dermatology Life Quality Index scores after 6 months compared with those receiving non-biologic treatment (- 5.7 vs - 0.8%; p < 0.001). The proportion of patients who achieved a ≥ 4-point improvement in Dermatology Life Quality Index scores was approximately two times greater in the biologic-treated group versus the non-biologic-treated group (56.4 vs 27.7%). CONCLUSIONS Biologic treatment showed a greater reduction in the Dermatology Life Quality Index scores of patients with psoriasis versus non-biologic treatment. These results highlight the importance of early treatment with more efficacious treatment options, such as biologic therapies, to improve the overall health-related quality of life of patients with psoriasis.
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Itch as a critical factor in impaired health-related quality of life in patients with plaque psoriasis achieving clear or almost-clear skin: Analysis of the single-arm, open-label, multicenter, prospective ProLOGUE study. JAAD Int 2022; 8:146-153. [PMID: 35942062 PMCID: PMC9356143 DOI: 10.1016/j.jdin.2022.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2022] [Indexed: 11/22/2022] Open
Abstract
Background Patients with psoriasis report impaired health-related quality of life (HRQoL; Dermatology Life Quality Index score ≥ 2) even after achieving clear or almost-clear skin with biologic treatment. Objective To assess the effectiveness of brodalumab in HRQoL improvement and the factors associated with incomplete HRQoL improvement in Japanese patients with psoriasis. Methods As a part of the single-arm, open-label, multicenter, prospective ProLOGUE study (Japan Registry of Clinical Trials identifier: jRCTs031180037), patients were treated with 210 mg of subcutaneous brodalumab in daily clinical practice until week 48. The absolute Psoriasis Area and Severity Index scores and patient-reported outcomes were assessed at baseline and weeks 12 and 48. Results Seventy-three patients (male, 82.2%; median age, 54.0 years) were enrolled. The Dermatology Life Quality Index and European Quality of Life 5-Dimension 5-Level Utility Index scores significantly improved from baseline to weeks 12 and 48. At week 48, all 13 patients with a Dermatology Life Quality Index score of ≥2 and an absolute Psoriasis Area and Severity Index score of 0 to ≤2 reported itching. Limitations Unclear generalizability of the results to other biologics. Conclusion Treatment with brodalumab improved HRQoL in patients with psoriasis. Itching may contribute to incomplete HRQoL improvement in patients who have achieved clear or almost-clear skin.
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Hebert AA, Browning J, Kwong PC, Duarte AM, Price HN, Siegfried E. Managing Pediatric Psoriasis: Update on Treatments and Challenges-A Review. J DERMATOL TREAT 2022; 33:2433-2442. [PMID: 35736804 DOI: 10.1080/09546634.2022.2059051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Psoriasis is a chronic, immune-mediated inflammatory disease with prominent cutaneous features, although the limited number of medications approved for pediatric psoriasis makes treating this population difficult. This review provides an overview of the challenges associated with diagnosing and treating pediatric psoriasis as well as the approved and off-label treatments for children and infants with psoriasis. METHODS Articles relevant to pediatric psoriasis were identified using series of PubMed searches. Topics relevant to pediatric psoriasis were explored, including disease characteristics, epidemiology, treatment efficacy and safety, and access to care. Publications previously known to the authors were also included. RESULTS Clinical features of psoriasis can be challenging to identify clinically, and patients face challenges gaining access to treatment. Most medications that have been approved for adult psoriasis lack data and labelling to support safe and effective use in pediatric patients, and therefore access is limited. A growing number of clinical trials using biologic agents for pediatric psoriasis aim to broaden available treatment options but may also raise unique concerns associated with the use of these medications in children. CONCLUSION Pediatric psoriasis is underrecognized and often undertreated. Clinicians must balance relative risks and potential benefits when developing a treatment strategy for these patients.
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Affiliation(s)
- A A Hebert
- UTHealth McGovern Medical School, Houston, TX, USA
| | - J Browning
- UT Health San Antonio, San Antonio, TX, USA
| | - P C Kwong
- Wolfson Children's Hospital, Jacksonville, FL, USA
| | - A M Duarte
- The Children's Skin Center, Nicklaus Children's Hospital, Miami, FL, USA
| | - H N Price
- Phoenix Children's Hospital, Phoenix, AZ, USA
| | - E Siegfried
- Saint Louis University School of Medicine, St. Louis, MO, USA
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Canal-García E, Bosch-Amate X, Belinchón I, Puig L. Psoriasis ungueal. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:481-490. [DOI: 10.1016/j.ad.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 01/11/2022] [Accepted: 01/15/2022] [Indexed: 10/19/2022] Open
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Canal-García E, Bosch-Amate X, Belinchón I, Puig L. [Translated article] Nail Psoriasis. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2022.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Imafuku S, Ohata C, Okubo Y, Tobita R, Saeki H, Mabuchi T, Hashimoto Y, Murotani K, Kitabayashi H, Kanai Y. Effectiveness of brodalumab in achieving treatment satisfaction for patients with plaque psoriasis: the ProLOGUE study. J Dermatol Sci 2022; 105:176-184. [DOI: 10.1016/j.jdermsci.2022.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/25/2022] [Accepted: 02/12/2022] [Indexed: 10/19/2022]
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Choi S, Oh S, Yoon HS. Association Between Short-Term PASI90 Achievement and Drug Survival of Biologics in Patients with Psoriasis. Ann Dermatol 2022; 34:173-181. [PMID: 35721333 PMCID: PMC9171179 DOI: 10.5021/ad.2022.34.3.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 11/07/2021] [Accepted: 01/12/2022] [Indexed: 11/08/2022] Open
Affiliation(s)
- Sungjun Choi
- Department of Dermatology, Seoul National University Hospital, Seoul, Korea
- Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Sohee Oh
- Department of Biostatistics, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Hyun-Sun Yoon
- Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea
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Papadimitriou I, Bakirtzi K, Katoulis A, Ioannides D. Scalp Psoriasis and Biologic Agents: A Review. Skin Appendage Disord 2021; 7:439-448. [PMID: 34901174 DOI: 10.1159/000517806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 06/06/2021] [Indexed: 01/10/2023] Open
Abstract
Scalp-localized psoriasis is common among patients affected with plaque psoriasis, rendering its treatment exceedingly difficult. Furthermore, the symptoms caused by the disease like scaling, erythema, and pruritus, among others, pose a major psychological impact and a significant regression in the quality of life of the affected patients. Biologics have proved their efficacy in assuaging the symptoms, in terms of Psoriasis Area and Severity Index (PASI) reduction, and offering optimum quality of life, by decreasing the Dermatology Life Quality Index (DLQI) in the patients suffering from plaque psoriasis. Herein, we sought to evaluate the efficacy of biologics and small molecules in controlling the symptoms and their ability to offer long-term maintenance in the disease activity.
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Affiliation(s)
- Ilias Papadimitriou
- First Dermatology and Venereology Department, School of Medicine Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Katerina Bakirtzi
- First Dermatology and Venereology Department, School of Medicine Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Alexander Katoulis
- Second Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, "Attikon" University Hospital, Athens, Greece
| | - Dimitrios Ioannides
- First Dermatology and Venereology Department, School of Medicine Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
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Abstract
Nail psoriasis is a chronic nail disorder that requires personalized treatment. General prophylactic measures are suggested for all patients. Topical treatment is considered when treating a few-nail disease, with involvement of 3 or fewer nails, without joint involvement and without (or with mild) skin psoriasis. The ideal formulation should be ointment, solution, or foam. When moderate to severe skin psoriasis or psoriatic arthritis coexists, systemic treatment is suggested. This also should be considered when more than 3 nails are affected or significant impairment of quality of life is present. Conventional systemic agents, biologics, and small molecules are highly efficacious.
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Imafuku S, Kanai Y, Murotani K, Nomura T, Ito K, Ohata C, Yamazaki F, Miyagi T, Takahashi H, Okubo Y, Saeki H, Honma M, Tada Y, Mabuchi T, Higashiyama M, Kobayashi S, Hashimoto Y, Seishima M, Kakuma T. Utility of the Dermatology Life Quality Index at initiation or switching of biologics in real-life Japanese patients with plaque psoriasis: Results from the ProLOGUE study. J Dermatol Sci 2021; 101:185-193. [PMID: 33495058 DOI: 10.1016/j.jdermsci.2021.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/27/2020] [Accepted: 01/03/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Plaque psoriasis significantly affects patients' health-related quality of life. To aid treatment decisions, not only objective assessment by physicians but also subjective assessment by patients is important. OBJECTIVE To assess the significance of Dermatology Life Quality Index (DLQI) evaluation at the time of biologics introduction in clinical practice in Japanese patients with plaque psoriasis. METHODS This was a single-arm, open-label, multicenter study. At baseline, Psoriasis Area and Severity Index (PASI) and DLQI scores were measured and stratified based on DLQI scores ≥6/≤5 and PASI scores ≤10/>10. Other patient-reported outcomes assessed included EQ-5D-5L, itch numerical rating scale (NRS), skin pain NRS, Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-8 (PHQ-8), Sleep Problem Index-II (SPI-II), and Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9). RESULTS Of the 73 enrolled patients, 23 had PASI scores ≤10. Those with PASI/DLQI scores >10/≥6 had a significantly higher median PASI score than those with PASI/DLQI scores >10/≤5 (p = 0.0125). Regardless of PASI scores (>10/≤10), median itch NRS and GAD-7 scores were significantly higher in patients with DLQI scores ≥6 than in those with DLQI scores ≤5 (itch NRS, p = 0.0361 and p = 0.0086, respectively; GAD-7, p = 0.0167 and p = 0.0273, respectively). Patients with PASI/DLQI scores ≤10/≥6 had significantly higher skin pain NRS (p = 0.0292) and PHQ-8 (p = 0.0255) scores and significantly lower median SPI-II scores (p = 0.0137) and TSQM-9 Effectiveness domain scores (p = 0.0178) than those with PASI/DLQI scores ≤10/≤5. CONCLUSION DLQI may be useful for assessing patients' concerns that cannot be identified by PASI alone while initiating biologics or switching from other biologics in clinical practice.
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Affiliation(s)
- Shinichi Imafuku
- Department of Dermatology, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
| | | | | | | | - Kei Ito
- Department of Dermatology, JR Sapporo Hospital, Sapporo, Hokkaido, Japan
| | - Chika Ohata
- Department of Dermatology, Osaka General Medical Center, Osaka, Japan
| | | | - Takuya Miyagi
- Department of Dermatology, University of the Ryukyus, Okinawa, Japan
| | | | - Yukari Okubo
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Hidehisa Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Masaru Honma
- Department of Dermatology, Asahikawa Medical University, Hokkaido, Japan
| | - Yayoi Tada
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Tomotaka Mabuchi
- Department of Dermatology, Tokai University School of Medicine, Kanagawa, Japan
| | | | - Satomi Kobayashi
- Department of Dermatology, Seibo International Catholic Hospital, Tokyo, Japan
| | - Yuki Hashimoto
- Department of Dermatology, Toho University School of Medicine, Tokyo, Japan
| | - Mariko Seishima
- Department of Dermatology, Gifu University Graduate School of Medicine, Gifu, Japan
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Honma M, Hayashi K. Psoriasis: Recent progress in molecular‐targeted therapies. J Dermatol 2021; 48:761-777. [DOI: 10.1111/1346-8138.15727] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 11/24/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Masaru Honma
- Department of Dermatology Asahikawa Medical University Hospital Asahikawa Japan
- International Medical Support Center Asahikawa Medical University Hospital Asahikawa Japan
| | - Kei Hayashi
- International Medical Support Center Asahikawa Medical University Hospital Asahikawa Japan
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Seo SJ, Shin BS, Lee JH, Jeong H. Efficacy and safety of brodalumab in the Korean population for the treatment of moderate to severe plaque psoriasis: A randomized, phase III, double-blind, placebo-controlled study. J Dermatol 2020; 48:807-817. [PMID: 33373480 PMCID: PMC8246806 DOI: 10.1111/1346-8138.15733] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 11/12/2020] [Accepted: 11/30/2020] [Indexed: 01/06/2023]
Abstract
Psoriasis, a chronic inflammatory skin disease, negatively impacts patients’ quality of life (QoL). This randomized, phase III, double‐blind, placebo‐controlled, multicenter study evaluated the efficacy and safety of brodalumab, a human anti‐interleukin‐17 receptor A monoclonal antibody, in Korean patients with moderate to severe plaque psoriasis. Coprimary end‐points were the percentage of patients with 75% or more improvement in Psoriasis Area and Severity Index (PASI 75) and static Physician’s Global Assessment (sPGA) success (score 0/1) at week 12. Secondary end‐points included the percentage improvement from baseline in PASI score and proportion of patients with PASI 50/75/90/100 responses. QoL was assessed with the Dermatology Life Quality Index (DLQI). Eligible patients were randomized to receive brodalumab 210 mg (N = 40) or placebo (N = 22) every 2 weeks (Q2W) at a 2:1 ratio for 12 weeks. Subsequently, all patients entered an open‐label extension phase and received brodalumab 210 mg Q2W until week 62. At week 12, the proportion of patients who achieved the coprimary end‐points, PASI 75 and sPGA success, was significantly higher in the brodalumab 210 mg Q2W group compared with the placebo group (92.5% vs 0%). At week 12, the mean ± SD percentage improvement in the PASI score was 96.87 ± 6.01% in the brodalumab 210 mg Q2W group, which was maintained until study end (week 64). PASI 50/75/90 responses were achieved by 100% of patients receiving brodalumab 210 mg Q2W at weeks 6, 13, and 24, respectively; PASI 100 was achieved by 82.8% of patients at week 64. Brodalumab treatment rapidly improved DLQI scores. The most common treatment‐emergent adverse events were nasopharyngitis, upper respiratory tract infections, tinea pedis, and urticaria. Overall, treatment with brodalumab 210 mg Q2W resulted in a rapid and significant clinical benefit and was well tolerated in patients with moderate to severe plaque psoriasis in Korea.
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Affiliation(s)
- Seong Jun Seo
- Department of Dermatology, Chung-Ang University Hospital, Seoul, South Korea
| | - Bong Seok Shin
- Department of Dermatology, Chosun University Hospital, Gwangju, South Korea
| | - Joo-Heung Lee
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Haeyoun Jeong
- Clinical Development Department, Kyowa Kirin Korea Co., Ltd., Seoul, South Korea
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Bruins FM, Bronckers IMGJ, Groenewoud HMM, van de Kerkhof PCM, de Jong EMGJ, Seyger MMB. Association Between Quality of Life and Improvement in Psoriasis Severity and Extent in Pediatric Patients. JAMA Dermatol 2020; 156:72-78. [PMID: 31774449 DOI: 10.1001/jamadermatol.2019.3717] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Treatment of psoriasis is associated with improved quality of life (QOL) in those with the disease. However, in daily clinical practice, the association between the degree of psoriasis clearance and QOL has not been studied to date, especially in the pediatric population. Objectives To identify the association between the degree of psoriasis improvement (as measured by the Psoriasis Area Severity Index [PASI] and body surface area [BSA] response) and QOL (as measured by the Children's Dermatology Life Quality Index [CDLQI]) in pediatric psoriasis, and to assess the association of treatment type with QOL, independent of psoriasis improvement. Design, Setting, and Participants Data used in this single-center cohort study were extracted from the Child-CAPTURE (Continuous Assessment of Psoriasis Treatment Use Registry), a prospective, observational, daily clinical practice cohort of all children (aged <18 years) with a psoriasis diagnosis who attended the outpatient clinic of the Department of Dermatology at the Radboud University Medical Center in Nijmegen, the Netherlands, between September 3, 2008, and May 4, 2018. All records of treatment episodes with CDLQI, PASI, and BSA scores were included in the analysis. Exposures Patients were treated according to daily clinical care. Treatments were clustered into topical, dithranol, conventional systemic, and biological treatments. Because of low numbers of UV-B phototherapy, this treatment was not assessed. Main Outcomes and Measures Primary outcomes were mean change of CDLQI scores per PASI and BSA response categories (0 to <50, 50 to <75, 75 to <90, and ≥90) and mean CDLQI change per treatment categories. Results In total, 319 patients (median [interquartile range] age, 10.0 [7.0] years; 183 female [57.4%]) were analyzed for PASI score improvement (399 treatment episodes) and improvement in BSA involvement (366 treatment episodes). The greatest improvements in CDLQI scores were seen in the PASI ≥90 response category, with an estimated marginal mean change in CDLQI score of -6.6 (95% CI, -7.5 to -5.7). The greatest improvements in CDLQI scores were also observed in the BSA ≥90 response category, with an estimated marginal mean change in CDLQI score of -6.8 (95% CI, -7.5 to -6.1). Systemic treatment demonstrated a greater degree of improvement of CDLQI compared with topical treatment, independent of PASI response categories. Conclusions and Relevance This cohort study in a real-world setting found that the greatest improvements in QOL were associated with PASI 90 or greater, a decrease in BSA involvement of 90% or greater, and systemic treatments. These findings suggest that reaching PASI 90 or greater and decreasing BSA involvement by at least 90% may be clinically meaningful treatment goals that will help pediatric patients with psoriasis reach optimal QOL.
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Affiliation(s)
- Finola M Bruins
- Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Inge M G J Bronckers
- Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hans M M Groenewoud
- Department for Health Evidence, Radboud University, Nijmegen, the Netherlands
| | | | - Elke M G J de Jong
- Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marieke M B Seyger
- Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands
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17
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Finlay AY, Chernyshov PV, Tomas Aragones L, Bewley A, Svensson A, Manolache L, Marron S, Suru A, Sampogna F, Salek MS, Poot F. Methods to improve quality of life, beyond medicines. Position statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes. J Eur Acad Dermatol Venereol 2020; 35:318-328. [PMID: 33094518 DOI: 10.1111/jdv.16914] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 08/21/2020] [Indexed: 12/21/2022]
Abstract
The pharmaceutical approach to skin disease has been hugely successful, but despite effective drugs being available and used, there are still vast numbers of people who continue to have some level of persisting skin disease and continue to experience quality of life (QoL) impairment. So the question that needs to be answered, while we await further advances in our drug-based armamentarium, is how can we improve patients' QoL, beyond drugs? A working group was formed from members of the EADV Task Force on QoL and Patient Oriented Outcomes. Participants were asked to suggest all the ways in which they considered patients' QoL may be improved beyond medicines. Four groups of management approaches that may improve QoL in dermatology were identified: interventions within the dermatology service (hospitalization, multidisciplinary teams, patch testing and establishing relevant allergens and education), external services (corrective make-up, climatotherapy and balneotherapy), psychological (psychological intervention, cognitive therapy, hypnosis), lifestyle (lifestyle behavioural changes, religion and spirituality and music). The ultimate aim of therapy is to eradicate a disease in an individual and return the person's life to normal. But until the day comes when this has been achieved for every skin disease and for every patient there will be a need to support and assist many patients in additional non-pharmaceutical ways. These 'adjuvant' approaches receive too little attention while dermatologists and researchers strive for better pharmacological therapy. The different ways in which patients may benefit have been reviewed in our paper, but the reality is that most have a very poor evidence base. The research challenges that we have to meet are to identify those approaches that might be of value and to provide evidence for their optimal use. In the meantime, clinicians should consider the use of these approaches where QoL remains impaired despite optimal use of standard therapy.
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Affiliation(s)
- A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - L Tomas Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - A Bewley
- Whipps Cross University Hospital, London, UK.,Queen Mary University Medical School, London, UK
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - S Marron
- Department of Dermatology, Aragon Psychodermatology Research Group (GAI+PD), University Hospital Miguel Servet, Zaragoza, Spain
| | - A Suru
- Dermatology Research Unit, Paediatric Dermatology Discipline, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - F Sampogna
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - M S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - F Poot
- Department of Dermatology, University Hospital Erasme, Brussels, Belgium
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18
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Reich K, Körber A, Mrowietz U, Sticherling M, Sieder C, Früh J, Bachhuber T. Secukinumab 2-weekly vs. 4-weekly dosing in patients with plaque-type psoriasis: results from the randomized GAIN study. Br J Dermatol 2020; 184:849-856. [PMID: 32652528 DOI: 10.1111/bjd.19398] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Secukinumab is a fully human monoclonal antibody that selectively neutralizes interleukin-17A and shows long-lasting efficacy and safety in plaque psoriasis. More evidence is required to optimize secukinumab dosing according to clinical response. OBJECTIVES GAIN compared the efficacy and safety of secukinumab 300 mg every 2 weeks (q2w) with 300 mg every 4 weeks (q4w) in patients achieving ≥ 75% improvement in Psoriasis Area and Severity Index (PASI 75) but not PASI 90 after 16 weeks. METHODS In total, 772 patients with moderate-to-severe plaque psoriasis received secukinumab 300 mg subcutaneously at baseline and weeks 1, 2, 3 and 4, then q4w until week 16. At week 16, patients with PASI ≥ 75 to PASI < 90 were randomized 1: 1 to continue q4w dosing (n = 162) or switch to q2w (n = 163) to week 32. The primary endpoint was superiority of q2w to q4w dosing for PASI 90 response at week 32. RESULTS PASI 90 response at week 32 was numerically greater with secukinumab 300 mg q2w than with secukinumab 300 mg q4w in suboptimal responders, but this did not reach statistical significance (64·4% vs. 57·4%; odds ratio 0·64, 95% confidence interval 0·39-1·07; P = 0·087). Although the primary endpoint was not met, absolute PASI was significantly lower at week 32 in q2w vs. q4w patients (2·11 vs. 2·84, P = 0·024). Significantly more patients with q2w vs. q4w dosing showed minimal disease activity (Investigator's Global Assessment score 0 or 1: 73·0% vs. 64·1%, P < 0·05) and improved quality of life (Dermatology Life Quality Index score 0 or 1: 58·9% vs. 50·6%, P < 0·05) at week 32. No new or unexpected safety signals arose. CONCLUSIONS Most patients achieved PASI 90 response with secukinumab q4w. There was potential benefit of q2w dosing in some suboptimal responders. Continued q4w treatment can improve response even after 16 weeks.
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Affiliation(s)
- K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, and Skinflammation® Center, Hamburg, Germany
| | - A Körber
- Department of Dermatology, University Hospital Essen, Essen, Germany
| | - U Mrowietz
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - M Sticherling
- Department of Dermatology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - C Sieder
- Novartis Pharma GmbH, Nürnberg, Germany
| | - J Früh
- Novartis Pharma AG, Basel, Switzerland
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19
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Carretero G, Carrascosa JM, Puig L, Sánchez-Carazo JL, López-Ferrer A, Cueva P, Soria C, Rivera R, Belinchón I. Definition of minimal disease activity in psoriasis. J Eur Acad Dermatol Venereol 2020; 35:422-430. [PMID: 32367536 DOI: 10.1111/jdv.16564] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/03/2020] [Accepted: 04/10/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To generate an operational definition to adequately reflect the construct 'Minimal Disease Activity (MDA)' in psoriasis. METHODS A systematic review of domains included in clinical trials of psoriasis was presented to a panel of dermatologists and patients. Further domains were elicited by panel discussions. Domains (and instruments measuring these) were items of two consecutive Delphi rounds targeting dermatologists from the Psoriasis Group of the Spanish Academy of Dermatology and Venereology and patients from the Acción Psoriasis association. The instruments selected were used to generate 388 patient vignettes. The expert group then classified these vignettes as 'No MDA/MDA/Unclassifiable'. The items were further reduced by factorial analysis. Using the classification variable as gold standard, several operational constructions were tested in regression models and ROC curves and accuracy was evaluated with area under the curve (AUC). RESULTS The following domains were included: itching, scaling, erythema and visibility by 0-10 scales, extension by BSA, impact on quality of life by DLQI, special location and presence of arthritis as yes/no. The definition with the highest AUC and best balance between sensitivity and specificity was the one including no presence of arthritis plus at least three others below the upper limit of the 95% confidence interval (AUC, 0.897; sensitivity, 95.2%, specificity, 84.1%). CONCLUSION This study provides, for the very first time, the construct of 'Minimal Disease Activity' in psoriasis as agreed by dermatologists and patients. MDA is defined as absence of active arthritis plus 3 out of 6: itching ≤ 1/10; scaling ≤ 2/10; redness ≤ 2/10; visibility ≤ 2/10; BSA ≤ 2; DLQI ≤ 2; and no lesions in special locations. By design, domains are representative of disease impact. This MDA definition may be used as a measure of adequate management and replace other subjective or restrictive tools.
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Affiliation(s)
- G Carretero
- Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - J M Carrascosa
- Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - L Puig
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | - P Cueva
- Hospital Universitario Infanta Leonor, Madrid, Spain
| | - C Soria
- Hospital General Universitario Reina Sofía de Murcia, Murcia, Spain
| | - R Rivera
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | - I Belinchón
- Hospital General Universitario de Alicante, Alicante, Spain
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20
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Marsili F, Travaglini M, Stinco G, Manzoni R, Tiberio R, Prignano F, Mazzotta A, Cannavò SP, Cuccia A, Germino M, Bongiorno MR, Persechino S, Florio T, Pettinato M, Tabanelli M, Sarkar R, Aloisi E, Bartezaghi M, Orsenigo R. Effectiveness of cyclosporine A in patients with moderate to severe plaque psoriasis in a real-life clinical setting in Italy: the TRANSITION study. J DERMATOL TREAT 2020; 33:401-407. [PMID: 32349568 DOI: 10.1080/09546634.2020.1757017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Cyclosporine A (CsA) is one of the systemic therapeutic options for moderate-to-severe psoriasis, based on its efficacy and rapidity of action. The current study investigated the response to CsA in patients with moderate-to-severe plaque psoriasis.Materials and Methods: TRANSITION was an observational, cross-sectional, multicentre study which evaluated the proportion of partial- and suboptimal-responders among patients with moderate-to-severe plaque psoriasis treated with continuous CsA for ≥12 weeks. Patients demonstrating a Psoriasis Area and Severity Index (PASI) response of ≥90, ≥75 and <90, ≥50 and <75 and <50 were defined as responders, suboptimal-responders, partial-responders, and non-responders, respectively.Results: A total of 196 patients (mean age, 46.6 years; 62.8% males) from 14 sites in Italy were evaluated. At the study visit, the mean (SD) PASI score was 4.2(5.5) compared with 15.3(7.1) prior to the last CsA cycle. For response categories, 39.8%, 22.4%, 16.8%, and 20.9% of patients were responders, suboptimal-responders, partial-responders, and non-responders to CsA treatment. Overall, 28.6% of patients permanently discontinued treatment with CsA (lack of efficacy [10.2%], poor tolerability and voluntary discontinuation [3.6% each], and other [11.7%]).Conclusion: Patients were only partially satisfied with CsA treatment, reporting measurable impact on quality of life. Only 40% patients showed a satisfactory response to CsA.
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Affiliation(s)
- F Marsili
- Unit of Dermatology, Versilia Hospital, Lido di Camaiore, Lucca, Italy
| | - M Travaglini
- Centro per la cura della Psoriasi, Hospital "Di Summa-Perrino", Brindisi, Italy
| | - G Stinco
- Institute of Dermatology, Department of Medicine, University Hospital, Udine, Italy
| | - R Manzoni
- Division of Dermatology, Azienda Sanitaria Locale of Biella, Ponderano, Italy
| | - R Tiberio
- SCDU Dermatology, AOU Maggiore della Carità, Novara, Italy
| | - F Prignano
- Department of Health Science Dermatology Unit, University of Florence, Firenze, Italy
| | - A Mazzotta
- Dermatology Unit, San Camillo-Forlanini Hospital, Rome, Italy
| | - S P Cannavò
- Dermatology Unit, University Hospital Policlinico "G. Martino", Messina, Italy
| | - A Cuccia
- Unit of Dermatology, San Donato Hospital, Arezzo, Italy
| | - M Germino
- Department of Dermatology, Hospital Policlinico Città di Udine, Udine, Italy
| | - M R Bongiorno
- Dermatology Unit, University Hospital Policlinico "P. Giaccone", Palermo, Italy
| | - S Persechino
- Dermatology Unit, NESMOS Department, S. Andrea Hospital, University of Rome "Sapienza", Rome, Italy
| | - T Florio
- Dermatology Unit, Hospital Di Venere-Carbonara di Bari, Bari, Italy
| | - M Pettinato
- Dermatology Unit, University Hospital "Policlinico-Vittorio Emanuele", Catania, Italy
| | - M Tabanelli
- U.O.C. Dermatologia Ravenna AUSL Romagna, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | - R Sarkar
- Novartis Pharma AG, Basel, Switzerland
| | - E Aloisi
- Novartis Farma SpA, Origgio, Italy
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21
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Blauvelt A, Shi N, Zhu B, Burge R, Malatestinic WN, Lin CY, Lew CR, Zimmerman NM, Goldblum OM, Murage MJ. Comparison of Health Care Costs Among Patients with Psoriasis Initiating Ixekizumab, Secukinumab, or Adalimumab. J Manag Care Spec Pharm 2019; 25:1366-1376. [PMID: 31778621 PMCID: PMC10398217 DOI: 10.18553/jmcp.2019.25.12.1366] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND As more biologics become available for the treatment of psoriasis (PsO), there is a lack of direct comparisons of health care costs between patients who are treated by different medications, including ixekizumab (IXE), secukinumab (SEC), and adalimumab (ADA). OBJECTIVE To compare the real-world health care costs of patients with PsO initiating IXE with those of patients initiating either SEC or ADA. METHODS Patients diagnosed with PsO between July 1, 2015, and May 31, 2018, were identified from the IBM MarketScan commercial and Medicare databases. Two weighted patient sample sets were constructed based on drug claims between March 1, 2016, and May 31, 2018: IXE versus SEC and IXE versus ADA. Within each sample, the first claim of eligible drugs was set as the index date. Patients were aged ≥ 18 years and had ≥ 12 months of continuous eligibility before and after the index date. Patients with other indications for the index drug in the preperiod or with use of the index drug within 90 days before the index date were excluded. Inverse probability of treatment weighting (IPTW) was employed to balance cohorts. All-cause and PsO-related health care costs per member per month (PMPM) incurred during the 12-month follow-up period were assessed. Monthly PsO-related pharmacy costs were adjusted using drug discount rates published by the Institute for Clinical and Economic Review (ICER). Annual index drug costs were estimated by adjusting for medication possession ratio and ICER discount rates. All costs were weighted by IPTW. RESULTS Two study samples were identified: 357 IXE users were compared with 763 SEC users, and 388 IXE users were separately compared with 2,578 ADA users. Before weighting, IXE users were demographically and clinically similar to SEC users but were older and had worse health status than ADA users. Cohorts were balanced postweighting. After weighting, mean monthly all-cause health care costs were $7,313 and $6,477 (P = 0.002) and mean PsO-related costs were $6,303 and $5,437 (P < 0.001), for IXE and SEC users, respectively. Similarly, mean monthly all-cause health care costs were $6,535 and $5,557 (P = 0.026) and mean PsO-related costs were $5,792 and $4,754 (P = 0.017), for IXE and ADA users, respectively. After applying ICER adjustments, mean monthly PsO-related costs were comparable between groups: $3,637/IXE versus $3,443/SEC (P = 0.132) and $3,320/IXE versus $3,287/ADA (P = 0.907). CONCLUSIONS After adjusting for drug discount programs (through application of ICER discount rate), this real-world study estimated that average monthly PsO-related costs during the first year of treatment were similar between patients treated with IXE compared with those treated with SEC or ADA. DISCLOSURES Funding for this study was provided to IBM Watson Health by Eli Lilly and Company. The analysis was conducted independently by IBM Watson Health. Eli Lilly and Company and IBM Watson Health collaborated on study design and interpretation of results. Shi, Lew, and Zimmerman were employed by IBM Watson Health and received funding from Eli Lilly and Company to conduct this study. Zhu, Burge, Malatestinic, Lin, Goldblum, and Murage were employed by Eli Lilly and Company while this study was conducted. Blauvelt has served as a scientific adviser and/or clinical study investigator for AbbVie, Aclaris, Akros, Allergan, Almirall, Amgen, Arena, Athenex, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Dermavant, Dermira, Eli Lilly and Company, FLX Bio, Galderma, Genentech/Roche, GlaxoSmithKline, Janssen, Leo, Meiji, Merck Sharp & Dohme, Novartis, Pfizer, Purdue Pharma, Regeneron, Revance, Sandoz, Sanofi Genzyme, Sienna Pharmaceuticals, Sun Pharma, UCB Pharma, Valeant, and Vidac, and as a paid speaker for AbbVie, Regeneron, and Sanofi Genzyme. A portion of these results were presented at the 2019 International Society for Pharmacoeconomics and Outcomes Research Annual Meeting; May 18-22, 2019; New Orleans, LA, and the 2019 Academy of Managed Care Pharmacy Annual Meeting; March 25-28, 2019; San Diego, CA.
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Affiliation(s)
| | | | - Baojin Zhu
- Eli Lilly and Company, Indianapolis, Indiana
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22
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Colls-Gonzalez M, Notario-Rosa J, Bas-Minguet J, Padullés-Zamora A, Morandeira-Rego F, Valentí-Medina F, Colom-Codina H, Padullés-Zamora N. Association between infliximab concentrations and clinical response in psoriasis: a prospective cohort study. J DERMATOL TREAT 2019; 32:180-187. [PMID: 31696747 DOI: 10.1080/09546634.2019.1690623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Infliximab (IFX) trough concentrations (Cmin) have been linked to treatment efficacy in psoriatic patients. Inter-individual IFX Cmin variability and factors influencing IFX pharmacokinetics could explain differences in treatment response. OBJECTIVE To evaluate the association between IFX Cmin and clinical outcomes in psoriatic patients. METHODS Prospective study of 33 patients with moderate to severe psoriasis receiving IFX at Bellvitge University Hospital, between October 2013 and November 2016. IFX Cmin and antibodies toward infliximab (ATI) were measured. RESULTS We collected 155 IFX Cmin and ATI values (mean age, 46 (14) years; 11 (33.3%) women). Mean IFX Cmin was 2.5 (2.4) mg/L and ATIs were detected in six patients, resulting in undetectable IFX Cmin. IFX Cmin was significantly associated with ATI and body mass index (BMI) (β -2.51, 95% CI -3.56 to -1.4 and β -0.05, 95% CI -0.09 to -0.01). PASI score and PASI 90/100 response were significantly associated with IFX Cmin (IRR 0.80, 95% CI 0.70 to 0.92; OR 1.79, 95% CI 1.18 to 2.71 and OR 1.79, 95% CI 1.14 to 2.81). CONCLUSION IFX Cmin significantly influences PASI 90/100 response rates. IFX Cmin wa significantly associated with ATI and BMI. The observed inter-individual variability in IFX Cmin supports the need for IFX drug monitoring.
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Affiliation(s)
- M Colls-Gonzalez
- Department of Pharmacy, Hospital Universitari de Bellvitge, Pharmacotherapy, Pharmacogenetics and Pharmaceutical Technology Program, Institut D'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - J Notario-Rosa
- Department of Dermatology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - J Bas-Minguet
- Department of Immunology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Padullés-Zamora
- Department of Pharmacy, Hospital Universitari de Bellvitge, Pharmacotherapy, Pharmacogenetics and Pharmaceutical Technology Program, Institut D'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - F Morandeira-Rego
- Department of Immunology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - F Valentí-Medina
- Department of Dermatology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - H Colom-Codina
- Pharmacy and Pharmaceutical Technology Department, School of Pharmacy, Universitat de Barcelona - UB, Pharmacotherapy, Pharmacogenetics and Pharmaceutical Technology Program, Institut D'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - N Padullés-Zamora
- Department of Pharmacy, Hospital Universitari de Bellvitge, Pharmacotherapy, Pharmacogenetics and Pharmaceutical Technology Program, Institut D'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
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23
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Norlin J, Nilsson K, Persson U, Schmitt‐Egenolf M. Complete skin clearance and Psoriasis Area and Severity Index response rates in clinical practice: predictors, health‐related quality of life improvements and implications for treatment goals. Br J Dermatol 2019; 182:965-973. [DOI: 10.1111/bjd.18361] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2019] [Indexed: 12/21/2022]
Affiliation(s)
- J.M. Norlin
- The Swedish Institute for Health Economics (IHE) Lund Sweden
| | - K. Nilsson
- The Swedish Institute for Health Economics (IHE) Lund Sweden
| | - U. Persson
- The Swedish Institute for Health Economics (IHE) Lund Sweden
| | - M. Schmitt‐Egenolf
- Department of Public Health and Clinical Medicine, Dermatology Umeå University 901 87 Umeå Sweden
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24
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A Cost-per-Number Needed to Treat Analysis Assessing the Efficiency of Biologic Drugs in Moderate to Severe Plaque Psoriasis. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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25
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Subedi S, Gong Y, Chen Y, Shi Y. Infliximab and biosimilar infliximab in psoriasis: efficacy, loss of efficacy, and adverse events. DRUG DESIGN DEVELOPMENT AND THERAPY 2019; 13:2491-2502. [PMID: 31413544 PMCID: PMC6661374 DOI: 10.2147/dddt.s200147] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 05/28/2019] [Indexed: 12/16/2022]
Abstract
Psoriasis is a chronic immune-mediated skin disease affecting multiple systems, and tumor necrosis factor-α (TNF-α) plays a significant role in the initiation and progression of the disease process. Psoriasis has a high prevalence rate in the Western world, especially in the USA and Australia; in China, although the prevalence rate is much lower, there is still a large number of patients suffering from psoriasis and its comorbidities. As TNF-α is thought to be crucial in the pathogenesis of psoriasis, specific therapy blocking TNF-α may be beneficial in the treatment of this disease. Infliximab, a murine-human monoclonal antibody, is highly efficacious in the treatment of moderate-to-severe psoriasis, with better skin clearance and faster onset of action than topical medications such as methotrexate, narrow-band ultraviolet B, and calcipotriol. Lack of adherence to infliximab therapy is mainly due to loss of response (LOR) over time and adverse events, particularly because infusion reactions are usually encountered. Anti-infliximab antibody is thought to be responsible for the LOR and infusion reactions. However, the mechanism underlying the formation of anti-infliximab antibody and its side effects remains unclear. Further studies identifying patients at risk for LOR will probably help clinicians to select the right patients for anti-TNF-α therapy and to increase the durability of the treatment. This review discusses the efficacy of infliximab as demonstrated by various clinical trials, LOR to infliximab, combatting LOR, as well as the adverse events usually faced during the use of infliximab therapy and the infliximab biosimilar Remsima®. We hope that we can discover a better way to use infliximab in the therapy of psoriasis from the current research data.
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Affiliation(s)
- Smriti Subedi
- Department of Dermatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, People's Republic of China.,Department of Dermatology, Institute of Psoriasis, Tongji University School of Medicine, Shanghai 200072, People's Republic of China
| | - Yu Gong
- Department of Dermatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, People's Republic of China.,Department of Dermatology, Institute of Psoriasis, Tongji University School of Medicine, Shanghai 200072, People's Republic of China
| | - Youdong Chen
- Department of Dermatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, People's Republic of China.,Department of Dermatology, Institute of Psoriasis, Tongji University School of Medicine, Shanghai 200072, People's Republic of China
| | - Yuling Shi
- Department of Dermatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, People's Republic of China.,Department of Dermatology, Institute of Psoriasis, Tongji University School of Medicine, Shanghai 200072, People's Republic of China
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26
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Reich K, Rich P, Maari C, Bissonnette R, Leonardi C, Menter A, Igarashi A, Klekotka P, Patel D, Li J, Tuttle J, Morgan‐Cox M, Edson‐Heredia E, Friedrich S, Papp K. Efficacy and safety of mirikizumab (
LY
3074828) in the treatment of moderate‐to‐severe plaque psoriasis: results from a randomized phase
II
study. Br J Dermatol 2019; 181:88-95. [DOI: 10.1111/bjd.17628] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2019] [Indexed: 10/27/2022]
Affiliation(s)
- K. Reich
- Dermatologikum Berlin Berlin Germany
- SCIderm Research Institute Hamburg Germany
| | - P. Rich
- Dermatology and Clinical Research Oregon Health Science University Portland OR U.S.A
| | - C. Maari
- Innovaderm Research Montreal QC Canada
| | | | - C. Leonardi
- St Louis University School of Medicine St Louis MO U.S.A
| | - A. Menter
- Department of Dermatology Baylor University Medical Center Dallas TX U.S.A
| | | | | | - D. Patel
- Eli Lilly and Company Indianapolis IN U.S.A
| | - J. Li
- Eli Lilly and Company Indianapolis IN U.S.A
| | - J. Tuttle
- Eli Lilly and Company Indianapolis IN U.S.A
| | | | | | | | - K. Papp
- Probity Medical Research Waterloo ON Canada
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27
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Chernyshov PV. The Evolution of Quality of Life Assessment and Use in Dermatology. Dermatology 2019; 235:167-174. [PMID: 30928986 DOI: 10.1159/000496923] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 01/15/2019] [Indexed: 11/19/2022] Open
Abstract
The creation of the Dermatology Life Quality Index (DLQI) questionnaire facilitated many studies on the impact of skin diseases on patients' quality of life (QoL). Many national and international guidelines recommend QoL assessment in dermatology, and some of them contain detailed recommendations on treatment goals and changes of treatment approaches based on DLQI score banding and minimal clinically important difference. The methodology of QoL in strument development and validation is constantly becoming more rigorous. Initiatives on selection of core outcome sets for skin diseases are focused on clinical trials but may also be beneficial for clinicians. There are various benefits of using QoL information in clinical practice, but experience of this is very limited at the moment. QoL assessment in dermatology is a rapidly developing field with a gradual shift from theory to practice.
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Affiliation(s)
- Pavel V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine,
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28
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Núñez M, Huete T, de la Cueva P, Sacristán JA, Hartz S, Dilla T. A Cost-per-Number Needed to Treat Analysis Assessing the Efficiency of Biologic Drugs in Moderate to Severe Plaque Psoriasis. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:546-553. [PMID: 30851873 DOI: 10.1016/j.ad.2018.10.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 10/01/2018] [Accepted: 10/01/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Psoriasis is a chronic inflammatory skin disease with an estimated prevalence in Spain of 2.3% of the population. Approximately 30% of patients have moderate-to-severe forms. Treatment with biologic agents is proving to be a step forward in the management of the disease, although these treatments are very expensive. The objective of this study was to determine the efficiency, in terms of cost per number needed to treat (NNT), of the biologic drugs available in Spain for the treatment of moderate to severe plaque psoriasis. METHODS NNT data were obtained from a network meta-analysis that included all randomized clinical trials of biologic drugs sold in Spain. The cost of each treatment was calculated based on the approved dosage for the first year of treatment, as indicated in the Summary of Product Characteristics. These data were used to calculate the cost per NNT of the drugs for various PASI scores (75, 90, and 100). A sensitivity analysis was performed taking into consideration only the PASI-response measurement time (after 10, 12, or 16 weeks, depending on the drug). RESULTS The order of efficiency, from most to least efficient, in the case of a PASI 75 response was ixekizumab > ustekinumab 45mg > ustekinumab 90mg > secukinumab > infliximab > etanercept > adalimumab. The order for PASI 90 was ixekizumab >secukinumab >ustekinumab 45mg > ustekinumab 90mg > infliximab > adalimumab > etanercept. The order for PASI 100 was ixekizumab > secukinumab > infliximab > ustekinumab 90mg > ustekinumab 45mg > adalimumab > etanercept. The sensitivity analysis showed some changes in the order, depending on the response-assessment period. CONCLUSIONS The findings show a link between the efficacy of the biologic therapies available in Spain for the treatment of moderate-to-severe plaque psoriasis and their efficiency. Ixekizumab had the lowest cost per NNT for all PASI-response scores (75, 90, and 100) during the first year of treatment.
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Affiliation(s)
- M Núñez
- Eli Lilly and Company, Madrid, España.
| | - T Huete
- Eli Lilly and Company, Madrid, España
| | - P de la Cueva
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, España
| | | | - S Hartz
- Eli Lilly and Company, Surrey, Reino Unido
| | - T Dilla
- Eli Lilly and Company, Madrid, España
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29
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López-Estebaranz J, de la Cueva-Dobao P, de la Torre Fraga C, Galán Gutiérrez M, González Guerra E, Mollet Sánchez J, Belinchón Romero I. Manejo de la psoriasis moderada-grave en condiciones de práctica habitual en el ámbito hospitalario español. ACTAS DERMO-SIFILIOGRAFICAS 2018; 109:631-642. [DOI: 10.1016/j.ad.2018.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 02/12/2018] [Accepted: 02/26/2018] [Indexed: 10/14/2022] Open
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30
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López-Estebaranz J, de la Cueva-Dobao P, de la Torre Fraga C, Galán Gutiérrez M, González Guerra E, Mollet Sánchez J, Belinchón Romero I. Management of Moderate to Severe Psoriasis in Routine Clinical Practice in Spanish Hospitals. ACTAS DERMO-SIFILIOGRAFICAS 2018. [DOI: 10.1016/j.adengl.2018.06.021] [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] Open
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31
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Therapeutics for Adult Nail Psoriasis and Nail Lichen Planus: A Guide for Clinicians. Am J Clin Dermatol 2018; 19:559-584. [PMID: 29488102 DOI: 10.1007/s40257-018-0350-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Nail psoriasis (NP) and nail lichen planus (NLP) can be limiting, stigmatizing and difficult to treat. Dermatologists commonly treat psoriasis and lichen planus but when associated onychodystrophy is present or is an isolated finding, some develop apprehension. The goal of this review is to develop therapeutic ladders to be used as a guide for the management of NP and NLP in everyday clinical practice. Evidence-based therapies for NP are robust and range from topical treatments to conventional systemic therapies (i.e., methotrexate, cyclosporine), new oral agents (i.e., apremilast and tofacitinib), and biologics. The literature for treatment of NLP is severely limited, with therapy mainly consisting of topical, intralesional, or systemic corticosteroids or methotrexate.
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32
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Warren RB, Brnabic A, Saure D, Langley RG, See K, Wu JJ, Schacht A, Mallbris L, Nast A. Matching-adjusted indirect comparison of efficacy in patients with moderate-to-severe plaque psoriasis treated with ixekizumab vs. secukinumab. Br J Dermatol 2018; 178:1064-1071. [PMID: 29171861 DOI: 10.1111/bjd.16140] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND Head-to-head randomized studies comparing ixekizumab and secukinumab in the treatment of psoriasis are not available. OBJECTIVES To assess efficacy and quality of life using matching-adjusted indirect comparisons for treatment with ixekizumab vs. secukinumab. METHODS Psoriasis Area and Severity Index (PASI) improvement of at least 75%, 90% and 100% and Dermatology Life Quality Index (DLQI) 0/1 response rates for approved dosages of ixekizumab (160 mg at Week 0, then 80 mg every two weeks for the first 12 weeks) and secukinumab (300 mg at Weeks 0, 1, 2, 3 and 4, then 300 mg every 4 weeks) treatment were compared using data from active (etanercept and ustekinumab) and placebo-controlled studies. Comparisons were made using the Bucher (BU) method and two modified versions of the Signorovitch (SG) method (SG total and SG separate). Subsequently, results based on active treatment common comparators were combined using generic inverse-variance meta-analysis. RESULTS In the meta-analysis of studies with active comparators, PASI 90 response rates were 12·7% [95% confidence interval (CI) 5·5-19·8, P = 0·0005], 10·0% (95% CI 2·1-18·0, P = 0·01) and 11·2% (95% CI 3·2-19·1, P = 0·006) higher and PASI 100 response rates were 11·7% (95% CI 5·9-17·5, P < 0·001), 12·7% (95% CI 6·0-19·4, P < 0·001) and 13·1% (95% CI 6·3-19·9, P < 0·001) higher for ixekizumab compared with secukinumab using BU, SG total and SG separate methods. PASI 75 results were comparable when SG methods were used and favoured ixekizumab when the BU method was used. Week 12 DLQI 0/1 response rates did not differ significantly. CONCLUSIONS Ixekizumab had higher PASI 90 and PASI 100 responses at week 12 compared with secukinumab using adjusted indirect comparisons.
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Affiliation(s)
- R B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, U.K
| | - A Brnabic
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, U.S.A
| | - D Saure
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, U.S.A
| | - R G Langley
- Division of Clinical Dermatology and Cutaneous Science, Dalhousie University, Halifax, NS, Canada
| | - K See
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, U.S.A
| | - J J Wu
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, U.S.A
| | - A Schacht
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, U.S.A
| | - L Mallbris
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, U.S.A
| | - A Nast
- Division of Evidence-Based Medicine, Department of Dermatology, Venereology and Allergology, Charité Universitätsmedizin Berlin, Berlin, Germany
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33
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Carretero G, Puig L, Carrascosa JM, Ferrándiz L, Ruiz-Villaverde R, de la Cueva P, Belinchon I, Vilarrasa E, Del Rio R, Sánchez-Carazo JL, López-Ferrer A, Peral F, Armesto S, Eiris N, Mitxelena J, Vilar-Alejo J, A Martin M, Soria C. Redefining the therapeutic objective in psoriatic patients candidates for biological therapy. J DERMATOL TREAT 2017; 29:334-346. [PMID: 29099667 DOI: 10.1080/09546634.2017.1395794] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The advances in psoriasis management currently allow achieving a good control of the disease. In particular, with the latest developed molecules, available evidence suggests that it is possible to pose an ambitious therapeutic goal, such as a Dermatology Life Quality Index 0/1, a Physician Global Assessment 0/1, or a Psoriasis Area and Severity Index 90/100 response. However, patients often fail to achieve the complete clearance of their cutaneous lesions or the improvement of disease factors that impair their quality of life. To optimize the treatment of psoriasis, it is not enough to define precisely the therapeutic objective, but also to adapt the therapeutic strategy to make the necessary modifications in case of not achieving it at the time point (at the end of the induction phase, or every 3-6 months) to be agreed with the patient (the so-called treat-to-target approach). In the present report, based on the Delphi methodology, 11 dermatologists from the Spanish Psoriasis Group addressed key issues that could be involved in the achievement and maintenance of the therapeutic goals of patients with moderate to severe psoriasis. The document provides 27 consensus statements intended to support clinical decision-making by healthcare professionals for patients who might be candidates to receive biologic therapy.
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Affiliation(s)
- G Carretero
- a Hospital Universitario de Gran Canaria Doctor Negrín , Las Palmas de Gran Canaria , Spain
| | - L Puig
- b Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona , Barcelona , Spain
| | - J M Carrascosa
- c Hospital Universitari Germans Trias I Pujol, Universitat Autònoma de Barcelona , Badalona , Spain
| | - L Ferrándiz
- d Hospital Universitario Virgen Macarena , Sevilla , Spain
| | | | - P de la Cueva
- f Hospital Universitario Infanta Leonor , Madrid , Spain
| | - I Belinchon
- g Hospital General Universitario de Alicante-ISABIAL , Alicante , Spain
| | - E Vilarrasa
- b Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona , Barcelona , Spain
| | - R Del Rio
- h Fundació Hospital L'Esperit Sant , Santa Coloma de Gramenet , Spain
| | | | - A López-Ferrer
- b Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona , Barcelona , Spain
| | - F Peral
- j Hospital Universitario Infanta Cristina de Badajoz , Badajoz , Spain
| | - S Armesto
- k Hospital Universitario Marqués de Valdecilla , Santander , Spain
| | - N Eiris
- l Complejo Asistencial Universitario de León , Spain
| | | | - J Vilar-Alejo
- a Hospital Universitario de Gran Canaria Doctor Negrín , Las Palmas de Gran Canaria , Spain
| | - M A Martin
- n Hospital Clínico Universitario Lozano Blesa , Zaragoza , Spain
| | - C Soria
- o Hospital General Universitario Reina Sofia , Murcia , Spain
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34
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Elewski BE, Puig L, Mordin M, Gilloteau I, Sherif B, Fox T, Gnanasakthy A, Papavassilis C, Strober BE. Psoriasis patients with psoriasis Area and Severity Index (PASI) 90 response achieve greater health-related quality-of-life improvements than those with PASI 75–89 response: results from two phase 3 studies of secukinumab. J DERMATOL TREAT 2017; 28:492-499. [DOI: 10.1080/09546634.2017.1294727] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
| | - Lluís Puig
- Department of Dermatology, Hospital de la Sanat Creu i Sant Pau, Barcelona, Spain
| | | | | | - Bintu Sherif
- RTI Health Solutions, Research Triangle Park, NC, USA
| | - Todd Fox
- Novartis Pharma AG, Basel, Switzerland
| | | | | | - Bruce E. Strober
- University of Connecticut Health Center, Farmington, CT, USA
- Probity Medical Research, Waterloo, Canada
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Abstract
BACKGROUND Scalp psoriasis is commonly the initial presentation of psoriasis, and almost 80 % of patients with psoriasis will eventually experience it. OBJECTIVE Although several systematic reviews and guidelines exist, an up-to-date evidence-based review including more recent progress on the use of biologics and new oral small molecules was timely. METHODS Of the 475 studies initially retrieved from PubMed and the 845 from Embase (up to May 2016), this review includes 27 clinical trials, four papers reporting pooled analyses of other clinical trials, ten open-label trials, one case series, and two case reports after excluding non-English literature. RESULTS To our knowledge, few randomized controlled trials (RCTs) are conducted specifically in scalp psoriasis. Topical corticosteroids provide good effects and are usually recommended as first-line treatment. Calcipotriol-betamethasone dipropionate is well tolerated and more effective than either of its individual components. Localized phototherapy is better than generalized phototherapy on hair-bearing areas. Methotrexate, cyclosporine, fumaric acid esters, and acitretin are well-recognized agents in the treatment of psoriasis, but we found no published RCTs evaluating these agents specifically in scalp psoriasis. Biologics and new small-molecule agents show excellent effects on scalp psoriasis, but the high cost of these treatments mean they may be limited to use in extensive scalp psoriasis. CONCLUSIONS More controlled studies are needed for an evidence-based approach to scalp psoriasis.
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36
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Lacour JP, Paul C, Jazayeri S, Papanastasiou P, Xu C, Nyirady J, Fox T, Papavassilis C. Secukinumab administration by autoinjector maintains reduction of plaque psoriasis severity over 52 weeks: results of the randomized controlled JUNCTURE trial. J Eur Acad Dermatol Venereol 2017; 31:847-856. [PMID: 28111801 DOI: 10.1111/jdv.14073] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 11/04/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND User satisfaction is an important factor associated with treatment adherence in chronic diseases including moderate-to-severe psoriasis. OBJECTIVE To evaluate the efficacy, safety and patient acceptability of 300 and 150 mg secukinumab - a fully human anti-interleukin-17A monoclonal antibody that has demonstrated efficacy in the treatment of patients with moderate-to-severe plaque psoriasis - self-administered by autoinjection. METHODS Patients with moderate-to-severe plaque psoriasis were randomized to secukinumab 300 mg, secukinumab 150 mg or placebo self-administered by autoinjection at baseline, Weeks 1, 2 and 3 and then every 4 weeks from Week 4 to Week 48. Efficacy responses [≥75/90/100% improvement in Psoriasis Area and Severity Index (PASI 75/90/100) and clear/almost clear skin by Investigator's Global Assessment 2011 modified version (IGA mod 2011 0/1)] were measured at Week 52. Patient-reported usability of the autoinjector was evaluated by the self-injection assessment questionnaire to Week 48. RESULTS At Week 52 with secukinumab 300 mg, PASI 75/90/100 and IGA mod 2011 0/1 responses were achieved by 81.4/64.1/38.8% and 69.6% of patients, respectively, by multiple imputation. At Week 52 with secukinumab 150 mg, PASI 75/90/100 and IGA mod 2011 0/1 responses were achieved by 75.2/57.4/33.1% and 60.2% of patients, respectively, by multiple imputation. Patient-assessed acceptability of the autoinjector remained high to Week 48. The proportion of patients experiencing adverse events was greater with secukinumab 300 mg (88.6%) than with secukinumab 150 mg (78.7%). CONCLUSION Self-administration of secukinumab using an autoinjector was associated with robust and sustained efficacy, a good safety profile and high acceptability.
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Affiliation(s)
- J-P Lacour
- Department of Dermatology, University Hospital of Nice, Nice, France
| | - C Paul
- Department of Dermatology, Paul Sabatier University, Toulouse, France
| | - S Jazayeri
- Alliance Dermatology and MOHS Center, Phoenix, AZ, USA
| | | | - C Xu
- Stanford University, Stanford, CA, USA
| | - J Nyirady
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - T Fox
- Novartis Pharma AG, Basel, Switzerland
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Zhang M, Zhang N. Quality of life assessment in patients with alopecia areata and androgenetic alopecia in the People's Republic of China. Patient Prefer Adherence 2017; 11:151-155. [PMID: 28203058 PMCID: PMC5293494 DOI: 10.2147/ppa.s121218] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION In medical terms, alopecia is considered a relatively mild dermatological condition that nevertheless is a serious condition, but it causes major depression in many sufferers. Alopecia areata (AA) and androgenetic alopecia (AGA) are the main types of hair loss. This study assessed the quality of life (QoL) of Chinese patients with AA and AGA using the Dermatology Life Quality Index (DLQI) questionnaire. METHODS A total of 178 AA and AGA patients were enrolled in this study, and DLQI was used to evaluate the QoL of the patients. The DLQI used 10 items regarding symptoms and feelings, daily activities, leisure, work and school, personal relationships, and treatment as dimensions of life. Each was scored on a 0-3 scale. The total DLQI score equaled 0-30; higher scores showed greater impact on QoL. RESULTS The DLQI scores of the 178 patients ranged from 0 to 28, with a mean score of 6.3. Higher DLQI scores were reported by younger patients (P<0.05) and by those who had hair loss for a duration of >12 months (P<0.05). The DLQI score of AA patients was significantly higher than that of AGA patients (P<0.05). QoL was not affected by gender, marital status, educational level, past history of alopecia, family history of alopecia, or severity of alopecia. CONCLUSION AA and AGA moderately affected the QoL of the patients. A higher DLQI score was significantly associated with younger age, hair loss for a duration of >12 months, and AA. Both AA and AGA moderately affected the QoL of the patients not only in physiological aspects but also in their emotional and social aspects. The bio-psycho-social aspects of disease need to be addressed in patients with AA and AGA, even though these conditions are not life-threatening.
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Affiliation(s)
| | - Nan Zhang
- Department of Oncology, Jinan Central Hospital Affiliated to Shandong University, Jinan, People’s Republic of China
- Correspondence: Nan Zhang, Department of Oncology, Jinan Central Hospital Affiliated to Shandong University, Jinan 250012, People’s Republic of China, Tel +86 133 7058 2850, Email
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38
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Feldman SR, Thaçi D, Gooderham M, Augustin M, de la Cruz C, Mallbris L, Buonanno M, Tatulych S, Kaur M, Lan S, Valdez H, Mamolo C. Tofacitinib improves pruritus and health-related quality of life up to 52 weeks: Results from 2 randomized phase III trials in patients with moderate to severe plaque psoriasis. J Am Acad Dermatol 2016; 75:1162-1170.e3. [DOI: 10.1016/j.jaad.2016.07.040] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 06/16/2016] [Accepted: 07/22/2016] [Indexed: 11/25/2022]
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39
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Torii H, Nakano M, Yano T, Kondo K, Nakagawa H. Efficacy and safety of dose escalation of infliximab therapy in Japanese patients with psoriasis: Results of the SPREAD study. J Dermatol 2016; 44:552-559. [PMID: 27882586 PMCID: PMC5434916 DOI: 10.1111/1346-8138.13698] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 10/11/2016] [Indexed: 12/11/2022]
Abstract
Although infliximab is approved for psoriasis, its efficacy is reduced over time in some patients. The aim of this phase III trial is to evaluate efficacy and safety of infliximab dose escalation in Japanese psoriasis patients with loss of efficacy to standard‐dose therapy. Patients with plaque psoriasis, psoriatic arthritis, pustular psoriasis or psoriatic erythroderma who showed loss of efficacy to standard‐dose therapy received infliximab dose escalation (10 mg/kg every 8 weeks) from weeks 0 to 32. Loss of efficacy was defined as not maintaining 50% reduction in the Psoriasis Area and Severity Index (PASI 50) after achieving PASI 75. Efficacy and safety were evaluated up to week 40. Fifty‐one patients received dose escalation and 43 completed the study. PASI 75 and median improvement rate of PASI score at week 40 were 44% and 70.0%, respectively, showing efficacy in skin symptoms. Efficacies in quality of life, nail psoriasis and joint pain were also obtained. Median serum infliximab level increased from less than 0.1 to 1.1 μg/mL from weeks 0 to 40, showing positive correlation between efficacy and serum infliximab level at week 40. Favorable efficacy was observed in patients with detectable serum infliximab levels (≥0.1 μg/mL) at baseline. Incidences of adverse events, serious adverse events, serious infections and serious infusion reactions were 92%, 10%, 4% and 0%, respectively. No marked difference was observed in both efficacy and safety among psoriasis types. No new safety concerns were observed. Infliximab dose escalation was effective and well‐tolerated in psoriasis patients with loss of efficacy to standard‐dose therapy, suggesting that dose escalation may be a useful therapeutic option for these patients.
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Affiliation(s)
- Hideshi Torii
- Division of Dermatology, Tokyo Yamate Medical Center, Tokyo, Japan
| | - Masayuki Nakano
- Sohyaku Innovative Research Division, Mitsubishi Tanabe Pharma, Tokyo, Japan
| | - Toshiro Yano
- Ikuyaku Integrated Value Developmental Division, Mitsubishi Tanabe Pharma, Osaka, Japan
| | - Kazuoki Kondo
- Sohyaku Innovative Research Division, Mitsubishi Tanabe Pharma, Tokyo, Japan
| | - Hidemi Nakagawa
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
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40
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Reich K, Leonardi C, Lebwohl M, Kerdel F, Okubo Y, Romiti R, Goldblum O, Dennehy EB, Kerr L, Sofen H. Sustained response with ixekizumab treatment of moderate-to-severe psoriasis with scalp involvement: results from three phase 3 trials (UNCOVER-1, UNCOVER-2, UNCOVER-3). J DERMATOL TREAT 2016; 28:282-287. [DOI: 10.1080/09546634.2016.1249820] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Kristian Reich
- Dermatologikum Hamburg and SCIderm GmbH, Hamburg, Germany
| | - Craig Leonardi
- Department of Dermatology, Saint Louis University School of Medicine, St Louis, MO, USA
| | - Mark Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Yukari Okubo
- Department of Dermatology, Tokyo Medical University, Shinjuku, Tokyo, Japan
| | - Ricardo Romiti
- Department of Dermatology Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Lisa Kerr
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Howard Sofen
- Department of Medicine, Division of Dermatology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
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Puig L, Thom H, Mollon P, Tian H, Ramakrishna G. Clear or almost clear skin improves the quality of life in patients with moderate-to-severe psoriasis: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2016; 31:213-220. [DOI: 10.1111/jdv.14007] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 07/22/2016] [Indexed: 01/19/2023]
Affiliation(s)
- L. Puig
- Department of Dermatology; Hospital de la Santa Creu i Sant Pau; Universitat Autonoma de Barcelona Medical School; Barcelona Spain
| | - H. Thom
- School of Social and Community Medicine; University of Bristol; Bristol UK
| | - P. Mollon
- Global Patient Access; Novartis Pharma AG; Basel Switzerland
| | - H. Tian
- Global Medical Affairs; Novartis Pharmaceuticals Corporation; One Health Plaza East Hanover NJ USA
| | - G.S. Ramakrishna
- Patient Access Services; Novartis Healthcare Private Limited; Hyderabad India
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Zweegers J, Roosenboom B, van de Kerkhof P, van den Reek J, Otero M, Atalay S, Kuijpers A, Koetsier M, Arnold W, Berends M, Weppner-Parren L, Bijen M, Njoo M, Mommers J, van Lümig P, Driessen R, Kievit W, de Jong E. Frequency and predictors of a high clinical response in patients with psoriasis on biological therapy in daily practice: results from the prospective, multicenter BioCAPTURE cohort. Br J Dermatol 2016; 176:786-793. [DOI: 10.1111/bjd.14888] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2016] [Indexed: 01/24/2023]
Affiliation(s)
- J. Zweegers
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - B. Roosenboom
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - P.C.M. van de Kerkhof
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - J.M.P.A. van den Reek
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - M.E. Otero
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - S. Atalay
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | | | | | - W.P. Arnold
- Ziekenhuis Gelderse Vallei; Ede the Netherlands
| | - M.A. Berends
- Slingeland Ziekenhuis; Doetinchem the Netherlands
| | | | - M. Bijen
- Ziekenhuisgroep Twente; Almelo/Hengelo the Netherlands
| | - M.D. Njoo
- Ziekenhuisgroep Twente; Almelo/Hengelo the Netherlands
| | | | - P.P.M. van Lümig
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - R.J.B. Driessen
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
| | - W. Kievit
- Department of Epidemiology, Biostatistics and Health Technology Assessment; Radboud University Medical Center; Nijmegen the Netherlands
| | - E.M.G.J. de Jong
- Department of Dermatology; Radboud University Medical Center; Nijmegen the Netherlands
- Radboud University Nijmegen; Nijmegen the Netherlands
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Yamasaki K, Nakagawa H, Kubo Y, Ootaki K. Efficacy and safety of brodalumab in patients with generalized pustular psoriasis and psoriatic erythroderma: results from a 52-week, open-label study. Br J Dermatol 2016; 176:741-751. [DOI: 10.1111/bjd.14702] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2016] [Indexed: 12/19/2022]
Affiliation(s)
- K. Yamasaki
- Department of Dermatology; Tohoku University Graduate School of Medicine; Tohoku University Hospital; 1-1 Seiryo-cho Aoba-ku Sendai Miyagi 980-8574 Japan
| | - H. Nakagawa
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - Y. Kubo
- Department of Dermatology; Institute of Biomedical Sciences; Tokushima University Graduate School; Tokushima Japan
| | - K. Ootaki
- Kyowa Hakko Kirin Co. Ltd; Tokyo Japan
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44
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Masaki S, Tatsukawa R, Uryu M, Takahara M, Furue M, Ohata C, Nakama T, Hino R, Nakamura M, Nakayama J, Imafuku S. Treatment satisfaction, willingness to pay and quality of life in Japanese patients with psoriasis. J Dermatol 2016; 44:143-146. [PMID: 27599656 DOI: 10.1111/1346-8138.13541] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 06/27/2016] [Indexed: 01/30/2023]
Abstract
There is a range of psoriasis treatments available, from topical applications to biologic therapy, with corresponding cost variations. The efficacy of each treatment is usually evaluated by objective measures such as the Psoriasis Area and Severity Index (PASI) or subjective measures such as the Dermatology Life Quality Index (DLQI). However, the social and economic impacts of psoriasis, including cost-effectiveness, have not been assessed in Japan. The EuroQol 5-Dimension (EQ-5D) is a generic instrument used worldwide to calculate quality-adjusted life years, on which calculations of treatment cost-effectiveness are based. We conducted a pilot study to determine the cost-effectiveness of psoriasis treatment in Japan. We administered a questionnaire to 133 patients with psoriasis (105 men and 28 women) who visited four university hospitals in Fukuoka Prefecture. The questionnaire covered medical costs, satisfaction and willingness to pay (WTP), and we investigated the relationships between these items. PASI was evaluated by physicians. More participants indicated satisfaction with treatment in the group paying less than ¥5000/month. WTP, PASI and EQ-5D showed little correlation. However, the DLQI and EQ-5D showed a moderate correlation (r = 0.472). WTP seemed more dependent on participants' economic backgrounds. We found that it was difficult to reflect the PASI with the EQ-5D. However, the DLQI may be used to estimate the cost-benefit relationship in patients with psoriasis. This is the first study to evaluate the EQ-5D in patients with psoriasis in Japan.
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Affiliation(s)
- Saori Masaki
- Department of Dermatology, Fukuoka University, Fukuoka, Japan
| | - Ryoko Tatsukawa
- Department of Dermatology, Fukuoka University, Fukuoka, Japan
| | - Miki Uryu
- Department of Dermatology, Kyusyu University, Fukuoka, Japan
| | | | - Masutaka Furue
- Department of Dermatology, Kyusyu University, Fukuoka, Japan
| | - Chika Ohata
- Kurume University School of Medicine, Kurume, Japan
| | | | - Ryosuke Hino
- Department of Dermatology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Motonobu Nakamura
- Department of Dermatology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Juichiro Nakayama
- Department of General Medical Study Center, Fukuoka University, Fukuoka, Japan
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45
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Gordon KB, Blauvelt A, Papp KA, Langley RG, Luger T, Ohtsuki M, Reich K, Amato D, Ball SG, Braun DK, Cameron GS, Erickson J, Konrad RJ, Muram TM, Nickoloff BJ, Osuntokun OO, Secrest RJ, Zhao F, Mallbris L, Leonardi CL. Phase 3 Trials of Ixekizumab in Moderate-to-Severe Plaque Psoriasis. N Engl J Med 2016; 375:345-56. [PMID: 27299809 DOI: 10.1056/nejmoa1512711] [Citation(s) in RCA: 578] [Impact Index Per Article: 72.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Two phase 3 trials (UNCOVER-2 and UNCOVER-3) showed that at 12 weeks of treatment, ixekizumab, a monoclonal antibody against interleukin-17A, was superior to placebo and etanercept in the treatment of moderate-to-severe psoriasis. We report the 60-week data from the UNCOVER-2 and UNCOVER-3 trials, as well as 12-week and 60-week data from a third phase 3 trial, UNCOVER-1. METHODS We randomly assigned 1296 patients in the UNCOVER-1 trial, 1224 patients in the UNCOVER-2 trial, and 1346 patients in the UNCOVER-3 trial to receive subcutaneous injections of placebo (placebo group), 80 mg of ixekizumab every 2 weeks after a starting dose of 160 mg (2-wk dosing group), or 80 mg of ixekizumab every 4 weeks after a starting dose of 160 mg (4-wk dosing group). Additional cohorts in the UNCOVER-2 and UNCOVER-3 trials were randomly assigned to receive 50 mg of etanercept twice weekly. At week 12 in the UNCOVER-3 trial, the patients entered a long-term extension period during which they received 80 mg of ixekizumab every 4 weeks through week 60; at week 12 in the UNCOVER-1 and UNCOVER-2 trials, the patients who had a response to ixekizumab (defined as a static Physicians Global Assessment [sPGA] score of 0 [clear] or 1 [minimal psoriasis]) were randomly reassigned to receive placebo, 80 mg of ixekizumab every 4 weeks, or 80 mg of ixekizumab every 12 weeks through week 60. Coprimary end points were the percentage of patients who had a score on the sPGA of 0 or 1 and a 75% or greater reduction from baseline in Psoriasis Area and Severity Index (PASI 75) at week 12. RESULTS In the UNCOVER-1 trial, at week 12, the patients had better responses to ixekizumab than to placebo; in the 2-wk dosing group, 81.8% had an sPGA score of 0 or 1 and 89.1% had a PASI 75 response; in the 4-wk dosing group, the respective rates were 76.4% and 82.6%; and in the placebo group, the rates were 3.2% and 3.9% (P<0.001 for all comparisons of ixekizumab with placebo). In the UNCOVER-1 and UNCOVER-2 trials, among the patients who were randomly reassigned at week 12 to receive 80 mg of ixekizumab every 4 weeks, 80 mg of ixekizumab every 12 weeks, or placebo, an sPGA score of 0 or 1 was maintained by 73.8%, 39.0%, and 7.0% of the patients, respectively. Patients in the UNCOVER-3 trial received continuous treatment of ixekizumab from weeks 0 through 60, and at week 60, at least 73% had an sPGA score of 0 or 1 and at least 80% had a PASI 75 response. Adverse events reported during ixekizumab use included neutropenia, candidal infections, and inflammatory bowel disease. CONCLUSIONS In three phase 3 trials involving patients with psoriasis, ixekizumab was effective through 60 weeks of treatment. As with any treatment, the benefits need to be weighed against the risks of adverse events. The efficacy and safety of ixekizumab beyond 60 weeks of treatment are not yet known. (Funded by Eli Lilly; UNCOVER-1, UNCOVER-2, and UNCOVER-3 ClinicalTrials.gov numbers NCT01474512, NCT01597245, and NCT01646177, respectively.).
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Affiliation(s)
- Kenneth B Gordon
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
| | - Andrew Blauvelt
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
| | - Kim A Papp
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
| | - Richard G Langley
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
| | - Thomas Luger
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
| | - Mamitaro Ohtsuki
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
| | - Kristian Reich
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
| | - David Amato
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
| | - Susan G Ball
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
| | - Daniel K Braun
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
| | - Gregory S Cameron
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
| | - Janelle Erickson
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
| | - Robert J Konrad
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
| | - Talia M Muram
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
| | - Brian J Nickoloff
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
| | - Olawale O Osuntokun
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
| | - Roberta J Secrest
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
| | - Fangyi Zhao
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
| | - Lotus Mallbris
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
| | - Craig L Leonardi
- From the Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago (K.B.G.); Oregon Medical Research Center, Portland (A.B.); K. Papp Clinical Research and Probity Medical Research, Waterloo, ON (K.A.P.), and the Department of Medicine, Division of Dermatology, Dalhousie University, Halifax, NS (R.G.L.) - both in Canada; the Department of Dermatology, University of Münster, Münster (T.L.), and SCIderm Research Institute and Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany; the Department of Dermatology, Jichi Medical University, Shimotsuke-shi, Japan (M.O.); Lilly Research Laboratories, Eli Lilly, Indianapolis (D.A., S.G.B., D.K.B., G.S.C., J.E., R.J.K., T.M.M., B.J.N., O.O.O., R.J.S., F.Z., L.M.); and the Department of Dermatology, Saint Louis University School of Medicine, St. Louis (C.L.L.)
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Abstract
Nail involvement affects 80-90 % of patients with plaque psoriasis, and is even more prevalent in patients with psoriatic arthritis. This review is the result of a systemic approach to the literature and covers topical, intralesional, conventional systemic, and biologic systemic treatments, as well as non-pharmacological treatment options for nail psoriasis. The available evidence suggests that all anti-tumor necrosis factor-α, anti-interleukin (IL)-17, and anti-IL-12/23 antibodies which are available for plaque psoriasis and psoriatic arthritis are highly effective treatments for nail psoriasis. Conventional systemic treatments, including methotrexate, cyclosporine, acitretin, and apremilast, as well as intralesional corticosteroids, can also be effective treatments for nail psoriasis. Topical treatments, including corticosteroids, calcipotriol, tacrolimus, and tazarotene, have also been shown to have a position in the treatment of nail psoriasis, particularly in mild cases. Finally, non-pharmacological treatment options, including phototherapy, photodynamic therapy, laser therapy, and several radiotherapeutic options, are also reviewed but cannot be advised as first-line treatment options. Another conclusion of this review is that the lack of a reliable core set of outcomes measures for trials in nail psoriasis hinders the interpretation of results, and is urgently needed.
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Affiliation(s)
- Marcel C Pasch
- Department of Dermatology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen (370), The Netherlands.
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Canavan TN, Elmets CA, Cantrell WL, Evans JM, Elewski BE. Anti-IL-17 Medications Used in the Treatment of Plaque Psoriasis and Psoriatic Arthritis: A Comprehensive Review. Am J Clin Dermatol 2016; 17:33-47. [PMID: 26649440 DOI: 10.1007/s40257-015-0162-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Our ability to successfully treat patients with moderate to severe psoriasis has improved significantly over the last several years with the development of more targeted therapies. IL-17A, a member of the IL-17 family of interleukins, is involved in regulating the innate and adaptive immune systems and has been identified as a key cytokine involved in the pathogenesis of psoriasis and psoriatic arthritis. In this review, we summarize our understanding of IL-17 and its role in psoriasis and psoriatic arthritis, as well as key findings from clinical trials using anti-IL-17 medications for the treatment of the aforementioned diseases. Secukinumab, ixekizumab, and brodalumab are three anti-IL-17 medications used for treating psoriasis, of which only secukinumab is FDA approved; ixekizumab and brodalumab remain under clinical development. Results from clinical trials show that these three medications are highly effective in treating psoriasis and appear to be as safe as other biologic treatments that are FDA approved.
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MESH Headings
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/adverse effects
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/therapeutic use
- Arthritis, Psoriatic/drug therapy
- Biological Products/adverse effects
- Biological Products/therapeutic use
- Clinical Trials, Phase II as Topic
- Clinical Trials, Phase III as Topic
- Humans
- Interleukin-17/antagonists & inhibitors
- Interleukin-17/metabolism
- Molecular Targeted Therapy
- Psoriasis/drug therapy
- Signal Transduction
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Affiliation(s)
- Theresa N Canavan
- Department of Dermatology, The Kirklin Clinic, University of Alabama at Birmingham, 2000 6th Ave South 3rd floor Dermatology, Birmingham, AL, USA
| | - Craig A Elmets
- Department of Dermatology, The Kirklin Clinic, University of Alabama at Birmingham, 2000 6th Ave South 3rd floor Dermatology, Birmingham, AL, USA
| | - Wendy L Cantrell
- Department of Dermatology, The Kirklin Clinic, University of Alabama at Birmingham, 2000 6th Ave South 3rd floor Dermatology, Birmingham, AL, USA
| | - John M Evans
- Department of Dermatology, The Kirklin Clinic, University of Alabama at Birmingham, 2000 6th Ave South 3rd floor Dermatology, Birmingham, AL, USA
| | - Boni E Elewski
- Department of Dermatology, The Kirklin Clinic, University of Alabama at Birmingham, 2000 6th Ave South 3rd floor Dermatology, Birmingham, AL, USA.
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48
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Brodalumab, a human anti-interleukin-17-receptor antibody in the treatment of Japanese patients with moderate-to-severe plaque psoriasis: Efficacy and safety results from a phase II randomized controlled study. J Dermatol Sci 2016; 81:44-52. [DOI: 10.1016/j.jdermsci.2015.10.009] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 09/18/2015] [Accepted: 10/13/2015] [Indexed: 12/17/2022]
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49
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Providing Guidance for Patients With Moderate-to-Severe Psoriasis Who Are Candidates for Biologic Therapy. JOURNAL OF THE DERMATOLOGY NURSES' ASSOCIATION 2016; 8:14-26. [PMID: 27004085 PMCID: PMC4770271 DOI: 10.1097/jdn.0000000000000185] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Psoriasis is a chronic, immune-mediated disease characterized by itchy, scaly, and often painful plaques in the skin. Psoriasis can have significant psychosocial burdens and increased risks for numerous comorbidities, including diabetes, hypertension, and cardiovascular disease, particularly in patients with moderate-to-severe disease. Dermatology nurse practitioners and physician assistants are an important part of the healthcare team, contributing to all aspects of psoriasis management. This review reinforces the unique aspects of care that nurse practitioners and physician assistants provide to patients with psoriasis, such as facilitating conversations about managing disease, setting appropriate expectations, and considering treatment options, including when treatment response or tolerability is suboptimal. The importance of relationship building is stressed. Patient management topics discussed include helpful tips about assessing treatment options, initiating biologic therapy, optimizing patient adherence, and managing comorbidities. Also reviewed are how to deal with common barriers including lack of knowledge about psoriasis or making healthy lifestyle changes, fear of injections or side effect risks, lack of health insurance, and concerns about treatment costs. Overall, by forming meaningful relationships and engaging patients in their psoriasis care, nurse practitioners and physician assistants can help to optimize clinical efficacy outcomes and consistently manage moderate-to-severe psoriasis and its comorbidities over the patient’s life course.
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50
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Dannepond C, Ternant D, Maruani A, Machet L, Paintaud G, Samimi M. Serum infliximab concentrations and disease activity: a descriptive study of patients with psoriasis. Br J Dermatol 2015; 174:198-200. [DOI: 10.1111/bjd.13831] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- C. Dannepond
- Dermatology Department University François Rabelais Hospital of Tours Tours France
| | - D. Ternant
- CNRS GICC UMR 7292 Laboratory of Pharmacology Toxicology Hospital of Tours Tours France
| | - A. Maruani
- Dermatology Department University François Rabelais Hospital of Tours Tours France
- INSERM Imagerie et Cerveau UMR U930 Tours France
| | - L. Machet
- Dermatology Department University François Rabelais Hospital of Tours Tours France
- INSERM Imagerie et Cerveau UMR U930 Tours France
| | - G. Paintaud
- CNRS GICC UMR 7292 Laboratory of Pharmacology Toxicology Hospital of Tours Tours France
| | - M. Samimi
- Dermatology Department University François Rabelais Hospital of Tours Tours France
- INRA ISP UMR 1282 Université François Rabelais Tours France
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