1
|
Ioannides D, Antonakopoulos N, Georgiou S, Chasapi V, Katsantonis I, Drosos A, Rigopoulos D, Antoniou C, Anastasiadis G, Bassukas I, Ioannidou D, Protopapa A, Neofotistou O, Krasagakis K, Aronis P, Papageorgiou M, Lazaridou E, Patsatsi A, Lefaki I, Roussaki-Schulze AV, Satra F, Anagnostopoulos Z, Papakonstantis M. Effectiveness and safety of apremilast in biologic-naïve patients with moderate psoriasis treated in routine clinical practice in Greece: the APRAISAL study. J Eur Acad Dermatol Venereol 2021; 35:1838-1848. [PMID: 34036627 DOI: 10.1111/jdv.17392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/28/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Apremilast is an oral phosphodiesterase-4 inhibitor indicated for patients with moderate-to-severe chronic plaque psoriasis and active psoriatic arthritis. OBJECTIVES To examine the effectiveness of apremilast on Dermatology Life Quality Index (DLQI), Psoriasis Area and Severity Index (PASI) and nail, scalp and palmoplantar involvement, when administered prior to biologics. METHODS This 52-week real-world study included biologic-naive adults with moderate psoriasis (psoriasis-involved body surface area 10% to <20%, or PASI 10 to <20 and DLQI 10 to <20). Apremilast was initiated ≤7 days before enrolment. Data from the first 100 eligible patients who completed 24 weeks (W24) of observation (or were prematurely withdrawn) are presented in this interim analysis using the last-observation-carried-forward imputation method. RESULTS Eligible patients (mean age: 49.9 years; 71.0% males; median disease duration: 8.0 years) were consecutively enrolled between April and October 2017, by 18 dermatology specialists practising in hospital outpatient settings in Greece. Baseline DLQI (median: 12.0) and PASI (median: 11.7) scores improved (P < 0.001) at all postbaseline timepoints (Weeks 6, 16 and 24; W24 median decreases: 9.0 and 9.4 points respectively). At W24, DLQI ≤5, DLQI 0 or 1, and PASI-75 response rates were 63.0%, 25.0% and 48.0% respectively. The Nail Psoriasis Severity Index score in patients with baseline nail involvement (n = 57) decreased at all postbaseline timepoints (P < 0.001; W24 median decrease: 20.0 points). At W24, 50.0% and 51.7% of patients with baseline scalp (n = 76) and palmoplantar (n = 29) involvement respectively achieved postbaseline Physician's Global Assessment (PGA) score of 0 or 1 if baseline score was ≥3, or 0 if baseline score was 1 or 2. The adverse drug reaction rate was 21.0% (serious: 2.0%). CONCLUSIONS These interim results indicate that through 24 weeks, apremilast improved quality of life and reduced disease severity in biologic-naive patients with moderate plaque psoriasis, while demonstrating safety consistent with the known safety profile.
Collapse
Affiliation(s)
- D Ioannides
- 1st University Department of Dermatology, Aristotle University of Thessaloniki, Hospital of Venereal & Skin Diseases of Thessaloniki, Thessaloniki, Greece
| | | | - S Georgiou
- Department of Dermatology, University General Hospital of Patras, Patras, Greece
| | - V Chasapi
- Dermatology and Venereology Department of N.H.S, 'Andreas Sygros' Hospital Athens, Athens, Greece
| | - I Katsantonis
- Dermatology Unit, Piraeus Regional General Hospital 'Tzaneio', Piraeus, Greece
| | - A Drosos
- Department of Dermatology, General Hospital of Xanthi, Xanthi, Greece
| | - D Rigopoulos
- 1st Department of Dermatology & Venereology, National Kapodistrian University of Athens, 'Andreas Sygros' Hospital, Athens, Greece
| | - C Antoniou
- 1st Department of Dermatology & Venereology, National Kapodistrian University of Athens, 'Andreas Sygros' Hospital, Athens, Greece
| | - G Anastasiadis
- Department of Dermatology, General Hospital of Athens 'Evangelismos', Athens, Greece
| | - I Bassukas
- Department of Skin and Venereal Diseases, University of Ioannina, Ioannina, Greece
| | - D Ioannidou
- Department of Dermatology and Venereology, General Hospital of Heraklion 'Venizeleio- Pananeio', Heraklion, Greece
| | - A Protopapa
- Outpatient Department of Dermatology, General Hospital of Sitia, Sitia, Greece
| | - O Neofotistou
- Dermatology Department, Konstantopoulio District General Hospital of Nea Ionia, Athens, Greece
| | - K Krasagakis
- Department of Dermatology, University General Hospital of Heraklion, Heraklion, Greece
| | - P Aronis
- Clinical Dermatology, Hellenic Airforce 251 General Hospital, Athens, Greece
| | - M Papageorgiou
- State Department of Dermatology, Hospital of Venereal & Skin Diseases of Thessaloniki, Thessaloniki, Greece
| | - E Lazaridou
- 2nd University Department of Dermatology, Aristotle University of Thessaloniki, General Hospital of Thessaloniki 'Papageorgiou', Thessaloniki, Greece
| | - A Patsatsi
- 2nd University Department of Dermatology, Aristotle University of Thessaloniki, General Hospital of Thessaloniki 'Papageorgiou', Thessaloniki, Greece
| | - I Lefaki
- Dermatology Unit, 'EUROMEDICA' General Clinic, Thessaloniki, Greece
| | - A V Roussaki-Schulze
- University Clinic of Dermatology, University General Hospital of Larissa, Larissa, Greece
| | - F Satra
- Genesis Pharma, Athens, Greece
| | | | - M Papakonstantis
- Clinic of Dermatology, 401 General Military Hospital of Athens, Athens, Greece
| |
Collapse
|
2
|
Abstract
Stratified medicine is the tailoring of treatment to the individual characteristics of each patient. This is a challenging task in the context of psoriasis, a complex disease with a variety of phenotypic presentations and a comorbidity burden that extends beyond cutaneous manifestations. In recent years, considerable progress has been made in understanding the immunology of psoriasis, and this has informed the development of increasingly precise and efficacious therapies. However, not all patients respond to biologic therapy, and access is limited to patients with moderate to severe disease. However, subpopulations of patients are emerging with distinct patterns of response to therapy, largely determined by clinical and pharmacogenomic factors. Despite progress to date, the natural history of psoriasis remains poorly understood. It is likely that disease onset, progression, development of comorbidities and response to therapy are due to a combination of genetic, inflammatory and environmental factors. We envision that a greater understanding of the natural history of psoriasis will be a key factor in progressing a stratified medicine approach to patient care, as will earlier intervention in the course of the disease.
Collapse
|
3
|
Maul J, Navarini A, Sommer R, Anzengruber F, Sorbe C, Mrowietz U, Drach M, Blome C, Boehncke W, Thaci D, Reich K, Kiedrowski R, Körber A, Yawalkar N, Mainetti C, Laffitte E, Streit M, Rustenbach S, Conrad C, Borradori L, Gilliet M, Cozzio A, Itin P, Häusermann P, French L, Radtke M, Augustin M. Gender and age significantly determine patient needs and treatment goals in psoriasis – a lesson for practice. J Eur Acad Dermatol Venereol 2019; 33:700-708. [DOI: 10.1111/jdv.15324] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 10/04/2018] [Indexed: 11/28/2022]
Affiliation(s)
- J.‐T. Maul
- Department of Dermatology University Hospital Zurich Zurich Switzerland
| | - A.A. Navarini
- Department of Dermatology University Hospital Zurich Zurich Switzerland
| | - R. Sommer
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - F. Anzengruber
- Department of Dermatology University Hospital Zurich Zurich Switzerland
| | - C. Sorbe
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - U. Mrowietz
- Department of Dermatology University Medical Center Schleswig‐Holstein Kiel Germany
| | - M. Drach
- Department of Dermatology University Hospital Zurich Zurich Switzerland
| | - C. Blome
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - W.‐H. Boehncke
- Department of Dermatology and Venereology Geneva University Hospitals Geneva Switzerland
- Department of Pathology and Immunology Geneva University Hospitals Geneva Switzerland
| | - D. Thaci
- Comprehensive Center for Inflammation Medicine University Hospital Schleswig‐Holstein Lübeck Germany
| | - K. Reich
- Dermatologikum Berlin and SCIderm Research Institute Hamburg Germany
| | | | - A. Körber
- Dermatology Practice Essen Essen Germany
| | - N. Yawalkar
- Department of Dermatology Inselspital University Hospital Bern University of Bern Bern Switzerland
| | - C. Mainetti
- Department of Dermatology Regional Hospital Bellinzona Bellinzona Switzerland
| | - E. Laffitte
- Department of Dermatology and Venereology Geneva University Hospitals Geneva Switzerland
| | - M. Streit
- Department of Dermatology Cantonal Hospital Aarau Aarau Switzerland
| | - S. Rustenbach
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - C. Conrad
- Department of Dermatology University Hospital Lausanne Lausanne Switzerland
| | - L. Borradori
- Department of Dermatology Inselspital University Hospital Bern University of Bern Bern Switzerland
| | - M. Gilliet
- Department of Dermatology University Hospital Lausanne Lausanne Switzerland
| | - A. Cozzio
- Department of Dermatology Cantonal Hospital St. Gallen St. Gallen Switzerland
| | - P. Itin
- Department of Dermatology University Hospital Basel Basel Switzerland
| | - P. Häusermann
- Department of Dermatology University Hospital Basel Basel Switzerland
| | - L.E. French
- Department of Dermatology University Hospital Zurich Zurich Switzerland
| | - M.A. Radtke
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| |
Collapse
|
4
|
Wolf P, Weger W, Legat F, Painsi C, Saxinger W, Müllegger R, Sator P, Ratzinger G, Selhofer S, Richter L, Salmhofer W, Lange-Asschenfeldt B, Trautinger F, Mlynek A, Strohal R, Augustin M, Quehenberger F. Quality of life and treatment goals in psoriasis from the patient perspective: results of an Austrian cross-sectional survey. J Dtsch Dermatol Ges 2018; 16:981-990. [PMID: 30117711 DOI: 10.1111/ddg.13613] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 02/06/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients with psoriasis experience impairment in quality of life. Thus, high-quality dermatological care is of particular importance. PATIENTS AND METHODS We performed a nationwide cross-sectional survey in Austria (BQSAustria Psoriasis 2014/2015) with a special focus on quality of life and satisfaction with treatment among psoriasis patients predominantly treated at tertiary care centers. RESULTS Overall, 70.2 % of 1,184 patients reported impaired quality of life (DLQI 2-5: 29.4 %; 6-10: 19.3 %; 11-15: 11.5 %; 16-20: 5.2 % and > 20: 4.9 %) despite treatment over the preceding four weeks (topical treatment in 88.2 % of cases and/or systemic treatment in 38.7 %). On average, none of the 25 defined subjective treatment goals was achieved to a sufficient degree. In particular, 82.2 % of patients continued to have pruritus despite treatment, which was highly significantly associated with a poor general health status over the preceding week (Spearman's rank correlation; p = 1.1e-45), the extent of body surface area (p = 3.2e-11) and scalp area (p = 3.2e-11) affected, as well as pain (p = 2.3e-22). Treatment with a biologic was significantly correlated with higher patient satisfaction (Wilcoxon-Test, p = 2.0e-16). CONCLUSIONS Despite dermatological care, the majority of Austrian psoriasis patients continues to experience impaired quality of life; there is potential for improvement in the achievement of treatment goals.
Collapse
Affiliation(s)
- Peter Wolf
- Department of Dermatology and Venereology, Graz Medical University, Graz, Austria
| | - Wolfgang Weger
- Department of Dermatology and Venereology, Graz Medical University, Graz, Austria
| | - Franz Legat
- Department of Dermatology and Venereology, Graz Medical University, Graz, Austria.,Kurhaus Bad Gleichenberg, Bad Gleichenberg, Austria
| | - Clemens Painsi
- Department of Dermatology and Venereology, Graz Medical University, Graz, Austria.,Department of Dermatology and Venereology, Klagenfurt Medical Center, Klagenfurt, Austria
| | - Werner Saxinger
- Department of Dermatology and Venereology, Wels-Grieskirchen Medical Center, Wels, Austria
| | - Robert Müllegger
- Department of Dermatology and Venereology, State Medical Center, Wiener Neustadt, Austria
| | - Paul Sator
- Department of Dermatology, Hietzing Hospital, Vienna, Austria
| | - Gudrun Ratzinger
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Austria
| | - Sylvia Selhofer
- Department of Dermatology, Paracelsus Private Medical University, Salzburg, Austria
| | - Leo Richter
- Department of Dermatology and Venereology, The Rudolfstiftung Hospital, Vienna, Austria
| | - Wolfgang Salmhofer
- Department of Dermatology and Venereology, Graz Medical University, Graz, Austria
| | | | - Franz Trautinger
- Department of Dermatology and Venereology, University Medical Center St. Pölten, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Alexander Mlynek
- Department of Dermatology, Elisabethinen Medical Center, Linz, Austria
| | - Robert Strohal
- Department of Dermatology and Venereology, State Hospital and Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franz Quehenberger
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| |
Collapse
|
5
|
Wolf P, Weger W, Legat F, Painsi C, Saxinger W, Müllegger R, Sator P, Ratzinger G, Selhofer S, Richter L, Salmhofer W, Lange‐Asschenfeldt B, Trautinger F, Mlynek A, Strohal R, Augustin M, Quehenberger F. Lebensqualität und Behandlungsziele bei Psoriasis aus Patientensicht: Ergebnisse eines österreichweiten Querschnitt‐Survey. J Dtsch Dermatol Ges 2018; 16:981-991. [DOI: 10.1111/ddg.13613_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 02/06/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Peter Wolf
- Universitätsklinik für Dermatologie und VenerologieMedizinische Universität Graz Graz Österreich
| | - Wolfgang Weger
- Universitätsklinik für Dermatologie und VenerologieMedizinische Universität Graz Graz Österreich
| | - Franz Legat
- Universitätsklinik für Dermatologie und VenerologieMedizinische Universität Graz Graz Österreich
- Das Kurhaus Bad GleichenbergBad Gleichenberg Österreich
| | - Clemens Painsi
- Universitätsklinik für Dermatologie und VenerologieMedizinische Universität Graz Graz Österreich
- Abteilung für Dermatologie und VenerologieKlinikum Klagenfurt am Wörthersee Klagenfurt Österreich
| | - Werner Saxinger
- Abteilung für Haut‐ und GeschlechtskrankheitenKlinikum Wels‐Grieskirchen Wels Österreich
| | - Robert Müllegger
- Abteilung für Dermatologie und VenerologieLandesklinikum Wiener Neustadt Wiener Neustadt Österreich
| | - Paul Sator
- Dermatologische AbteilungKrankenhaus Hietzing Wien Österreich
| | - Gudrun Ratzinger
- Universitätsklinik für DermatologieVenerologie und AllergologieMedizinische Universität Innsbruck Innsbruck Österreich
| | - Sylvia Selhofer
- Universitätsklinik für DermatologieParacelsus Medizinische Privatuniversität Salzburg Salzburg Österreich
| | - Leo Richter
- Abteilung für Dermatologie und VenerologieKrankenanstalt Wien‐Rudolfstiftung Wien Österreich
| | - Wolfgang Salmhofer
- Universitätsklinik für Dermatologie und VenerologieMedizinische Universität Graz Graz Österreich
| | | | - Franz Trautinger
- Abteilung für Haut‐ und GeschlechtskrankheitenUniversitätsklinikum St. Pölten, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften Krems Österreich
| | - Alexander Mlynek
- Abteilung für DermatologieOrdensklinikum Linz – Elisabethinen Linz Österreich
| | - Robert Strohal
- Abteilung für Dermatologie und VenerologieLandeskrankenhaus Feldkirch – Akademisches Lehrspital Feldkirch Österreich
| | - Matthias Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei PflegeberufenUniversitätsklinikum Hamburg‐Eppendorf Hamburg Deutschland
| | - Franz Quehenberger
- Institut für Medizinische InformatikStatistik und DokumentationMedizinische Universität Graz, Graz Österreich
| |
Collapse
|
6
|
Florek AG, Wang CJ, Armstrong AW. Treatment preferences and treatment satisfaction among psoriasis patients: a systematic review. Arch Dermatol Res 2018; 310:271-319. [DOI: 10.1007/s00403-018-1808-x] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 12/21/2017] [Accepted: 01/12/2018] [Indexed: 12/01/2022]
|
7
|
Wang J, Suárez-Fariñas M, Estrada Y, Parker ML, Greenlees L, Stephens G, Krueger J, Guttman-Yassky E, Howell MD. Identification of unique proteomic signatures in allergic and non-allergic skin disease. Clin Exp Allergy 2017; 47:1456-1467. [DOI: 10.1111/cea.12979] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 05/19/2017] [Indexed: 12/21/2022]
Affiliation(s)
- J. Wang
- MedImmune, LLC; Gaithersburg MD USA
| | - M. Suárez-Fariñas
- Department of Dermatology and the Laboratory for Inflammatory Skin Diseases; Icahn School of Medicine at Mount Sinai Medical Center; New York NY USA
- Department of Population Health Science and Policy; Icahn School of Medicine at Mount Sinai Medical Center; New York NY USA
- Icahn Institute for Genomics and Multiscale Biology at Mount Sinai; Icahn School of Medicine at Mount Sinai; New York NY USA
- Laboratory for Investigative Dermatology; Rockefeller University; New York NY USA
| | - Y. Estrada
- Department of Dermatology and the Laboratory for Inflammatory Skin Diseases; Icahn School of Medicine at Mount Sinai Medical Center; New York NY USA
| | | | | | | | - J. Krueger
- Laboratory for Investigative Dermatology; Rockefeller University; New York NY USA
| | - E. Guttman-Yassky
- Department of Dermatology and the Laboratory for Inflammatory Skin Diseases; Icahn School of Medicine at Mount Sinai Medical Center; New York NY USA
| | | |
Collapse
|