1
|
Paller AS, Weidinger S, Capozza K, Pink AE, Tang M, Guillaume X, Praestgaard A, Leclerc M, Chuang CC, Thomas RB, Prescilla R. Similarities and Differences in the Perception of Atopic Dermatitis Burden Between Patients, Caregivers, and Independent Physicians (AD-GAP Survey). Dermatol Ther (Heidelb) 2023; 13:961-980. [PMID: 36922463 DOI: 10.1007/s13555-022-00850-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 10/31/2022] [Indexed: 03/17/2023] Open
Abstract
INTRODUCTION Atopic dermatitis (AD)-a chronic inflammatory skin disease characterized by intense itching-can have a detrimental impact on quality of life (QoL). We report results of a quantitative assessment of pediatric patient, caregiver, and physician perceptions of AD burden in children and adolescents. METHODS Pediatric patients (aged 6-11 [children] or 12-17 [adolescents] years) with moderate-to-severe AD, their caregivers, and independent physicians were recruited in 13 countries. Caregivers and their children/adolescents completed an online survey about the impact of AD on 16 key items of patient QoL. Physicians completed surveys on their patients aged 6-11 and 12-17 years. Best-worst scaling was used to rank the importance of the QoL items. RESULTS Overall, 1447 children/adolescents with moderate-to-severe AD (aged 6-11 years: 701; 12-17 years: 746), 1447 caregivers, and 1092 physicians participated. Patients and caregivers in both age groups ranked disturbed sleep as the most important QoL item, followed by feeling ashamed because of AD. Independent physicians ranked feeling ashamed because of AD as the most important QoL item for both age groups, followed by disturbed sleep for those aged 6-11 years and being singled out for those aged 12-17 years. The relative importance of the 16 QoL items to patients was strongly aligned between patients in both age groups and their caregivers, but somewhat less so between patients and physicians. Between-country differences were more apparent in physician- versus patient-/caregiver-reported results. CONCLUSION The most burdensome QoL items were impact of AD on sleep and feeling ashamed. Caregivers and physicians correctly identified the QoL items most burdensome to patients. However, patient and caregiver perceptions were generally more closely aligned than patient and physician perceptions. Between-country differences in perceptions (particularly for physicians) were observed, probably due to multifactorial reasons, necessitating further evaluation. Video Abstract (MP4 42,877 kb) INFOGRAPHIC.
Collapse
Affiliation(s)
- Amy S Paller
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Ann and Robert H. Lurie Children's Hospital, Chicago, IL, USA
| | | | - Korey Capozza
- Global Parents for Eczema Research, Santa Barbara, CA, USA
| | - Andrew E Pink
- St John's Institute of Dermatology, Guy's & St. Thomas' Hospitals, London, UK
| | - Mark Tang
- Mount Alvernia Medical Centre, Singapore, Singapore
| | | | | | | | | | | | | |
Collapse
|
2
|
Gale RP, Finger RP, Eldem B, Aslam T, Barratt J, Daien V, Kodjikian L, Loewenstein A, Okada M, Wong TY, Sylvanowicz M, Rodríguez FJ. The management of neovascular age-related macular degeneration: A systematic literature review of patient-reported outcomes, patient mental health and caregiver burden. Acta Ophthalmol 2023; 101:e26-e42. [PMID: 35790079 PMCID: PMC10084380 DOI: 10.1111/aos.15201] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE The aim of this systematic literature review was to describe patient-reported outcomes, mental health and caregiver burden in patients with neovascular age-related macular degeneration (nAMD) treated with anti-vascular endothelial growth factor (VEGF) agents in routine clinical practice. METHODS Electronic searches were conducted in Embase and MEDLINE according to pre-defined criteria. RESULTS Of 856 records identified, 63 met inclusion criteria. Depression or depressive symptoms were reported in up to 42% of patients with nAMD. Of 25/63 (40%) studies evaluating quality of life (QoL) and using various tools, eight studies reported composite National Eye Institute Visual Functioning Questionnaire scores following anti-VEGF treatment. Of these, seven reported a statistically significant improvement at the earliest time point measured (Month 3-12) and approximately 50% reported sustained QoL benefits at 12 months. In studies comparing the attributed or different regimens, the most important factor from the patient's perspective was the likelihood that a particular regimen would maintain vision. There was a preference towards treat and extend, which was associated with a perceived reduction in patient and caregiver burden, compared to fixed dosing. CONCLUSIONS A coordinated holistic approach to patient care is key to optimizing patient well-being as well as visual outcomes. Further research regarding the patient-reported impact of nAMD management outside the trial setting (particularly international longitudinal studies) is warranted. Standardization of QoL studies would assist in establishing whether sustained QoL improvement, rather than prevention of QoL decline, should be a realistic expectation of treatment of nAMD in the longer term.
Collapse
Affiliation(s)
- Richard P Gale
- York and Scarborough Teaching Hospital NHS Foundation Trust, York, UK
| | - Robert P Finger
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | | | - Tariq Aslam
- Manchester Royal Eye Hospital, Manchester, UK.,University of Manchester, Manchester, UK
| | - Jane Barratt
- International Federation on Ageing, Toronto, ON, Canada
| | - Vincent Daien
- Department of Ophthalmology, University Hospital of Montpellier, Montpellier, France
| | - Laurent Kodjikian
- University of Lyon, Lyon, France.,Croix-Rousse University Hospital, Lyon, France
| | - Anat Loewenstein
- Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mali Okada
- Royal Victorian Eye and Ear Hospital, Melbourne, Vic., Australia
| | - Tien Yin Wong
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | | | - Francisco J Rodríguez
- Department of Ophthalmology, Fundación Oftalmológica Nacional and Universidad del Rosario School of Medicine, Bogotá, Colombia
| |
Collapse
|
3
|
Chiu HY, Su IW, Yu YW, Chen YC, Chen CC, Lin JH. Soreness or sng: a common symptom with differential clinical impact from pain in degenerative lumbar spine diseases. BMJ Open Qual 2023; 12:e001982. [PMID: 36690383 PMCID: PMC9872478 DOI: 10.1136/bmjoq-2022-001982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 01/06/2023] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Soreness is a common complaint in patients who receive lumbar spine surgery (LSS) for degenerative lumbar spine diseases (DLSD). However, soreness is not assessed independently and its impacts on outcomes of LSS remains largely unknown. Sng(pronounced sә-ng, ) in Chinese language is the word with the closest meaning to soreness, and Chinese-speaking people naturally use sng to describe their non-pain 'soreness' symptom. This study was aimed to investigate the prevalence and impacts of soreness or sng on outcome of LSS by introducing Visual Analogue Scale (VAS) of sng on back and leg. MATERIALS AND METHODS This prospective cohort study recruited patients who receive LSS for DLSD. Participants completed the patient-reported outcome measures at 1 week before and 1 years after LSS. The patient-reported outcome measures included (1) VAS for back pain, leg pain, back sng and leg sng, (2) Oswestry Disability Index (ODI) and (3) RAND 36-item Short Form Health Survey. The minimal clinical important difference (MCID) of ODI and physical component health-related quality of life (HRQoL) was used. RESULTS A total of 258 consecutive patients were included and 50 dropped out at follow-up. Preoperatively, the prevalence of sng was comparable to pain both on back and leg; postoperatively, the prevalence of sng was higher than pain. Leg and back sng were associated with preoperative and postoperative mental HRQoL, respectively. The reduction of sng on back and leg were significantly less than pain postoperatively. Leg sng was the only symptom independently associated with attaining MCID. CONCLUSION Soreness or sng should be assessed independently from pain in patients receiving LSS for DLSD because soreness or sng had substantial clinical impacts on the outcome of LSS.
Collapse
Affiliation(s)
- Hsiao-Yen Chiu
- School of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan
| | - I-Wen Su
- Neurobiology & Cognitive Science Center, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei City, Taiwan
- Graduate Institute of Linguistics, National Taiwan University, Taipei City, Taiwan
| | - Yu-Wen Yu
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- Neuroscience research center, Taipei Medical University, Taipei, Taiwan
| | - Yi-Chen Chen
- Department of Neurosurgery, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chih-Cheng Chen
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- Neuroscience research center, Taipei Medical University, Taipei, Taiwan
| | - Jiann-Her Lin
- Neuroscience research center, Taipei Medical University, Taipei, Taiwan
- Department of Neurosurgery, Taipei Medical University Hospital, Taipei, Taiwan
- Division of Neurosurgery, Department of Surgery, School of Medicine, Taipei Medical University, Taipei, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
4
|
Vazquez T, Forouzandeh M, Lin D, Chin F, Perez M, Caban-Martinez A, Maderal A. Insurance delays in the approval of biologic medications for patients with psoriasis and psoriatic arthritis. Arch Dermatol Res 2022; 315:1401-1403. [DOI: 10.1007/s00403-022-02457-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 11/03/2022] [Indexed: 11/15/2022]
|
5
|
Coates LC, de Wit M, Buchanan-Hughes A, Smulders M, Sheahan A, Ogdie AR. Residual Disease Associated with Suboptimal Treatment Response in Patients with Psoriatic Arthritis: A Systematic Review of Real-World Evidence. Rheumatol Ther 2022; 9:803-821. [PMID: 35412298 PMCID: PMC9127027 DOI: 10.1007/s40744-022-00443-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/14/2022] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE This systematic literature review aimed to identify and summarise real-world observational studies reporting the type, prevalence and/or severity of residual symptoms and disease in adults with psoriatic arthritis (PsA) who have received treatment and been assessed against remission or low disease activity targets. METHODS Patients had received treatment and been assessed with treat-to-target metrics, including minimal disease activity (MDA), Disease Activity Index in PsA (DAPSA) and others. MEDLINE, Embase® and the Cochrane Database of Systematic Reviews (CDSR) were searched using search terms for PsA, treatment targets and observational studies. Screening of search results was completed by two independent reviewers; studies were included if they reported relevant residual disease outcomes in adults with PsA who had received one or more pharmacological treatments for PsA in a real-world setting. Non-observational studies were excluded. Information from included studies was extracted into a prespecified grid by a single reviewer and checked by a second reviewer. RESULTS Database searching yielded 2328 articles, of which 42 publications (27 unique studies) were included in this systematic literature review. Twenty-three studies reported outcomes for MDA-assessed patients, and 14 studies reported outcomes for DAPSA-assessed patients. Physician- and patient-reported residual disease was less frequent and/or severe in patients reaching targets, but often not absent, including when patients achieved very low disease activity (VLDA) or remission. For example, studies reported that 0-8% patients in remission according to DAPSA (or clinical DAPSA) had > 1 tender joint, 25-39% had Psoriasis Area and Severity Index (PASI) score > 1 and 0-10% had patient-reported pain > 15. Residual disease was usually less frequent and/or severe among patients achieving MDA-assessed targets versus DAPSA--assessed targets, especially for skin outcomes. CONCLUSION The findings demonstrate a need for further optimisation of care for patients with PsA.
Collapse
Affiliation(s)
- Laura C. Coates
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | | | | | - Maartje Smulders
- UCB Pharma, Anderlecht, Belgium
- Present Address: Astellas Pharma Europe B.V., Leiden, The Netherlands
| | | | - Alexis R. Ogdie
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| |
Collapse
|
6
|
Ogdie A, Myers K, Mansfield C, Tillett W, Nash P, Leach C, Nowell WB, Gavigan K, Zueger P, McDearmon-Blondell E, Walsh J. Experiences and Treatment Preferences in Patients With Psoriatic Arthritis: A Cross-Sectional Study in the ArthritisPower Registry. Rheumatol Ther 2022; 9:735-751. [PMID: 35279798 PMCID: PMC8964868 DOI: 10.1007/s40744-022-00436-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/25/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Despite recent advances in treatment for psoriatic arthritis (PsA), many patients experience inadequate response or intolerance to therapy, indicating that unmet treatment-related needs remain. To further characterize these unmet needs, we evaluated patients’ experiences regarding the burden of PsA symptoms and disease impacts, and patients’ preferences for treatment. Methods Patients from ArthritisPower, a rheumatology research registry, completed a web-based survey. Object case best–worst scaling (BWS) was used to evaluate the relative burden of 11 PsA-related symptoms and the relative importance of improvement in nine PsA-related disease impacts. BWS data were analyzed using a random-parameters logit model. Patient demographics, preferences for mode and frequency of therapy, and preferences for methotrexate were analyzed descriptively. Results Among the 332 participants, most were White (94%), female (80%), with mean age of 54 years (SD 11.4). In the BWS, joint pain was the most bothersome symptom, followed by other musculoskeletal pain and fatigue. The BWS for disease impacts found that improvements in the ability to perform physical activities were most important, followed by improvements in the ability to function independently, sleep quality, and the ability to perform daily activities. The most burdensome symptoms and desired disease impact improvements were similar in patients regardless of their experience with biologic disease-modifying antirheumatic drugs. The most preferred mode and frequency of treatment administration was oral, once-daily medication (preferred by 38% of respondents), and 74% prioritized therapies that significantly improved joint-related symptoms versus psoriasis-related symptoms. The majority of respondents (65%) preferred PsA treatment regimens that did not include methotrexate. Conclusions Patients with PsA from a rheumatology registry found musculoskeletal pain symptoms to be the most bothersome and prioritized improvements to functional impacts of their disease. These findings can better inform development of new therapies and guide shared patient-provider treatment decision-making. Supplementary Information The online version contains supplementary material available at 10.1007/s40744-022-00436-x.
Collapse
Affiliation(s)
- Alexis Ogdie
- Division of Rheumatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kelley Myers
- RTI Health Solutions, 3040 East Cornwallis Road, Post Office Box 12194, Research Triangle Park, NC, 27709-2194, USA.
| | - Carol Mansfield
- RTI Health Solutions, 3040 East Cornwallis Road, Post Office Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - William Tillett
- Department of Rheumatology, Royal National Hospital for Rheumatic Diseases, Bath, UK
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| | - Peter Nash
- Department of Medicine, Griffith University, Brisbane, QLD, Australia
| | - Colton Leach
- RTI Health Solutions, 3040 East Cornwallis Road, Post Office Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | | | - Kelly Gavigan
- Global Healthy Living Foundation, Upper Nyack, NY, USA
| | | | | | - Jessica Walsh
- Division of Rheumatology, University of Utah School of Medicine, Salt Lake City, UT, USA
| |
Collapse
|
7
|
Gossec L. Interpreting the efficacy of secukinumab on patient-reported outcomes in psoriatic arthritis. THE LANCET. RHEUMATOLOGY 2022; 4:e159-e160. [PMID: 38288933 DOI: 10.1016/s2665-9913(22)00004-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 04/26/2024]
Affiliation(s)
- Laure Gossec
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France; Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Rheumatology Department, Paris 75013, France.
| |
Collapse
|
8
|
Feldman SR, Poulos C, Gilloteau I, Mange B, Boehm K, Boeri M, Naatz M, Augustin M. Exploring determinants of psoriasis patients' treatment choices: a discrete-choice experiment study in the United States and Germany. J DERMATOL TREAT 2021; 33:1511-1520. [PMID: 33535847 DOI: 10.1080/09546634.2020.1839007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Biologic psoriasis treatments are differentiated by efficacy, side effects, and other attributes. OBJECTIVE Determine attributes of biologic psoriasis treatments that drive patients' treatment choices. METHODS Respondents (USA: n = 300; Germany: n = 300) with moderate-to-severe psoriasis completed a discrete-choice-experiment survey, choosing between hypothetical treatments characterized by attributes with varying levels: chance of clear skin after 1 year, number of first-year treatments, first-year risks of mild-to-moderate injection site reaction (ISR) and serious infection, and years of proven efficacy/safety. RESULTS U.S. respondents most valued clear skin (conditional relative importance, 1.88; p < .05). While other attributes were of generally equivalent importance, ISR risk outweighed serious-infection risk (1.06 vs. 0.70; p < .05). German respondents placed greatest importance on ISR risk (1.61; p < .05) and clear skin (1.49; p < .05). LIMITATIONS Respondents evaluated hypothetical treatments and were recruited from web panels. CONCLUSIONS Clear skin and ISR risk are stronger drivers of treatment choice than injection frequency and infection risk.
Collapse
Affiliation(s)
- Steven R Feldman
- Departmemt of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | | | | | - Brennan Mange
- RTI Health Solutions, Research Triangle Park, NC, USA
| | | | | | - Mandy Naatz
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
9
|
Goel N. Conducting research in psoriatic arthritis: the emerging role of patient research partners. Rheumatology (Oxford) 2021; 59:i47-i55. [PMID: 32159791 PMCID: PMC7065462 DOI: 10.1093/rheumatology/kez338] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 06/24/2019] [Indexed: 12/16/2022] Open
Abstract
Since 2003, patients have become increasingly involved in research endeavours related to psoriatic arthritis (PsA), progressing into a patient research partner (PRP) role. This paper reviews the general considerations related to PRP involvement in research endeavours and more specifically, the evolution of PRP contributions related to PsA research. The addition of the perspective from individuals with lived experience of PsA can bring unique insights to the research process, and increase the likelihood that the results of research are meaningful and relevant to PsA patients. There are also potential issues to address when incorporating PRPs, such as the need for additional time and effort to identify, train, and collaborate with PRPs as members of a research team. Overall, while there are challenges to overcome, and the opportunities to include PRPs are sometimes overlooked, efforts to include PRPs in PsA research should offer significant benefits to patients, researchers, and trials.
Collapse
Affiliation(s)
- Niti Goel
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| |
Collapse
|
10
|
Mease P, Elaine Husni M, Chakravarty SD, Kafka S, Parenti D, Kim L, Hung Lo K, Hsia EC, Kavanaugh A. Evaluation of Improvement in Skin and Nail Psoriasis in Bio-naïve Patients With Active Psoriatic Arthritis Treated With Golimumab: Results Through Week 52 of the GO-VIBRANT Study. ACR Open Rheumatol 2020; 2:640-647. [PMID: 33073933 PMCID: PMC7672302 DOI: 10.1002/acr2.11180] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 08/04/2020] [Indexed: 11/12/2022] Open
Abstract
Objective To evaluate whether intravenous (IV) golimumab produces improvements in skin and nail symptoms that are concomitant with improvements in quality of life (QoL) and joint symptoms in patients with psoriatic arthritis. Methods Patients were randomized to either IV golimumab 2 mg/kg at weeks 0, 4, then every 8 weeks (q8w) through week 52 or placebo at weeks 0, 4, then q8w, with crossover to IV golimumab 2 mg/kg at weeks 24, 28, and then q8w through week 52. Assessments included Psoriasis Area and Severity Index (PASI), modified Nail Psoriasis Severity Index (mNAPSI), Dermatology Life Quality Index (DLQI), and American College of Rheumatology (ACR) rheumatoid arthritis response criteria. Results Through week 24, achievement of PASI 75/90/100 responses (P ≤ .0098) and mean improvements in mNAPSI (−11.4 vs −3.7; P < .0001) and DLQI (−9.8 vs −2.9; P < .0001) were significantly greater with golimumab versus placebo. Responses were maintained in patients treated with golimumab through week 52. In placebo‐crossover patients, increases in the proportion of patients achieving PASI 75/90/100 responses were observed from weeks 24 to 52, and mean improvements in mNAPSI (from −3.7 to −12.9) and DLQI (from −2.9 to −7.8) increased from weeks 24 to 52. Simultaneous achievement of PASI and DLQI responses, PASI and ACR responses, and mNAPSI and DLQI responses were also observed. Similar responses were observed for all assessments regardless of concomitant methotrexate use. Conclusion Improvements in skin and nail psoriasis symptoms with IV golimumab in patients with psoriatic arthritis were concomitant with improvements in QoL and arthritis disease activity through 1 year.
Collapse
Affiliation(s)
- Philip Mease
- Swedish Medical Center, Seattle, Washington and University of Washington School of Medicine, Seattle
| | | | - Soumya D Chakravarty
- Janssen Scientific Affairs, LLC, Horsham, Pennsylvania, and, Drexel University College of Medicine, Philadelphia, PA
| | - Shelly Kafka
- Janssen Scientific Affairs, LLC, Horsham, Pennsylvania
| | | | - Lilianne Kim
- Janssen Research & Development, LLC, Spring House, Pennsylvania
| | - Kim Hung Lo
- Janssen Research & Development, LLC, Spring House, Pennsylvania
| | - Elizabeth C Hsia
- Janssen Research & Development, LLC, Spring House, Pennsylvania, and University of Pennsylvania, Philadelphia
| | | |
Collapse
|
11
|
Tillett W, Merola JF, Thaçi D, Holdsworth E, Booth N, Lobosco LS, Milligan G, Hufford MM, Birt JA, Boehncke WH. Disease Characteristics and the Burden of Joint and Skin Involvement Amongst People With Psoriatic Arthritis: A Population Survey. Rheumatol Ther 2020; 7:617-637. [PMID: 32700230 PMCID: PMC7410983 DOI: 10.1007/s40744-020-00221-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Psoriatic arthritis (PsA) is a chronic, systemic, inflammatory disease where disease burden and quality of life (QoL) are affected by both joint and skin manifestations. METHODS Patient and physician reported data were collected about 3200 patients in a cross-sectional survey of patients from nine countries. Patient-reported outcomes (PROs) included perceptions of symptom importance, EuroQol questionnaire (EQ-5D), Psoriatic Arthritis Impact of Disease (PsAID12), and Work Productivity and Activity Impairment (WPAI) Index. Outcomes were compared in patients with 'joint-only' and 'joint and skin' disease symptoms. RESULTS Of the 3200 patients, 2703 had complete information for 'joint-only' or 'joint and skin' involvement and were included in the analysis. Patients had a mean age of 49.2 years, 45.2% were female, and 64.5% had 'joint and skin' involvement. Patients with 'joint and skin' involvement had higher mean tender and swollen joint counts (5.2 and 4.8) than patients who were 'joint-only' (2.0 and 1.5). Significantly more patients with active 'joint and skin' symptoms experienced a flare (currently or within the last 12 months) compared with 'joint-only' patients (34.9 vs. 23.2%, p < 0.001). When asked to prioritize the burden of symptoms, 61.6% of patients prioritized joints, 38.4% prioritized skin. Anxiety/depression was experienced by 41.4% of patients, 62.4% of whom indicated that both joint and skin symptoms were the cause. Patients with 'joint and skin' involvement reported significantly worse QoL, work productivity and activity impairment than 'joint-only' patients (EQ-5D index 0.79 vs. 0.85, p < 0.001; EQ-5D VAS 71.98 vs. 77.68, p < 0.001; PsAID12 2.91 vs. 1.66, p < 0.001; WPAI overall work impairment 25.61 vs. 16.32, p < 0.001). CONCLUSIONS PsA patients who experience 'joint and skin' symptoms had significantly worse clinical outcomes, health-related QoL, and work productivity compared with patients with 'joint-only' symptoms.
Collapse
Affiliation(s)
- William Tillett
- Royal National Hospital for Rheumatic Diseases, Bath, UK
- Pharmacy and Pharmacology, University of Bath, Bath, UK
| | - Joseph F Merola
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Diamant Thaçi
- Institute and Comprehensive Center Inflammation Medicine, University of Lübeck, Lübeck, Germany
| | | | | | | | | | | | - Julie A Birt
- Lilly Research Labs, Eli Lilly and Company, Indianapolis, IN, USA
| | - Wolf-Henning Boehncke
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva University Hospitals, Geneva, Switzerland
| |
Collapse
|
12
|
Merola JF, Papp KA, Nash P, Gratacós J, Boehncke WH, Thaçi D, Graham D, Hsu MA, Wang C, Wu J, Young P. Tofacitinib in psoriatic arthritis patients: skin signs and symptoms and health-related quality of life from two randomized phase 3 studies. J Eur Acad Dermatol Venereol 2020; 34:2809-2820. [PMID: 32271970 PMCID: PMC7818414 DOI: 10.1111/jdv.16433] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 02/28/2020] [Accepted: 03/16/2020] [Indexed: 12/14/2022]
Abstract
Background Psoriatic arthritis (PsA) is a chronic, systemic immune‐mediated inflammatory musculoskeletal disease. The onset of dermatologic symptoms often precedes rheumatic manifestations. Tofacitinib is an oral Janus kinase inhibitor for the treatment of PsA that has been shown to improve dermatologic symptoms in patients with PsA. Objectives To investigate the efficacy of tofacitinib in improving dermatologic endpoints in adult patients with active PsA. Methods This analysis included data from two placebo‐controlled, double‐blind, phase 3 studies in patients with active PsA and an inadequate response (IR) to ≥1 conventional synthetic disease‐modifying antirheumatic drug (csDMARD) who were tumor necrosis factor inhibitor (TNFi)‐naïve (OPAL Broaden; NCT01877668) or an IR to ≥1 TNFi (OPAL Beyond; NCT01882439). Patients had active plaque psoriasis at screening and received a stable dose of one csDMARD during the study. Patients were randomized to tofacitinib 5 mg twice daily (BID), 10 mg BID, adalimumab 40 mg subcutaneous injection once every 2 weeks (OPAL Broaden only) or placebo (to Month 3). Dermatologic endpoints: Psoriasis Area and Severity Index (PASI) total score; PASI90 overall; PASI75 and PASI90 by baseline PASI severity; Physician’s Global Assessment of Psoriasis; Nail Psoriasis Severity Index; Dermatology Life Quality Index total and sub‐dimension scores; Itch Severity Item; and Patient’s Global Joint and Skin Assessment‐Visual Analog Scale‐Psoriasis question. Results In patients with active PsA, including those stratified by mild or moderate/severe dermatologic symptoms, greater improvements from baseline and percentage of responders were observed in tofacitinib‐treated patients vs. placebo for the majority of analyzed dermatologic endpoints at Months 1 and 3, and improvements were maintained to Month 12 in OPAL Broaden and Month 6 in OPAL Beyond. Similar effects were observed in adalimumab‐treated patients vs. placebo in OPAL Broaden across dermatologic endpoints. Conclusions Tofacitinib provides a treatment option for patients with active PsA, including the burdensome dermatologic symptoms of PsA.
Collapse
Affiliation(s)
- J F Merola
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - K A Papp
- Probity Medical Research and K Papp Clinical Research Inc, Waterloo, ON, Canada
| | - P Nash
- Department of Medicine, Griffith University, Brisbane, QLD, Australia
| | - J Gratacós
- Servicio de Reumatología, Hospital Universitari Parc Taulí Sabadell, Barcelona, Spain
| | - W H Boehncke
- Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland.,Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - D Thaçi
- Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany
| | | | | | - C Wang
- Pfizer Inc, Groton, CT, USA
| | - J Wu
- Pfizer Inc, Groton, CT, USA
| | - P Young
- Pfizer Inc, Collegeville, PA, USA
| |
Collapse
|
13
|
Conaghan PG, Alten R, Deodhar A, Sullivan E, Blackburn S, Tian H, Gandhi K, Jugl SM, Strand V. Relationship of pain and fatigue with health-related quality of life and work in patients with psoriatic arthritis on TNFi: results of a multi-national real-world study. RMD Open 2020; 6:e001240. [PMID: 32611650 PMCID: PMC7425192 DOI: 10.1136/rmdopen-2020-001240] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/22/2020] [Accepted: 06/05/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND/OBJECTIVE The incidence of pain and/or fatigue in people with psoriatic arthritis (PsA) is associated with reduced health-related quality of life (HRQoL) and the ability to work, despite modern advanced therapeutic approaches. This real-world, international study examined these relationships in patients with PsA treated with tumour necrosis factor inhibitors (TNFi). METHODS Data from 13 countries were analysed. Patients with PsA and their physicians completed questionnaires capturing demographics, current therapy, current disease status, HRQoL and work status via Medical Outcomes Study 36-Item Short-Form version 2 (SF-36v2), 3-level 5-dimension EuroQoL questionnaire, Health Assessment Questionnaire Disability Index, and Work Productivity and Activity Impairment (WPAI) questionnaire. RESULTS 640 patients with PsA were included who had been receiving TNFi for ≥3 months and had completed SF-36v2 bodily pain and vitality domains. Of these, 33.1%, 29.2% and 37.7% of patients reported no, moderate and severe pain, respectively, and 31.9%, 22.5% and 45.6% of patients reported low, moderate and severe fatigue, respectively. Scores across HRQoL variables and WPAI were significantly different across pain and fatigue cohorts (all p<0.0001), with HRQoL and WPAI measures considerably worse in patients with moderate to severe pain or fatigue than those with low pain or fatigue. CONCLUSIONS Despite treatment with biologic agents such as TNFi, data from this global study demonstrated that substantial pain and/or fatigue persist in patients with PsA and that these are significantly associated with reduced HRQoL, physical function and work productivity. These findings suggest that there is an unmet need for additional PsA therapies.
Collapse
Affiliation(s)
- P G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Rieke Alten
- Internal Medicine II, Rheumatology, SCHLOSSPARK-KLINIK, University Medicine Berlin, Berlin, Germany
| | - Atul Deodhar
- Oregon Health & Science University, Portland, Oregon, USA
| | - Emma Sullivan
- Adelphi Values, Bollington, UK
- Adelphi Real World, Bollington, UK
| | | | - Haijun Tian
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | - Kunal Gandhi
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | | | - Vibeke Strand
- Immunology/Rheumatology, Stanford University, Stanford, California, USA
- Biopharmaceutical Consultant, Portola Valley, California, USA
| |
Collapse
|
14
|
Mease PJ, Etzel CJ, Huster WJ, Armstrong AW, Muram TM, Lisse J, Rebello S, Dodge R, Murage MJ, Greenberg JD, Malatestinic WN. Evaluation of Changes in Skin and Joint Outcomes and Associated Treatment Changes in Psoriatic Arthritis (PsA): Experience From the Corrona PsA/SpA Registry. J Rheumatol 2020; 48:376-384. [PMID: 32358158 DOI: 10.3899/jrheum.190422] [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] [Accepted: 03/20/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To characterize skin severity and joint activity outcomes and associated treatment changes in patients with psoriatic arthritis (PsA) through 12 months of follow-up after enrollment in the Corrona Psoriatic Arthritis/Spondyloarthritis (PsA/SpA) Registry. METHODS Patients ≥ 18 years of age with a diagnosis of PsA and a history of psoriasis between March 21, 2013, and September 30, 2016, were enrolled (n = 647). Demographics, clinical features, and treatment characteristics were collected and stratified by skin severity and joint activity. Change in joint and skin from enrollment to the 12-month visit was classified by change in category of Clinical Disease Activity Index (CDAI) or body surface area (BSA). Tests of association evaluated the relationship between changes in therapy and changes in skin severity and joint activity. RESULTS Patients with improvement in both joint activity and skin severity saw the largest median reduction in both CDAI and BSA, while those who worsened in both had the greatest median increase in both CDAI and BSA. The majority of PsA patients (> 50%) had no change in skin severity regardless if they had reduced therapy (50%), no therapy changes (54%), or increased therapy (56%; P = 0.5875). However, there was a significant association between changes in therapy and changes in joint activity (P < 0.001). Patients who increased therapy were more likely to have improvement in joint activity (32%) compared to patients who reduced therapy (22%) or had no therapy changes (11%). CONCLUSION The clinical implication for our findings suggests the assessment and incorporation of both skin and joint components may be advisable.
Collapse
Affiliation(s)
- Philip J Mease
- P.J. Mease, MD, MACR, Swedish-Providence-St. John Health Systems, and University of Washington, Seattle, Washington;
| | - Carol J Etzel
- C.J. Etzel, PhD, S. Rebello, MPH, R. Dodge, MS, Corrona, LLC, Waltham, Massachusetts
| | - William J Huster
- W. Huster, PhD, T. Muram, MD, J. Lisse, MD, M.J. Murage, PhD, MPH, W. Malatestinic, PharmD, MBA, Eli Lilly and Company, Indianapolis, Indiana
| | - April W Armstrong
- A. Armstrong, MD, MPH, University of Southern California, Los Angeles, California
| | - Talia M Muram
- W. Huster, PhD, T. Muram, MD, J. Lisse, MD, M.J. Murage, PhD, MPH, W. Malatestinic, PharmD, MBA, Eli Lilly and Company, Indianapolis, Indiana
| | - Jeffrey Lisse
- W. Huster, PhD, T. Muram, MD, J. Lisse, MD, M.J. Murage, PhD, MPH, W. Malatestinic, PharmD, MBA, Eli Lilly and Company, Indianapolis, Indiana
| | - Sabrina Rebello
- C.J. Etzel, PhD, S. Rebello, MPH, R. Dodge, MS, Corrona, LLC, Waltham, Massachusetts
| | - Rhiannon Dodge
- C.J. Etzel, PhD, S. Rebello, MPH, R. Dodge, MS, Corrona, LLC, Waltham, Massachusetts
| | - Mwangi J Murage
- W. Huster, PhD, T. Muram, MD, J. Lisse, MD, M.J. Murage, PhD, MPH, W. Malatestinic, PharmD, MBA, Eli Lilly and Company, Indianapolis, Indiana
| | - Jeffrey D Greenberg
- J.D. Greenberg, MD, MPH, Corrona, LLC, Waltham, Massachusetts, and New York School of Medicine, New York, New York, USA
| | - William N Malatestinic
- W. Huster, PhD, T. Muram, MD, J. Lisse, MD, M.J. Murage, PhD, MPH, W. Malatestinic, PharmD, MBA, Eli Lilly and Company, Indianapolis, Indiana
| |
Collapse
|
15
|
Carubbi F, Fidanza R, Palmieri M, Ventura A, Tambone S, Cipriani P, Giacomelli R, Fargnoli MC. Safety and efficacy of certolizumab pegol in a real-life cohort of patients with psoriasis and psoriatic arthritis. J DERMATOL TREAT 2019; 31:692-697. [DOI: 10.1080/09546634.2019.1605143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Francesco Carubbi
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Science, School of Medicine, University of L'Aquila, L'Aquila, Italy
- Department of Medicine, ASL1 Avezzano-Sulmona-L’Aquila, L’Aquila, Italy
| | - Rosaria Fidanza
- Department of Medicine, ASL1 Avezzano-Sulmona-L’Aquila, L’Aquila, Italy
- San Salvatore Hospital, UOSD Dermatologia, L’Aquila, Italy
| | - Maria Palmieri
- Dermatology Department, Department of Biotechnological and Applied Clinical Science, School of Medicine, University of L'Aquila, L'Aquila, Italy
| | - Alessandra Ventura
- Dermatology Department, Department of Biotechnological and Applied Clinical Science, School of Medicine, University of L'Aquila, L'Aquila, Italy
| | - Sara Tambone
- Dermatology Department, Department of Biotechnological and Applied Clinical Science, School of Medicine, University of L'Aquila, L'Aquila, Italy
| | - Paola Cipriani
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Science, School of Medicine, University of L'Aquila, L'Aquila, Italy
| | - Roberto Giacomelli
- Rheumatology Unit, Department of Biotechnological and Applied Clinical Science, School of Medicine, University of L'Aquila, L'Aquila, Italy
| | - Maria Concetta Fargnoli
- Dermatology Department, Department of Biotechnological and Applied Clinical Science, School of Medicine, University of L'Aquila, L'Aquila, Italy
| |
Collapse
|