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Inotai A, Nagy D, Kaló Z, Vokó Z. Population-level norm values by EQ-5D-3L in Hungary - a comparison of survey results from 2022 with those from 2000. Qual Life Res 2024; 33:2417-2428. [PMID: 38839684 PMCID: PMC11390784 DOI: 10.1007/s11136-024-03699-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE Although population norms of the EQ-5D-3L instrument had been available in Hungary since 2000, their evaluation was based on a United Kingdom (UK) value set. Our objective was to estimate the population norms for EQ-5D-3L by using the new Hungarian value set available since 2020, to extend the scope to adolescents, and to compare with norms from 2000. METHODS A cross sectional EQ-5D-3L survey representative of the Hungarian population was conducted in 2022. The EQ-5D-3L dimensional responses were analyzed by age and sex and compared with the survey from 2000, by estimating population frequencies with their 95% confidence intervals; index values were evaluated by both value sets. RESULTS Altogether, 11,910 respondents, aged 12 or more (578 between 12 and 17), completed the EQ-5D-3L. There was a notable improvement in reporting problems for both sexes (age 35-64) regarding the pain/discomfort and anxiety/depression compared to 2000. Below the age 44, both sexes had an EQ-5D-3L index plateau of 0.98, while above the age 55, men tended to have numerically higher index values compared to women, with the difference increasing with older age. Improvement in dimensional responses were also translated to numerically higher index values for both sexes between ages 18 and 74 compared to 2000. Multivariate regression analysis showed that higher educational attainment, lower age, larger household size, and active occupational status were associated with higher index values. CONCLUSION Over the past 22 years, there was a large improvement in HRQoL of the middle-aged to elderly men and women in Hungary.
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Affiliation(s)
- András Inotai
- Center for Health Technology Assessment, Semmelweis University, Üllői út 25, Budapest, 1091, Hungary.
| | - Dávid Nagy
- Center for Health Technology Assessment, Semmelweis University, Üllői út 25, Budapest, 1091, Hungary
- Syreon Research Institute, Mexikói út 65, Budapest, 1142, Hungary
| | - Zoltán Kaló
- Center for Health Technology Assessment, Semmelweis University, Üllői út 25, Budapest, 1091, Hungary
- Syreon Research Institute, Mexikói út 65, Budapest, 1142, Hungary
| | - Zoltán Vokó
- Center for Health Technology Assessment, Semmelweis University, Üllői út 25, Budapest, 1091, Hungary
- Syreon Research Institute, Mexikói út 65, Budapest, 1142, Hungary
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He S, Yang F, Lu C, Wang Y, Duan X, Li H, Wu L, Wang Y, Su J, Li M, Leng X, Zeng X. Sex-specific differences in patients with psoriatic arthritis:a nationwide study from the Chinese Registry of Psoriatic Arthritis (CREPAR IV). Clin Rheumatol 2024; 43:1063-1071. [PMID: 38200254 DOI: 10.1007/s10067-023-06859-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/22/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVES To elucidate the sex-specific differences in demographic features, clinical characteristics, and quality of life in Chinese patients with psoriatic arthritis (PsA). METHODS A total of 1,074 patients with PsA registered between December 2018 and June 2021 from the Chinese REgistry of Psoriatic ARthritis (CREPAR) cohort were selected. The baseline data on demographics, clinical characteristics, commonly used laboratory tests, comorbidities, and quality of life assessments were collected for this cross-sectional analysis. RESULTS A total of 1,074 patients were included in this study, 585 (54.47%) of them were male and 489 (45.53%) were female. The age at PsA onset in male patients was earlier than that in female patients (38.10 ± 12.79 vs 40.37 ± 13.41, p = 0.005). For clinical characteristics, male patients presented with higher rates of axial involvement (43.89% vs 37.74%, p = 0.044) and nail involvement (66.15% vs 58.08%, p = 0.006), while female patients presented with higher rates of peripheral arthritis (89.57% vs 83.93%, p = 0.007). For laboratory tests, men presented with a higher percentage of HLA-B27 positivity than women (24.65% vs 16.70%, p = 0.002) and had higher levels of CRP (median 9.70 vs 5.65, p < 0.001). Regarding disease assessment indices, male patients scored higher in PASI and BASFI (median 5.00 vs 3.00, p = 0.007 and 1.80 vs 1.40, p = 0.012, respectively). No sex difference was found in rates of achieving remission. Factors associated with disease remission were also analyzed in both sexes. CONCLUSION Demographic and clinical characteristics tend to vary between male and female patients with PsA. Male patients reported more functional limitations in daily life. Key Points • The demographic and clinical features vary greatly between male and female patients with PsA. • Male patients reported more functional burden in daily life as measured by BASFI.
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Affiliation(s)
- Shihao He
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, No. 1 Shuaifuyuan, Wangfujing Ave, Beijing, 100730, China
| | - Fan Yang
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, No. 1 Shuaifuyuan, Wangfujing Ave, Beijing, 100730, China
| | - Chaofan Lu
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, No. 1 Shuaifuyuan, Wangfujing Ave, Beijing, 100730, China
| | - Yanhong Wang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences; School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China
| | - Xinwang Duan
- Department of Rheumatology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Hongbin Li
- Department of Rheumatology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, China
| | - Lijun Wu
- Department of Rheumatology, The People's Hospital of the Xinjiang Uygur Autonomous Region, Urumqi, 830001, Xinjiang, China
| | - Yongfu Wang
- Department of Rheumatology, First Affiliated Hospital of Baotou Medical College, Baotou, 014010, Inner Mongolia, China
| | - Jinmei Su
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, No. 1 Shuaifuyuan, Wangfujing Ave, Beijing, 100730, China
| | - Mengtao Li
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, No. 1 Shuaifuyuan, Wangfujing Ave, Beijing, 100730, China
| | - Xiaomei Leng
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, No. 1 Shuaifuyuan, Wangfujing Ave, Beijing, 100730, China.
| | - Xiaofeng Zeng
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, No. 1 Shuaifuyuan, Wangfujing Ave, Beijing, 100730, China.
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Fairushina IF, Abdulganieva DI, McKenna SP, Сoffey A. Psoriatic Arthritis Quality of Life Questionnaire: results of translation, cultural adaptation and validation in Russian language. MODERN RHEUMATOLOGY JOURNAL 2023. [DOI: 10.14412/1996-7012-2023-1-58-63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Psoriatic arthritis (PsA) is a chronic progressive disease from the pondyloarthritis group of diseases. In recent years, there has been a significant increase in the incidence of PsA and cases of its severe course, with significant influence on the quality of life (QoL) of patients and early disability. Psoriatic Arthritis Quality of Life Questionnaire (PsAQoL) is the first quality of life questionnaire designed specifically for PsA that has not been previously validated in Russia.Objective: to translate the original PsAQoL questionnaire into Russian and evaluate the psychometric properties of the Russian version.Material and methods. The original PsAQoL was translated into Russian using two translational panels. In all, 12 local residents were included in the translation stage of the study. The external and logical validity of the questionnaire was assessed. Further, Russian-speaking patients with an established diagnosis of PsA (n=10) tested the questionnaire. A separate cohort of patients with PsA (n=50) was enrolled in a postal test retest study on 2 occasions, 2 weeks apart. Clinical data and the Medical Outcomes Study-Short Form (SF-36) questionnaire were used to assess convergent validity.Results and discussion. The Russian version of PsAQoL was relevant, clear, and easy to complete (6.1 minutes on average). PsAQoL had high internal consistency (Cronbach's á=0.87) and excellent retest validity (r>0.85). PsAQoL scores correlated most strongly with the SF-36 General Health Scale (r=-0.68, p<0.01). PsAQoL score did not depend on sex and age (p>0.05). The PsAQoL could distinguish between groups of patients defined by self-reported general health status and self-reported severity of PsA.Conclusion. The Russian version of PsAQoL proved to be understandable and easy to complete, as well as a reliable and valid tool for assessing the quality of life of patients with PsA.
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Affiliation(s)
| | | | - S. P. McKenna
- Galen Research Ltd, Manchester;
School of Health Sciences, University of Manchester
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Bulut S, Karakaya J, Oksuz S, Kalyoncu U, Unal E. The reliability, validity, and responsiveness of Cognitive Exercise Therapy Approach: Biopsychosocial Questionnaire for patients with psoriatic arthritis. Rheumatol Int 2022; 42:1973-1981. [PMID: 35831716 DOI: 10.1007/s00296-022-05170-9] [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] [Received: 05/04/2022] [Accepted: 07/04/2022] [Indexed: 11/29/2022]
Abstract
Although the importance of the biopsychosocial model that aims the optimum treatment is emphasized in the literature, there is a lack of scales that evaluate individuals with PsA in a multi-dimensional way, including all areas of influence. This study aimed to determine the validity, reliability, and responsiveness of the Cognitive Exercise Therapy Approach-Biopsychosocial Questionnaire (BETY-BQ) in individuals diagnosed with Psoriatic Arthritis (PsA). Psoriatic Arthritis Quality of Life Questionnaire (PsAQoL), Health Assessment Questionnaire, Hospital Anxiety and Depression Scale, and Short Form-36 were used for the validity of the BETY-BQ. For scale reliability, the test-retest method was performed, Intraclass Correlation Coefficient (ICC) was calculated, and Cronbach's alpha (α) coefficient was checked for internal consistency. For the responsiveness of the scale, all scales were re-applied with 3 months intervals. The correlations of BETY-BQ with the other scales were found medium to very high. ICC was analyzed to compare the reliability of the test-retest results and it was found to be excellent. Cronbach's α value was found to be 0.940 which showed an excellent internal consistency. The time-dependent change sensitivity of BETY-BQ was found to be highly correlated with the PsA-specific scale, the PsAQoL questionnaire. BETY-BQ was determined as a valid, reliable, and sensitive assessment tool that health professionals can use in individuals with PsA diagnosis. In this study, a scale that will reveal the biopsychosocial responses of individuals with PsA to pharmacological and non-pharmacological treatments was presented to the literature.
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Affiliation(s)
- Senem Bulut
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Jale Karakaya
- Faculty of Medicine, Department of Biostatistics, Hacettepe University, Ankara, Turkey
| | - Sevim Oksuz
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Eastern Mediterranean University, North Cyprus via Mersin 10, 99628, Famagusta, Turkey
| | - Umut Kalyoncu
- Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Hacettepe University, Ankara, Turkey
| | - Edibe Unal
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
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Moraes FA, da Silva MRR, Dos Santos JBR, Acurcio FA, Almeida AM, Kakehasi AM, Alvares-Teodoro J. Health-Related Quality of Life in Psoriatic Arthritis: Findings and Implications. Value Health Reg Issues 2021; 26:135-141. [PMID: 34390960 DOI: 10.1016/j.vhri.2021.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 05/05/2021] [Accepted: 06/14/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To assess the quality of life (QOL) and its associated factors in patients with psoriatic arthritis (PsA) who would start treatment with biologic drugs at the Brazilian Unified Health System. METHODS A cross-sectional study was performed at a single center pharmacy in Belo Horizonte, State of Minas Gerais, Brazil. EQ-5D was used to assess the patients' QOL. The functional status was assessed using the Health Assessment Questionnaire-Disability Index, whereas disease activity was evaluated through the Bath Ankylosing Spondylitis Disease Activity Index and the Clinical Disease Activity Index. Simple and multiple linear regression analyses were performed to assess the factors associated with QOL. RESULTS A total of 212 patients with PsA were included, of which 185 (87.3%) reported having some pain/discomfort, and 148 (69.8%) presented some level of anxiety/depression. Patients with PsA had a mean QOL score of 0.651 (SD 0.12) with a significant reduction in female patients, concomitant use of nonsteroidal anti-inflammatory drugs, comorbidity, and worse clinical and functional status. Poor QOL was associated with worse functional status by the Health Assessment Questionnaire-Disability Index, disease activity by the Bath Ankylosing Spondylitis Disease Activity Index, and with diagnoses of osteoporosis, hypothyroidism, and depression. CONCLUSION PsA and its associated comorbidities negatively affect the QOL, evidencing the need for a comprehensive and effective clinical approach.
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Affiliation(s)
- Felipe A Moraes
- Department of Social Pharmacy, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Michael R R da Silva
- Health Assessment, Technology, and Economy Group, Center for Exact, Natural, and Health Sciences, Federal University of Espírito Santo, Alegre, Espírito Santo, Brazil
| | - Jéssica B R Dos Santos
- Health Assessment, Technology, and Economy Group, Center for Exact, Natural, and Health Sciences, Federal University of Espírito Santo, Alegre, Espírito Santo, Brazil.
| | - Francisco A Acurcio
- Department of Social Pharmacy, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Alessandra M Almeida
- Faculty of Medical Sciences of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Adriana M Kakehasi
- Medicine School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Juliana Alvares-Teodoro
- Department of Social Pharmacy, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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OMERACT Filter 2.1 Instrument Selection for Physical Function Domain in Psoriatic Arthritis: Provisional Endorsement for HAQ-DI and SF-36 PF. Semin Arthritis Rheum 2021; 51:1117-1124. [PMID: 34392975 PMCID: PMC8453108 DOI: 10.1016/j.semarthrit.2021.07.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 06/04/2021] [Accepted: 07/07/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Physical function is one of the core domains to be measured in all trials in psoriatic arthritis (PsA). We aimed to evaluate two instruments for physical function in PsA: The Health Assessment Questionnaire-disability index (HAQ-DI) and the physical functioning subscale of the Medical Outcome Survey Short-Form 36 items (SF-36 PF). METHODS We followed guidelines set out by the OMERACT Filter 2.1. A working group was formed to evaluate each instrument for domain match and feasibility to reach consensus. Two systematic literature reviews (SLRs) were conducted to identify the relevant articles supporting measurement properties of both instruments. Five additional measurement properties were appraised: construct validity, test-retest reliability, longitudinal construct validity, clinical trial discrimination, and threshold of meaning. New evidence was synthesized to fill the gap. Data were presented to the OMERACT technical advisory group (TAG) and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) community for endorsement. RESULTS The results for seven measurement properties for HAQ-DI and SF-36 PF were presented in Summary of Measurement Property (SOMP) tables. The working group proposed "Provisional Endorsement" for both instruments. The body of evidence was approved by the OMERACT TAG. In two Delphi exercises among GRAPPA members, HAQ-DI received 93.9% and 97.5% endorsement votes, while that for SF-36 PF were 86.7% and 77.3%. CONCLUSION Both HAQ-DI and SF-36 PF were provisionally endorsed for the measurement of physical function in PsA trials, using the OMERACT Filter 2.1.
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Gado SE, El-Khouly RM, Aboelhawa MA, Fouda MH, El-Banna HS. The association between IL17, fatigue and quality of life in psoriatic arthritis patients. Expert Rev Clin Immunol 2021; 17:539-544. [PMID: 33734916 DOI: 10.1080/1744666x.2021.1905522] [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: 10/21/2022]
Abstract
Background: Psoriatic arthritis is a chronic inflammatory condition. It impacts patients both physically and psychologically. Fatigue may be an early symptom of PsA, which impairs quality of life.Objectives: To assess serum IL-17, fatigue, quality of life and function impairment in PsA patients and to correlate them with clinical disease activity.Methods: 80 consecutive PsA patients were included. Fatigue assessed by Functional Assessment of Chronic Illness Therapy-Fatigue. Quality of life assessed by Psoriatic Arthritis Quality of Life. Functional capacity assessed by health assessment questionnaire. Disease activity assessed by Disease Activity in Psoriatic Arthritis. Serum IL-17 measured by ELISA.Results: There was significant difference in FACIT-F, PsAQOL, and HAQ (p<0.001) in different disease activity subgroups. There was statistically significant correlation of disease duration with disease activity, fatigue, reduced function capacity, and quality of life impairment (p≤0.05), while no correlation with the patients' age. There was statistically significant correlation between FACIT-F, PsAQOL, HAQ, and DAPSA scores (p<0.001). Serum IL-17 was significantly correlated with clinical parameters of disease activity, fatigue, function, and quality of life impairment (p≤0.05).Conclusion: Fatigue is a common clinical symptom in psoriatic arthritis patients. It is significantly associated with IL17, quality of life, functional impairment and disease activity.
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Affiliation(s)
- Souzan Ezzat Gado
- Physical medicine, Rheumatology & Rehabilitation, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | | | | | - Hanaa Samy El-Banna
- Physical Medicine, Rheumatology & Rehabilitation, Tanta University, Tanta, Egypt
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da Cruz Ribeiro E Souza E, da Silva Carneiro SC, Yazbek MA, de Cássia Menin R, Campanholo CB, Carneiro JN, da Silva CHM, Ranza R. Validation and clinical interpretability of PsAID - psoriatic arthritis impact of disease. Adv Rheumatol 2020; 60:49. [PMID: 32962756 DOI: 10.1186/s42358-020-00149-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 08/21/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Psoriatic arthritis (PsA) is a chronic inflammatory disease of widely varying presentation, which determines functional and psychological impairment, with a high negative impact on patients' quality of life. Therefore, knowing the patient's perception of their health status is of fundamental importance for understanding the real impact of PsA. Given this context, the European League Against Rheumatism (EULAR) recently developed the Psoriatic Arthritis Impact of Disease (PsAID) - instrument to specifically assess the impact of PsA for the patient. OBJECTIVE Validate the brazilian portuguese version of PsAID-12 (Psoriatic Arthritis Impact of Disease) and to verify its interpretability in clinical practice, through its relation with measures of psoriatic arthritis activity. METHODS A multicenter cross-sectional study, which recruited 160 patients, who met the Classification criteria for Psoriatic Arthritis (CASPAR), in six Brazilian centers of rheumatology. Reliability was assessed by Cronbach's alpha coefficient and by the intraclass correlation coefficient (ICC). The construct validity was evaluated by exploratory factorial analysis and also by Spearman correlation with other PROMs and measures of disease activity evaluation. RESULTS Of the total number of participants, 50% were female, with a mean age (SD) of 54.0 ± 11.2 years; 68% had only peripheral arthritis and 32% had pure or mixed axial involvement. The majority (67.7%) of the patients were using biological treatment. The reliability of internal consistency (alpha-Cronbach = 0.93) and test-retest (ICC = 0.996) were good. Factor analysis revealed two factors, named physical and psychosocial, which included the skin evaluation item. PsAID-12 correlated significantly with other PROMs, demonstrating good construct validity. PsAID-12 was also significantly associated with the disease activity assessment instruments (DAS28-ESR, ASDAS, and BASDAI) and the MDA status: "Minimum Disease Activity". Fibromyalgia did not significantly affect the final PsAID-12 score. CONCLUSION The brazilian version of PsAID-12 has been shown to be a reliable and valid measure of the impact of the disease in patients with psoriatic arthritis. Moreover, it associated significantly with the scores of disease activity assessment.
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Affiliation(s)
- Elziane da Cruz Ribeiro E Souza
- Department of Rheumatology, Federal University of Uberlândia, Av. Mato Grosso, 3395, 302, Umuarama, Uberlândia, Minas Gerais, 38405-314, Brazil.
| | | | | | - Rita de Cássia Menin
- Faculty of Medicine of São José do Rio Preto, São Paulo, São José do Rio Preto, Brazil
| | | | | | - Carlos Henrique Martis da Silva
- Department of Rheumatology, Federal University of Uberlândia, Av. Mato Grosso, 3395, 302, Umuarama, Uberlândia, Minas Gerais, 38405-314, Brazil
| | - Roberto Ranza
- Department of Rheumatology, Federal University of Uberlândia, Av. Mato Grosso, 3395, 302, Umuarama, Uberlândia, Minas Gerais, 38405-314, Brazil
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Yang Z, Li S, Wang X, Chen G. Health state utility values derived from EQ-5D in psoriatic patients: a systematic review and meta-analysis. J DERMATOL TREAT 2020; 33:1029-1036. [PMID: 32716651 DOI: 10.1080/09546634.2020.1800571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND To determine pooled EQ-5D utility scores for psoriasis as a general condition, plaque psoriasis, and psoriatic arthritis. METHODS A systematic review and meta-analysis of EQ-5D utility scores for psoriatic patients was conducted. Univariate meta-regression was used to explore the degree of heterogeneity. RESULTS Seventy-five studies were included in the systematic review. The EQ-5D in psoriatic patients demonstrated decent convergent, known-groups validity, and a degree of responsiveness with a ceiling effect. Among the five EQ-5D dimensions, 'self-care' showed the lowest and 'pain/discomfort' showed the highest percentages of reporting any problems. For meta-analysis, we identified 70 utility scores from 59 studies: 22 for plaque psoriasis, 26 for psoriasis as a general condition, and 22 for psoriatic arthritis. The mean (95% CIs; I2) of the EQ-5D utility scores for psoriasis as a general condition, plaque psoriasis, and psoriatic arthritis was 0.748 (0.718, 0.777; 98.8%), 0.755 (0.727, 0.783; 98.6%), and 0.585 (0.538, 0.632; 98.2%), respectively. For psoriasis as a general condition and plaque psoriasis, factors such as country, psoriasis area and severity index (PASI), dermatology life quality index (DLQI) and questionnaire version (EQ-5D-3L or EQ-5D-5L) all significantly influenced the utility scores. CONCLUSION Psoriasis imposes a substantial impairment on patients' quality of life, especially the pain/discomfort dimension. Heterogeneity exists among different EQ-5D utility values found in the literature.
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Affiliation(s)
- Zhonghua Yang
- School of Health Care Management, Cheeloo College of Medicine, Shandong University, Jinan, China.,Sichuan Development Centre for Health Aging, Chengdu, China.,NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Shunping Li
- School of Health Care Management, Cheeloo College of Medicine, Shandong University, Jinan, China.,NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Xuewen Wang
- School of Health Care Management, Cheeloo College of Medicine, Shandong University, Jinan, China.,NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, Australia
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Seng JJB, Kwan YH, Fong W, Phang JK, Lui NL, Thumboo J, Leung YY. Validity and reliability of EQ-5D-5L among patients with axial spondyloarthritis in Singapore. Eur J Rheumatol 2020; 7:71-78. [PMID: 32644927 DOI: 10.5152/eurjrheum.2020.19043] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 01/11/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE This study aims to evaluate the reliability and validity of EuroQOL-5 Dimensions-5 Levels (EQ-5D-5L) among patients with axial spondyloarthritis (SpA) in Singapore. METHODS A cross-sectional study was conducted involving patients with axial SpA in an Asian tertiary hospital from 2017 to 2018. This study followed the COnsensus-based Standards for selection of health Measurement Instruments framework. Construct validity was evaluated by testing 22 a priori hypotheses with other patient-reported outcomes measures. Cronbach's alpha was used to estimate the internal consistency of the EQ-5D-5L, while its test-retest reliability was assessed using weighted kappa and the intraclass correlation coefficient (ICC). The measurement error was assessed by analyzing minimal detectable change (MDC). RESULTS The median age of included patients (n=118) was 35 years (interquartile range: 28, 49). Ninety-six (81.4%) patients were male, while 112 (94.9%) patients were of Chinese ethnicity. The EQ-5D-5L demonstrated good internal consistency with a Cronbach's alpha of 0.79. The test-retest reliability of the EQ-5D-5L was good with a weighted kappa of ≥0.61 for mobility, self-care, usual activities, and anxiety/depression; the ICC was 0.92 and 0.99 for the EQ-5D-5L index and visual analog scale (VAS) scores, respectively. The weighted kappa for the EQ-5D-5L pain/discomfort was moderate [0.53, 95% confidence interval: 0.41-0.60]. The MDC for EQ-5D-5L index and VAS scores was 0.06 and 4.5, respectively. Convergent validity was supported as all hypotheses were confirmed in the results. CONCLUSION This study supports EQ-5D-5L as a valid and reliable instrument for assessing health-related quality of life among patients with axial SpA in Singapore.
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Affiliation(s)
| | - Yu Heng Kwan
- Program in Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore
| | - Warren Fong
- Department of Medicine, Duke-NUS Medical School, 8 College Road, Singapore.,Department of Rheumatology and Immunology, Singapore General Hospital, Outram Road, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 12 Science Drive 2, Singapore
| | - Jie Kie Phang
- Department of Rheumatology and Immunology, Singapore General Hospital, Outram Road, Singapore
| | - Nai Lee Lui
- Department of Rheumatology and Immunology, Singapore General Hospital, Outram Road, Singapore
| | - Julian Thumboo
- Program in Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore.,Department of Rheumatology and Immunology, Singapore General Hospital, Outram Road, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 12 Science Drive 2, Singapore
| | - Ying Ying Leung
- Department of Medicine, Duke-NUS Medical School, 8 College Road, Singapore.,Department of Rheumatology and Immunology, Singapore General Hospital, Outram Road, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 12 Science Drive 2, Singapore
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11
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Abstract
A treat-to-target approach to psoriatic arthritis has emerged as a topic of interest following successful application of this treatment paradigm to rheumatoid arthritis. In psoriatic arthritis, this has been examined in one randomized trial to date showing benefits of a tight control treatment strategy over standard care. Nonetheless, international treatment recommendations have called for clinicians to aim for a target of remission or low disease activity, although little or no consensus exists on how to measure these targets. An ideal measure to define a treatment target should be able to address all the disease domains and preferences pertinent to an individual patient.
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Affiliation(s)
- Amy D Zhang
- University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0943, USA
| | - Arthur Kavanaugh
- University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0943, USA.
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12
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Zrubka Z, Beretzky Z, Hermann Z, Brodszky V, Gulácsi L, Rencz F, Baji P, Golicki D, Prevolnik-Rupel V, Péntek M. A comparison of European, Polish, Slovenian and British EQ-5D-3L value sets using a Hungarian sample of 18 chronic diseases. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2019; 20:119-132. [PMID: 31104218 PMCID: PMC6544595 DOI: 10.1007/s10198-019-01069-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 04/15/2019] [Indexed: 05/31/2023]
Abstract
BACKGROUND In the Central and Eastern European region, the British EQ-5D-3L value set is used commonly in quality of life (QoL) studies. Only Poland and Slovenia have country-specific weights. Our study aimed to investigate the impact of value set choice on the evaluation of 18 chronic conditions in Hungary. METHODS Patients' EQ-5D-3L index scores were calculated using the VAS-based Slovenian and European and the time-trade-off-based Polish and British value sets. We performed pairwise comparisons of mean index values by dimensions, diagnoses and age groups. We evaluated disease burden by comparing index values matched by age and gender in each condition with those of the general population of the CEE region in all four value sets. RESULTS Altogether, 2421 patients (55% female) were included in our sample with the average age of 55.87 years (SD = 17.75). The average Slovenian, European, Polish and British EQ-5D-3L scores were 0.598 (SD = 0.279), 0.661 (SD = 0.257), 0.770 (SD = 0.261) and 0.644 (SD = 0.279), respectively. We found highly significant differences in most diagnoses, with the greatest difference between the Polish and Slovenian index values in Parkinson's disease (0.265). Systematic pairwise comparison across all conditions and value sets revealed greatest differences between the time-trade-off (TTO) and VAS-based value sets as well as varying sensitivity of the disease burden evaluations of chronic disease conditions to the choice of value sets. CONCLUSIONS Our results suggest that the choice of value set largely influences the health state utility results in chronic diseases, and might have a significant impact on health policy decisions.
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Affiliation(s)
- Zsombor Zrubka
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary.
- Doctoral School of Business and Management, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary.
| | - Zsuzsanna Beretzky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary
- Doctoral School of Business and Management, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary
| | - Zoltán Hermann
- Centre for Economic and Regional Studies, Hungarian Academy of Sciences, Tóth Kálmán u. 4, Budapest, 1097, Hungary
- Centre of Labour Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary
- Premium Postdoctoral Research Program, Hungarian Academy of Sciences, Nádor u. 7, Budapest, 1051, Hungary
| | - Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary
| | - Dominik Golicki
- Department of Clinical and Experimental Pharmacology, Medical University of Warsaw, Banacha 1B, Warsaw, 02-097, Poland
| | | | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary
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13
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Chiowchanwisawakit P, Srinonprasert V, Thaweeratthakul P, Katchamart W. Disease activity and functional status associated with health-related quality of life and patient-acceptable symptom state in patients with psoriatic arthritis in Thailand: A cross-sectional study. Int J Rheum Dis 2019; 22:700-707. [PMID: 30666824 DOI: 10.1111/1756-185x.13473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 12/19/2018] [Accepted: 12/22/2018] [Indexed: 01/02/2023]
Abstract
AIM To identify factors associated with the EuroQol-5 Dimensions-5 levels (EQ-5D-5L) and patient acceptable symptom state (PASS) and to estimate health utility (HU) in Thai patients with psoriatic arthritis (PsA). METHODS A cross-sectional study of consecutive PsA patients visiting Siriraj Hospital was performed between 31 May, 2012 and 31 March, 2016. Data of patient demographics, HU outcomes (Thai EQ-5D-5L), disease activity (Disease Activity Index for Psoriatic Arthritis [DAPSA], the Clinical DAPSA [cDAPSA], the minimal disease activity [MDA]), and the Health Assessment Questionnaire (HAQ) were collected. Regression analyses were used to explore factors associated with each EQ-5D domain, HU, and PASS. RESULTS Of 129 PsA patients, the mean age was 47.6 years; 53.5% were male. The mean HU was 0.76. Univariable analysis showed lower disease activity and less impaired function were significantly associated with higher HU and no to mild problem in each EQ-5D domain. Multivariable analysis showed HAQ and disease activity indices (cDAPSA, DAPSA, MDA) adjusting for age, had good goodness-of-fit to HU (adjusted R2 : 0.63-0.65). Patients answering "yes" to PASS had significantly longer disease duration of PsA, higher HU, lower disease activity, less disability, and were more often married than those answering "no" to PASS. Pain problem was the most important association to PASS adjusting for other domains and age. CONCLUSIONS Disease activity and functional status in PsA patients were significant factors related to HU and PASS. To improve quality of life, the goal of treatment should be achieving remission, improving function, and controlling pain.
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Affiliation(s)
- Praveena Chiowchanwisawakit
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Varalak Srinonprasert
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Phakhamon Thaweeratthakul
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Wanruchada Katchamart
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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14
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Strand V, de Vlam K, Covarrubias-Cobos JA, Mease PJ, Gladman DD, Chen L, Kudlacz E, Wu J, Cappelleri JC, Hendrikx T, Hsu MA. Effect of tofacitinib on patient-reported outcomes in patients with active psoriatic arthritis and an inadequate response to tumour necrosis factor inhibitors in the phase III, randomised controlled trial: OPAL Beyond. RMD Open 2019; 5:e000808. [PMID: 30713722 PMCID: PMC6340607 DOI: 10.1136/rmdopen-2018-000808] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 10/05/2018] [Accepted: 10/13/2018] [Indexed: 01/27/2023] Open
Abstract
Objectives Tofacitinib is an oral Janus kinase inhibitor for treatment of psoriatic arthritis (PsA). Patient-reported outcomes (PROs) were evaluated in patients with PsA with inadequate responses to tumour necrosis factor inhibitors (TNFi-IR) in a 6-month, phase III randomised controlled trial (OPAL Beyond [NCT01882439]). Methods Patients (N=394) received tofacitinib 5 or 10 mg twice daily or placebo (advancing to tofacitinib 5 or 10 mg twice daily at month 3). Least squares mean changes from baseline and percentages of patients reporting improvements ≥minimum clinically important differences and scores ≥normative values were determined in Patient Global Assessment of disease activity (PtGA), Pain, Patient Global Joint and Skin Assessment (PGJS), Short Form-36 Health Survey version 2 (SF-36v2), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue), EuroQol 5-Dimensions-3-level (EQ-5D-3L), EQ-VAS and Ankylosing Spondylitis Quality of Life (ASQoL). Nominal p values are without multiple comparison adjustments. Results At month 3, PtGA, Pain, PGJS, SF-36v2 Physical Component Summary (PCS), physical functioning (PF), bodily pain (BP), vitality and social functioning (SF) domains, FACIT-Fatigue Total score, EQ-5D-3L pain/discomfort, EQ-VAS and ASQoL scores exceeded placebo with both tofacitinib doses (role physical [RP] with 10 mg twice daily only; p≤0.05). Patients reporting improvements ≥MCID (%) in PtGA, PGJS, Pain, ASQoL and SF-36v2 PCS, PF, RP, BP, SF (both tofacitinib doses) exceeded placebo (p≤0.05). Conclusion TNFi-IR patients with PsA receiving tofacitinib reported statistically and clinically meaningful improvements in PROs versus placebo over 3 months, which were maintained to month 6. Despite lower baseline scores, these improvements were similar to the csDMARD-IR TNFi-naive OPAL Broaden trial.
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Affiliation(s)
- Vibeke Strand
- Division of Immunology/Rheumatology, Stanford University, Palo Alto, California, USA
| | - Kurt de Vlam
- Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium
| | | | - Philip J Mease
- Swedish Medical Center and University of Washington, Seattle, Washington, USA
| | - Dafna D Gladman
- University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada
| | | | | | - Joseph Wu
- Pfizer Inc, Groton, Connecticut, USA
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15
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Strand V, de Vlam K, Covarrubias-Cobos JA, Mease PJ, Gladman DD, Graham D, Wang C, Cappelleri JC, Hendrikx T, Hsu MA. Tofacitinib or adalimumab versus placebo: patient-reported outcomes from OPAL Broaden-a phase III study of active psoriatic arthritis in patients with an inadequate response to conventional synthetic disease-modifying antirheumatic drugs. RMD Open 2019; 5:e000806. [PMID: 30713721 PMCID: PMC6340575 DOI: 10.1136/rmdopen-2018-000806] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 10/18/2018] [Accepted: 10/18/2018] [Indexed: 01/11/2023] Open
Abstract
Objectives Tofacitinib is an oral Janus kinase inhibitor for treatment of psoriatic arthritis (PsA). We evaluated patient-reported outcomes (PROs) in patients with PsA refractory to ≥1 conventional synthetic disease-modifying antirheumatic drug (csDMARD-IR) and tumour necrosis factor inhibitor-naïve in a 12-month, phase III randomised controlled trial (OPAL Broaden [NCT01877668]). Methods Patients (N=422) received tofacitinib 5 mg or 10 mg twice daily, adalimumab 40 mg subcutaneously every 2 weeks or placebo advancing to tofacitinib 5 mg or 10 mg twice daily at month 3. Least squares mean changes from baseline and percentages of patients reporting improvements ≥minimum clinically important differences (MCID); and scores ≥normative values in: Patient Global Assessment of disease activity (PtGA), Pain, Patient Global Joint and Skin Assessment (PGJS), Short Form-36 Health Survey version 2 (SF-36v2), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue), EuroQol 5-Dimensions-3-level questionnaire (EQ-5D-3L) and Ankylosing Spondylitis Quality of Life (ASQoL) were determined. Nominal p values were cited without multiple comparison adjustments. Results At month 3, PtGA, Pain, PGJS, FACIT-Fatigue, EQ-5D-3L, ASQoL and SF-36v2 Physical Component Summary (PCS), physical functioning (PF), bodily pain (BP) and vitality domain scores exceeded placebo with both tofacitinib doses (p≤0.05); SF-36v2 social functioning with 5 mg twice daily (p≤0.05). Percentages reporting improvements ≥MCID in PtGA, Pain, PGJS, FACIT-Fatigue, ASQoL and SF-36v2 PCS, PF, BP and general health scores exceeded placebo with both tofacitinib doses (p≤0.05) and were similar with adalimumab. Conclusion csDMARD-IR patients with active PsA reported statistically and clinically meaningful improvements in PROs with tofacitinib compared with placebo at Month 3.
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Affiliation(s)
- Vibeke Strand
- Division of Immunology/Rheumatology, Stanford University, Palo Alto, California, USA
| | - Kurt de Vlam
- Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium
| | | | - Philip J Mease
- Swedish Medical Center and University of Washington, Seattle, Washington, USA
| | - Dafna D Gladman
- University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada
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16
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Mease P, Strand V, Gladman D. Functional impairment measurement in psoriatic arthritis: Importance and challenges. Semin Arthritis Rheum 2018; 48:436-448. [DOI: 10.1016/j.semarthrit.2018.05.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 04/27/2018] [Accepted: 05/21/2018] [Indexed: 12/21/2022]
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17
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Corbett M, Chehadah F, Biswas M, Moe-Byrne T, Palmer S, Soares M, Walton M, Harden M, Ho P, Woolacott N, Bojke L. Certolizumab pegol and secukinumab for treating active psoriatic arthritis following inadequate response to disease-modifying antirheumatic drugs: a systematic review and economic evaluation. Health Technol Assess 2018; 21:1-326. [PMID: 28976302 DOI: 10.3310/hta21560] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Several biologic therapies are approved by the National Institute for Health and Care Excellence (NICE) for psoriatic arthritis (PsA) patients who have had an inadequate response to two or more synthetic disease-modifying antirheumatic drugs (DMARDs). NICE does not specifically recommend switching from one biologic to another, and only ustekinumab (UST; STELARA®, Janssen Pharmaceuticals, Inc., Horsham, PA, USA) is recommended after anti-tumour necrosis factor failure. Secukinumab (SEC; COSENTYX®, Novartis International AG, Basel, Switzerland) and certolizumab pegol (CZP; CIMZIA®, UCB Pharma, Brussels, Belgium) have not previously been appraised by NICE. OBJECTIVE To determine the clinical effectiveness and cost-effectiveness of CZP and SEC for treating active PsA in adults in whom DMARDs have been inadequately effective. DESIGN Systematic review and economic model. DATA SOURCES Fourteen databases (including MEDLINE and EMBASE) were searched for relevant studies from inception to April 2016 for CZP and SEC studies; update searches were run to identify new comparator studies. REVIEW METHODS Clinical effectiveness data from randomised controlled trials (RCTs) were synthesised using Bayesian network meta-analysis (NMA) methods to investigate the relative efficacy of SEC and CZP compared with comparator therapies. A de novo model was developed to assess the cost-effectiveness of SEC and CZP compared with the other relevant comparators. The model was specified for three subpopulations, in accordance with the NICE scope (patients who have taken one prior DMARD, patients who have taken two or more prior DMARDs and biologic-experienced patients). The models were further classified according to the level of concomitant psoriasis. RESULTS Nineteen eligible RCTs were included in the systematic review of short-term efficacy. Most studies were well conducted and were rated as being at low risk of bias. Trials of SEC and CZP demonstrated clinically important efficacy in all key clinical outcomes. At 3 months, patients taking 150 mg of SEC [relative risk (RR) 6.27, 95% confidence interval (CI) 2.55 to 15.43] or CZP (RR 3.29, 95% CI 1.94 to 5.56) were more likely to be responders than patients taking placebo. The NMA results for the biologic-naive subpopulations indicated that the effectiveness of SEC and CZP relative to other biologics and each other was uncertain. Limited data were available for the biologic-experienced subpopulation. Longer-term evidence suggested that these newer biologics reduced disease progression, with the benefits being similar to those seen for older biologics. The de novo model generated incremental cost-effectiveness ratios (ICERs) for three subpopulations and three psoriasis subgroups. In subpopulation 1 (biologic-naive patients who had taken one prior DMARD), CZP was the optimal treatment in the moderate-severe psoriasis subgroup and 150 mg of SEC was optimal in the subgroups of patients with mild-moderate psoriasis or no concomitant psoriasis. In subpopulation 2 (biologic-naive patients who had taken two or more prior DMARDs), etanercept (ETN; ENBREL®, Pfizer Inc., New York City, NY, USA) is likely to be the optimal treatment in all subgroups. The ICERs for SEC and CZP versus best supportive care are in the region of £20,000-30,000 per quality-adjusted life-year (QALY). In subpopulation 3 (biologic-experienced patients or patients in whom biologics are contraindicated), UST is likely to be the optimal treatment (ICERs are in the region of £21,000-27,000 per QALY). The optimal treatment in subpopulation 2 was sensitive to the choice of evidence synthesis model. In subpopulations 2 and 3, results were sensitive to the algorithm for Health Assessment Questionnaire-Disability Index costs. The optimal treatment is not sensitive to the use of biosimilar prices for ETN and infliximab (REMICADE®, Merck Sharp & Dohme, Kenilworth, NJ, USA). CONCLUSIONS SEC and CZP may be an effective use of NHS resources, depending on the subpopulation and subgroup of psoriasis severity. There are a number of limitations to this assessment, driven mainly by data availability. FUTURE WORK Trials are needed to inform effectiveness of biologics in biologic-experienced populations. STUDY REGISTRATION This study is registered as PROSPERO CRD42016033357. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Mark Corbett
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Fadi Chehadah
- Centre for Health Economics, University of York, York, UK
| | - Mousumi Biswas
- Centre for Reviews and Dissemination, University of York, York, UK
| | | | - Stephen Palmer
- Centre for Health Economics, University of York, York, UK
| | - Marta Soares
- Centre for Health Economics, University of York, York, UK
| | - Matthew Walton
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Melissa Harden
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Pauline Ho
- The Kellgren Centre for Rheumatology, Central Manchester and Manchester Children's University Hospitals Trust, Manchester, UK
| | - Nerys Woolacott
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Laura Bojke
- Centre for Health Economics, University of York, York, UK
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Kragsnaes MS, Kjeldsen J, Horn HC, Munk HL, Pedersen FM, Holt HM, Pedersen JK, Holm DK, Glerup H, Andersen V, Fredberg U, Kristiansen K, Christensen R, Ellingsen T. Efficacy and safety of faecal microbiota transplantation in patients with psoriatic arthritis: protocol for a 6-month, double-blind, randomised, placebo-controlled trial. BMJ Open 2018; 8:e019231. [PMID: 29703851 PMCID: PMC5922473 DOI: 10.1136/bmjopen-2017-019231] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION An unbalanced intestinal microbiota may mediate activation of the inflammatory pathways seen in psoriatic arthritis (PsA). A randomised, placebo-controlled trial of faecal microbiota transplantation (FMT) infused into the small intestine of patients with PsA with active peripheral disease who are non-responsive to methotrexate (MTX) treatment will be conducted. The objective is to explore clinical aspects associated with FMT performed in patients with PsA. METHODS AND ANALYSIS This trial is a randomised, two-centre stratified, double-blind (patient, care provider and outcome assessor), placebo-controlled, parallel-group study. Eighty patients will be included and randomised (1:1) to either placebo (saline) or FMT provided from an anonymous healthy donor. Throughout the study, both groups will continue the weekly self-administered subcutaneous MTX treatment, remaining on the preinclusion dosage (15-25 mg/week). The clinical measures of psoriasis and PsA disease activity used include the Short (2-page) Health Assessment Questionnaire, the Dermatology Quality of Life Index, the Spondyloarthritis Research Consortium of Canada Enthesitis Index, the Psoriasis Area Severity Index, a dactylitis digit count, a swollen/tender joint count (66/68), plasma C reactive protein as well as visual analogue scales for pain, fatigue and patient and physician global assessments. The primary end point is the proportion of patients who experience treatment failure during the 6-month trial period. The number of adverse events will be registered throughout the study. ETHICS AND DISSEMINATION This is a proof-of-concept clinical trial and will be performed in agreement with Good Clinical Practice standards. Approvals have been obtained from the local Ethics Committee (DK-S-20150080) and the Danish Data Protection Agency (15/41684). The study has commenced in May 2017. Dissemination will be through presentations at national and international conferences and through publications in international peer-reviewed journal(s). TRIAL REGISTRATION NUMBER NCT03058900; Pre-results.
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Affiliation(s)
- Maja Skov Kragsnaes
- Department of Rheumatology, Odense University Hospital, Odense, Denmark
- Odense Patient data Explorative Network (OPEN), Department of Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Jens Kjeldsen
- Department of Gastroenterology, Odense University Hospital, Odense, Denmark
| | | | | | | | - Hanne Marie Holt
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
| | | | | | - Henning Glerup
- Diagnostic Centre, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Vibeke Andersen
- IRS-Centre Sonderjylland, Hospital of Southern Jutland, Aabenraa, Denmark
- Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Ulrich Fredberg
- Diagnostic Centre, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Karsten Kristiansen
- Laboratory of Genomics and Molecular Biomedicine, Department of Biology, University of Copenhagen, Copenhagen, Denmark
- Institute of Metagenomics, BGI-Shenzhen, Shenzhen, China
| | - Robin Christensen
- Musculoskeletal Statistics Unit, Parker Institute, Frederiksberg and Bispebjerg Hospital, Copenhagen, Denmark
| | - Torkell Ellingsen
- Department of Rheumatology, Odense University Hospital, Odense, Denmark
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Højgaard P, Klokker L, Orbai AM, Holmsted K, Bartels EM, Leung YY, Goel N, de Wit M, Gladman DD, Mease P, Dreyer L, Kristensen LE, FitzGerald O, Tillett W, Gossec L, Helliwell P, Strand V, Ogdie A, Terwee CB, Christensen R. A systematic review of measurement properties of patient reported outcome measures in psoriatic arthritis: A GRAPPA-OMERACT initiative. Semin Arthritis Rheum 2018; 47:654-665. [DOI: 10.1016/j.semarthrit.2017.09.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 09/06/2017] [Indexed: 01/10/2023]
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20
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O'Dwyer JL, Meads DM, Hulme CT, Mcparland L, Brown S, Coates LC, Moverley AR, Emery P, Conaghan PG, Helliwell PS. Cost-Effectiveness of Tight Control of Inflammation in Early Psoriatic Arthritis: Economic Analysis of a Multicenter Randomized Controlled Trial. Arthritis Care Res (Hoboken) 2018; 70:462-468. [DOI: 10.1002/acr.23293] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/16/2017] [Indexed: 11/07/2022]
Affiliation(s)
- John L. O'Dwyer
- Leeds Institute of Health Sciences; University of Leeds; Leeds UK
| | - David M. Meads
- Leeds Institute of Health Sciences; University of Leeds; Leeds UK
| | - Claire T. Hulme
- Leeds Institute of Health Sciences; University of Leeds; Leeds UK
| | - Lucy Mcparland
- Leeds Institute of Clinical Trials Research; University of Leeds; Leeds UK
| | - Sarah Brown
- Leeds Institute of Clinical Trials Research; University of Leeds; Leeds UK
| | - Laura C. Coates
- Leeds Institute of Rheumatic and Musculoskeletal Medicine; Chapel Allerton Hospital; Leeds UK
| | - Anna R. Moverley
- Leeds Institute of Rheumatic and Musculoskeletal Medicine; Chapel Allerton Hospital; Leeds UK
| | - Paul Emery
- Leeds Institute of Rheumatic and Musculoskeletal Medicine; Chapel Allerton Hospital; Leeds UK
| | - Philip G. Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine; Chapel Allerton Hospital; Leeds UK
| | - Philip S. Helliwell
- Leeds Institute of Rheumatic and Musculoskeletal Medicine; Chapel Allerton Hospital; Leeds UK
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Torre-Alonso JC, Queiro R, Comellas M, Lizán L, Blanch C. Patient-reported outcomes in European spondyloarthritis patients: a systematic review of the literature. Patient Prefer Adherence 2018; 12:733-747. [PMID: 29780239 PMCID: PMC5951138 DOI: 10.2147/ppa.s162420] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE This review aims to summarize the current literature on patient-reported outcomes (PROs) in spondyloarthritis (SpA). PATIENTS AND METHODS We performed a systematic literature review to identify studies (original articles and narrative and systematic reviews) regarding PROs (health-related quality of life [HRQoL], satisfaction, preferences, adherence/compliance, and persistence) in SpA patients published in the European Union through December 2016. International databases (Medline/PubMed, Cochrane Library, ISI Web of Knowledge, Scopus) were searched using keywords in English. The methodological quality of the studies was assessed using the Oxford Centre for Evidence-Based Medicine criteria. RESULTS A total of 26 publications met the inclusion criteria. Generally, studies indicated that SpA has a negative impact on patients' HRQoL. In patients with ankylosing spondylitis, physical domains were more affected than emotional ones, whereas for psoriatic arthritis, both physical and psychological factors were strongly affected by the disease. Data indicated that biological agents (BAs) greatly contributed to improvement in HRQoL in both ankylosing spondylitis and psoriatic arthritis patients. Findings on compliance with BAs were heterogeneous. However, persistence rates exceeded 50% irrespective of the BA administered. Results on preferences indicated that most SpA patients prefer being involved in decisions regarding their treatment and that besides efficacy and safety, frequency and route of administration may influence patients' preferences for BAs. CONCLUSION Implementing management programs for SpA patients focuses on the physical, emotional, and social consequences of the disease, in addition to assessing and including patient preferences in the treatment decision-making process, could be crucial to improve patients' HRQoL and ensure their satisfaction and compliance with treatment.
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Affiliation(s)
- Juan Carlos Torre-Alonso
- Rheumatology Department, Faculty of Medicine and Health Sciences, University of Oviedo, Hospital Monte Naranco, Oviedo, Spain
- Correspondence: Juan Carlos Torre-Alonso, Facultad de Medicina y Ciencias de la Salud, Reumatología Hospital Universitario Monte Naranco, 107 Avenida Doctores Fernández Vega, Oviedo, Asturias 33012, Spain, Tel +34 985 106 900, Email
| | - Rubén Queiro
- Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | | | - Luís Lizán
- Outcomes 10, Castellón de la Plana, Spain
- Medicine Department, Jaime I University, Castellón de la Plana, Spain
| | - Carles Blanch
- Health Economics & Market Access, Novartis Pharmaceuticals, Barcelona, Spain
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Zrubka Z, Rencz F, Závada J, Golicki D, Rupel VP, Simon J, Brodszky V, Baji P, Petrova G, Rotar A, Gulácsi L, Péntek M. EQ-5D studies in musculoskeletal and connective tissue diseases in eight Central and Eastern European countries: a systematic literature review and meta-analysis. Rheumatol Int 2017; 37:1957-1977. [PMID: 28849432 DOI: 10.1007/s00296-017-3800-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/17/2017] [Indexed: 02/05/2023]
Abstract
EQ-5D is becoming the preferred instrument to measure health-state utilities involved in health technology assessment. The objective of this study is to assess the state of EQ-5D research in musculoskeletal disorders in 8 Central and Eastern European countries and to provide a meta-analysis of EQ-5D index scores. Original research articles published in any language between Jan 2000 and Sept 2016 were included, if they reported any EQ-5D outcome from at least two musculoskeletal patients from Austria, Bulgaria, the Czech Republic, Hungary, Poland, Romania, Slovakia, or Slovenia. Risk of bias was assessed with the Cochrane Collaboration's tool. Twenty-nine articles (5992 patients) were included on rheumatoid arthritis (n = 7), osteoporosis (n = 5), chronic pain (n = 5), osteoarthritis (n = 4), ankylosing spondylitis (n = 2), psoriatic arthritis (n = 2), total hip replacement (n = 2), and scleroderma (n = 2). Low back pain was under-represented, while studies in neck pain, systemic lupus erythematosus, gout, and childhood disorders were lacking. EQ-5D index scores were reported in 24 studies, while the version of the instrument and the value-set was not specified in 41% and 46% of the articles, respectively. Meta-analysis was performed on 24 disease states involving 6876 observation points. Intervention effect was reported in 22 subgroups, out of which risk of bias was low in 41%. This review provides recommendations to improve reporting standards of EQ-5D results and highlights potential areas for future research. Coordinated research in conditions with greatest public health impact as well as a development of a regional value-set could provide locally relevant health-state utilities that are transferable among countries within the region.
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Affiliation(s)
- Zsombor Zrubka
- Doctoral School of Business and Management, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary
- Sandoz Hungária Kft, Bartók Béla u. 43-47, 1134, Budapest, Hungary
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary
| | - Jakub Závada
- Institute of Rheumatology, Na Slupi 4, Prague, 128 00, Czech Republic
| | - Dominik Golicki
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, ul. Banacha 1b, 02-097, Warsaw, Poland
| | | | - Judit Simon
- Department of Health Economics, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1 1090, Vienna, Austria
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary
| | - Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary
| | - Guenka Petrova
- Department of Social Pharmacy and Pharmacoeconomics, Faculty of Pharmacy, Medical University, Sofia, Bulgaria
| | - Alexandru Rotar
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 22660, 1100 DD, Amsterdam, The Netherlands
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary.
- Department of Rheumatology, Flór Ferenc County Hospital, Semmelweis tér 1, 2143, Kistarcsa, Hungary.
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23
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Braun J. New targets in psoriatic arthritis. Rheumatology (Oxford) 2017; 55:ii30-ii37. [PMID: 27856658 DOI: 10.1093/rheumatology/kew343] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 08/23/2016] [Indexed: 12/30/2022] Open
Abstract
PsA is an immune-mediated chronic inflammatory disease that affects both skin and joints; it is a heterogeneous disease characterized by synovitis, enthesitis, dactylitis and spondylitis. The impact on patients and the burden of disease are substantial. For assessment of the disease, patient-reported outcomes are increasingly important. Conventional therapy consists of NSAIDs, local and systemic CSs, and synthetic and biological DMARDs. While MTX, LEF, SSZ and CYC are the synthetic drugs mainly used, TNF-α blocking agents have represented the majority of biologics used in the last decade (infliximab, etanercept, adalimumab, certolizumab and golimumab). Treat-to-target strategies have been used successfully in PsA. This review concentrates on new developments, mainly covering biologic agents with an IL-17 inhibitor (secukinumab) and an anti-IL-23 agent (ustekinumab), but also synthetic drugs, including a novel phosphodiesterase-4 inhibitor (apremilast) and a Janus kinase inhibitor (tofacitinib) that blocks mainly Jak3 and Jak1 and, to a lesser extent, Jak2. The efficacy of some of these new agents may be even better for the skin than for the joints.
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Affiliation(s)
- Juergen Braun
- Rheumazentrum Ruhrgebiet, Herne, Ruhr University Bochum, Germany
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24
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Gladman DD, Poulin Y, Adams K, Bourcier M, Barac S, Barber K, Chandran V, Dutz J, Flanagan C, Gooderham MJ, Gulliver WP, Ho VC, Hong CH, Karsh J, Khraishi MM, Lynde CW, Papp KA, Rahman P, Rohekar S, Rosen CF, Russell AS, Vender RB, Yeung J, Ziouzina O, Zummer M. Treating Psoriasis and Psoriatic Arthritis: Position Paper on Applying the Treat-to-target Concept to Canadian Daily Practice. J Rheumatol 2017; 44:519-534. [DOI: 10.3899/jrheum.161473] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective.To develop preliminary treat-to-target (T2T) recommendations for psoriasis and psoriatic arthritis (PsA) for Canadian daily practice.Methods.A task force composed of expert Canadian dermatologists and rheumatologists performed a needs assessment among Canadian clinicians treating these diseases as well as an extensive literature search on the outcome measures used in clinical trials and practice.Results.Based on results from the needs assessment and literature search, the task force established 5 overarching principles and developed 8 preliminary T2T recommendations.Conclusion.The proposed recommendations should improve management of psoriasis and PsA in Canadian daily practice. However, these recommendations must be further validated in a real-world observational study to ensure that their use leads to better longterm outcomes.
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Rencz F, Gulácsi L, Drummond M, Golicki D, Prevolnik Rupel V, Simon J, Stolk EA, Brodszky V, Baji P, Závada J, Petrova G, Rotar A, Péntek M. EQ-5D in Central and Eastern Europe: 2000-2015. Qual Life Res 2016; 25:2693-2710. [PMID: 27472992 DOI: 10.1007/s11136-016-1375-6] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Cost per quality-adjusted life year data are required for reimbursement decisions in many Central and Eastern European (CEE) countries. EQ-5D is by far the most commonly used instrument to generate utility values in CEE. This study aims to systematically review the literature on EQ-5D from eight CEE countries. METHODS An electronic database search was performed up to 1 July 2015 to identify original EQ-5D studies from the countries of interest. We analysed the use of EQ-5D with respect to clinical areas, methodological rigor, population norms and value sets. RESULTS We identified 143 studies providing 152 country-specific results with a total sample size of 81,619: Austria (n = 11), Bulgaria (n = 6), Czech Republic (n = 18), Hungary (n = 47), Poland (n = 51), Romania (n = 2), Slovakia (n = 3) and Slovenia (n = 14). Cardiovascular (21 %), neurologic (17 %), musculoskeletal (15 %) and endocrine, nutritional and metabolic diseases (13 %) were the most frequently studied clinical areas. Overall, 112 (78 %) of the studies reported EQ VAS results and 86 (60 %) EQ-5D index scores, of which 27 (31 %) did not specify the applied tariff. Hungary, Poland and Slovenia have population norms. Poland and Slovenia also have a national value set. CONCLUSIONS Increasing use of EQ-5D is observed throughout CEE. The spread of health technology assessment activities in countries seems to be reflected in the number of EQ-5D studies. However, improvement in informed use and methodological quality of reporting is needed. In jurisdictions where no national value set is available, in order to ensure comparability we recommend to apply the most frequently used UK tariff. Regional collaboration between CEE countries should be strengthened.
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Affiliation(s)
- Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, H-1093, Hungary.,Semmelweis University Doctoral School of Clinical Medicine, Üllői út 26., Budapest, H-1085, Hungary
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, H-1093, Hungary.
| | - Michael Drummond
- Centre for Health Economics, University of York, Heslington, York, YO10 5DD, UK
| | - Dominik Golicki
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Poland, ul. Banacha 1b, 02-097, Warsaw, Poland
| | | | - Judit Simon
- Department of Health Economics, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1, 1090, Vienna, Austria
| | - Elly A Stolk
- Institute of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, H-1093, Hungary
| | - Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, H-1093, Hungary
| | - Jakub Závada
- Institute of Rheumatology, 1st Faculty of Medicine, Charles University, Na Slupi 4, 128 00, Prague, Czech Republic
| | - Guenka Petrova
- Department of Social Pharmacy and Pharmacoeconomics, Faculty of Pharmacy, Medical University, Sofia, Bulgaria
| | - Alexandru Rotar
- Department of Social Medicine, University of Amsterdam, Meibergdreef 9, 22660, 1100 DD, Amsterdam, The Netherlands
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, H-1093, Hungary
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Reliability and Validity of the Turkish Adaptation of VITACORA-19 in Patients with Psoriatic Arthritis. Arch Rheumatol 2016; 31:321-328. [PMID: 29900999 DOI: 10.5606/archrheumatol.2016.5741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 12/28/2015] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to evaluate the reliability and validity of the Turkish language version of VITACORA-19 (psoriatic arthritis quality of life questionnaire) in patients with psoriatic arthritis. Patients and methods The Turkish version of VITACORA-19 questionnaire was obtained after a translation and back translation process. The study sample included 61 PsA patients (22 males, 39 females; mean age 46.5±12.2 years; range 19 to 71 years). To assess the test-retest reliability of the Turkish VITACORA-19, the questionnaire was reapplied 10 to 15 days after the first interview (interclass correlation coefficient). Cronbach's alpha (a) was used to evaluate the internal consistency. VITACORA-19 was compared with visual analog scale for physician and patient global assessments, the Health Assessment Questionnaire, and Nottingham Health Profile for construct validity. The internal structure of VITACORA-19 was examined by factor analysis. Results The individual item intraclass correlation coefficient ranged from 0.77 to 0.98 and Cronbach's alpha ranged from 0.77 to 0.98. The Cronbach's alpha value for whole scale was determined as 0.96. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.90, and Bartlett's test of sphericity had a p<0.001. Turkish VITACORA-19 total scores were correlated negatively with Health Assessment Questionnaire, visual analog scale for pain, and Nottingham Health Profile subgroups, and positively with physician and patient global assessments (p<0.01). Conclusion Turkish version of VITACORA-19 questionnaire is a reliable and valid measure for health-related quality of life in Turkish patients with psoriatic arthritis.
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Betteridge N, Boehncke W, Bundy C, Gossec L, Gratacós J, Augustin M. Promoting patient-centred care in psoriatic arthritis: a multidisciplinary European perspective on improving the patient experience. J Eur Acad Dermatol Venereol 2016; 30:576-85. [PMID: 26377041 PMCID: PMC5049610 DOI: 10.1111/jdv.13306] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 06/15/2015] [Indexed: 01/05/2023]
Abstract
Patients with psoriatic arthritis (PsA) may not be optimally treated. The impact of the disease extends beyond skin and joint symptoms, impairing quality of life. This indicates that the adoption of a patient-focused approach to PsA management is necessary. An expert multidisciplinary working group was convened, with the objective of developing an informed perspective on current best practice and needs for the future management of PsA. Topics of discussion included the barriers to current best practice and calls to action for the improvement of three areas in PsA management: early and accurate diagnosis of PsA, management of disease progression and management of the impact of the condition on the patient. The working group agreed that, to make best use of the available of diagnostic tools, clinical care recommendations and effective treatments, there is a clear need for healthcare professionals from different disciplines to collaborate in the management of PsA. By facilitating appropriate and rapid referral, providing high quality information about PsA and its treatment to patients, and actively involving patients when choosing management plans and setting treatment goals, management of PsA can be improved. The perspective of the working group is presented here, with recommendations for the adoption of a multidisciplinary, patient-focused approach to the management of PsA.
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Affiliation(s)
| | - W.‐H. Boehncke
- Department of DermatologyGeneva University HospitalGenevaSwitzerland
- Department of Pathology and ImmunologyUniversity of GenevaGenevaSwitzerland
| | - C. Bundy
- Centre for Dermatology ResearchInstitute for Inflammation and RepairUniversity of Manchester and Manchester Academic Health Sciences CentreManchesterUK
| | - L. Gossec
- Sorbonne UniversitésUPMC Univ Paris 06ParisFrance
- Pitie‐Salpétrière Hospital AP‐HPParisFrance
| | - J. Gratacós
- Rheumatology Service, Hospital Universitari Parc Taulí of SabadellUABBarcelonaSpain
| | - M. Augustin
- University Medical Center Hamburg‐EppendorfHamburgGermany
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Abstract
Patient-reported outcome (PRO) measures are an important component to assessing disease impact and therapy response in patients with psoriatic arthritis (PsA). Overall, there are few PsA-specific PROs. Most PROs used in PsA are borrowed from other diseases (eg, rheumatoid arthritis and ankylosing spondylitis) or general population PROs. PROs are used in PsA clinical trials and in the clinical management of PsA. In this review, we discuss the most commonly used PRO in PsA, including their inclusion in composite measures. Future studies may be helpful to determine the best performing PROs in patients with PsA.
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Affiliation(s)
- Ana-Maria Orbai
- Division of Rheumatology, Johns Hopkins University, Asthma and Allergy Building, Room 1B19, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA.
| | - Alexis Ogdie
- Division of Rheumatology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, White Building, Room 5024, 3400 Spruce Street, Philadelphia, PA 19104, USA
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Yang Y, Brazier J, Longworth L. EQ-5D in skin conditions: an assessment of validity and responsiveness. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2015; 16:927-39. [PMID: 25358263 PMCID: PMC4646948 DOI: 10.1007/s10198-014-0638-9] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 09/24/2014] [Indexed: 05/07/2023]
Abstract
AIMS AND OBJECTIVES This systematic literature review aims to assess the reliability, validity and responsiveness of three widely used generic preference-based measures of health-related quality of life (HRQL), i.e., EQ-5D, Health Utility Index 3 (HUI3) and SF-6D in patients with skin conditions. METHODS A systematic search was conducted to identify studies reporting health state utility values obtained using EQ-5D, SF-6D, or HUI3 alongside other HRQL measures or clinical indices for patients with skin conditions. Data on test-retest analysis for reliability, known group differences or correlation and regression analyses for validity, and change over time or responsiveness indices analysis were extracted and reviewed. RESULTS A total of 16 papers reporting EQ-5D utilities in people with skin conditions were included in the final review. No papers for SF-6D and HUI3 were found. Evidence of reliability was not found for any of these measures. The majority of studies included in the review (12 out of 16) examined patients with plaque psoriasis or psoriatic arthritis and the remaining four studies examined patients with either acne, hidradenitis suppurativa, hand eczema, or venous leg ulcers. The findings were generally positive in terms of performance of EQ-5D. Six studies showed that EQ-5D was able to reflect differences between severity groups and only one reported differences that were not statistically significant. Four studies found that EQ-5D detected differences between patients and the general population, and differences were statistically different for three of them. Further, moderate-to-strong correlation coefficients were found between EQ-5D and other skin-specific HRQL measures in four studies. Eight studies showed that EQ-5D was able to detect change in HRQL appropriately over time and the changes were statistically significant in seven studies. CONCLUSIONS Overall, the validity and responsiveness of the EQ-5D was found to be good in people with skin diseases, especially plaque psoriasis or psoriatic arthritis. No evidence on SF-6D and HUI3 was available to enable any judgments to be made on their performance.
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Affiliation(s)
- Yaling Yang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, New Radcliffe House, Walton Street, Oxford, OX2 6NW, UK.
| | - John Brazier
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Louise Longworth
- Health Economics Research Group, Brunel University, Middlesex, UK
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Rencz F, Brodszky V, Péntek M, Balogh O, Remenyik E, Szegedi A, Holló P, Kárpáti S, Jókai H, Herszényi K, Herédi E, Szántó S, Gulácsi L. [Disease burden of psoriasis associated with psoriatic arthritis in Hungary]. Orv Hetil 2015; 155:1913-21. [PMID: 25417138 DOI: 10.1556/oh.2014.30044] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Psoriasis is a frequent, chronic, systemic immune-mediated disease mainly affecting the skin and joints. AIM To assess health related quality of life and cost-of-illness in moderate to severe psoriasis associated with psoriatic arthritis. METHOD A cross-sectional questionnaire survey was conducted at two academic dermatology clinics in Hungary. RESULTS Fifty-seven patients (65% males) completed the survey with a mean age of 54.3±11.6 years and mean EQ-5D score of 0.48±0.4. Mean annual total cost was €8,977 per patient, of which 71% occurred due to biological therapy and 21% were indirect costs, respectively. Permanent work disability due to psoriasis accounted for €1,775 (95% of the indirect costs). Per patient costs of subgroups not receiving systemic therapy (21%), traditional systemic therapy (32%), and biological systemic therapy (47%) amounted to the sum of €1,729, €1,799, and €16,983, respectively. CONCLUSIONS Patients on biological therapy showed significantly better health related quality of life. As for health economics, the efficacy of systemic treatments is appropriate to be assessed together in patients with moderate to severe psoriasis associated with psoriatic arthritis, since actual health gain might exceed that reported in psoriasis or psoriatic arthritis separately.
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Affiliation(s)
- Fanni Rencz
- Budapesti Corvinus Egyetem Egészségügyi Közgazdaságtan Tanszék Budapest Fővám tér 8. 1093 Semmelweis Egyetem, Általános Orvostudományi Kar Klinikai Orvostudományok Doktori Iskola Budapest
| | - Valentin Brodszky
- Budapesti Corvinus Egyetem Egészségügyi Közgazdaságtan Tanszék Budapest Fővám tér 8. 1093
| | - Márta Péntek
- Budapesti Corvinus Egyetem Egészségügyi Közgazdaságtan Tanszék Budapest Fővám tér 8. 1093 Pest Megyei Flór Ferenc Kórház Reumatológiai Osztály Kistarcsa
| | - Orsolya Balogh
- Budapesti Corvinus Egyetem Egészségügyi Közgazdaságtan Tanszék Budapest Fővám tér 8. 1093
| | - Eva Remenyik
- Debreceni Egyetem, Klinikai Központ, Általános Orvostudományi Kar Bőrgyógyászati Klinika, Bőrgyógyászati Allergológiai Tanszék Debrecen
| | - Andrea Szegedi
- Debreceni Egyetem, Klinikai Központ, Általános Orvostudományi Kar Bőrgyógyászati Klinika, Bőrgyógyászati Allergológiai Tanszék Debrecen
| | - Péter Holló
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest
| | - Sarolta Kárpáti
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest
| | - Hajnalka Jókai
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest
| | - Krisztina Herszényi
- Semmelweis Egyetem, Általános Orvostudományi Kar Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest
| | - Emese Herédi
- Debreceni Egyetem, Klinikai Központ, Általános Orvostudományi Kar Bőrgyógyászati Klinika, Bőrgyógyászati Allergológiai Tanszék Debrecen
| | - Sándor Szántó
- Debreceni Egyetem, Klinikai Központ, Általános Orvostudományi Kar Belgyógyászati Intézet, Reumatológiai Tanszék Debrecen
| | - László Gulácsi
- Budapesti Corvinus Egyetem Egészségügyi Közgazdaságtan Tanszék Budapest Fővám tér 8. 1093
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de Oliveira Junior HA, dos Santos JB, Acurcio FA, Almeida AM, Kakehasi AM, Alvares J, de Carvalho LFD, Cherchiglia ML. Poorer functionality is related to better quality of life response following the use of biological drugs: 6-month outcomes in a prospective cohort from the Public Health System (Sistema Único de Saúde), Minas Gerais, Brazil. Expert Rev Pharmacoecon Outcomes Res 2015; 15:403-12. [PMID: 25603696 DOI: 10.1586/14737167.2015.1003367] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
We aim to analyze factors associated with the quality of life (QOL) response of individuals with rheumatic diseases treated by the Public Health System (Sistema Único de Saúde) with biological disease-modifying antirheumatic drugs (bDMARDs). Data from 428 patients using bDMARDs were collected using a standardized form at baseline and 6 months after the onset of treatment. The average reduction of the scores on EuroQol-five dimension was 0.11 ± 0.18 6 months after the onset of treatment with bDMARDs, denoting significant improvement of the participants' QOL. All the investigated types of disease exhibited significant improvement at the 6-month assessment, without any difference among them (p = 0.965). The participants with baseline poorest functionality and best QOL exhibited the best QOL outcomes after 6 months of treatment. Our study showed that the use of biological drugs induced considerable improvement in the participants' QOL.
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Affiliation(s)
- Haliton Alves de Oliveira Junior
- Departamento de Farmácia Social, Programa de Pós-graduação em Medicamentos e Assistência Farmacêutica, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Campus Pampulha, bloco 2, 1° andar, sala 1023. Belo Horizonte, Minas Gerais, CEP 31270-901, Brazil
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Abstract
Psoriatic arthritis (PsA) is a heterogeneous inflammatory arthritis with a varied clinical phenotype. There has been considerable international collaboration over recent years to develop and prioritise appropriate disease domains and outcome measures to capture all aspects of this complex disease. It has been recognised that patient-reported measures and physician assessments are complementary and, when used together, allow an improved reflection of disease burden. Taking this concept one step further, the experience in rheumatoid arthritis has demonstrated benefits of incorporating the patient perspective in the development of outcome measures. We report a systematic review demonstrating (1) that there has been little incorporation of the patient perspective in the development of outcome measures and domains in PsA, (2) the proceedings from the preliminary patient involvement in outcome measures for PsA (PIOMPSA) meetings, and (3) a proposed roadmap for improving patient involvement.
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Torre-Alonso JC, Gratacós J, Rey-Rey JS, Valdazo de Diego JP, Urriticoechea-Arana A, Daudén E, Moreno M, Zarco-Montejo P, Collantes-Estévez E, Fernández-López JA. Development and validation of a new instrument to measure health-related quality of life in patients with psoriatic arthritis: the VITACORA-19. J Rheumatol 2014; 41:2008-17. [PMID: 25179846 DOI: 10.3899/jrheum.131021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To develop/validate an instrument to measure health-related quality of life (HRQoL) in patients with psoriatic arthritis (PsA), for use in clinical studies. METHODS An item pool of 35 items was generated following standardized procedures. Item reduction was performed using clinimetric and psychometric approaches after administration to 66 patients with PsA. The resulting instrument, the VITACORA-19, consists of 19 items. Its validity content, internal consistency, test-retest reliability, known groups/convergent validity, and sensitivity to change were tested in a longitudinal and multicenter study conducted in 10 hospitals in Spain, with 323 patients who also completed the EuroQol 5-dimensional questionnaire (EQ-5D) and a health status transition item. There were 3 study groups: group A (n = 209, patients with PsA), group B (n = 71, patients with arthritis without psoriatic aspect, patients with arthrosis, and patients with dermatitis), and group C (n = 43, healthy controls). RESULTS The questionnaire was considered easy/very easy to answer by 94.7% of the patients with PsA. The factorial analysis clearly identified only 1 factor. Cronbach's alpha coefficient and interclass correlation coefficients exceeded 0.90. Statistically significant differences (p < 0.001) were observed between groups: subjects from group C had better HRQoL, followed by group B, and finally group A had the worst HRQoL. The VITACORA-19 scores showed significant correlations (p < 0.001) to PsA disease activity, EQ-5D, and perceived health state, scoring the patients with better health state higher. The minimum important difference was established as an 8-point change in the global score. CONCLUSION The Spanish-developed VITACORA-19, designed to measure HRQoL in patients with PsA, has good validity, reliability, and sensitivity to change.
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Affiliation(s)
- Juan Carlos Torre-Alonso
- From the Facultad de Medicina; Hospital Monte Naranco, Oviedo; Hospital Parc Tauli, Sabadell; Complejo Hospitalario Toledo, Toledo; Hospital Virgen de la Concha, Zamora; Hospital Can Mises, Ibiza; Hospital Universitario de la Princesa; Hospital Alcorcon, Madrid; University Hospital "Reina Sofía"/IMIBIC, Cordoba; Centro Salud Riosa, Astorias, Spain.J.C. Torre-Alonso, MD, PhD, Facultad de Medicina, Hospital Monte Naranco; J. Gratacós, MD, PhD; M. Moreno, MD, Hospital Parc Tauli; J.S. Rey-Rey, MD, Complejo Hospitalario Toledo; J.P. Valdazo de Diego, MD, Hospital Virgen de la Concha; A. Urriticoechea-Arana, MD, Hospital Can Mises; E. Daudén, MD, PhD, Hospital Universitario de la Princesa; P. Zarco-Montejo, MD, PhD, Hospital Alcorcon; E. Collantes-Estévez, MD, PhD, University Hospital "Reina Sofía"/IMIBIC, Cordoba; J.A. Fernández-López, MD, PhD, Centro Salud Riosa.
| | - Jordi Gratacós
- From the Facultad de Medicina; Hospital Monte Naranco, Oviedo; Hospital Parc Tauli, Sabadell; Complejo Hospitalario Toledo, Toledo; Hospital Virgen de la Concha, Zamora; Hospital Can Mises, Ibiza; Hospital Universitario de la Princesa; Hospital Alcorcon, Madrid; University Hospital "Reina Sofía"/IMIBIC, Cordoba; Centro Salud Riosa, Astorias, Spain.J.C. Torre-Alonso, MD, PhD, Facultad de Medicina, Hospital Monte Naranco; J. Gratacós, MD, PhD; M. Moreno, MD, Hospital Parc Tauli; J.S. Rey-Rey, MD, Complejo Hospitalario Toledo; J.P. Valdazo de Diego, MD, Hospital Virgen de la Concha; A. Urriticoechea-Arana, MD, Hospital Can Mises; E. Daudén, MD, PhD, Hospital Universitario de la Princesa; P. Zarco-Montejo, MD, PhD, Hospital Alcorcon; E. Collantes-Estévez, MD, PhD, University Hospital "Reina Sofía"/IMIBIC, Cordoba; J.A. Fernández-López, MD, PhD, Centro Salud Riosa
| | - José Santos Rey-Rey
- From the Facultad de Medicina; Hospital Monte Naranco, Oviedo; Hospital Parc Tauli, Sabadell; Complejo Hospitalario Toledo, Toledo; Hospital Virgen de la Concha, Zamora; Hospital Can Mises, Ibiza; Hospital Universitario de la Princesa; Hospital Alcorcon, Madrid; University Hospital "Reina Sofía"/IMIBIC, Cordoba; Centro Salud Riosa, Astorias, Spain.J.C. Torre-Alonso, MD, PhD, Facultad de Medicina, Hospital Monte Naranco; J. Gratacós, MD, PhD; M. Moreno, MD, Hospital Parc Tauli; J.S. Rey-Rey, MD, Complejo Hospitalario Toledo; J.P. Valdazo de Diego, MD, Hospital Virgen de la Concha; A. Urriticoechea-Arana, MD, Hospital Can Mises; E. Daudén, MD, PhD, Hospital Universitario de la Princesa; P. Zarco-Montejo, MD, PhD, Hospital Alcorcon; E. Collantes-Estévez, MD, PhD, University Hospital "Reina Sofía"/IMIBIC, Cordoba; J.A. Fernández-López, MD, PhD, Centro Salud Riosa
| | - Juan Pablo Valdazo de Diego
- From the Facultad de Medicina; Hospital Monte Naranco, Oviedo; Hospital Parc Tauli, Sabadell; Complejo Hospitalario Toledo, Toledo; Hospital Virgen de la Concha, Zamora; Hospital Can Mises, Ibiza; Hospital Universitario de la Princesa; Hospital Alcorcon, Madrid; University Hospital "Reina Sofía"/IMIBIC, Cordoba; Centro Salud Riosa, Astorias, Spain.J.C. Torre-Alonso, MD, PhD, Facultad de Medicina, Hospital Monte Naranco; J. Gratacós, MD, PhD; M. Moreno, MD, Hospital Parc Tauli; J.S. Rey-Rey, MD, Complejo Hospitalario Toledo; J.P. Valdazo de Diego, MD, Hospital Virgen de la Concha; A. Urriticoechea-Arana, MD, Hospital Can Mises; E. Daudén, MD, PhD, Hospital Universitario de la Princesa; P. Zarco-Montejo, MD, PhD, Hospital Alcorcon; E. Collantes-Estévez, MD, PhD, University Hospital "Reina Sofía"/IMIBIC, Cordoba; J.A. Fernández-López, MD, PhD, Centro Salud Riosa
| | - Ana Urriticoechea-Arana
- From the Facultad de Medicina; Hospital Monte Naranco, Oviedo; Hospital Parc Tauli, Sabadell; Complejo Hospitalario Toledo, Toledo; Hospital Virgen de la Concha, Zamora; Hospital Can Mises, Ibiza; Hospital Universitario de la Princesa; Hospital Alcorcon, Madrid; University Hospital "Reina Sofía"/IMIBIC, Cordoba; Centro Salud Riosa, Astorias, Spain.J.C. Torre-Alonso, MD, PhD, Facultad de Medicina, Hospital Monte Naranco; J. Gratacós, MD, PhD; M. Moreno, MD, Hospital Parc Tauli; J.S. Rey-Rey, MD, Complejo Hospitalario Toledo; J.P. Valdazo de Diego, MD, Hospital Virgen de la Concha; A. Urriticoechea-Arana, MD, Hospital Can Mises; E. Daudén, MD, PhD, Hospital Universitario de la Princesa; P. Zarco-Montejo, MD, PhD, Hospital Alcorcon; E. Collantes-Estévez, MD, PhD, University Hospital "Reina Sofía"/IMIBIC, Cordoba; J.A. Fernández-López, MD, PhD, Centro Salud Riosa
| | - Esteban Daudén
- From the Facultad de Medicina; Hospital Monte Naranco, Oviedo; Hospital Parc Tauli, Sabadell; Complejo Hospitalario Toledo, Toledo; Hospital Virgen de la Concha, Zamora; Hospital Can Mises, Ibiza; Hospital Universitario de la Princesa; Hospital Alcorcon, Madrid; University Hospital "Reina Sofía"/IMIBIC, Cordoba; Centro Salud Riosa, Astorias, Spain.J.C. Torre-Alonso, MD, PhD, Facultad de Medicina, Hospital Monte Naranco; J. Gratacós, MD, PhD; M. Moreno, MD, Hospital Parc Tauli; J.S. Rey-Rey, MD, Complejo Hospitalario Toledo; J.P. Valdazo de Diego, MD, Hospital Virgen de la Concha; A. Urriticoechea-Arana, MD, Hospital Can Mises; E. Daudén, MD, PhD, Hospital Universitario de la Princesa; P. Zarco-Montejo, MD, PhD, Hospital Alcorcon; E. Collantes-Estévez, MD, PhD, University Hospital "Reina Sofía"/IMIBIC, Cordoba; J.A. Fernández-López, MD, PhD, Centro Salud Riosa
| | - Mireia Moreno
- From the Facultad de Medicina; Hospital Monte Naranco, Oviedo; Hospital Parc Tauli, Sabadell; Complejo Hospitalario Toledo, Toledo; Hospital Virgen de la Concha, Zamora; Hospital Can Mises, Ibiza; Hospital Universitario de la Princesa; Hospital Alcorcon, Madrid; University Hospital "Reina Sofía"/IMIBIC, Cordoba; Centro Salud Riosa, Astorias, Spain.J.C. Torre-Alonso, MD, PhD, Facultad de Medicina, Hospital Monte Naranco; J. Gratacós, MD, PhD; M. Moreno, MD, Hospital Parc Tauli; J.S. Rey-Rey, MD, Complejo Hospitalario Toledo; J.P. Valdazo de Diego, MD, Hospital Virgen de la Concha; A. Urriticoechea-Arana, MD, Hospital Can Mises; E. Daudén, MD, PhD, Hospital Universitario de la Princesa; P. Zarco-Montejo, MD, PhD, Hospital Alcorcon; E. Collantes-Estévez, MD, PhD, University Hospital "Reina Sofía"/IMIBIC, Cordoba; J.A. Fernández-López, MD, PhD, Centro Salud Riosa
| | - Pedro Zarco-Montejo
- From the Facultad de Medicina; Hospital Monte Naranco, Oviedo; Hospital Parc Tauli, Sabadell; Complejo Hospitalario Toledo, Toledo; Hospital Virgen de la Concha, Zamora; Hospital Can Mises, Ibiza; Hospital Universitario de la Princesa; Hospital Alcorcon, Madrid; University Hospital "Reina Sofía"/IMIBIC, Cordoba; Centro Salud Riosa, Astorias, Spain.J.C. Torre-Alonso, MD, PhD, Facultad de Medicina, Hospital Monte Naranco; J. Gratacós, MD, PhD; M. Moreno, MD, Hospital Parc Tauli; J.S. Rey-Rey, MD, Complejo Hospitalario Toledo; J.P. Valdazo de Diego, MD, Hospital Virgen de la Concha; A. Urriticoechea-Arana, MD, Hospital Can Mises; E. Daudén, MD, PhD, Hospital Universitario de la Princesa; P. Zarco-Montejo, MD, PhD, Hospital Alcorcon; E. Collantes-Estévez, MD, PhD, University Hospital "Reina Sofía"/IMIBIC, Cordoba; J.A. Fernández-López, MD, PhD, Centro Salud Riosa
| | - Eduardo Collantes-Estévez
- From the Facultad de Medicina; Hospital Monte Naranco, Oviedo; Hospital Parc Tauli, Sabadell; Complejo Hospitalario Toledo, Toledo; Hospital Virgen de la Concha, Zamora; Hospital Can Mises, Ibiza; Hospital Universitario de la Princesa; Hospital Alcorcon, Madrid; University Hospital "Reina Sofía"/IMIBIC, Cordoba; Centro Salud Riosa, Astorias, Spain.J.C. Torre-Alonso, MD, PhD, Facultad de Medicina, Hospital Monte Naranco; J. Gratacós, MD, PhD; M. Moreno, MD, Hospital Parc Tauli; J.S. Rey-Rey, MD, Complejo Hospitalario Toledo; J.P. Valdazo de Diego, MD, Hospital Virgen de la Concha; A. Urriticoechea-Arana, MD, Hospital Can Mises; E. Daudén, MD, PhD, Hospital Universitario de la Princesa; P. Zarco-Montejo, MD, PhD, Hospital Alcorcon; E. Collantes-Estévez, MD, PhD, University Hospital "Reina Sofía"/IMIBIC, Cordoba; J.A. Fernández-López, MD, PhD, Centro Salud Riosa
| | - Juan Antonio Fernández-López
- From the Facultad de Medicina; Hospital Monte Naranco, Oviedo; Hospital Parc Tauli, Sabadell; Complejo Hospitalario Toledo, Toledo; Hospital Virgen de la Concha, Zamora; Hospital Can Mises, Ibiza; Hospital Universitario de la Princesa; Hospital Alcorcon, Madrid; University Hospital "Reina Sofía"/IMIBIC, Cordoba; Centro Salud Riosa, Astorias, Spain.J.C. Torre-Alonso, MD, PhD, Facultad de Medicina, Hospital Monte Naranco; J. Gratacós, MD, PhD; M. Moreno, MD, Hospital Parc Tauli; J.S. Rey-Rey, MD, Complejo Hospitalario Toledo; J.P. Valdazo de Diego, MD, Hospital Virgen de la Concha; A. Urriticoechea-Arana, MD, Hospital Can Mises; E. Daudén, MD, PhD, Hospital Universitario de la Princesa; P. Zarco-Montejo, MD, PhD, Hospital Alcorcon; E. Collantes-Estévez, MD, PhD, University Hospital "Reina Sofía"/IMIBIC, Cordoba; J.A. Fernández-López, MD, PhD, Centro Salud Riosa
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Herédi E, Rencz F, Balogh O, Gulácsi L, Herszényi K, Holló P, Jókai H, Kárpáti S, Péntek M, Remenyik É, Szegedi A, Brodszky V. Exploring the relationship between EQ-5D, DLQI and PASI, and mapping EQ-5D utilities: a cross-sectional study in psoriasis from Hungary. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2014; 15 Suppl 1:S111-S119. [PMID: 24832842 DOI: 10.1007/s10198-014-0600-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 03/31/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND There is a growing interest in policy making for using utility measures and identifying algorithms to convert disease-specific measures into utilities. OBJECTIVES To analyse the relationship between EQ-5D, Dermatology Life Quality Index (DLQI) and Psoriasis Area and Severity Index (PASI) in psoriasis. To transform DLQI scores, and key clinical, demographic and health service utilisation variables into utilities. METHODS A cross-sectional questionnaire survey of 200 consecutive adult patients with moderate to severe psoriasis was carried out in two Hungarian university clinics. The relationship between the outcome measures were analysed with correlations and with the known-groups method. Bivariate and multivariate regression algorithms on EQ-5D scores were formulated. RESULTS The mean age of respondents was 51 years (SD = 12.9), 68.5% were male, and 51.5% received biological therapy. Median EQ-5D, DLQI, and PASI scores were 0.73, 3.0, and 3.45, respectively. EQ-5D showed a moderate correlation with the DLQI and with the PASI (r s = -0.48 and -0.43, p < 0.05). Strong correlation was found between DLQI and PASI (r s = 0.81, p < 0.05). DLQI and PASI discriminated better among groups categorised by the localisation of the lesions than EQ-5D. Presence of psoriasis on the neck and/or décolletage was associated with the greatest health related quality of life (HRQOL) impairment. Ten variables were incorporated in a multivariate algorithm that accounted for 48.8% of EQ-5D variance (ANOVA p < 0.001). CONCLUSIONS This study provided the first evidence that patients with visible psoriatic lesions have significantly worse HRQOL compared to those with non-visible lesions, measured not only with DLQI but also with EQ-5D. In addition to demographic and clinical variables, our model included health service utilisation variables related to psoriasis, and explained higher proportion of EQ-5D variance than any previous findings in the literature.
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Affiliation(s)
- Emese Herédi
- Departments of Dermatology and Dermatological Allergology, University of Debrecen, Nagyerdei krt. 98., Debrecen, 4032, Hungary
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A patient-derived and patient-reported outcome measure for assessing psoriatic arthritis: elaboration and preliminary validation of the Psoriatic Arthritis Impact of Disease (PsAID) questionnaire, a 13-country EULAR initiative. Ann Rheum Dis 2014; 73:1012-9. [DOI: 10.1136/annrheumdis-2014-205207] [Citation(s) in RCA: 241] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Tezel N, Yilmaz Tasdelen O, Bodur H, Gul U, Kulcu Cakmak S, Oguz ID, Karabulut E. Is the health-related quality of life and functional status of patients with psoriatic arthritis worse than that of patients with psoriasis alone? Int J Rheum Dis 2014; 18:63-9. [PMID: 24460852 DOI: 10.1111/1756-185x.12283] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
AIM The aim of this study was to compare the health-related quality of life and functional status of patients with psoriasis (Ps), psoriatic arthritis (PsA) and control subjects. METHOD Eighty patients with PsA, 40 patients with Ps and 40 healthy subjects were included. Physical functions were evaluated with the Health Assessment Questionnaire for Spondyloarthropathies (HAQ-S) while life satisfaction was evaluated with the Psoriatic Arthritis Quality of Life (PsAQoL) questionnaire. The Disease Activity Score 28 (DAS28), Disease Activity Index for the Assessment of Reactive Arthritis (DAREA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score-C-Reactive Protein (ASDAS-CRP), Maastrich Ankylosing Spondylitis Enthesitis Score (MASES) and visual analog scale-pain were calculated. RESULTS The HAQ-S data revealed that physical functional status in the PsA group was worse than the Ps and control groups (mean scores: 0.5 ± 0.5, 0.2 ± 0.5 and 0.1 ± 0.3, respectively). The PsAQoL data revealed a worse quality of life in the PsA and Ps groups than in the control group but the same quality of life in the PsA and Ps groups (mean scores: 6.9 ± 5.4, 7 ± 5.9 and 3.3 ± 4.2, respectively). Both the HAQ-S and PsAQoL data were found to be moderately to weakly correlated with disease activity measures (DAS28, DAREA, BASDAI, ASDAS-CRP), pain and enthesitis. CONCLUSION Patients with Ps and PsA had worse quality of life and patients with PsA had worse functional status than healthy individuals. Although Ps patients with arthritis had a worse functional status than the ones without arthritis, quality of life according to PSAQoL was found to be similar between them.
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Affiliation(s)
- Nihal Tezel
- Department of Physical Medicine and Rehabilitation, Ankara Numune Education and Research Hospital, Ankara, Turkey
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Gratacós J, Daudén E, Gómez-Reino J, Moreno JC, Casado MÁ, Rodríguez-Valverde V. Health-related quality of life in psoriatic arthritis patients in Spain. ACTA ACUST UNITED AC 2014; 10:25-31. [DOI: 10.1016/j.reuma.2013.05.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Revised: 03/22/2013] [Accepted: 05/01/2013] [Indexed: 11/16/2022]
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Roussou E, Chopra S, Ngandu DL. Phenotypic and clinical differences between Caucasian and South Asian patients with psoriatic arthritis living in North East London. Clin Rheumatol 2012; 32:591-9. [PMID: 23247553 DOI: 10.1007/s10067-012-2139-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 11/03/2012] [Accepted: 11/29/2012] [Indexed: 10/27/2022]
Abstract
To test for demographic and clinical differences between Caucasian and South Asian patients with psoriatic arthritis (PsA) living in the same environment and for differences between sexes. The demographic characteristics of patients attending outpatient clinics were obtained using a semi-structured questionnaire. Clinical parameters included disease activity (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte sedimentation rate (ESR), C-reactive protein), function (Bath Ankylosing Spondylitis Functional Index (BASFI)) and visual analogue scale (VAS) scores for well-being and night pain (10 cm, where 10 = worst possible response). The first symptom experienced at disease onset and the main symptoms during the disease course were recorded in the questionnaire. A total of 217 patents were assessed of whom 151 were Caucasians and 66 were Asians. South Asian patients were significantly younger [(mean) 45.9 years [(SD)(±11.4)] for Asians and 53.1 years (±14.2) for Caucasians (p < 0.005)] and were diagnosed at an earlier age [40.7 years (±11.7) for Asians and 46.7 years (±15.8) for Caucasians (p < 0.05)] compared to Caucasians patients. Asian females with PsA had worse disease in terms of activity (ESR = 23.9 mmHg/h; BASDAI = 6.7), function (BASFI = 5.5), night pain (7.1 on VAS) and well-being (6.6 on VAS) compared with Asian males (13.2 mmHg/h, 5.3, 3.6, 4.1, 4.6, respectively) or Caucasian males and females (15.8 mmHg/h, 5.9, 5.3, 5.4, 5.4; 18.9 mmHg/h, 6.1, 6.1, 5.3, 5.8, respectively). There were no significant differences in symptoms at disease onset or the main symptoms during the disease course between Caucasian and Asian patients, although there was a trend towards more frequent enthesitis in Asian females during the course of disease suggested by pain with pressure compared to Asian males. South Asian patients may develop PsA earlier in life than Caucasian patients do, but their clinical characteristics are generally similar. Asian females with PsA have worse disease activity, function, night pain and well-being than Asian males and Caucasian males and females.
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Affiliation(s)
- Euthalia Roussou
- Barking, Havering and Redbridge University Hospitals NHS Trust, Rheumatology and Rehabilitation, King George Hospital, Barley Lane, Goodmayes, Ilford IG3 8YB, UK.
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Gignac MAM, Cao X, Mcalpine J, Badley EM. Measures of disability: Arthritis Impact Measurement Scales 2 (AIMS2), Arthritis Impact Measurement Scales 2-Short Form (AIMS2-SF), The Organization for Economic Cooperation and Development (OECD) Long-Term Disability (LTD) Questionnaire, EQ-5D, World Health Organization Disability Assessment Schedule II (WHODASII), Late-Life Function and Disability Instrument (LLFDI), and Late-Life Function and Disability Instrument-Abbreviated Version (LLFDI-Abbreviated). Arthritis Care Res (Hoboken) 2012; 63 Suppl 11:S308-24. [PMID: 22588753 DOI: 10.1002/acr.20640] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Monique A M Gignac
- Toronto Western Research Institute, and University of Toronto, Toronto, Ontario, Canada.
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