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van Ee I, Deprez E, Egeberg A, Augustin M, Conrad C, Corazza V, Donati L, Lambert J, Lăpădatu R, Meyer A, Paul C, Penzer-Hick R, Stephen K, van der Zon J, Bewley A. Freedom from disease in psoriasis: a Delphi consensus definition by patients, nurses and physicians. J Eur Acad Dermatol Venereol 2021; 36:403-412. [PMID: 34816508 PMCID: PMC9303201 DOI: 10.1111/jdv.17829] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 11/03/2021] [Indexed: 12/22/2022]
Abstract
Background Physician‐reported clinical outcome and quality of life (QoL) measures are currently used to assess outcomes and direct treatment of plaque psoriasis. However, people with psoriasis may have different criteria for judging treatment success. Objectives To build a unified consensus on the definition of ‘freedom from disease’ from a European stakeholder group, including people with psoriasis, dermatologists and nurses. Methods The modified Delphi consensus methodology was used to define ‘freedom from disease’, with a consensus group consisting of people with psoriasis, nurses and dermatologists. This methodology involved people with psoriasis during the entire process and consisted of a 15‐member Facilitating Consensus Panel to drive the programme content and a larger Voting Consensus Panel to vote on defining ‘freedom from disease’. The Facilitating Panel agreed on disease domains, and aspects of each domain were put forward to the Voting Consensus Panel to establish relative importance. Following two voting rounds, a meeting was held to agree on a final consensus statement. Results The Facilitating Panel consisted of six patient advocacy group representatives, three specialist nurses and six dermatologists. Voting rounds 1 and 2 were completed by 166 and 130 respondents from the Voting Consensus Panel, respectively. The outputs from both rounds of voting were similar, focusing on normality of living, symptom control, and a relationship of mutual respect and trust between the individual with psoriasis and their healthcare professional. The consensus statement emphasizes that ‘freedom from disease’ is multifaceted and includes the following domains ‘management of clinical symptoms’, ‘psychosocial elements’, ‘QoL and well‐being’, ‘treatment’ and ‘healthcare team support’. ‘Freedom from disease’ means all aspects are addressed. Conclusions Freedom from disease in psoriasis is a multicomponent concept including five main domains. This diverse and multifaceted patient perspective will help us to improve understanding of the outcomes of treatment interventions in people with psoriasis.
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Affiliation(s)
- I van Ee
- Psoriasispatiënten Nederland (PN), Nijkerk, The Netherlands
| | - E Deprez
- Ghent University Hospital, Ghent, Belgium
| | - A Egeberg
- Department of Dermatology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - M Augustin
- IVDP Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - C Conrad
- Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - V Corazza
- Fondazione Natalino Corazza Onlus Psoriasis & Co, Bologna, Italy
| | - L Donati
- Fondazione Natalino Corazza Onlus Psoriasis & Co, Bologna, Italy
| | - J Lambert
- Ghent University Hospital, Ghent, Belgium
| | - R Lăpădatu
- Associaţia Pacienţilor cu Afecţiuni Autoimune (APAA), Bucharest, Romania
| | - A Meyer
- Deutscher Psoriasis Bund e.V. (DPB), Hamburg, Germany
| | - C Paul
- Paul Sabatier University, Toulouse, France.,Centre Hospitalier Universitaire, Toulouse, France
| | | | | | - J van der Zon
- Psoriasispatiënten Nederland (PN), Nijkerk, The Netherlands
| | - A Bewley
- Barts Health NHS Trust & Queen Mary University, London, UK
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Taliercio V, Langner AU, Secrest AM, Duffin KC. Assessing psoriasis severity: psychometric validation of overall physician global assessment (OPGA). J Am Acad Dermatol 2021; 86:637-638. [PMID: 33465432 DOI: 10.1016/j.jaad.2021.01.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/31/2020] [Accepted: 01/04/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Vanina Taliercio
- Department of Dermatology, University of Utah, Salt Lake City, UT
| | | | - Aaron M Secrest
- Department of Dermatology, University of Utah, Salt Lake City, UT; Department of Population Health Sciences, University of Utah, Salt Lake City, UT
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3
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Gold LS, Hansen JB, Patel D, Veverka KA, Strober B. PGAxBSA composite versus PASI: Comparison across disease severities and as therapeutic response measure for Cal/BD foam in plaque psoriasis. J Am Acad Dermatol 2020; 83:131-138. [DOI: 10.1016/j.jaad.2020.02.077] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/04/2020] [Accepted: 02/21/2020] [Indexed: 01/08/2023]
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Callis Duffin K, Merola JF, Christensen R, Latella J, Garg A, Gottlieb AB, Armstrong AW. Identifying a Core Domain Set to Assess Psoriasis in Clinical Trials. JAMA Dermatol 2019; 154:1137-1144. [PMID: 29874367 DOI: 10.1001/jamadermatol.2018.1165] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Importance There is no consensus on which domains should be measured or which instruments should be used in clinical trials for psoriasis therapies. Objective To achieve international consensus among psoriasis stakeholders on a core set of domains that should be measured in all psoriasis clinical trials. Design, Setting, and Participants Literature review, pre-Delphi survey exercises, nominal group discussions, and audience voting at 4 stakeholder meetings were used to develop candidate domains for 2 rounds of a Delphi survey. Stakeholders were patients or advocates of patients with psoriasis and health care professionals (HCPs) with expertise in psoriasis, including physicians, scientists, advocacy organization representatives, and regulators. Delphi surveys were conducted electronically from October through December 2015 and between September and October 2016. Stakeholder discussions with audience response voting were conducted at live meetings in the United States, Canada, and Italy from January 2013 to December 2016 to refine and ratify the core set of domains. Main Outcomes and Measures Two rounds of an electronic Delphi survey were used to determine consensus. A domain was considered "core" (ie, should be measured in all trials) if a threshold consensus of at least 70% was met in both patient and HCP groups. Domains meeting consensus in only 1 group were considered to be important but were not required to be measured in all trials ("middle ring"). These domains were included for rerating in round 2. Domains that did not meet consensus in either of the groups ("outer ring") were considered to be of uncertain importance and were placed in the research agenda. Results In round 1 of the Delphi survey, 107 HCPs and 14 patients participated. Most HCPs (72 [67%]) were dermatologists between 46 and 64 years old (71 [66%]), white (78 [73%]), and male (75 [70%]) from North America (60 [57%]) and Europe (34 [32%]).There were 10 pharmaceutical industry clinical or health economic scientists, 3 advocacy organization representatives, 2 regulatory agency representatives, and 5 "other." In the second round, 77 HCPs and 15 patients participated. Of the 20 candidate domains, the following 6 met consensus as core domains: skin manifestations, psoriasis and psoriatic arthritis symptoms, health-related quality of life, investigator global assessment, patient global assessment, and treatment satisfaction. Secondary skin manifestations as well as nail, inverse, genital, and guttate psoriasis were classified as important but not mandatory. Psoriatic arthritis signs, work productivity or participation, economic impact (direct and indirect cost), and cardiovascular disease comprised the research agenda. Conclusions and Relevance This iterative Delphi process yielded international consensus among professional and patient stakeholders on 6 domains that should be measured in all clinical trials for psoriasis. Future International Dermatology Outcome Measures group efforts will focus on development of a core outcome measurement set for psoriasis trials.
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Affiliation(s)
| | - Joseph F Merola
- Division of Rheumatology, Department of Dermatology, Brigham and Women's Hospital Harvard Medical School, Boston, Massachusetts.,Division of Rheumatology, Department of Medicine, Brigham and Women's Hospital Harvard Medical School, Boston, Massachusetts
| | - Robin Christensen
- Musculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen F, Denmark
| | - John Latella
- International Dermatology Outcome Measures Board of Directors, Windsor, Connecticut
| | - Amit Garg
- Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York
| | - Alice B Gottlieb
- Department of Dermatology, New York Medical College, Metropolitan Hospital, New York, New York
| | - April W Armstrong
- Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles.,Clinical Evidence Synopsis Editor and Editorial Board Member
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Walsh JA, Jones H, Mallbris L, Duffin KC, Krueger GG, Clegg DO, Szumski A. The Physician Global Assessment and Body Surface Area composite tool is a simple alternative to the Psoriasis Area and Severity Index for assessment of psoriasis: post hoc analysis from PRISTINE and PRESTA. PSORIASIS-TARGETS AND THERAPY 2018; 8:65-74. [PMID: 30324088 PMCID: PMC6181091 DOI: 10.2147/ptt.s169333] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background The product of Physician Global Assessment and Body Surface Area (PGA × BSA) is a new outcome measure for psoriasis severity and response to therapy. The objective of this study was to evaluate PGA × BSA as an alternative to Psoriasis Area and Severity Index (PASI) for psoriasis assessments. Methods The relationship between PASI and PGA × BSA was assessed in a post hoc analysis of pooled data from the PRISTINE (NCT00663052) and PRESTA (NCT00245960) trials in patients with moderate-to-severe psoriasis who received etanercept 50 mg/week. Data were analyzed using Spearman and intra-class correlation coefficients, effect sizes, scatterplots, Bland–Altman plots, and Kappa statistics. Results Spearman correlations at baseline, week 12, and week 24 were strong for PGA × BSA versus PASI (r=0.78, 0.87, and 0.90, respectively; all P<0.0001) as were intra-class correlations (0.76 [95% confidence interval 0.73–0.80], 0.80 [0.76–0.83], and 0.85 [0.82–0.87], respectively). The effect size was −1.53 for PASI and −0.94 for PGA × BSA (baseline to week 24). Scatterplots and Bland–Altman plots detected a trend across the range of measurement. Kappa statistics (at 12 and 24 weeks) between PASI50/75/90 and 50/75/90% improvement in PGA × BSA showed good agreement (0.58–0.69 at week 12 and 0.63–0.67, respectively; all P<0.0001). At baseline, the Spearman correlation coefficients were 0.96, 0.51, 0.19, and 0.17 for PGA × BSA versus BSA, PGA, Patient Global Assessment, and Dermatology Life Quality Index, respectively (all P<0.001). Conclusion PGA × BSA has advantages over PASI for measuring moderate-to-severe psoriasis; it is intuitive, sensitive, and easy to use.
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Affiliation(s)
- Jessica A Walsh
- Division of Rheumatology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA,
| | - Heather Jones
- Inflammation and Immunology,Global Medical Affairs, Pfizer, Collegeville, PA, USA
| | - Lotus Mallbris
- Inflammation and Immunology,Global Medical Affairs, Pfizer, Collegeville, PA, USA
| | - Kristina Callis Duffin
- Department of Dermatology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Gerald G Krueger
- Department of Dermatology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Daniel O Clegg
- Division of Rheumatology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA,
| | - Annette Szumski
- Pfizer Business Unit (PBU) Syneos Health, Princeton, NJ, United States
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Mease PJ, Coates LC. Considerations for the definition of remission criteria in psoriatic arthritis. Semin Arthritis Rheum 2017; 47:786-796. [PMID: 29566966 DOI: 10.1016/j.semarthrit.2017.10.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/17/2017] [Accepted: 10/30/2017] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Psoriatic arthritis (PsA) is an autoimmune disease that can cause progressive structural damage of the joints and irreversible disability. The potentially achievable results of biologic therapy for PsA has led to the view that disease remission should be the goal of treatment. However, the heterogeneity of disease manifestations and need for validated outcome measures makes defining remission in PsA challenging. This article evaluates proposed criteria for defining remission in PsA and discusses how these criteria can be applied in clinical practice. METHODS A primary literature search was conducted in PubMed to identify articles discussing potential PsA treatment goals or targets, including minimal disease activity. English-language publications from the last 10 years were included in this assessment. RESULTS There are 5 clinical domains in PsA that must be considered when evaluating remission: synovitis, enthesitis, dactylitis, spondylitis, and psoriasis/nail psoriasis. Due to variability in the completeness of remission and time to achieve remission with different therapies between these domains, remission should be measured clinically through a combination of objective measures, or a composite assessment tool. Composite measures are more efficient than unidimensional instruments in measuring remission, but remission rates differ between the available composite indices. CONCLUSION Although the concept of remission as a treatment goal in PsA is gaining acceptance among rheumatologists, further work is necessary to develop a broadly acceptable definition of remission.
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Affiliation(s)
- Philip J Mease
- Swedish Medical Center, University of Washington, Seattle, United States of America.
| | - Laura C Coates
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
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Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L in psoriasis patients. Qual Life Res 2017; 26:3409-3419. [DOI: 10.1007/s11136-017-1699-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2017] [Indexed: 01/04/2023]
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Armstrong AW, Feldman SR, Korman NJ, Meng X, Guana A, Nyirady J, Herrera V, Zhao Y. Assessing the overall benefit of a medication: cumulative benefit of secukinumab over time in patients with moderate-to-severe plaque psoriasis. J DERMATOL TREAT 2016; 28:200-205. [DOI: 10.1080/09546634.2016.1214667] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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9
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An J, Li Z, Dong Y, Ren J, Huo J. Amentoflavone protects against psoriasis-like skin lesion through suppression of NF-κB-mediated inflammation and keratinocyte proliferation. Mol Cell Biochem 2016; 413:87-95. [DOI: 10.1007/s11010-015-2641-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 12/23/2015] [Indexed: 12/11/2022]
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10
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Abstract
Psoriasis is an immune-mediated, genetic disease manifesting in the skin or joints or both. A diverse team of clinicians with a range of expertise is often needed to treat the disease. Psoriasis provides many challenges including high prevalence, chronicity, disfiguration, disability, and associated comorbidity. Understanding the role of immune function in psoriasis and the interplay between the innate and adaptive immune system has helped to manage this complex disease, which affects patients far beyond the skin. In this Seminar, we highlight the clinical diversity of psoriasis and associated comorbid diseases. We describe recent developments in psoriasis epidemiology, pathogenesis, and genetics to better understand present trends in psoriasis management. Our key objective is to raise awareness of the complexity of this multifaceted disease, the potential of state-of-the-art therapeutic approaches, and the need for early diagnosis and comprehensive management of patients with psoriasis.
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Affiliation(s)
- Wolf-Henning Boehncke
- Department of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland; Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland.
| | - Michael P Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center, Georg August University, Göttingen, Germany.
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11
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Kjær TN, Thorsen K, Jessen N, Stenderup K, Pedersen SB. Resveratrol ameliorates imiquimod-induced psoriasis-like skin inflammation in mice. PLoS One 2015; 10:e0126599. [PMID: 25965695 PMCID: PMC4428792 DOI: 10.1371/journal.pone.0126599] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 04/06/2015] [Indexed: 01/19/2023] Open
Abstract
Background The polyphenol resveratrol has anti-inflammatory effects in various cells, tissues, animals and human settings of low-grade inflammation. Psoriasis is a disease of both localized and systemic low-grade inflammation. The Sirtuin1 enzyme thought to mediate the effects of resveratrol is present in skin and resveratrol is known to down regulate NF-κB; an important contributor in the development of psoriasis. Consequently we investigated whether resveratrol has an effect on an Imiquimod induced psoriasis-like skin inflammation in mice and sought to identify candidate genes, pathways and interleukins mediating the effects. Methods The study consisted of three treatment groups: A control group, an Imiquimod group and an Imiquimod+resveratrol group. Psoriasis severity was assessed using elements of the Psoriasis Area Severity Index, skin thickness measurements, and histological examination. We performed an RNA microarray from lesional skin and afterwards Ingenuity pathway analysis to identify affected signalling pathways. Our microarray was compared to a previously deposited microarray to determine if gene changes were psoriasis-like, and to a human microarray to determine if findings could be relevant in a human setting. Results Imiquimod treatment induced a psoriasis-like skin inflammation. Resveratrol significantly diminished the severity of the psoriasis-like skin inflammation. The RNA microarray revealed a psoriasis-like gene expression-profile in the Imiquimod treated group, and highlighted several resveratrol dependent changes in relevant genes, such as increased expression of genes associated with retinoic acid stimulation and reduced expression of genes involved in IL-17 dependent pathways. Quantitative PCR confirmed a resveratrol dependent decrease in mRNA levels of IL-17A and IL-19; both central in developing psoriasis. Conclusions Resveratrol ameliorates psoriasis, and changes expression of retinoic acid stimulated genes, IL-17 signalling pathways, IL-17A and IL-19 mRNA levels in a beneficial manner, which suggests resveratrol, might have a role in the treatment of psoriasis and should be explored further in a human setting.
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Affiliation(s)
- Thomas Nordstrøm Kjær
- Department of Endocrinology and Internal medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- * E-mail:
| | - Kasper Thorsen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Niels Jessen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Karin Stenderup
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Steen Bønløkke Pedersen
- Department of Endocrinology and Internal medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Kingsley GH, Scott DL. Assessing the effectiveness of synthetic and biologic disease-modifying antirheumatic drugs in psoriatic arthritis - a systematic review. PSORIASIS (AUCKLAND, N.Z.) 2015; 5:71-81. [PMID: 29387584 PMCID: PMC5683113 DOI: 10.2147/ptt.s52893] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Psoriatic arthritis is an inflammatory arthritis the primary manifestations of which are locomotor and skin disease. Although a number of guidelines have been published citing strategies for reducing disease progression, the evidence base for disease-modifying agents is unclear. This forms the focus of this systematic review. METHODS The systematic review was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 checklist. We selected randomized controlled trials (RCTs) that looked at the impact of interventions with disease-modifying agents, either synthetic drugs or biologics on musculoskeletal outcomes, notably American College of Rheumatology 20 percent responders. Results were analyzed using Review Manager 5.1.6 (Cochrane Collaboration, Oxford, UK). Whilst our primary focus was on published trials, we also looked at new trials presented in abstract form in 2013-2014 that were not yet published to avoid omitting important and up-to-date information on developing treatments. RESULTS Our in-depth analysis included 28 trials overall enrolling 5,177 patients published between the 1980s and now as well as limited analysis of some studies in abstract form as described earlier. The most frequently available locomotor outcome measure was the American College of Rheumatology 20 percent responders. The risk ratio for achieving an American College of Rheumatology 20 percent responders response was positive in favor of treatment (risk ratio 2.30; 95% confidence interval 1.78-2.96); however, there was evidence of considerable heterogeneity between trials. Overall randomized controlled trials of established synthetic disease-modifying agents were largely negative (methotrexate, ciclosporin and sulfasalazine) though leflunomide showed a small positive effect. A new synthetic agent, apremilast, did show a positive benefit. For biologics, TNF inhibitors already licensed for use were effective and similar benefits were seen with newer agents including ustekinumab, secukinumab, brodalumab, and abatacept, although the latter did not impact on skin problems. Important limitations of the systematic review included, first, the fact that for many agents there were little data and, second, much of the recent data for newer biologics were only available in abstract form. CONCLUSION Conventional disease-modifying agents, with the possible exception of leflunomide, do not show clear evidence of disease-modifying effects in psoriatic arthritis, though a newer synthetic disease-modifying agents, apremilast, appears more effective. Biologic agents appear more beneficial, although more evidence is required for newer agents. This review suggests that it may be necessary to review existing national and international management guidelines for psoriatic arthritis.
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Gottlieb AB, Levin AA, Armstrong AW, Abernethy A, Duffin KC, Bhushan R, Garg A, Merola JF, Maccarone M, Christensen R. The International Dermatology Outcome Measures Group: Formation of patient-centered outcome measures in dermatology. J Am Acad Dermatol 2015; 72:345-8. [DOI: 10.1016/j.jaad.2014.11.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 11/03/2014] [Indexed: 10/24/2022]
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Machado PM, Raychaudhuri SP. Disease activity measurements and monitoring in psoriatic arthritis and axial spondyloarthritis. Best Pract Res Clin Rheumatol 2014; 28:711-28. [DOI: 10.1016/j.berh.2014.10.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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15
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Villacorta R, Hay JW, Messali A. Novel methods of measuring clinical outcomes from psoriasis and psoriatic arthritis clinical trials. Expert Rev Pharmacoecon Outcomes Res 2014; 14:545-58. [PMID: 24820676 DOI: 10.1586/14737167.2014.917970] [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: 11/08/2022]
Abstract
Numerous instruments exist that measure the clinical and health related quality of life impact of psoriasis and psoriatic arthritis (PsA) in clinical trials. However, many of these instruments are not typically used in economic evaluations to inform decision problems facing health care decision makers. This study reviews the current state of psoriasis and PsA health outcome measures and evaluates their limitations in cost-effectiveness analyses (CEAs). We highlight the health related quality of life and clinical outcome measures that are typically used in CEAs, with special focus on studies with quality adjusted life years as a primary outcome measure. Despite the high prevalence of psoriasis and PsA health outcome measures in clinical trials, only a few are used in CEAs. The methods by which utilities are estimated from these measures vary across cost-effectiveness studies. These differences should be considered when conducting cost-effectiveness research in psoriasis and PsA.
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Affiliation(s)
- Reginald Villacorta
- University of Southern California, Leonard D. Schaeffer Center for Health Policy and Economics, 3335 S. Figueroa St., Unit A, University Park Campus, UGW-Unit A, Los Angeles, CA 90089-7273, USA
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Langley RGB, Feldman SR, Nyirady J, van de Kerkhof P, Papavassilis C. The 5-point Investigator’s Global Assessment (IGA) Scale: A modified tool for evaluating plaque psoriasis severity in clinical trials. J DERMATOL TREAT 2013; 26:23-31. [DOI: 10.3109/09546634.2013.865009] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Mease PJ, Boehncke WH, Gladman DD. Prologue: 2012 Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). J Rheumatol 2013; 40:1407-9. [PMID: 23908533 DOI: 10.3899/jrheum.130450] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The 2012 Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) was held in June 2012 in Stockholm, Sweden, and attended by rheumatologists, dermatologists, and representatives of biopharmaceutical companies and patient groups from around the world. In this Prologue we introduce discussions that were held among meeting attendees. Prior to the 2012 meeting, 2 GRAPPA members organized a Fellows Symposium adjacent to the European Academy of Dermatology and Venerology meeting in Verona, where they discussed comorbidities and treatments of patients with psoriasis. The 2012 GRAPPA meeting began with a trainee symposium, where 30 rheumatology fellows and dermatology residents presented their research work. Other presentations and discussions included a review of arthritis mutilans; dermatology issues including screening tools for psoriatic arthritis (PsA) and the instruments to measure psoriasis severity; cardiovascular and other comorbidities of psoriasis and PsA; development of criteria to define inflammatory arthritis, enthesitis, dactylitis, and spondylitis; distinctions between peripheral spondyloarthritis and PsA; the status of an ultrasound outcome measure for dactylitis; and updates on several GRAPPA projects, including a study of biomarkers to predict structural damage in PsA, the ongoing video project, and several education initiatives.
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Affiliation(s)
- Philip J Mease
- Swedish Medical Center and University of Washington, Seattle, Washington, USA.
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Callis Duffin K, Gottlieb AB. Outcome Measures for Psoriasis Severity: A Report from the GRAPPA 2012 Annual Meeting. J Rheumatol 2013; 40:1423-4. [DOI: 10.3899/jrheum.130454] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
At the 2012 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) in Stockholm, Sweden, dermatology members provided summaries of ongoing work with outcome measures for psoriasis severity. Controversies around the physician global assessment (PGA) were summarized, including discussions of variations and limitations of the static PGA instruments in use. The Psoriasis Outcome Measures project was introduced, with a goal of developing measures for use in clinical trials and practice. This project will follow the Outcome Measures in Rheumatology (OMERACT) process and may become a model for outcome measures of other dermatologic diseases.
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