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Montero-Menárguez J, Amat Samaranch V, Puig Sanz L, Ruiz-Villaverde R, Arias-Santiago S, Larrea García M, Ruiz Genao D, Ferrán M, Schneller-Pavelescu L, Romero Ferreiro C, Rivera Díaz R. Pityriasis Rubra Pilaris: A Multicentric Case Series of 65 Spanish Patients. Actas Dermosifiliogr 2024:S0001-7310(24)00161-3. [PMID: 38401879 DOI: 10.1016/j.ad.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/13/2023] [Accepted: 02/06/2024] [Indexed: 02/26/2024] Open
Abstract
INTRODUCTION PRP is a rare entity of unknown etiopathogenesis. Lack of management guidelines makes it a challenge for clinicians. OBJECTIVE To add our experience to increase evidence about PRP. METHODS We performed a retrospective, descriptive and multicentric study of 65 patients with PRP, being the largest European case series of patients with PRP. RESULTS PRP was more frequent in male patients with an average age of 51 years, but erythrodermic forms presented in older patients (average age 61 years). Six (75%) paediatric patients and ten (60%) non-erythrodermic adults controlled their disease with topical corticosteroids. On the contrary, 26 (68%) erythrodermic patients required biologic therapy as last and effective therapy line requiring an average of 6.5 months to achieve complete response. CONCLUSION Our study showed a statistical difference in terms of outcome and response to treatment between children or patients with limited disease and patients who develop erythroderma.
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Affiliation(s)
- J Montero-Menárguez
- Dermatology Department of the Hospital Universitario 12 de Octubre, Madrid, Spain.
| | - V Amat Samaranch
- Dermatology Department of Hospital de la Santa Creu i Sant Pau de Barcelona, Spain
| | - L Puig Sanz
- Dermatology Department of Hospital de la Santa Creu i Sant Pau de Barcelona, Spain
| | - R Ruiz-Villaverde
- Dermatology Department of Hospital Universitario San Cecilio de Granada, Spain
| | - S Arias-Santiago
- Dermatology Department of Hospital Virgen de las Nieves de Granada, School of Medicine, Granada University, Instituto de Investigación Biosanitaria IBS, Granada, Spain
| | - M Larrea García
- Dermatology Department of Hospital Universitario de Navarra, Spain
| | - D Ruiz Genao
- Dermatology Department of Fundación Hospital Alcorcón, Spain
| | - M Ferrán
- Dermatology Department of Hospital del Mar de Barcelona, Spain
| | | | - C Romero Ferreiro
- Unidad de Soporte Científico, Instituto de Investigación Sanitaria, Hospital Universitario 12 de Octubre, Spain; Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
| | - R Rivera Díaz
- Dermatology Department of the Hospital Universitario 12 de Octubre, Madrid, Spain
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Nieto Benito L, Carretero G, Rivera-Díaz R, Carrascosa J, Daudén E, de la Cueva P, Sahuquillo-Torralba A, Herrera-Acosta E, Baniandrés-Rodríguez O, Lopez-Estebaranz J, Belinchón I, Riera-Monroig J, Ferrán M, Gómez-García F, Mateu A, Rodríguez L, Vilar-Alejo J, García-Donoso C, Ballescá F, Velasco LM, Botella-Estrada R, Herrera-Ceballos E, Ruiz-Genao D, Descalzo M, García-Doval I. Psoriasis moderada-grave en pacientes pediátricos y jóvenes: experiencia en el registro BIOBADADERM. Actas Dermo-Sifiliográficas 2022; 113:401-406. [DOI: 10.1016/j.ad.2021.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 05/23/2021] [Indexed: 10/20/2022] Open
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Rivera-Diaz R, Llamas-Velasco M, Carretero G, Ruíz-Genao D, Belinchón I, Riera-Monroig J, de la Cueva P, Ferrán M, de Vega M, García-Doval I. Women with moderate-to-severe psoriasis in Spain (BIOBADADERM registry) breastfeed less when compared with general population. J Eur Acad Dermatol Venereol 2021; 36:e205-e207. [PMID: 34626521 DOI: 10.1111/jdv.17737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/26/2021] [Accepted: 09/16/2021] [Indexed: 11/30/2022]
Affiliation(s)
- R Rivera-Diaz
- Dermatology Department, University Hospital 12 de Octubre & Universidad Complutense, Madrid, Spain
| | - M Llamas-Velasco
- Dermatology Department, University Hospital La Princesa, Madrid, Spain
| | - G Carretero
- Dermatology Department, Universitary Hospital Gran Canaria Doctor Negrin, Gran Canaria, Spain
| | - D Ruíz-Genao
- Dermatology Department, Universitary Hopital Fundaciión Hospital Alcorcon, Madrid, Spain
| | - I Belinchón
- Dermatology Department, University General Hospital of Alicante & AlicanteInstitute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.,Clinical Medicine Department, Miguel Herniández University of Elche, Elche, Spain
| | - J Riera-Monroig
- Dermatology Department, Hospital Cliínic de Barcelona, Universy of Barcelona, Barcelona, Spain
| | - P de la Cueva
- Dermatology Department, Universitary Hopital Infanta Leonor, Madrid, Spain
| | - M Ferrán
- Dermatology Department, Parc de Salut Mar, Barcelona, Spain
| | - M de Vega
- Academia Española de Dermatologiía y Venereologiía, Research Unit, Fundaciión Piel Sana, Madrid, Spain
| | - I García-Doval
- Academia Española de Dermatologiía y Venereologiía, Research Unit, Fundaciión Piel Sana & Complexo Hospitalario Universitario de Vigo, Servicio de Dermatologia, Vigo, Spain
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4
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Hernández-Fernández C, Carretero G, Rivera R, Ferrándiz C, Daudén E, Cueva P, Belinchón I, Gómez-García F, Herrera-Acosta E, Ruiz-Genao D, Ferrán M, Alsina M, Baniandrés-Rodríguez O, Sánchez-Carazo J, Botella-Estrada R, Sahuquillo-Torralba A, Rodríguez L, Vilar-Alejo J, García-Donoso C, Carrascosa J, Llamas-Velasco M, Herrera-Ceballos E, López-Estebaranz J, Pujol-Marco C, Descalzo M, Garcia-Doval I, Group A. Effect of Sex in Systemic Psoriasis Therapy: Differences in Prescription, Effectiveness and Safety in the BIOBADADERM Prospective Cohort. Acta Derm Venereol 2021; 101:adv00354. [PMID: 33269405 PMCID: PMC9309850 DOI: 10.2340/00015555-3711] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The effect of sex on systemic therapy for psoriasis has not been well studied. The aim of this study was to analyse a large multicentre Spanish cohort of 2,881 patients with psoriasis (58.3% males), followed from January 2008 to November 2018, to determine whether sex influences prescription, effectiveness of therapy, and the risk of adverse events. The results show that women are more likely than men to be prescribed biologics. There were no differences between men and women in effectiveness of therapy, measured in terms of drug survival. Women were more likely to develop adverse events, but the difference in risk was small and does not justify different management. Study limitations include residual confounding and the use of drug survival as a proxy for effectiveness.
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5
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Rivera R, Martorell A, López A, Salgado L, Sahuquillo A, de la Cueva P, Herranz P, Ratón JA, Ferrán M, Izu R, Ruiz-Genao D, García-Donoso C, Carrascosa JM. Maintenance of response following discontinuation of guselkumab and secukinumab in Spanish patients who participated in the ECLIPSE study. J Eur Acad Dermatol Venereol 2020; 35:e65-e67. [PMID: 32648955 DOI: 10.1111/jdv.16809] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- R Rivera
- Dermatology Department, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
| | - A Martorell
- Dermatology Department, Hospital de Manises, Valencia, Spain
| | - A López
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Salgado
- Dermatology Department, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - A Sahuquillo
- Dermatology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - P de la Cueva
- Dermatology Department, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - P Herranz
- Dermatology Department, Hospital Universitario La Paz, Madrid, Spain
| | - J A Ratón
- Dermatology Department, Hospital Universitario de Cruces, Bilbao, Spain
| | - M Ferrán
- Dermatology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - R Izu
- Dermatology Department, Hospital de Basurto, Bilbao, Spain
| | - D Ruiz-Genao
- Dermatology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - C García-Donoso
- Dermatology Department, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
| | - J M Carrascosa
- Dermatology Department, Hospital Universitari Germans Trias i Pujol, Universidad Autónoma de Barcelona, Badalona, Barcelona, Spain
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6
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Gonzalez‐Cantero A, Carretero G, Rivera R, Ferrándiz C, Daudén E, Cueva P, Gómez‐García F, Belinchón I, Herrera‐Ceballos E, Ruiz‐Genao D, Ferrán M, Alsina M, Sánchez‐Carazo J, Baniandrés O, Sahuquillo‐Torralba A, Rodriguez L, Vilar J, García C, Carrascosa J, Llamas‐Velasco M, Herrera‐Acosta E, López‐Estebaranz J, Botella‐Estrada R, Descalzo M, García‐Doval I. Women with moderate‐to‐severe psoriasis in Spain (
BIOBADADERM
registry) show more than a 50% reduction in age‐adjusted fertility rate when compared with the general population. Br J Dermatol 2019; 181:1085-1087. [DOI: 10.1111/bjd.18164] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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7
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Belinchón I, Ramos J, Carretero G, Ferrándiz C, Rivera R, Daudén E, De la Cueva-Dobao P, Gómez-García F, Herrera-Ceballos E, Sánchez-Carazo J, López-Estebaranz J, Alsina M, Ferrán M, Torrado R, Carrascosa J, Llamas-Velasco M, Ortiz P, García-Doval I, Descalzo M. Adverse events associated with discontinuation of the biologics/classic systemic treatments for moderate-to-severe plaque psoriasis: data from the Spanish Biologics Registry, Biobadaderm. J Eur Acad Dermatol Venereol 2017; 31:1700-1708. [DOI: 10.1111/jdv.14314] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 04/12/2017] [Indexed: 11/26/2022]
Affiliation(s)
- I. Belinchón
- Hospital General Universitario de Alicante-ISABIAL; Alicante Spain
| | - J.M. Ramos
- Hospital General Universitario de Alicante-ISABIAL; Alicante Spain
| | - G. Carretero
- Hospital Universitario de Gran Canaria Dr Negrín; Las Palmas de Gran Canaria Spain
| | - C. Ferrándiz
- Hospital Universitario Germans Trias i Pujol; Badalona Spain
| | - R. Rivera
- Hospital Universitario 12 de Octubre, Institute i+12; Medical School; University Complutense; Madrid Spain
| | - E. Daudén
- Hospital Universitario de la Princesa; IIS-IP; Madrid Spain
| | | | | | | | | | | | - M. Alsina
- Hospital Clinic de Barcelona; Barcelona Spain
| | - M. Ferrán
- Hospital del Mar, Parc de Salut Mar; Barcelona Spain
| | - R. Torrado
- Hospital Universitario de Gran Canaria Dr Negrín; Las Palmas de Gran Canaria Spain
| | - J.M. Carrascosa
- Hospital Universitario Germans Trias i Pujol; Badalona Spain
| | | | - P.L. Ortiz
- Hospital Universitario 12 de Octubre, Institute i+12; Medical School; University Complutense; Madrid Spain
| | - I. García-Doval
- Research Unit; Fundación Piel Sana Academia Española de Dermatología y Venereología; Madrid Spain
- Complexo Hospitalario Universitario de Vigo; Vigo Spain
| | - M.A. Descalzo
- Research Unit; Fundación Piel Sana Academia Española de Dermatología y Venereología; Madrid Spain
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8
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Pérez-Plaza A, Carretero G, Ferrandiz C, Vanaclocha F, Gómez-García F, Herrera-Ceballos E, De la Cueva-Dobao P, Belinchón I, Sánchez-Carazo J, Alsina M, López-Estebaranz J, Ferrán M, Torrado R, Carrascosa J, Llamas-Velasco M, Rivera R, Jiménez-Puya R, García-Doval I, Descalzo M. Comparison of phenotype, comorbidities, therapy and adverse events between psoriatic patients with and without psoriatic arthritis. Biobadaderm registry. J Eur Acad Dermatol Venereol 2017; 31:1021-1028. [DOI: 10.1111/jdv.14188] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 02/06/2017] [Indexed: 12/31/2022]
Affiliation(s)
- A. Pérez-Plaza
- Hospital Universitario de la Princesa; IIS-IP; Madrid Spain
| | - G. Carretero
- Hospital Universitario de Gran Canaria Dr Negrin; Las Palmas de Gran Canaria Spain
| | - C. Ferrandiz
- Hospital Universitario Germans Trias i Pujol; Badalona Spain
| | | | | | | | | | - I. Belinchón
- Hospital General Universitario de Alicante; Alicante Spain
| | | | - M. Alsina
- Hospital Clinic de Barcelona; Universitat de Barcelona; Barcelona Spain
| | | | - M. Ferrán
- Hospital del Mar; Parc de Salut Mar; Barcelona Spain
| | - R. Torrado
- Hospital Universitario de Gran Canaria Dr Negrin; Las Palmas de Gran Canaria Spain
| | - J.M. Carrascosa
- Hospital Universitario Germans Trias i Pujol; Badalona Spain
| | | | - R. Rivera
- Hospital Universitario 12 de Octubre; Madrid Spain
| | | | - I. García-Doval
- Research Unit; Fundacion Piel Sana Academia Española de Dermatologia y Venereologia; Madrid Spain
- Complexo Hospitalario Universitario de Vigo; Vigo Spain
| | - M.A. Descalzo
- Research Unit; Fundacion Piel Sana Academia Española de Dermatologia y Venereologia; Madrid Spain
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9
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Galiano Mejías S, Carretero G, Ferrandiz C, Vanaclocha F, Daudén E, Gómez-García F, Herrera-Ceballos E, Belinchón-Romero I, Sánchez-Carazo J, López-Estebaranz J, Alsina M, Ferrán M, Torrado R, Carrascosa J, Rivera R, Llamas-Velasco M, Jiménez-Puya R, Mendiola MV, Ruiz-Genao D, Descalzo M, de la Cueva Dobao P. Management of Biologic Therapy in Moderate to Severe Psoriasis in Surgical Patients: Data From the Spanish Biobadaderm Registry. Actas Dermo-Sifiliográficas (English Edition) 2017. [DOI: 10.1016/j.adengl.2016.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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10
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Ruiz-Genao D, Perez-Zafrilla B, Lopez-Estebaranz JL, Belinchón-Romero I, Carrascosa JM, Ferrán M, Vanaclocha F, Herrera-Ceballos E, García-Doval I. Possible paradoxical occurrence of inflammatory arthritis in patients with psoriasis treated with biologics: findings in the Biobadaderm cohort. Br J Dermatol 2016; 176:797-799. [PMID: 27120993 DOI: 10.1111/bjd.14690] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- D Ruiz-Genao
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - B Perez-Zafrilla
- Research Unit, Fundación Academia Española de Dermatología y Venereología, Madrid, Spain.,Research Unit, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - J L Lopez-Estebaranz
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - I Belinchón-Romero
- Department of Dermatology, Hospital General Universitario de Alicante, Alicante, Spain
| | - J M Carrascosa
- Department of Dermatology, Hospital Universitario Germans Trias i Pujol, Universitat Autónoma de Barcelona, Badalona, Barcelona, Spain
| | - M Ferrán
- Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - F Vanaclocha
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - E Herrera-Ceballos
- Department of Dermatology, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - I García-Doval
- Research Unit, Fundación Academia Española de Dermatología y Venereología, Madrid, Spain.,Department of Dermatology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
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- Research Unit, Fundación Academia Española de Dermatología y Venereología, Madrid, Spain
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11
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Galiano Mejías S, Carretero G, Ferrandiz C, Vanaclocha F, Daudén E, Gómez-García FJ, Herrera-Ceballos E, Belinchón-Romero I, Sánchez-Carazo JL, López-Estebaranz JL, Alsina M, Ferrán M, Torrado R, Carrascosa JM, Rivera R, Llamas-Velasco M, Jiménez-Puya R, Mendiola MV, Ruiz-Genao D, Descalzo MA, de la Cueva Dobao P. Management of Biologic Therapy in Moderate to Severe Psoriasis in Surgical Patients: Data From the Spanish Biobadaderm Registry. Actas Dermosifiliogr 2016; 108:52-58. [PMID: 27658689 DOI: 10.1016/j.ad.2016.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Revised: 07/02/2016] [Accepted: 08/04/2016] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVE We now have considerable experience in the use of biologic agents to treat psoriasis, but doubts about management arise in certain clinical settings. Surgery is one of them. Although treatment guidelines advise that biologics be suspended before major surgery, data about actual clinical practices and associated complications are lacking. We aimed to analyze current practice in the clinical management of these cases. METHODS Retrospective study of cases in the Biobadaderm database. We analyzed the management of biologic therapy in patients with psoriasis who underwent surgical procedures. RESULTS Forty-eight of the 2113 patients registered in Biobadaderm underwent surgery. The largest percentage of procedures (31%) involved skin lesions. Biologic treatment was interrupted in 42% of the cases. No postsurgical complications were significantly related to treatment interruption. Likewise we detected no associations between treatment interruption and other variables, such as sex, age, or duration or severity of psoriasis. CONCLUSION Continuity of biologic treatment and the risk of postsurgical complications were not associated in this study, although conclusions are limited by the small sample size.
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Affiliation(s)
- S Galiano Mejías
- Servicio de Dermatología, Hospital Infanta Leonor, Madrid, España.
| | - G Carretero
- Servicio de Dermatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España
| | - C Ferrandiz
- Servicio de Dermatología, Hospital Universitario Germans Trias i Pujol, Badalona, Universitat Autónoma de Barcelona, Barcelona, España
| | - F Vanaclocha
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - E Daudén
- Servicio de Dermatología, Hospital Universitario La Princesa, Madrid, España
| | - F J Gómez-García
- Servicio de Dermatología, Hospital Universitario Reina Sofía, Córdoba, España
| | - E Herrera-Ceballos
- Servicio de Dermatología, Hospital Universitario Virgen de la Victoria, Málaga, España
| | - I Belinchón-Romero
- Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España
| | - J L Sánchez-Carazo
- Servicio de Dermatología, Hospital General Universitario de Valencia, Valencia, España
| | - J L López-Estebaranz
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - M Alsina
- Servicio de Dermatología, Hospital Universitario Clinic de Barcelona, Barcelona, España
| | - M Ferrán
- Servicio de Dermatología, Hospital del Mar, Parc de Salut Mar, Barcelona, España
| | - R Torrado
- Servicio de Dermatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitario Germans Trias i Pujol, Badalona, Universitat Autónoma de Barcelona, Barcelona, España
| | - R Rivera
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - M Llamas-Velasco
- Servicio de Dermatología, Hospital Universitario La Princesa, Madrid, España
| | - R Jiménez-Puya
- Servicio de Dermatología, Hospital Universitario Reina Sofía, Córdoba, España
| | - Mª V Mendiola
- Servicio de Dermatología, Hospital Universitario Virgen de la Victoria, Málaga, España
| | - D Ruiz-Genao
- Servicio de Dermatología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - M A Descalzo
- Unidad de Investigación, Fundación Academia Española de Dermatología y Venereología, Madrid, España
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12
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Dávila-Seijo P, Dauden E, Carretero G, Ferrandiz C, Vanaclocha F, Gómez-García FJ, Herrera-Ceballos E, De la Cueva-Dobao P, Belinchón I, Sánchez-Carazo JL, Alsina M, López-Estebaranz JL, Ferrán M, Torrado R, Carrascosa JM, Llamas M, Rivera R, Jiménez-Puya R, García-Doval I. Survival of classic and biological systemic drugs in psoriasis: results of the BIOBADADERM registry and critical analysis. J Eur Acad Dermatol Venereol 2016; 30:1942-1950. [PMID: 27329511 DOI: 10.1111/jdv.13682] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 02/22/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Few reported studies compare drug survival in moderate-to-severe psoriasis vulgaris. OBJECTIVES To describe and compare drug survival of systemic drugs, including biologic agents (infliximab, etanercept, adalimumab and ustekinumab) and classical drugs (acitretin, ciclosporin and methotrexate) in moderate-to-severe psoriasis. METHODS This was a multicenter, prospective, cohort study of patients receiving systemic therapies between 2008 and 2013 in 12 hospitals in Spain. Baseline data and drug discontinuation were collected. Drug survival is presented using Kaplan-Meier survival curves. We compared adjusted risk ratios of serious adverse events (AEs) with results of survival analysis for AEs. RESULTS A total of 1956 patients were included for analysis (1240 exposed to biologics during follow-up and 1076 to classic therapies). Median follow-up time was 3.3 years (0.0-5.1 years). There were 2209 discontinuations out of 3640 therapy cycles started. The main reason for discontinuation was lack of efficacy (36.4%) and remission (27.2%). Biologics showed a higher drug survival than classics and the pattern of survival results for all outcomes (positive or negative) were very similar. Adjusted risk ratios of serious AEs did not agree with results of survival analysis. LIMITATIONS A limitation is that this is an observational study with potential selection bias. CONCLUSION Survival as a proxy measure of drug safety in psoriasis is inadequate.
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Affiliation(s)
- P Dávila-Seijo
- Research Unit, Fundación Academia Española de Dermatología y Venereología, Madrid, Spain. .,Department of Dermatology, Hospital Universitario La Princesa, Madrid, Spain. .,Department of Dermatology, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain. .,Department of Dermatology, Hospital Universitario Germans Trias i Pujol, Badalona, Spain. .,Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain. .,Department of Dermatology, Hospital Universitario Reina Sofía, Córdoba, Spain. .,Department of Dermatology, Hospital Universitario Virgen de la Victoria, Málaga, Spain. .,Department of Dermatology, Hospital Infanta Leonor, Madrid, Spain. .,Department of Dermatology, Hospital General Universitario de Alicante, Alicante, Spain. .,Department of Dermatology, Hospital General Universitario de Valencia, Valencia, Spain. .,Department of Dermatology, Hospital Clinic de Barcelona, Barcelona, Spain. .,Department of Dermatology, Hospital Universitario Fundación Alcorcón, Madrid, Spain. .,Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain. .,Department of Dermatology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain. .,Department of Dermatology and Venereology, Umeå University Hospital, Umeå, Sweden.
| | - E Dauden
- Department of Dermatology, Hospital Universitario La Princesa, Madrid, Spain
| | - G Carretero
- Department of Dermatology, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
| | - C Ferrandiz
- Department of Dermatology, Hospital Universitario Germans Trias i Pujol, Badalona, Spain
| | - F Vanaclocha
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - F-J Gómez-García
- Department of Dermatology, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - E Herrera-Ceballos
- Department of Dermatology, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | | | - I Belinchón
- Department of Dermatology, Hospital General Universitario de Alicante, Alicante, Spain
| | - J-L Sánchez-Carazo
- Department of Dermatology, Hospital General Universitario de Valencia, Valencia, Spain
| | - M Alsina
- Department of Dermatology, Hospital Clinic de Barcelona, Barcelona, Spain
| | - J-L López-Estebaranz
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - M Ferrán
- Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - R Torrado
- Department of Dermatology, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
| | - J-M Carrascosa
- Department of Dermatology, Hospital Universitario Germans Trias i Pujol, Badalona, Spain
| | - M Llamas
- Department of Dermatology, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
| | - R Rivera
- Department of Dermatology, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - R Jiménez-Puya
- Department of Dermatology, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - I García-Doval
- Research Unit, Fundación Academia Española de Dermatología y Venereología, Madrid, Spain.,Department of Dermatology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
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Carrascosa J, Rivera N, Garcia-Doval I, Carretero G, Vanaclocha F, Daudén E, Gómez-García F, De-la-Cueva-Dobao P, Herrera-Ceballos E, Belinchón I, Alsina M, Sánchez-Carazo J, Ferrán M, Lopez-Estebaranz J, Pérez-Zafrilla B, Llamas M, Rivera R, Ferrándiz C. Does the treatment ladder for systemic therapy in moderate to severe psoriasis only go up? The percentage of patients with severe psoriasis on biologics increases over time. Actas Dermo-Sifiliográficas (English Edition) 2015. [DOI: 10.1016/j.adengl.2015.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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14
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Medina C, Carretero G, Ferrandiz C, Dauden E, Vanaclocha F, Gómez-García F, Herrera-Ceballos E, De la Cueva-Dobao P, Belinchón I, Sánchez-Carazo J, Alsina M, López-Estebaranz J, Ferrán M, Carrascosa J, Torrado R, Argila D, Rivera R, Jiménez-Puya R, García-Doval I. Safety of classic and biologic systemic therapies for the treatment of psoriasis in elderly: an observational study from national BIOBADADERM registry. J Eur Acad Dermatol Venereol 2014; 29:858-64. [DOI: 10.1111/jdv.12688] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 07/15/2014] [Indexed: 11/27/2022]
Affiliation(s)
- C. Medina
- Hospital Universitario de Gran Canaria Dr Negrín; Las Palmas de Gran Canaria Spain
| | - G. Carretero
- Hospital Universitario de Gran Canaria Dr Negrín; Las Palmas de Gran Canaria Spain
| | - C. Ferrandiz
- Hospital Universitario Germans Trias i Pujol; Badalona Spain
| | - E. Dauden
- Hospital Universitario la Princesa; Madrid Spain
| | | | | | | | | | - I. Belinchón
- Hospital General Universitario de Alicante; Alicante Spain
| | | | - M. Alsina
- Hospital Clinic de Barcelona; Barcelona Spain
| | | | - M. Ferrán
- Hospital del Mar; Parc de Salut Mar; Barcelona Spain
| | - J.M. Carrascosa
- Hospital Universitario Germans Trias i Pujol; Badalona Spain
| | - R. Torrado
- Hospital Universitario de Gran Canaria Dr Negrín; Las Palmas de Gran Canaria Spain
| | - D. Argila
- Hospital Universitario la Princesa; Madrid Spain
| | - R. Rivera
- Hospital Universitario 12 de Octubre; Córdoba Spain
| | | | - I. García-Doval
- Research Unit.; Fundación Academia Española de Dermatología y Venereología; Madrid Spain
- Complexo Hospitalario Universitario de Vigo; Vigo Spain
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15
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Vanaclocha F, Crespo-Erchiga V, Jiménez-Puya R, Puig L, Sánchez-Carazo JL, Ferrán M, Sancho C, Juliá B, Cea-Calvo L, Marín-Jiménez I, García-Vicuña R. Immune-mediated inflammatory diseases and other comorbidities in patients with psoriasis: baseline characteristics of patients in the AQUILES study. Actas Dermosifiliogr 2014; 106:35-43. [PMID: 25091923 DOI: 10.1016/j.ad.2014.06.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 05/26/2014] [Accepted: 06/01/2014] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Patients with psoriasis often have comorbidities, including other immune-mediated inflammatory diseases (IMIDs), and cardiovascular risk factors. In this article we describe the baseline prevalence of comorbidities-including other IMIDs-in a cohort of patients with psoriasis. PATIENTS AND METHODS AQUILES was a prospective observational multicenter study of 3 patient cohorts (patients with psoriasis, spondyloarthritis, or inflammatory bowel disease) undertaken to investigate the prevalence of comorbidities, including other IMIDs, in these settings. The psoriasis cohort comprised patients aged at least 18 years who were seen in hospital dermatology clinics. A predefined protocol was used to collect demographic and clinical data. RESULTS The study enrolled 528 patients with psoriasis (60.2% men and 39.8% women). Mean age was 46.7 years; 89.8% of the participants had plaque psoriasis, and the median Psoriasis Area Severity Index score (PASI) was 3.2 (1.5-7.4). Comorbid IMIDs were present in 82 (15.5%) of the patients (CI 95%, 12.7%-18.9%). Spondyloarthritis was observed in 14% of patients (95% CI, 11.3%-17.2%), mostly in the form of psoriatic arthritis, for which the overall prevalence was 13.1% (95% CI, 10.5%-16.2%). Inflammatory bowel disease was present in 1.3% (95% CI, 0.6%-2.7%) and uveitis in .2% (95% CI, 0.1%-1.4%). Psoriatic arthritis was associated with male sex (odds ratio, 1.75 [.98-2.98]) and a disease duration of over 8 years (OR, 4.17 [1.84-9.44] vs a duration of < 4 years). In 73.1%, at least 1 cardiovascular risk factor was identified: smoking (40.5%), obesity (26.0%), dyslipidemia (24.8%), hypertension (24.3%), and diabetes mellitus (12.3%). CONCLUSION In patients with psoriasis the prevalence of other IMIDs was 15.5%, a level slightly higher than that found in the general population. Nearly three-quarters of these patients had at least 1 cardiovascular risk factor.
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Affiliation(s)
- F Vanaclocha
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - V Crespo-Erchiga
- Servicio de Dermatología, Hospital Regional Universitario Carlos Haya, Málaga, España
| | - R Jiménez-Puya
- Servicio de Dermatología, Hospital Universitario Reina Sofía, Córdoba, España
| | - L Puig
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - J L Sánchez-Carazo
- Servicio de Dermatología, Hospital General Universitario, Valencia, España
| | - M Ferrán
- Servicio de Dermatología, Hospital del Mar, Barcelona, España
| | - C Sancho
- Medical Affairs, Merck Sharp & Dohme, España
| | - B Juliá
- Medical Affairs, Merck Sharp & Dohme, España.
| | - L Cea-Calvo
- Medical Affairs, Merck Sharp & Dohme, España
| | - I Marín-Jiménez
- Servicio de Gastroenterología, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - R García-Vicuña
- Servicio de Reumatología, Hospital Universitario La Princesa, IISP, Madrid, España
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16
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Carretero G, Ferrandiz C, Dauden E, Vanaclocha Sebastián F, Gómez-García FJ, Herrera-Ceballos E, De la Cueva-Dobao P, Belinchón I, Sánchez-Carazo JL, Alsina-Gibert M, López-Estebaranz JL, Ferrán M, Torrado R, Carrascosa JM, Carazo C, Rivera R, Jiménez-Puya R, García-Doval I. Risk of adverse events in psoriasis patients receiving classic systemic drugs and biologics in a 5-year observational study of clinical practice: 2008-2013 results of the Biobadaderm registry. J Eur Acad Dermatol Venereol 2014; 29:156-63. [PMID: 24684267 DOI: 10.1111/jdv.12492] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 03/03/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Biobadaderm is the Spanish registry of psoriasis patients receiving systemic treatment in clinical practice. OBJECTIVE To compare the safety of biologics and classic systemic treatment. METHODS Prospective cohort of patients receiving biologics and classic systemic therapies between 2008 and 2013 in 12 hospitals are included. We registered demographic data, diagnoses, comorbidities, treatments and adverse events (AE). We obtained raw relative risks (RR) for specific AE. Multivariate analysis consisted of Cox models adjusting for age, gender, chronic hepatic disease and previous cancer. RESULTS A total of 1030 patients received biologics (2061 AE in 3681 person-years), 926 patients classic systemic drugs (1015 AE in 1517 person-years). Ninety-three per cent of AE in both groups were non-serious, 6% serious and 0.003% fatal. The age- and gender-adjusted hazard ratio of AE was lower in the biologics group [hazard ratio 0.6 (95% CI: 0.5-0.7)].We found no differences in rates of serious and mortal AE. Some system organ class AE rates differed between both groups. As limitations: Prescription bias might affect the incidence of AE in both groups. Association of drug and AE was based on timing: associations might not be causal. CONCLUSION Patients receiving biologics had lower risk of AE. We did not find differences in the risk of serious or fatal AE.
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Affiliation(s)
- G Carretero
- Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
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17
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Navarro R, Vilarrasa E, Herranz P, Puig L, Bordas X, Carrascosa JM, Taberner R, Ferrán M, García-Bustinduy M, Romero-Maté A, Pedragosa R, García-Diez A, Daudén E. Safety and effectiveness of ustekinumab and antitumour necrosis factor therapy in patients with psoriasis and chronic viral hepatitis B or C: a retrospective, multicentre study in a clinical setting. Br J Dermatol 2013; 168:609-16. [PMID: 22985451 DOI: 10.1111/bjd.12045] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Both the safety and efficacy of biologic therapy may be affected in the presence of highly prevalent chronic viral hepatitis. OBJECTIVE To evaluate the safety and effectiveness of ustekinumab and antitumour necrosis factor therapy in patients with psoriasis and concomitant chronic viral hepatitis. METHODS This was a retrospective, multicentre study. Twenty-five patients with psoriasis and concurrent hepatitis C virus (HCV) (20 patients) or hepatitis B virus (HBV) (five patients) infection who had received at least one biologic agent (etanercept, 21 treatments; adalimumab, four; ustekinumab, four; infliximab, two) were included. Clinical, imaging and laboratory data were recorded. RESULTS In the case of HCV infection, the majority of the patients did not exhibit increases in their viral load or serum liver tests. Aspartate aminotransferase, alanine aminotransferase and gamma glutamyl transpeptidase were doubled from the baseline measurement in only one patient treated with etanercept. Two other cases exhibited viral load increases during the follow-up period. In total, 18 of the 26 treatments achieved a 75% improvement in their Psoriasis Area and Severity Index (PASI 75) score during the follow-up period. Two patients treated with etanercept were diagnosed with hepatocellular carcinoma. In the case of HBV infection, all of the patients were being treated with antiviral therapy, and none presented significant variations in viral load or serum liver enzymes. All patients achieved a PASI 75 during follow-up. CONCLUSIONS Biologic therapy was effective and safe for the majority of our patients with HCV and HBV infection, although there may be a risk of reactivation or aggravation. We describe the first cases to receive ustekinumab. The use of biologics should be limited to those cases in which the risk-benefit ratio is justified.
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Affiliation(s)
- R Navarro
- Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain.
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18
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Carrascosa J, Vilavella M, Garcia-Doval I, Carretero G, Vanaclocha F, Daudén E, Gómez-García F, Herrera-Ceballos E, De la Cueva Dobao P, Belinchón I, Sánchez-Carazo J, Alsina M, López-Estebaranz J, Ferrán M, Peral F, Torrado R, Rivera R, Jiménez-Puya R, Mendiola M, Ferrándiz C. Body mass index in patients with moderate-to-severe psoriasis in Spain and its impact as an independent risk factor for therapy withdrawal: results of the Biobadaderm Registry. J Eur Acad Dermatol Venereol 2013; 28:907-14. [DOI: 10.1111/jdv.12208] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 05/04/2013] [Accepted: 06/10/2013] [Indexed: 02/01/2023]
Affiliation(s)
- J.M. Carrascosa
- Hospital Universitari Germans Trías i Pujol, Badalona; Universitat Autònoma de Barcelona; Barcelona
| | - M. Vilavella
- Hospital Universitari Germans Trías i Pujol, Badalona; Universitat Autònoma de Barcelona; Barcelona
| | - I. Garcia-Doval
- Research Unit; Fundación Academia Española de Dermatología y Venereología [Spanish Academy of Dermatology and Venereology Foundation]; Madrid
| | - G. Carretero
- Hospital Universitario de Gran Canaria Dr Negrín; Las Palmas de Gran Canaria
| | | | - E. Daudén
- Hospital Universitario la Princesa; Madrid
| | | | | | | | - I. Belinchón
- Hospital General Universitario de Alicante; Alicante
| | | | - M. Alsina
- Hospital Clinic de Barcelona; Barcelona
| | | | - M. Ferrán
- Hospital del Mar; Parc de Salut Mar; Barcelona
| | - F. Peral
- Hospital Universitario Virgen de la Macarena; Sevilla Spain
| | - R. Torrado
- Hospital Universitario de Gran Canaria Dr Negrín; Las Palmas de Gran Canaria
| | - R. Rivera
- Hospital Universitario 12 de Octubre; Madrid
| | | | - M.V. Mendiola
- Hospital Universitario Virgen de la Victoria; Málaga
| | - C. Ferrándiz
- Hospital Universitari Germans Trías i Pujol, Badalona; Universitat Autònoma de Barcelona; Barcelona
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19
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Sánchez-Moya A, García-Doval I, Carretero G, Sánchez-Carazo J, Ferrandiz C, Herrera Ceballos E, Alsina M, Ferrán M, López-Estebaranz JL, Gómez-García F, De la Cueva Dobao P, Carrascosa JM, Vanaclocha F, Belinchón I, Peral F, Dauden E. Latent tuberculosis infection and active tuberculosis in patients with psoriasis: a study on the incidence of tuberculosis and the prevalence of latent tuberculosis disease in patients with moderate-severe psoriasis in Spain. BIOBADADERM registry. J Eur Acad Dermatol Venereol 2012; 27:1366-74. [DOI: 10.1111/jdv.12011] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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20
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Morell L, Carrascosa JM, Ferrándiz C, García-Bustinduy M, Fonseca E, Carretero G, Daudén E, Marrón SE, López-Estebaranz JL, Ferrán M, Sánchez-Regaña M, Muñoz-Santos C, Belinchón I, Puig L. [Clinical characteristics and disease course in patients treated with efalizumab following suspension of marketing authorization by the European medicines agency: a multicenter observational study]. Actas Dermosifiliogr 2011; 102:354-64. [PMID: 21530928 DOI: 10.1016/j.ad.2010.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Revised: 12/16/2010] [Accepted: 12/20/2010] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The withdrawal of marketing authorization for efalizumab by the European Medicines Agency in February, 2009 provided a unique opportunity to assess the course of disease in patients who were not subject to the selection criteria and biases that were common in the pivotal trials. The aim of this study was to evaluate the course of psoriasis following forced suspension of efalizumab in a group of patients treated in normal clinical practice. As secondary objectives, we sought to assess the relationships between clinical characteristics, treatment response, and disease course during efalizumab treatment and 12 and 24 weeks after suspension. PATIENTS AND METHODS Information on the epidemiological profile and disease course during treatment and following suspension of the drug was collected from a group of patients treated with efalizumab. Statistical analyses were performed to identify predictive factors. RESULTS One hundred forty-seven patients from 12 Spanish hospitals were included in the study. During treatment, 4% of patients were diagnosed with generalized inflammatory flares. Most patients could be classified as having a good (55%) or moderate (18%) response to treatment. Rebound following withdrawal of efalizumab was observed in 30% of patients. The likelihood of rebound was independent of clinical characteristics, treatment response, or therapeutic approach used by the dermatologist following suspension. CONCLUSIONS There was a high frequency of rebound following suspension of efalizumab, exceeding the rate reported in pivotal trials. This is particularly noteworthy given the large proportion of patients with a good response to treatment and therefore believed to have a better prognosis. Other significant findings were the higher frequency of positive treatment response than observed in previous studies (possibly influenced by the mean treatment duration) and the high frequency of generalized inflammatory flares.
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Affiliation(s)
- L Morell
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
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21
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Rivera R, García-Doval I, Carretero G, Daudén E, Sánchez-Carazo J, Ferrándiz C, Herrera E, Alsina M, Ferrán M, López-Estebaranz J, Gómez F, Herranz J, Carrascosa J, Vanaclocha F. BIOBADADERM, the Spanish Registry of Adverse Events Associated With Biologic Drugs in Dermatology: First Report. Actas Dermo-Sifiliográficas (English Edition) 2011. [DOI: 10.1016/s1578-2190(11)70770-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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22
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Tribó MJ, Andión O, Ros S, Gilaberte M, Gallardo F, Toll A, Ferrán M, Bulbena A, Pujol RM, Baños JE. Clinical characteristics and psychopathological profile of patients with vulvodynia: an observational and descriptive study. Dermatology 2008; 216:24-30. [PMID: 18032895 DOI: 10.1159/000109354] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2006] [Accepted: 05/17/2007] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Vulvodynia is a fairly common dermatological symptom that often interferes with the personal, social and working activities of affected women and results in a significant loss of their quality of life. It is a persistent and tedious clinical disorder which is often resistant to conventional treatments. OBJECTIVES The aim of this study is to evaluate the main clinical signs, associated psychopathological disorders and outcome after antidepressant treatment of patients with vulvodynia. METHODS Eighty patients were included. Clinical characteristics and psychopathological profiles were determined by appropriate instruments. The improvement of clinical symptoms after combined antidepressant drug therapy was also evaluated. RESULTS Pain (70%), burning (63.7%), dyspareunia (57.5%) and stinging (56.2%) were the most commonly reported symptoms. Most patients (56.5%) showed anxiety, and 52.2% of them were reported as having a depression disorder. When evaluated by psychometric tools, 81.4% of patients scored >150 on the Life Event Scale, which means a risk >50% of suffering an illness in the near future, and patients' scores in the Dermatology Life Quality Index showed higher values than the mean of the Spanish validation group. After 6 months of combined treatment with escitalopram (10-20 mg/day), perfenazine (2-4 mg/day) and amytriptiline (10 mg/day), a complete remission of the clinical symptoms was achieved in 41% of patients. In contrast, only 12% of patients who did not follow drug treatment reported a complete resolution of the clinical symptoms. CONCLUSIONS Our results seem to confirm that vulvodynia is associated with psychiatric co-morbidity such as stress and depression. The study highlights that the psychiatric treatment may be a useful option to improve clinical symptoms. Whether these patients should be evaluated for depression or be referred to a psychiatrist, remains to be investigated.
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Affiliation(s)
- M J Tribó
- Department of Dermatology, Hospital del Mar, Universitat Autónoma de Barcelona, Barcelona, Spain.
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23
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Tassies D, Berga L, Feliu E, Ferrán M, Nomdedeu B, Bombí JA, Vives-Corrons JL, Rozman C. [Cavernous hemangioma of the spleen with a localized intravascular coagulation syndrome (Kasabach-Merritt syndrome). Ultrastructural study]. Sangre (Barc) 1992; 37:145-9. [PMID: 1621186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Haemangioma is the commonest non-malignant tumour of the spleen. Cytopenia and coagulopathy, secondary to cell trapping and coagulation factors consumption inside the haemangioma, respectively. May occasionally occur as accompanying phenomena. A woman is presented who had splenic haemangioma associated with leucopenia and thrombocytopenia along with decrease fibrinogen and prolonged prothrombin time as well as low complement rates. She had massive splenomegaly with portal hypertension, and the partial oxygen pressure values in mesenteric and portal blood were concurrent with the presence of arteriovenous shunts. The leucocyte and platelet count, the serum complement, the fibrinogen rate and the prothrombin time recovered after splenectomy. The cavernous characteristics of the spleen, containing multiple thrombi, were confirmed upon scanning electron microscope examination. The pathophysiology of the cytopenias and clotting factors consumption is discussed, stress being laid on the ultrastructural findings. A review is presented of the clinical aspects, differential diagnosis and treatment.
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Affiliation(s)
- D Tassies
- Servicio de Hematología, Hospital Clinic, Facultad de Medicina, Universidad de Barcelona
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24
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Ferrán M, Casabella B, Olivé E, Gómez J. [Post-traumatic diabetes insipidus. Diagnosis of a case in primary care]. Aten Primaria 1989; 6:435-6. [PMID: 2518939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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25
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Ferrán M, Buti M, González A, Boqué R, Esteban R, Guardia J. Pyogenic liver abscess by haemophilus influenzae complicating hydatid cysts. Infection 1986; 14:197. [PMID: 3489678 DOI: 10.1007/bf01645264] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Ferrán M, Arderiu A, Vilardell M, Tornos J. [Hereditary hemorrhagic telangiectasia and congenital factor XI deficiency]. Med Clin (Barc) 1986; 86:425-7. [PMID: 3713297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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