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Jiménez Gómez N, González-Cantero Á, Ruiz-Villaverde R, Llamas-Velasco M, de la Cueva Dobao P, Rivera Díaz R, Martínez Lorenzo E, Alonso Pacheco ML, Baniandrés Rodríguez O, Mollet Sánchez J, Pitarch Bort G, Izu Belloso RM, Jaén Olasolo P. Family Planning Concerns Among Women With Psoriasis: A Descriptive, Cross-Sectional, Multicenter Study. Actas Dermosifiliogr 2024; 115:10-20. [PMID: 37442420 DOI: 10.1016/j.ad.2023.06.015] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/21/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND AND OBJECTIVE A significant proportion of women of childbearing age have psoriasis. The aim of this study was to examine family planning concerns in this population. MATERIAL AND METHODS Observational, descriptive, cross-sectional, multicenter study conducted between March 2020 and October 2021. We collected sociodemographic data and analyzed responses to a family planning questionnaire administered to women aged 18 to 45 years with plaque psoriasis who were candidates for systemic treatment. RESULTS We studied 153 patients (mean [SD] age, 35.4 [8.0] years; mean disease duration, 16.7 years) being treated at 11 Spanish hospitals. Overall, 38.4% of women were considered to have moderate to severe psoriasis by their physicians; perceived severity ratings were significantly higher among women. Psoriasis affected the women's desire to become pregnant or led to their delaying pregnancy in 1 in 3 respondents. They were concerned that their condition might worsen if they had to discontinue or switch treatment or that the treatment might harm the baby. Approximately half of the women had not received family planning counseling from their physicians, and this was more likely to be the case among never-pregnant women. Women on biologic therapy (58.7%) had better psoriasis control and a better quality of life than women on other treatments. Their sexual health was also less affected. CONCLUSIONS Women with psoriasis have numerous family planning concerns, which in some cases can lead them to delay pregnancy or affect their desire to become pregnant. Dermatologists need to receive better training regarding family planning in women with psoriasis so that they can provide their patients with more and better information.
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Affiliation(s)
- N Jiménez Gómez
- Hospital Universitario Ramón y Cajal, Madrid, España; Grupo de Dermatología Pedro Jaén, Madrid, España.
| | - Á González-Cantero
- Hospital Universitario Ramón y Cajal, Madrid, España; Grupo de Dermatología Pedro Jaén, Madrid, España; Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, España
| | - R Ruiz-Villaverde
- Hospital Universitario San Cecilio Granada, Instituto Biosanitario de Granada (Ibs), Granada, España
| | | | | | - R Rivera Díaz
- Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, España
| | | | | | | | | | - G Pitarch Bort
- Hospital General Universitario de Castellón, Castellón, España
| | | | - P Jaén Olasolo
- Hospital Universitario Ramón y Cajal, Madrid, España; Grupo de Dermatología Pedro Jaén, Madrid, España
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2
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Jiménez Gómez N, González-Cantero Á, Ruiz-Villaverde R, Llamas-Velasco M, de la Cueva Dobao P, Rivera Díaz R, Martínez Lorenzo E, Alonso Pacheco ML, Baniandrés Rodríguez O, Mollet Sánchez J, Pitarch Bort G, Izu Belloso RM, Jaén Olasolo P. [Translated article] Family Planning Concerns Among Women With Psoriasis: A Descriptive, Cross-Sectional, Multicenter Study. Actas Dermo-Sifiliográficas 2024; 115:T10-T20. [PMID: 37923069 DOI: 10.1016/j.ad.2023.10.030] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/28/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVE A significant proportion of women of childbearing age have psoriasis. The aim of this study was to examine family planning concerns in this population. MATERIAL AND METHODS Observational, descriptive, cross-sectional, multicenter study conducted between March 2020 and October 2021. We collected sociodemographic data and analyzed responses to a family planning questionnaire administered to women aged 18 to 45 years with plaque psoriasis who were candidates for systemic treatment. RESULTS We studied 153 patients (mean [SD] age, 35.4 [8.0] years; mean disease duration, 16.7 years) being treated at 11 Spanish hospitals. Overall, 38.4% of women were considered to have moderate to severe psoriasis by their physicians; perceived severity ratings were significantly higher among women. Psoriasis affected the women's desire to become pregnant or led to their delaying pregnancy in 1 in 3 respondents. They were concerned that their condition might worsen if they had to discontinue or switch treatment or that the treatment might harm the baby. Approximately half of the women had not received family planning counseling from their physicians, and this was more likely to be the case among never-pregnant women. Women on biologic therapy (58.7%) had better psoriasis control and a better quality of life than women on other treatments. Their sexual health was also less affected. CONCLUSIONS Women with psoriasis have numerous family planning concerns, which in some cases can lead them to delay pregnancy or affect their desire to become pregnant. Dermatologists need to receive better training regarding family planning in women with psoriasis so that they can provide their patients with more and better information.
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Affiliation(s)
- N Jiménez Gómez
- Hospital Universitario Ramón y Cajal, Madrid, Spain; Grupo de Dermatología Pedro Jaén, Madrid, Spain.
| | - Á González-Cantero
- Hospital Universitario Ramón y Cajal, Madrid, Spain; Grupo de Dermatología Pedro Jaén, Madrid, Spain; Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, Spain
| | - R Ruiz-Villaverde
- Hospital Universitario San Cecilio Granada, Instituto Biosanitario de Granada (Ibs), Granada, Spain
| | | | | | - R Rivera Díaz
- Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain
| | | | | | | | | | - G Pitarch Bort
- Hospital General Universitario de Castellón, Castellón, Spain
| | | | - P Jaén Olasolo
- Hospital Universitario Ramón y Cajal, Madrid, Spain; Grupo de Dermatología Pedro Jaén, Madrid, Spain
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Díez-Madueño K, Buendía Castaño D, Roldán Cortés D, de la Cueva Dobao P. Giant Cellulitis-like Sweet Syndrome: Contribution of a New Case and Medical Literature Review. Actas Dermosifiliogr 2023:S0001-7310(23)00964-X. [PMID: 38135002 DOI: 10.1016/j.ad.2023.04.038] [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: 03/07/2023] [Revised: 04/13/2023] [Accepted: 04/19/2023] [Indexed: 12/24/2023] Open
Affiliation(s)
- K Díez-Madueño
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, España
| | - D Buendía Castaño
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, España
| | - D Roldán Cortés
- Servicio de Anatomía Patológica, Hospital Universitario Infanta Leonor, Madrid, España
| | - P de la Cueva Dobao
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, España.
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Conde Montero E, Sommer R, Augustin M, Blome C, Cabeza Martínez R, Horcajada Reales C, Alsina Gibert M, Ramón Sapena R, Peral Vázquez A, Montoro López J, Guisado Muñoz S, Pérez Jerónimo L, de la Cueva Dobao P, Kressel N, Mohr N. Validation of the Spanish Wound-QoL Questionnaire. Actas Dermo-Sifiliográficas (English Edition) 2021. [DOI: 10.1016/j.adengl.2020.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Conde-Montero E, Bohbot S, Grado Sanz R, Peral Vázquez A, Recarte-Marín L, Pérez-Jerónimo L, Galán Sánchez JL, de la Cueva Dobao P. Association of autologous punch grafting, TLC-NOSF dressing and multitype compression therapy to rapidly achieve wound closure in hard-to-heal venous leg ulcers. J Med Vasc 2020; 45:316-325. [PMID: 33248534 DOI: 10.1016/j.jdmv.2020.10.123] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/02/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To document the efficacy of a combined therapeutic strategy in achieving rapid wound healing in patients with long-standing ulcers. MATERIALS AND METHODS Outpatients with hard-to-heal venous leg ulcers were included in an interventional, prospective, single-arm, mono-centre study and treated with autologous punch grafting, TLC-NOSF dressing and multi-type compression therapy. The primary outcome was the percentage of healed wounds by week 12. Secondary outcomes included time-to-reach wound closure, wound area reduction, treatment acceptability and safety. RESULTS From November 2018 to October 2019, 42 patients with 51 ulcers were included (23 males, 70.6±40.8 years old, with multiple comorbidities). Despite poor wound healing prognosis at baseline (47% of recurrent ulcers, with a mean duration of 15 months and a mean area of 12.6cm2), wound healing was achieved in 47 ulcers (92%) after a mean period of treatment of 25±13 days. A relative wound area reduction>75% was also reached in three additional ulcers by the last evaluation visit. No adverse event related to the procedure was reported throughout the study period. The associated treatment were very well tolerated and accepted by the patients. CONCLUSIONS The evaluated procedure induced fast re-epithelisation of the treated ulcers. Based on our experience, this simple and successful reparative strategy may be considered as an interesting option in the treatment of venous leg ulcers of poor prognosis.
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Affiliation(s)
- E Conde-Montero
- Department of dermatology, Hospital Universitario Infanta Leonor and Hospital Virgen-de-la-Torre, avenida Gran Via de Este 80, 28031 Madrid, Spain.
| | - S Bohbot
- Medical affairs department, Laboratoires URGO Medical, 15, avenue de Iena, 75116 Paris, France
| | - R Grado Sanz
- Centro de salud cervantes, Hospital Universitario de Guadalajara, calle Miguel-Cervantes, 16, 19001 Guadalajara, Spain
| | - A Peral Vázquez
- Centro de especialidades Vicente-Soldevilla, calle Sierra-de-Alquife, 8, 28053 Madrid, Spain
| | - L Recarte-Marín
- Centro de especialidades Vicente-Soldevilla, calle Sierra-de-Alquife, 8, 28053 Madrid, Spain
| | - L Pérez-Jerónimo
- Centro de especialidades Vicente-Soldevilla, calle Sierra-de-Alquife, 8, 28053 Madrid, Spain
| | - J-L Galán Sánchez
- Department of dermatology, Hospital Universitario Infanta Leonor and Hospital Virgen-de-la-Torre, avenida Gran Via de Este 80, 28031 Madrid, Spain
| | - P de la Cueva Dobao
- Department of dermatology, Hospital Universitario Infanta Leonor and Hospital Virgen-de-la-Torre, avenida Gran Via de Este 80, 28031 Madrid, Spain
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6
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Conde Montero E, Sommer R, Augustin M, Blome C, Cabeza Martínez R, Horcajada Reales C, Alsina Gibert M, Ramón Sapena R, Peral Vázquez A, Montoro López J, Guisado Muñoz S, Pérez Jerónimo L, de la Cueva Dobao P, Kressel N, Mohr N. Validation of the Spanish Wound-QoL Questionnaire. Actas Dermosifiliogr (Engl Ed) 2020; 112:44-51. [PMID: 33137321 DOI: 10.1016/j.ad.2020.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 03/09/2020] [Revised: 09/22/2020] [Accepted: 09/26/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND AND AIMS The Wound-QoL is a validated and feasible questionnaire for measuring disease-specific health-related quality of life in chronic wounds, originally developed for use in German. The objective of this study was to translate the Wound-QoL for use in clinical care and in clinical trials in Spain and to validate this version. MATERIALS AND METHODS Two independent fourth- and back translations of the Wound-QoL from the original German version were conducted, followed by an expert consensus of the resulting versions. After refinement, the final tool was piloted in N=10 patients and then used in the validation study. RESULTS A total of 115 patients were recruited. Mean age was 69.5 (SD 14.5) years, 60.0% were female. The Spanish version of Wound-QoL showed high internal consistency (Cronbach's alpha>0.8 in all scales). Factor analysis resulted in the same scales as the original version. There were satisfactory distribution characteristics of the global score and the subscales. Construct validity and convergent validity with other outcomes (generic QoL, healing rate) were satisfactory. The vast majority of patients considered the Wound-QoL a simple and feasible tool. Mean time needed for completing the questionnaire was 5minutes. Overall, 99.1% of the participants found it easy to understand the questions and 94.7% stated that the questionnaire suits the personal situation. CONCLUSIONS The Spanish version of the Wound-QoL shows good validity in clinical practice. It can be recommended for use in clinical routine and trials.
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Affiliation(s)
- E Conde Montero
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, España; Centro de Especialidades Vicente Soldevilla, Hospital Virgen de la Torre, Madrid, España; German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburgo, Alemania
| | - R Sommer
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburgo, Alemania
| | - M Augustin
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburgo, Alemania
| | - C Blome
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburgo, Alemania
| | - R Cabeza Martínez
- Servicio de Dermatología, Hospital Universitario Puerta de Hierro-Majadahonda (HUPHM), Madrid, España
| | - C Horcajada Reales
- Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Madrid, España
| | - M Alsina Gibert
- Servicio de Dermatología, Hospital Clínic de Barcelona, Barcelona, España
| | - R Ramón Sapena
- Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España
| | - A Peral Vázquez
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, España; Centro de Especialidades Vicente Soldevilla, Hospital Virgen de la Torre, Madrid, España
| | - J Montoro López
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, España; Centro de Especialidades Vicente Soldevilla, Hospital Virgen de la Torre, Madrid, España
| | - S Guisado Muñoz
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, España; Centro de Especialidades Vicente Soldevilla, Hospital Virgen de la Torre, Madrid, España
| | - L Pérez Jerónimo
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, España; Centro de Especialidades Vicente Soldevilla, Hospital Virgen de la Torre, Madrid, España
| | - P de la Cueva Dobao
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, España; Centro de Especialidades Vicente Soldevilla, Hospital Virgen de la Torre, Madrid, España
| | - N Kressel
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburgo, Alemania
| | - N Mohr
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburgo, Alemania.
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7
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Conde Montero E, Serra Perrucho N, de la Cueva Dobao P. Theory and Practice of Compression Therapy for Treating and Preventing Venous Ulcers. Actas Dermosifiliogr (Engl Ed) 2020; 111:829-834. [PMID: 32574718 DOI: 10.1016/j.ad.2020.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 12/13/2019] [Revised: 01/21/2020] [Accepted: 03/21/2020] [Indexed: 10/24/2022] Open
Abstract
Compression therapy is the basis for treating the cause of venous ulcers and preventing recurrence. Various systems are currently available for applying compression and adapting them to patients' needs can improve adherence to treatment. Understanding the principles that underlie compression therapy is essential for success. Although this paper focuses mainly on venous ulcers, compression has also proven beneficial for other conditions, such as lymphedema and wounds resulting from injury or inflammation.
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Affiliation(s)
- E Conde Montero
- Servicio de Dermatología. Hospital Universitario Infanta Leonor, Madrid, España.
| | | | - P de la Cueva Dobao
- Servicio de Dermatología. Hospital Universitario Infanta Leonor, Madrid, España
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8
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Guisado Muñoz S, Conde Montero E, de la Cueva Dobao P. Punch Grafting for the Treatment of Martorell Hypertensive Ischemic Leg Ulcer. Actas Dermo-Sifiliográficas (English Edition) 2019. [DOI: 10.1016/j.adengl.2019.07.015] [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: 12/01/2022] Open
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9
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Jalili A, Lebwohl M, Stein Gold L, Andersen SB, Jensen KL, Pink AE, Segaert S, Berg P, Calzavara-Pinton PG, de la Cueva Dobao P, Thaçi D. Itch relief in patients with psoriasis: effectiveness of calcipotriol plus betamethasone dipropionate foam. J Eur Acad Dermatol Venereol 2019; 33:709-717. [PMID: 30520168 DOI: 10.1111/jdv.15393] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/24/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Itch is common in psoriasis, adversely affecting health-related quality of life (HRQoL) and sleep. OBJECTIVE We evaluated the efficacy of topical fixed-dose combination calcipotriol 50 μg/g plus betamethasone dipropionate 0.5 mg/g cutaneous foam (Cal/BD foam) on itch, itch-related sleep loss and HRQoL vs. foam vehicle. METHODS We pooled data from three Phase II/III trials (NCT01536886/NCT01866163/NCT02132936) of Cal/BD foam vs. foam vehicle in adults with mild-severe psoriasis. For itch-related analyses, patients with baseline itch visual analogue scale (VAS) >40 (range 0-100) were analysed. Outcomes included the following: itch VAS reduction >40, ≥70% improvement in itch (Itch70) or itch-related sleep loss, 75% improvement in modified Psoriasis Area and Severity Index (excluding head; mPASI75) and Dermatology Life Quality Index (DLQI) scores 0/1 through 4 weeks. RESULTS Of 837 patients, 800 had baseline itch VAS >0 (Cal/BD foam, n = 610; foam vehicle, n = 190); 484 had baseline itch VAS >40. There was no correlation between itch VAS score and mPASI at baseline (R2 = 0.021). In patients with baseline itch VAS >40, more patients achieved itch VAS reduction >40 in the active vs. vehicle group from Day 5 onwards (Day 5: 57.5% vs. 40.2% [P < 0.05]; Week 4: 83.0% vs. 45.8% [P < 0.001]). More Cal/BD-foam-treated patients achieved Itch70 at Day 3 (34.2% vs. 22.5%; P < 0.05) through to Week 4 (79.3% vs. 38.1%; P < 0.001). In patients with baseline itch VAS >40 and sleep loss >20, improvements in itch-related sleep loss occurred at Week 1 and continued through 4 weeks. Itch-related improvements occurred before improvements in mPASI75. There were significant differences in the proportion of Cal/BD-foam- vs. foam-vehicle-treated patients with baseline DLQI >10 (n = 172 vs. n = 50) achieving DLQI ≤1 (25.0% vs. 4.0%; P = 0.001) and DLQI 0 (17.4% vs. 2.0%; P = 0.006) at Week 4. CONCLUSION Compared with foam vehicle, Cal/BD foam offers more rapid and effective itch relief, with associated significant improvements in sleep and DLQI.
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Affiliation(s)
- A Jalili
- Department of Dermatology, Bürgenstock Medical Center, Obbürgen, Switzerland
| | - M Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | | - A E Pink
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - S Segaert
- Dermatology Private Practice, Tremelo, Belgium
| | - P Berg
- Department of Laboratory Medicine, Karolinska University Hospital, Solna, Sweden
| | | | - P de la Cueva Dobao
- Department of Dermatology, University Hospital Infanta Leonor de Madrid, Madrid, Spain
| | - D Thaçi
- Comprehensive Center for Inflammation Medicine, University of Luebeck, Luebeck, Germany
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10
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de la Cueva Dobao P, Notario J, Ferrándiz C, López Estebaranz JL, Alarcón I, Sulleiro S, Borrás J, Daudén E, Carrascosa JM, Sánchez Carazo JL, Monte Boquet E, Puig L. Expert consensus on the persistence of biological treatments in moderate-to-severe psoriasis. J Eur Acad Dermatol Venereol 2019; 33:1214-1223. [PMID: 31037770 DOI: 10.1111/jdv.15600] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 03/12/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Treatment persistence is becoming a useful measure to evaluate long-term effectiveness and safety of biological therapies in real-world settings. OBJECTIVE The main objective of this study was to explore the scientific opinion of a panel of dermatologists and hospital pharmacists to reach a consensus about the impact, causes, and best strategies and interventions that might be associated with improved drug persistence in patients with psoriasis in Spain. METHODS This research was conducted using a modified Delphi method organized in two rounds and involving a panel of 90 dermatologists and 34 hospital pharmacists. A questionnaire of 70 items was developed. The items proposed to reach a consensus included topics such as definitions and measures in the treatment of psoriasis, analysis of treatment persistence, factors that may influence treatment persistence, impact of treatment persistence and economic cost of treatment. RESULTS Dermatologists reached a consensus on 77.1% of the items proposed, and hospital pharmacists reached a consensus on 71.4%. Both groups agreed that it is important to use standardized measures in the evaluation of treatment maintenance over time. Dermatologists agreed that treatment survival, persistence and retention are synonymous, but hospital pharmacists considered only treatment persistence as a valid term. In addition, panelists agreed that drug persistence is an indicator of success in the treatment of psoriasis that may be influenced by a drug's effectiveness and safety profile, as well as by patient satisfaction. They agreed that the different causes of treatment discontinuation should be considered in Kaplan-Meier analysis of treatment persistence. Moreover, treatment persistence was agreed to decrease the cost of therapy. CONCLUSION This Delphi consensus highlights the different perspectives of dermatologists and hospital pharmacists regarding the interpretation of treatment persistence, and the challenge of harmonizing the results obtained.
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Affiliation(s)
- P de la Cueva Dobao
- Department of Dermatology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - J Notario
- Department of Dermatology, Hospital Universitario de Bellvitge, Barcelona, Spain
| | - C Ferrándiz
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.,Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J L López Estebaranz
- Department of Dermatology, Hospital Universitario Fundación de Alcorcón, Alcorcón, Madrid, Spain
| | - I Alarcón
- Medical Affairs Department, Janssen-Cilag, Madrid, Spain
| | - S Sulleiro
- Medical Affairs Department, Janssen-Cilag, Madrid, Spain
| | - J Borrás
- Pharmacy Service, Hospital de Sagunto, Sagunto, Valencia, Spain
| | - E Daudén
- Department of Dermatology, Hospital Universitario de La Princesa, IIS-FIB, Madrid, Spain
| | - J M Carrascosa
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.,Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J L Sánchez Carazo
- Department of Dermatology, Hospital General Universitario de Valencia, Valencia, Spain
| | - E Monte Boquet
- Pharmacy Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - L Puig
- Universidad Autónoma de Barcelona, Barcelona, Spain.,Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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11
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Pink AE, Jalili A, Berg P, Calzavara-Pinton PG, de la Cueva Dobao P, Thaçi D, Torpet M, Jensen KL, Segaert S. Rapid onset of action of calcipotriol/betamethasone dipropionate cutaneous foam in psoriasis, even in patients with more severe disease. J Eur Acad Dermatol Venereol 2019; 33:1116-1123. [PMID: 30916417 DOI: 10.1111/jdv.15398] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 11/09/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The effectiveness of topical therapies in psoriasis is dependent on, amongst other factors, patient adherence. Together with treatment effectiveness and reduction of symptoms, speed of onset and health-related quality of life (HRQoL) are important influencers of adherence. METHODS This pooled analysis of three Phase II/III trials evaluated the efficacy of topical fixed-dose combination calcipotriol 50 μg/g plus betamethasone dipropionate 0.5 mg/g cutaneous foam (Cal/BD foam) vs. foam vehicle at early timepoints in mild-to-severe psoriasis using clinically meaningful modified Psoriasis Area and Severity Index (mPASI) and Dermatology Life Quality Index (DLQI) targets. RESULTS A greater proportion of Cal/BD-foam- vs. foam-vehicle-treated patients achieved absolute mPASI targets 0 (15.1% vs. 1.0%), ≤1 (41.4% vs. 5.2%), ≤3 (78.5% vs. 29.2%) and ≤5 (90.2% vs. 62.5%) at week 4 (P < 0.001; all targets). Significant differences between Cal/BD-foam- vs. foam-vehicle-treated patients were observed as early as week 1 in those achieving mPASI ≤1 (6.8% vs. 1.5%; P < 0.01), ≤3 (40.4% vs. 22.8%; P < 0.001) and ≤5 (69.7% vs. 50.8%; P < 0.001). In patients with more severe psoriasis (baseline mPASI >10), a greater proportion of Cal/BD-foam- vs. foam-vehicle-treated patients achieved mPASI ≤1 (20.2% vs. 5.9%; P < 0.05), ≤3 (49.2% vs. 8.8%; P < 0.001) and ≤5 (63.7% vs. 26.5%; P < 0.001) at week 4. In patients with severely impaired HRQoL (baseline DLQI >10), a greater proportion of Cal/BD-foam- vs. foam-vehicle-treated patients achieved target DLQI ≤1 or 0 (week 4: DLQI ≤1, 25.0% vs. 4%; P = 0.001; DLQI 0, 17.4% vs. 2.0%; P = 0.006). CONCLUSION We report rapid onset of action and greater efficacy with Cal/BD foam vs. foam vehicle, even in patients with more severe psoriasis, manageable with topical treatments. This may support physician management of patient expectations and improve patient adherence, translating into overall topical treatment effectiveness.
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Affiliation(s)
- A E Pink
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Jalili
- Department of Dermatology, Bürgenstock Medical Center, Obbürgen, Switzerland
| | - P Berg
- Department of Dermatology, Karolinska University Hospital, Solna, Sweden
| | | | - P de la Cueva Dobao
- Department of Dermatology, University Hospital Infanta Leonor de Madrid, Madrid, Spain
| | - D Thaçi
- Comprehensive Center for Inflammation Medicine, University of Luebeck, Luebeck, Germany
| | - M Torpet
- LEO Pharma A/S, Ballerup, Denmark
| | | | - S Segaert
- Dermatology Private Practice, Tremelo, Belgium
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de la Cueva Dobao P. Psoriasis moderada-grave en la infancia y la adolescencia: un reto terapéutico. Actas Dermo-Sifiliográficas 2018; 109:671. [DOI: 10.1016/j.ad.2018.07.003] [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: 07/03/2018] [Accepted: 07/05/2018] [Indexed: 11/17/2022] Open
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13
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de la Cueva Dobao P. Moderate to Severe Psoriasis in Childhood and Adolescence: A Therapeutic Challenge. Actas Dermo-Sifiliográficas (English Edition) 2018. [DOI: 10.1016/j.adengl.2018.07.023] [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: 11/17/2022] Open
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14
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Camarero-Mulas C, Delgado Jiménez Y, Sanmartín-Jiménez O, Garcés J, Rodríguez-Prieto M, Alonso-Alonso T, Miñano Medrano R, López-Estebaranz J, de Eusebio Murillo E, Redondo P, Ciudad-Blanco C, Toll-Abelló A, Artola Igarza J, Allende Markixana I, Suarez Fernández R, Alfaro Rubio A, Alonso Pacheco M, Vázquez-Veiga H, de la Cueva Dobao P, Ruiz-Salas V, Vilarrasa Rull E, Barchino L, Morales-Gordillo V, Ocerin-Guerra I, Navarro Tejedor R, Hueso L, Mayor Arenal M, Seoane-Pose M, Cano-Martinez N, Garcia-Doval I, Descalzo M. Mohs micrographic surgery in the elderly: comparison of tumours, surgery and first-year follow-up in patients younger and older than 80 years old in REGESMOHS. J Eur Acad Dermatol Venereol 2017; 32:108-112. [DOI: 10.1111/jdv.14586] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 09/05/2017] [Indexed: 11/26/2022]
Affiliation(s)
| | - Y. Delgado Jiménez
- Hospital de la Princesa; Madrid Spain
- Hospital Universitario Quirón Salud Madrid; Madrid Spain
| | | | - J.R. Garcés
- Hospital de la Santa Creu i Sant Pau; Barcelona Spain
- Centro Médico Teknon; Barcelona Spain
| | | | | | | | | | | | - P. Redondo
- Clínica Universidad de Navarra; Pamplona Spain
| | - C. Ciudad-Blanco
- Hospital La Zarzuela; Madrid Spain
- Hospital Gregorio Marañón; Madrid Spain
| | | | | | | | | | | | | | | | | | - V. Ruiz-Salas
- Hospital de la Santa Creu i Sant Pau; Barcelona Spain
| | - E. Vilarrasa Rull
- Hospital de la Santa Creu i Sant Pau; Barcelona Spain
- Centro Médico Teknon; Barcelona Spain
| | | | | | | | | | - L. Hueso
- Hospital Manises; Valencia Spain
| | | | | | - N. Cano-Martinez
- Hospital La Zarzuela; Madrid Spain
- Hospital Infanta Leonor; Madrid Spain
| | - I. Garcia-Doval
- Unidad de investigación; Fundación Piel Sana Academia Española de Dermatología; Madrid Spain
| | - M.A. Descalzo
- Unidad de investigación; Fundación Piel Sana Academia Española de Dermatología; Madrid Spain
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de la Cueva Dobao P. Tumor Necrosis Factor Inhibitors, Antinuclear Antibodies, and Autoimmunity in Patients With Psoriasis. Actas Dermo-Sifiliográficas (English Edition) 2017. [DOI: 10.1016/j.adengl.2017.02.022] [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: 11/25/2022] Open
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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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17
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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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