Patrick Mollon

Clear or almost clear skin improves the quality of life in patients with moderate-to-severe psoriasis: a systematic review and meta-analysis

Psoriasis Area and Severity Index (PASI) 75 response is currently considered the gold standard for assessing treatment efficacy in moderate‐to‐severe psoriatic patients. PASI 90 response denotes better clinical improvement compared to PASI 75. Very few studies have assessed if a greater PASI clinical response is associated with greater improvements in Dermatology Life Quality Index (DLQI). A systematic review and meta‐analysis was performed to assess the association between PASI response and DLQI. The study was conducted to assess whether greater improvement in PASI scores from PASI 75–89 to PASI 90 is associated with greater Quality of life (QoL) improvements, specifically DLQI scores. Systematic searches were conducted in MEDLINE, EMBASE and Cochrane Library to identify studies evaluating biologic interventions in adult moderate‐to‐severe psoriasis patients reporting PASI response and their corresponding DLQI change from baseline score. The quality of evidence was assessed through Jadad score for randomized controlled trials and Downs and Blacks checklist for observational studies. Meta‐analysis estimated change from baseline in DLQI for PASI 75–89 responders to be 78% (95% credible intervals [CrI]: 75–82%) and for PASI 90 responders to be 90% (95% CrI: 88–93%). This implies 12% greater improvement in DLQI score for PASI 90 responders compared with PASI 75–89 responders. In addition, the meta‐analysis also showed a statistically significant difference in DLQI score of 0/1 between PASI 75‐89 and PASI 90 responders (45% [95% Crl]; 41.0–50.0% and 73% [95% Crl]; 70.0–76.0%), respectively, Bayesian P < 0.0001). In conclusion, substantial improvement in clinical efficacy is associated with improved QoL in patients with moderate‐to‐severe psoriasis suggesting that PASI 90 responders (clear or almost clear skin) could achieve a superior QoL compared to PASI 75–89 responders.

Economic burden of comorbidities in psoriasis patients in the United States: results from a retrospective U.S. database

BackgroundPsoriasis is a multifactorial, inflammatory, skin disease associated with various comorbidities. The cost of those comorbidities is not well characterized. The present study assesses the incremental burden of comorbidities on healthcare resource utilization, direct costs and indirect costs associated with short-term disabilities among patients with psoriasis in the United States.MethodsA retrospective, U.S. cohort analysis was conducted using a large claims database. Adult psoriasis patients with at least two diagnoses of psoriasis during the years 2010 and 2011 (one psoriasis diagnosis had to happen in the year 2010) and with continuous enrollment of medical and pharmacy benefits in the years 2010 and 2011 were included. Psoriasis patients were categorized and compared according to the presence or absence of pre-selected comorbidities in the year 2010. Adjusted annual direct (costs associated with outpatient, emergency room, and inpatient claims, and outpatient pharmacy claims) and indirect costs (short-term disabilities) was assessed in patients with and without comorbidities using a regression analysis, controlling for age, gender, and psoriasis severity in year 2010.ResultsIn total, 56,406 patients (mean [SD]) age, 51.6 [14.6] years) were included in the analysis. The most prevalent comorbidities were hypertension (34.3%), hyperlipidemia (33.5%), cardiovascular disease (17.7%), diabetes (14.2%), and psoriatic arthritis (9.9%). Psoriasis patients with comorbidities used more healthcare resources than those without comorbidities. The incidence rate ratio (IRR) (95% CI) for patients with cardiovascular disease was 1.5 (1.4 − 1.5) for outpatient visits, 2.6 (2.4 − 2.8) for hospitalizations, and 2.3 (2.2 − 2.5) for ER visits, showing higher IRRs across all three types of resource use. The mean annual adjusted direct cost differences (i.e., incremental adjusted costs) in psoriasis patients with and without comorbidities were

Secukinumab sustains early patient-reported outcome benefits through 1 year: Results from 2 phase III randomized placebo-controlled clinical trials comparing secukinumab with etanercept

9914.3,

Cost-Effectiveness Analysis of Secukinumab Compared to Ustekinumab In The Treatment of Moderate to Severe Plaque Psoriasis In The Czech Republic.

8386.5, and

Clinical Outcomes, Health Resource Use, and Cost in Patients with Early versus Late Dual or Triple Anti-Platelet Treatment for Acute Coronary Syndrome

8275.1 for psoriatic arthritis, peripheral vascular disease, and cardiovascular disease, respectively. The mean annual incremental adjusted indirect costs of short-term disabilities were

Symptoms and Functional Limitations in the First Year Following a Myocardial Infarction: A Qualitative Study

1333,

Estimation of Indirect (Work-Related Productivity) Costs Associated With Moderate-To-Severe Plaque Psoriasis In Germany.

1195,

A New Cost-Effectiveness Framework For Modeling Psoriasis Treatments

994.9, and

Incremental Burden of Cardiovascular Comorbidity or Psoriatic Arthritis among Individuals with Moderate-to-Severe Psoriasis

996.6 for cerebrovascular disease, obesity, peripheral vascular disease, and depression, respectively.ConclusionThe presence of comorbidities was associated with higher healthcare resource utilization and costs among patients with psoriasis.

Biologics Switching Patterns and Associated Costs in Psoriasis Patients in a Large Commercially Insured Population in the United States

Background Psoriasis is a chronic condition with negative impact on patients’ quality of life that most often requires lifelong effective and safe treatment. Objective This analysis focused on the effect of secukinumab treatment on patient‐reported health‐related quality of life as assessed by the Dermatology Life Quality Index (DLQI) in patients with moderate to severe psoriasis. Methods The proportion of subjects achieving DLQI score 0/1 response at week 24, time to DLQI score 0/1 response, and sustained DLQI score 0/1 response up to week 52 were compared between secukinumab and etanercept. Results Of 1470 subjects, 1144 received secukinumab and 326 received etanercept. DLQI score 0/1 response rates were significantly higher for secukinumab than for etanercept at week 24. The median time to DLQI score 0/1 response was significantly shorter for secukinumab versus etanercept (12 vs 24 weeks; P < .01). The majority of secukinumab‐treated subjects achieved DLQI score 0/1 response at week 24 and sustained it through week 52 along with a 90% to 100% reduction in the Psoriasis Area and Severity Index total score response. Limitations Placebo comparisons are limited during the maintenance period because of rerandomization at week 12. Conclusion Secukinumab treatment provided faster and greater sustained improvements in quality of life than etanercept over 52 weeks, consistent with greater clinical response.