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Krantz Å, Carrero JJ, Yang Y, Schalin L, Lysell J, Mazhar F. Psoriasis/Psoriatic Arthritis Patients' Long-term Treatment Patterns and Adherence to Systemic Treatments Monitoring Recommendations. Acta Derm Venereol 2023; 103:adv6505. [PMID: 37318074 DOI: 10.2340/actadv.v103.6505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/24/2023] [Indexed: 06/16/2023] Open
Abstract
Limited information exists regarding treatment of patients with psoriasis/psoriatic arthritis in primary care. The aim of this study is to assess treatment patterns, adherence, persistence, and compliance in newly diagnosed patients with psoriasis/psoriatic arthritis from 2012 to 2018 in Stockholm, Sweden. In addition, laboratory monitoring before initiation of treatment and at recommended intervals was quantified for patients prescribed methotrexate or biologics. A total of 51,639 individuals were included, with 39% initiating treatment with topical corticosteroids and < 5% receiving systemic treatment within 6 months post-diagnosis. During a median (interquartile range) follow-up of 7 (4-8) years, 18% of patients received systemic treatments at some point. Overall, 5-year persistence rates were 32%, 45% and 19% for methotrexate, biologics, and other systemic treatments, respectively. Pre-initiation laboratory tests, as recommended by guidelines, were performed in approximately 70% and 62% of methotrexate and biologics users, respectively. Follow-up monitoring at recommended time intervals occurred in 14-20% and 31-33% of patients prescribed methotrexate and biologics, respectively. These findings highlight gaps in the pharmacological care of patients with psoriasis/psoriatic arthritis, including suboptimal adherence/persistence and inadequate laboratory monitoring.
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Affiliation(s)
- Åsa Krantz
- Dermatology and Venereology Section, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Juan Jesus Carrero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Yuanhang Yang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | | | - Josefin Lysell
- Dermatology and Venereology Section, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Faizan Mazhar
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden.
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Asawanonda P, Pattamadilok B, Chularojanamontri L, Chuamanochan M, Choonhakarn C, Chakkavittumrong P, Sangob N, Rajatanavin N. Real-world experience of secukinumab in moderate to severe psoriasis patients in Thailand: Characteristics, effectiveness, and safety. Dermatol Ther 2022; 35:e15958. [PMID: 36279306 PMCID: PMC10078165 DOI: 10.1111/dth.15958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/21/2022] [Accepted: 10/22/2022] [Indexed: 11/28/2022]
Abstract
Secukinumab demonstrated high efficacy and favorable safety profile in patients with moderate-to-severe plaque psoriasis (PsO) in clinical trials. However, understanding of patient characteristics and clinical outcomes in real world in Thailand is still limited. To describe patient characteristics, effectiveness and safety of secukinumab in Thai PsO patients. This retrospective study analyzed data from medical records of adult PsO patients who initiated secukinumab at 7 dermatology centers from September 2017 to April 2021. Study outcomes included patient characteristics and changes in Psoriasis Area and Severity Index (PASI) score from baseline at weeks 4 and 16 after secukinumab initiation. Adverse events were recorded. Subgroup analyses by adherence rate and completeness of loading dose were performed. Of 163 patients, the mean (SD) age was 44.0 (14.0) years. Most patients (84.7%) were previously treated with topical therapy while 62.0% and 21.5% of patients had received systemic and biologic therapy, respectively. The mean baseline PASI score was 15.4 (9.3). Overall, the mean PASI score improved by 58.0% at week 4 and 78.4% at week 16. Statistically significant differences in PASI approvement were revealed among subgroups of patients with different loading dose and adherence rate. Adverse effects were reported in 8.0% of patients. The characteristics of patients in this study were slightly different from clinical trials in terms of demographic and clinical characteristics, as well as PsO treatment. Secukinumab was effective and safe in Thai patients with PsO, especially among those with complete loading dose and a higher adherence rate.
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Affiliation(s)
- Pravit Asawanonda
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Leena Chularojanamontri
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Mati Chuamanochan
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Charoen Choonhakarn
- Division of Dermatology, Department of Medicine, Srinagarind Hospital Medical School, Khon Kaen University, Khon Kaen, Thailand
| | | | | | - Natta Rajatanavin
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Sariahmed K, Kurian J, Singh AK, Leyton C, Minuti A, Jerschow E, Arora S, Jariwala SP. Social, political, and economic determinants of access to biologics: A scoping review of structural determinants in the clinical disparities literature. Res Social Adm Pharm 2022; 18:4038-4047. [DOI: 10.1016/j.sapharm.2022.07.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 05/05/2022] [Accepted: 07/28/2022] [Indexed: 02/07/2023]
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Boscariol R, Caetano ÉA, Grotto D, Rosa-Castro RM, Oliveira Junior JM, Vila MMDC, Balcão VM. Transdermal Permeation Assays of Curcumin Aided by CAGE-IL: In Vivo Control of Psoriasis. Pharmaceutics 2022; 14:pharmaceutics14040779. [PMID: 35456612 PMCID: PMC9027471 DOI: 10.3390/pharmaceutics14040779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 03/26/2022] [Accepted: 03/30/2022] [Indexed: 02/04/2023] Open
Abstract
Psoriasis is a clinically heterogeneous skin disease with an important genetic component, whose pathophysiology is not yet fully understood and for which there is still no cure. Hence, alternative therapies have been evaluated, using plant species such as turmeric (Curcuma longa Linn.) in topical preparations. However, the stratum corneum is a barrier to be overcome, and ionic liquids have emerged as potential substances that promote skin permeation. Thus, the main objective of this research was to evaluate a biopolysaccharide hydrogel formulation integrating curcumin with choline and geranic acid ionic liquid (CAGE-IL) as a facilitator of skin transdermal permeation, in the treatment of chemically induced psoriasis in mice. The developed gel containing curcumin and CAGE-IL showed a high potential for applications in the treatment of psoriasis, reversing the histological manifestations of psoriasis to a state very close to that of normal skin.
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Affiliation(s)
- Rodrigo Boscariol
- Phagelab, Laboratory of Biofilms and Bacteriophages, University of Sorocaba (UNISO), Sorocaba 18023-000, Brazil; (R.B.); (É.A.C.); (D.G.); (R.M.R.-C.); (J.M.O.J.)
| | - Érika A. Caetano
- Phagelab, Laboratory of Biofilms and Bacteriophages, University of Sorocaba (UNISO), Sorocaba 18023-000, Brazil; (R.B.); (É.A.C.); (D.G.); (R.M.R.-C.); (J.M.O.J.)
| | - Denise Grotto
- Phagelab, Laboratory of Biofilms and Bacteriophages, University of Sorocaba (UNISO), Sorocaba 18023-000, Brazil; (R.B.); (É.A.C.); (D.G.); (R.M.R.-C.); (J.M.O.J.)
| | - Raquel M. Rosa-Castro
- Phagelab, Laboratory of Biofilms and Bacteriophages, University of Sorocaba (UNISO), Sorocaba 18023-000, Brazil; (R.B.); (É.A.C.); (D.G.); (R.M.R.-C.); (J.M.O.J.)
| | - José M. Oliveira Junior
- Phagelab, Laboratory of Biofilms and Bacteriophages, University of Sorocaba (UNISO), Sorocaba 18023-000, Brazil; (R.B.); (É.A.C.); (D.G.); (R.M.R.-C.); (J.M.O.J.)
| | - Marta M. D. C. Vila
- Phagelab, Laboratory of Biofilms and Bacteriophages, University of Sorocaba (UNISO), Sorocaba 18023-000, Brazil; (R.B.); (É.A.C.); (D.G.); (R.M.R.-C.); (J.M.O.J.)
- Correspondence: (M.M.D.C.V.); (V.M.B.); Tel.: +55-15-2101-7029 (M.M.D.C.V. & V.M.B.)
| | - Victor M. Balcão
- Phagelab, Laboratory of Biofilms and Bacteriophages, University of Sorocaba (UNISO), Sorocaba 18023-000, Brazil; (R.B.); (É.A.C.); (D.G.); (R.M.R.-C.); (J.M.O.J.)
- Department of Biology and CESAM, University of Aveiro, Campus Universitário de Santiago, P-3810-193 Aveiro, Portugal
- Correspondence: (M.M.D.C.V.); (V.M.B.); Tel.: +55-15-2101-7029 (M.M.D.C.V. & V.M.B.)
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Saastamoinen L, Verho J. Regional variation in potentially inappropriate medicine use in older adults. - A national register-based cross-sectional study on economic, health system-related and patient-related characteristics. Res Social Adm Pharm 2020; 17:1223-1227. [PMID: 33071213 DOI: 10.1016/j.sapharm.2020.08.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 08/19/2020] [Accepted: 08/23/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Potentially inappropriate medicines (PIM), i.e. medicines in which the potential harms may outweigh the benefits, use may be associated with e.g. hospitalization, outpatient visits and health care costs. As regional institutions are often responsible for financing pharmaceuticals, understanding the regional variation of PIM use could help to tackle the associated problems and costs. OBJECTIVE To explore regional variation in PIM use among older adults and the association with regional health-system related, patient-related and economic characteristics and the frequency of PIM use. METHODS This is a nation-wide study based on the Finnish Prescription Register. PIM use was defined according to the Finnish Meds75+ database and regional characteristics derived from national statistics. RESULTS Variation at the hospital district level was large, with the largest difference between the most and least PIM prescribing being 45.2%. The factors associated with high PIM prescribing were a higher share of women and a higher number of private doctor visits per inhabitant in a municipality. The factor associated to lower PIM prescribing was a higher share of Swedish-speaking population. The studied factors explained 23% of the municipal-level variation in PIM. CONCLUSIONS Large regional differences may lead to regional inequality in prescribing and in the distribution of pharmaceutical costs. As only a small share of the variation was explained by economic, health system-related and patient-related factors, the key reasons may lie in unobserved prescribing practices.
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Affiliation(s)
- Leena Saastamoinen
- Research Unit, The Social Insurance Institution of Finland, PO Box 450, 00056, Kela, Helsinki, Finland.
| | - Jouko Verho
- VATT Institute for Economic Research, Arkadiankatu 7, Helsinki, 00100, Finland.
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Patients' demographic and socioeconomic characteristics influence the therapeutic decision-making process in psoriasis. PLoS One 2020; 15:e0237267. [PMID: 32785291 PMCID: PMC7423114 DOI: 10.1371/journal.pone.0237267] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/22/2020] [Indexed: 02/06/2023] Open
Abstract
Background Knowledge regarding differences in care for psoriatic patients is limited. The aim of this study was to investigate factors influencing prescription of systemic treatments for patients with psoriasis with a special focus on socioeconomic factors. Methods and findings This was a non-interventional, cross-sectional study, conducted in 18 Italian University and/or hospital centers with psoriasis-specialized units. Questionnaires evaluating demographic and socioeconomic characteristics were administered to participants. Overall, 1880 consecutive patients affected by mild-to-severe psoriasis were recruited. Univariate and multivariable logistic regression analyses of systemic therapy prescription, with a special focus on biologics, accounting for the above mentioned characteristics were performed. Our analysis showed that all analyzed patients’ characteristics were significantly associated with biological therapy compared to non-biological systemic one. Particularly, women were less likely to receive biologics than men (OR = 0.66; 95% CI, 0.57–0.77). Elderly patients (≥65 years) and subjects with a BMI ≥30 had lower odds to receive biologics respect to adults (≥35–64 years) (OR = 0.33; 95% CI, 0.25–0.40), and subjects with BMI≥25<30 (OR = 0.64; 95% CI, 0.53–0.77), respectively. Northern and Southern patients were both less likely to receive biologics than Central patients (OR = 0.75; 95% CI, 0.63–0.89, and OR = 0.56; 95% CI,0.47–0.68, respectively). Lower economic profile and never reading books were both associated with decreased odds of receiving biological therapy. Conclusions This study shows that sex, age, comorbidities, and socioeconomic characteristics influence the prescription of systemic treatments in psoriasis, highlighting that there are still unmet needs influencing the therapeutic decision-making process that have to be addressed.
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Baumgart DC, Misery L, Naeyaert S, Taylor PC. Biological Therapies in Immune-Mediated Inflammatory Diseases: Can Biosimilars Reduce Access Inequities? Front Pharmacol 2019; 10:279. [PMID: 30983996 PMCID: PMC6447826 DOI: 10.3389/fphar.2019.00279] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 03/05/2019] [Indexed: 12/30/2022] Open
Abstract
Biological therapies are an effective treatment for a range of immune-mediated inflammatory diseases (IMIDs), including rheumatoid arthritis, psoriasis, and inflammatory bowel diseases. However, due to their high costs, considerable differences in their utilization exist across the world, even among the various European countries, with many countries restricting access despite professional society guideline recommendations. Adoption of biologics by healthcare providers has been particularly poor in many Central and Eastern European countries. Differences in utilization have also been observed across medical specialties, healthcare providers, and at a regional and national level. The objective of this paper is to provide an overview of the different market access policies for biologics in Europe and to investigate reasons for such differences. One of the potential solutions for providing broader access to IMID patients, where cost is the major barrier, is to encourage the use of biosimilars in place of their reference products. Biosimilars are generally less expensive alternatives to already licensed biological therapies and are approved on the basis that they are similar to the reference product in terms of quality, safety, and efficacy. Budget impact models predict considerable cost savings following the introduction of biosimilars in the next few years. These savings could be used to increase access to biologics and other innovative therapies.
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Affiliation(s)
- Daniel C. Baumgart
- Inflammatory Bowel Disease Unit – Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada
- Department of Gastroenterology and Hepatology, Charité Medical School, Humboldt-University of Berlin, Berlin, Germany
| | - Laurent Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
| | | | - Peter C. Taylor
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
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Daniyal M, Akram M, Zainab R, Munir N, Shah SMA, Liu B, Wang W, Riaz M, Jabeen F. Progress and prospects in the management of psoriasis and developments in phyto‐therapeutic modalities. Dermatol Ther 2019; 32:e12866. [DOI: 10.1111/dth.12866] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 02/04/2019] [Accepted: 02/13/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Muhammad Daniyal
- TCM and Ethnomedicine Innovation & Development International LaboratoryInnovative Materia Medica Research Institute, School of Pharmacy, Hunan University of Chinese Medicine Changsha China
| | - Muhammad Akram
- Department of Eastern Medicine and Surgery, Directorate of Medical SciencesGovernment College University Faisalabad Faisalabad Pakistan
| | - Rida Zainab
- Department of Eastern Medicine and Surgery, Directorate of Medical SciencesGovernment College University Faisalabad Faisalabad Pakistan
| | - Naveed Munir
- Directorate of Medical SciencesCollege of Allied Health Professionals, GC University Faisalabad Faisalabad Pakistan
- Department of BiochemistryGovernment College University Faisalabad Faisalabad Pakistan
| | - Syed Muhammad Ali Shah
- Department of Eastern Medicine and Surgery, Directorate of Medical SciencesGovernment College University Faisalabad Faisalabad Pakistan
| | - Bin Liu
- Hunan Province Key Laboratory of Plant Functional Genomics and Developmental RegulationCollege of Biology, Hunan University Changsha China
| | - Wei Wang
- TCM and Ethnomedicine Innovation & Development International LaboratoryInnovative Materia Medica Research Institute, School of Pharmacy, Hunan University of Chinese Medicine Changsha China
| | - Muhammad Riaz
- Department of Allied Health SciencesSargodha Medical College, University of Sargodha Sargodha Pakistan
| | - Farhat Jabeen
- Department of ZoologyGovernment College University Faisalabad Faisalabad Pakistan
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Affiliation(s)
- Mina Amin
- Department of Medicine, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA
| | - Erica B. Lee
- John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Tina Bhutani
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Jashin J. Wu
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA
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Feng H, Cohen JM, Neimann AL. Access to injectable biologic medications by medicare beneficiaries: geographic distribution of US dermatologist prescribers. J DERMATOL TREAT 2018; 30:237-239. [DOI: 10.1080/09546634.2018.1508819] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Hao Feng
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, USA
| | - Jeffrey M. Cohen
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, USA
| | - Andrea L. Neimann
- The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, USA
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