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Orbai AM, Tillett W, Grieb S, Peterson S, Holdsworth EA, Booth N, Chakravarty SD, Gossec L. Impact of Physician-Defined Flares on Quality of Life and Work Impairment: An International Survey of 2238 Patients With Psoriatic Arthritis. J Rheumatol 2023; 50:76-83. [PMID: 35970528 DOI: 10.3899/jrheum.211302] [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] [Accepted: 07/26/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To describe psoriatic arthritis (PsA) flares and their effect on patient-reported outcomes (PROs). METHODS Cross-sectional surveys of rheumatologists/dermatologists and their patients with PsA were conducted in France, Germany, Italy, Spain, the United Kingdom, and the United States, capturing data on physician-reported patient flare status, demographics, PsA severity, and clinical outcomes. Patient-completed surveys captured data on PROs: 5-level EuroQol 5-dimension, Work Productivity and Activity Impairment questionnaire, Health Assessment Questionnaire-Disability Index, and 12-item Psoriatic Arthritis Impact of Disease questionnaire. Patients were compared by flare status using parametric and nonparametric tests. Multivariate regression was used to identify flare associations. Multivariate logistic regression adjusted for patient demographics and physician specialty assessed the effect of flare status. RESULTS Among 2238 patients (586 from the US, 1652 from Europe) managed by 572 physicians, physician-reported flare was present for 168 patients (7.5%), and self-reported flare was present for 95 patients (10% of available data). Mean (SD) flare count over 12 months was 2.2 (4.9), lasting on average 16.4 (16.2) days. Flare status was linked to worse PROs. Patients who had not flared in the last 12 months or had never flared had a higher quality of life, lower overall work impairment, and a lower degree of disability compared with patients who were currently experiencing a flare (all; P < 0.01). CONCLUSION Actively experiencing a flare adversely affected QOL, disability, and work productivity. PsA flares should be routinely assessed and managed in clinical care.
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Affiliation(s)
- Ana-Maria Orbai
- A.M. Orbai, MD, MHS, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA;
| | - William Tillett
- W. Tillett, PhD, Royal National Hospital for Rheumatic Disease, and University of Bath, Pharmacy and Pharmacology and Centre for Therapeutic Innovation, Bath, UK
| | - Suzanne Grieb
- S. Grieb, PhD, Patient Research Partner, Baltimore, Maryland, USA
| | - Steve Peterson
- S. Peterson, MSc, Janssen Global Services, Horsham, Pennsylvania, USA
| | | | - Nicola Booth
- E.A. Holdsworth, MSc, N. Booth, MSc, Adelphi Real World, Bollington, UK
| | - Soumya D Chakravarty
- S.D. Chakravarty, MD, Janssen Scientific Affairs, Horsham, and Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Laure Gossec
- L. Gossec, MD, PhD, Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, and Pitié-Salpêtrière Hospital, AP-HP, Sorbonne Université, Rheumatology Department, Paris, France
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Lebwohl MG, Stein Gold L, Del Rosso JQ, Green L, Jacobson A. Posttreatment maintenance of therapeutic effect with fixed-combination halobetasol propionate 0.01%/tazarotene 0.045% lotion for moderate-to-severe plaque psoriasis. J DERMATOL TREAT 2021; 33:2068-2074. [PMID: 34130581 DOI: 10.1080/09546634.2021.1914310] [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] [Indexed: 10/21/2022]
Abstract
BACKGROUND The topical corticosteroid halobetasol propionate (HP) and retinoid tazarotene (TAZ) are effective in psoriasis treatment. Fixed-combination HP 0.01%/TAZ 0.045% lotion has demonstrated efficacy and safety in moderate-to-severe plaque psoriasis. OBJECTIVE To investigate the maintenance of therapeutic effects after cessation of once-daily HP/TAZ treatment. METHODS In two phase 3 studies (NCT02462070; NCT02462122), adults with moderate-to-severe psoriasis received HP/TAZ for 8 weeks. Data at week 12 were analyzed post hoc to evaluate posttreatment maintenance of treatment success (clear/almost clear skin), improvements in signs of psoriasis (erythema, plaque elevation, scaling), and reductions in affected body surface area (BSA). In a 52-week open-label study (NCT02462083), participants stopped HP/TAZ treatment after achievement of treatment success; data were analyzed post hoc to assess time to retreatment. RESULTS Across all studies, most participants who achieved treatment success maintained this effect for at least one month posttreatment. Treatment effects were similarly maintained for improvements in signs of psoriasis and reductions in BSA. Some participants continued to improve after cessation of treatment. Maintenance of treatment success and time to retreatment were greater for participants who achieved clear skin. CONCLUSION HP/TAZ lotion provides therapeutic effects that persist after treatment cessation, supporting its use in long-term management of plaque psoriasis.
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Affiliation(s)
- Mark G Lebwohl
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Lawrence Green
- Department of Dermatology, George Washington University School of Medicine, Washington, DC, USA
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Ribera M, Ros S, Madrid B, Ruiz-Villaverde R, Rebollo F, Gómez S, Loza E, Carretero G. Consensus Statement on the Psychological Needs of Patients With Chronic Inflammatory Skin Diseases. Actas Dermo-Sifiliográficas (English Edition) 2019. [DOI: 10.1016/j.adengl.2019.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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Ribera M, Ros S, Madrid B, Ruiz-Villaverde R, Rebollo F, Gómez S, Loza E, Carretero G. Documento de consenso sobre las necesidades psicológicas de los pacientes con enfermedades inflamatorias crónicas dermatológicas. Actas Dermo-Sifiliográficas 2019; 110:102-114. [DOI: 10.1016/j.ad.2018.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 10/07/2018] [Accepted: 10/08/2018] [Indexed: 01/10/2023] Open
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