1
|
Bakulev AL, Fitileva TV, Novodezerkina EА, Gilloteau I, Tian Н, Howe T, Pietri G. Psoriasis: clinical and epidemiological features and therapy issues. Vestnik dermatologii i venerologii 2018. [DOI: 10.25208/0042-4609-2018-94-3-67-76] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Aim. This study sets out to establish the demographic and clinical features of psoriasis and its co-morbidities; to describe approaches to treating patients in Russia, to whom the systemic therapy of drugs has been recommended; to assess the effects of this dermatosis on the patients' quality of life and work productivity; to assess the degree of consistency between dermatologists' and patients' estimates concerning the severity of the disease, complaints/objective manifestations and treatment satisfaction.Methods. Data from the GfK Disease Atlas was used. This ATLAS was filed within a global programme Growth from Knowledge that collected reliable data in the context of everyday clinical practice in 9 countries. The paper presents the results solely for the Russian sample. The study involved patients with moderate or severe psoriasis who were receiving systemic therapy for this disease. Using specially developed forms, ATLAS specialists registered data about patients, their disease and received treatment. The patients affected by psoriasis, who participated in the study, were questioned about their disease. Dermatologists assessed the severity of psoriasis, the patients' complaints, co-morbidities and received treatment. The patients completed questionnaires aimed at assessing the quality of their life [Dermatology Life Quality Index, DLQI] and their work productivity [Work Productivity and Activity Impairment, WPAI]. The concordance between the patients' and the dermatologists' estimates was assessed using Cohen's kappa coefficient.Results. Overall, 3,821 patients participated in the ATLAS programme, out of whom 300 patients were Russians. The average time since psoriasis diagnosis amounted to 9.9 years. 51 % of the patients complained about itching in the lesion areas. Psoriatic arthritis was registered in 19 % of the cases. Among co-morbidities, anxiety or depression was most often recorded (11 %, respectively). The proportion of patients with pruritus and related comorbid conditions increased with psoriasis severity. The disease negatively affected the quality of patients’ life (the average value of DLQI was 7.1) and their work productivity (a decrease in the work productivity reached 33.2 %), with these indicators deteriorating with psoriasis severity. Despite the dominance of moderate and severe psoriasis forms among the participants, 60 % of the patients received therapy only with topical medications. The concordance rate between the patients and the dermatologists concerning the estimation of psoriasis severity and treatment satisfaction was low.Conclusion. Despite the therapy with systemic drugs, the patients' quality of life affected by severe or moderate psoriasis forms remained low. The consistency between the views on the treatment success between the patients and the dermatologists was low.
Collapse
|
2
|
Warren RB, Halliday A, Graham CN, Gilloteau I, Miles L, McBride D. Secukinumab significantly reduces psoriasis-related work impairment and indirect costs compared with ustekinumab and etanercept in the United Kingdom. J Eur Acad Dermatol Venereol 2018; 32:2178-2184. [PMID: 29846965 PMCID: PMC6586050 DOI: 10.1111/jdv.15094] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 05/16/2018] [Indexed: 12/22/2022]
Abstract
Background Psoriasis causes work productivity impairment that increases with disease severity. Whether differential treatment efficacy translates into differential indirect cost savings is unknown. Objective To assess work hours lost and indirect costs associated with secukinumab versus ustekinumab and etanercept in the United Kingdom (UK). Methods This was a post hoc analysis of work impairment data collected in the CLEAR study (secukinumab vs. ustekinumab) and applied to the FIXTURE study (secukinumab vs. etanercept). Weighted weekly and annual average indirect costs per patient per treatment were calculated from (i) overall work impairment derived from Work Productivity and Activity Impairment data collected in CLEAR at 16 and 52 weeks by Psoriasis Area and Severity Index (PASI) response level; (ii) weekly/annual work productivity loss by PASI response level; (iii) weekly and annual indirect costs by PASI response level, based on hours of work productivity loss; and (iv) weighted average indirect costs for each treatment. In the primary analysis, work impairment data for employed patients in CLEAR at Week 16 were used to compare secukinumab and ustekinumab. Secondary analyses were conducted at different time points and with patient cohorts, including FIXTURE. Results In CLEAR, 452 patients (67%) were employed at baseline. At Week 16, percentages of weekly work impairment/mean hours lost decreased with higher PASI: PASI < 50: 22.8%/7.60 h; PASI 50–74: 13.3%/4.45 h; PASI 75–89: 6.4%/2.14 h; PASI ≥ 90: 4.9%/1.65 h. Weighted mean weekly/annual work hours lost were significantly lower for secukinumab than ustekinumab (1.96/102.51 vs. 2.40/125.12; P = 0.0006). Results were consistent for secukinumab versus etanercept (2.29/119.67 vs. 3.59/187.17; Ρ<0.0001). Average annual indirect cost savings with secukinumab were £355 vs. ustekinumab and £1061 versus etanercept. Results at 52 weeks were similar. Conclusions Secukinumab significantly reduced work impairment and associated indirect costs of psoriasis compared with ustekinumab and etanercept at Week 16 through 52 in the United Kingdom.
Collapse
Affiliation(s)
- R B Warren
- The Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - A Halliday
- Novartis Pharmaceuticals UK Limited, Frimley/Camberley, UK
| | - C N Graham
- RTI Health Solutions, Research Triangle Park, NC, USA
| | | | - L Miles
- RTI Health Solutions, Research Triangle Park, NC, USA
| | - D McBride
- RTI Health Solutions, Manchester, UK
| |
Collapse
|
3
|
Griffiths C, Augustin M, Naldi L, Romiti R, Guevara-Sangines E, Howe T, Pietri G, Gilloteau I, Richardson C, Tian H, Jo S. Patient-dermatologist agreement in psoriasis severity, symptoms and satisfaction: results from a real-world multinational survey. J Eur Acad Dermatol Venereol 2018. [DOI: 10.1111/jdv.14937] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- C.E.M. Griffiths
- Dermatology Centre; Salford Royal Hospital; NIHR Manchester Biomedical Research Centre; University of Manchester; Manchester UK
| | - M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - L. Naldi
- Department of Dermatology; AULSS 8, Ospedale san Bortolo; Vicenza Italy
| | - R. Romiti
- Department of Dermatology; Hospital das Clínicas, University of São Paulo (USP); São Paulo Brazil
| | | | | | | | | | | | - H. Tian
- Novartis Pharmaceuticals Corporation; East Hanover NJ USA
| | - S.J. Jo
- Department of Dermatology; Seoul National University Hospital; Seoul Korea
| |
Collapse
|
4
|
Griffiths C, Jo SJ, Naldi L, Romiti R, Guevara-Sangines E, Howe T, Pietri G, Gilloteau I, Richardson C, Tian H, Augustin M. A multidimensional overview of the burden of psoriasis. Br J Dermatol 2018. [DOI: 10.1111/bjd.16858] [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: 11/28/2022]
|
5
|
Griffiths C, Jo SJ, Naldi L, Romiti R, Guevara-Sangines E, Howe T, Pietri G, Gilloteau I, Richardson C, Tian H, Augustin M. 银屑病负担的多维概述. Br J Dermatol 2018. [DOI: 10.1111/bjd.16872] [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: 11/26/2022]
|
6
|
Augustin M, McBride D, Gilloteau I, O'Neill C, Neidhardt K, Graham CN. Cost-effectiveness of secukinumab as first biologic treatment, compared with other biologics, for moderate to severe psoriasis in Germany. J Eur Acad Dermatol Venereol 2018; 32:2191-2199. [PMID: 29729105 DOI: 10.1111/jdv.15047] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 04/13/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Secukinumab, a fully human monoclonal antibody that selectively neutralizes interleukin 17A, has demonstrated strong and sustained efficacy in adults with moderate to severe psoriasis in clinical trials. OBJECTIVE This analysis compared the cost per responder of secukinumab as first biologic treatment of moderate to severe psoriasis, with adalimumab, infliximab, etanercept and ustekinumab in Germany. METHODS A 52-week decision-tree model was developed. Response to treatment was assessed based on the likelihood of achieving a predefined Psoriasis Area and Severity Index (PASI) response to separate the cohort into responders (PASI ≥75), partial responders (PASI 50 to 74) and non-responders (PASI <50). Responders at week 16 continued initial treatment, whereas partial responders and non-responders were switched to standard of care, which included methotrexate, cyclosporine, phototherapy and topical corticosteroids. Sustained response was defined as 16-week response maintained at week 52. A German healthcare system perspective was adopted. Clinical efficacy data were obtained from a mixed-treatment comparison; 2016 resource unit costs from national sources; and adverse events and discontinuation rates from the literature. We calculated cost per PASI 90 responder over week 16 and week 52, as well as cost per sustained responder between weeks 16 and 52. RESULTS Secukinumab had the lowest cost per PASI 90 responder over 16 weeks (€18 026) compared with ustekinumab (€18 080), adalimumab (€23 499), infliximab (€29 599) and etanercept (€34 037). Over 52 weeks, costs per PASI 90 responder ranged from €42 409 (secukinumab) to €70 363 (etanercept). Likewise, secukinumab had the lowest cost per sustained 52-week PASI 90 responder (€22 690) compared with other biologic treatments. Sensitivity analyses, excluding patient copayments, showed similar results. CONCLUSIONS First biologic treatment with secukinumab for moderate to severe psoriasis is cost-effective, with lowest cost per responder compared with other biologic treatments in Germany.
Collapse
Affiliation(s)
- M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - D McBride
- RTI Health Solutions, Manchester, UK
| | | | - C O'Neill
- Novartis Ireland Limited, Dublin, Ireland
| | | | - C N Graham
- RTI Health Solutions, Research Triangle Park, NC, USA
| |
Collapse
|
7
|
Griffiths CEM, Jo SJ, Naldi L, Romiti R, Guevara-Sangines E, Howe T, Pietri G, Gilloteau I, Richardson C, Tian H, Augustin M. A multidimensional assessment of the burden of psoriasis: results from a multinational dermatologist and patient survey. Br J Dermatol 2018; 179:173-181. [PMID: 29328510 DOI: 10.1111/bjd.16332] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Psoriasis is a chronic, immune-mediated disease, characterized by symptoms that include itching and skin pain and is often associated with comorbidities. Patients have a substantial detriment to quality of life (QoL) and work productivity with associated cost burden. OBJECTIVES To investigate the incremental burden of comorbidities, itch and affected body areas among systemic eligible patients with psoriasis, using a multinational survey of dermatologists and their patients with psoriasis. METHODS Multinational data from the Growth from Knowledge (GfK) Disease Atlas Global Real-World Evidence program were used. Eligible patients were identified as those who were currently having or had ever had moderate-to-severe psoriasis, and must have been receiving prescription treatments at the time of the survey. Multivariable regression analyses were conducted to assess the incremental burden among psoriasis patients with physical and psychological comorbidities, itch and affected visible and sensitive body areas vs. psoriasis patients without these conditions, respectively. RESULTS The study enrolled 3821 patients with psoriasis, from nine countries, with an average Psoriasis Area and Severity Index score of 6·4. The presence of comorbidities was associated with a significant increase in the likelihood of skin pain, lower QoL, greater work impairment and increased usage of medical resources (except in psoriasis patients with obesity and type 2 diabetes). Psoriasis patients suffering from itch and those with visible and sensitive affected body areas also had impaired QoL vs. those without these conditions. CONCLUSIONS Psoriasis patients with physical and psychological comorbidities, itch and affected visible and sensitive body areas had lower QoL and greater work impairment compared to those without these conditions.
Collapse
Affiliation(s)
- C E M Griffiths
- Dermatology Centre, Salford Royal Hospital, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, U.K
| | - S-J Jo
- Department of Dermatology, Seoul National University Hospital, Seoul, Korea
| | - L Naldi
- Department of Dermatology, AULSS 8, Ospedale san Bortolo, Vicenza, Italy
| | - R Romiti
- Department of Dermatology, Hospital das Clínicas, University of São Paulo (USP), Brazil
| | - E Guevara-Sangines
- Hospital Regional "Lic. Adolfo López Mateos" ISSSTE, México City, Mexico
| | | | | | | | | | - H Tian
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, U.S.A
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| |
Collapse
|
8
|
Stull DE, Griffiths CEM, Gilloteau I, Zhao Y, Guana A, Finlay AY, Sherif B, Houghton K, Puig L. Differential effects of secukinumab vs. ustekinumab for treatment of psoriasis on quality of life, work productivity and activity impairment: a structural equation modelling analysis. Br J Dermatol 2018; 178:1297-1307. [PMID: 29355896 DOI: 10.1111/bjd.16366] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2018] [Indexed: 01/31/2023]
Abstract
BACKGROUND The appearance and lifelong, chronic nature of psoriasis result in considerable burden to patients, such as sleep impairment, depressive symptoms, negative self-esteem and reduced work productivity. OBJECTIVES To examine direct and indirect (mediated) effects of secukinumab vs. ustekinumab on quality of life, work productivity and activity impairment based on psoriasis severity and symptoms. METHODS Analyses were based on data from the CLEAR study. Structural equation modelling examined the effects of secukinumab vs. ustekinumab on the Dermatology Life Quality Index (DLQI) and on the Work Productivity and Activity Impairment (WPAI) questionnaire using Psoriasis Area and Severity Index (PASI) severity and symptoms (pain, itching and scaling) as potential mediators. Analyses were conducted primarily for patients achieving a PASI 90 response (90% or greater reduction in PASI from baseline) at week 16 (repeated at week 52) and for PASI 50, 75 and 100. RESULTS Results at weeks 16 and 52 showed that the effect of treatment on change in DLQI score was mediated by the PASI 90 response and by improvements in itching, pain, and scaling. Achieving any PASI response as early as week 16 directly resulted in significantly better WPAI scores. At week 52, both PASI response and improvement in scaling directly resulted in significantly better WPAI scores. Pain, itching and scaling were correlated (r = 0·51-0·68); improvement in any of these had a significant effect (directly or indirectly) on WPAI. All results favoured secukinumab over ustekinumab. CONCLUSIONS The results underscore the important role of both PASI response and reduction in symptoms on improvements in health-related quality of life and work and daily activity in favour of secukinumab vs. ustekinumab.
Collapse
Affiliation(s)
- D E Stull
- RTI Health Solutions, Research Triangle Park, NC, U.S.A
| | - C E M Griffiths
- Dermatology Centre, Salford Royal Hospital, University of Manchester, Manchester Academic Health Science Centre, The Dermatology Centre, Salford Royal NHS Foundation Trust, Barnes Building, Manchester, M6 8HD, U.K
| | | | - Y Zhao
- Sun Pharma, Cranbury, NJ, U.S.A
| | - A Guana
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, U.S.A
| | - A Y Finlay
- Department of Dermatology, Cardiff University School of Medicine, Cardiff, U.K
| | - B Sherif
- RTI Health Solutions, Research Triangle Park, NC, U.S.A
| | - K Houghton
- RTI Health Solutions, Research Triangle Park, NC, U.S.A
| | - L Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Mas Casanovas 90, Block A, 5th floor, Module 3, 08041, Barcelona, Spain
| |
Collapse
|
9
|
Bissonnette R, Luger T, Thaçi D, Toth D, Messina I, You R, Guana A, Fox T, Papavassilis C, Gilloteau I, Mrowietz U. Secukinumab sustains good efficacy and favourable safety in moderate-to-severe psoriasis after up to 3 years of treatment: results from a double-blind extension study. Br J Dermatol 2017; 177:1033-1042. [PMID: 28580579 DOI: 10.1111/bjd.15706] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2017] [Indexed: 01/16/2023]
Abstract
BACKGROUND Secukinumab has demonstrated significant efficacy with a good safety profile through 1 year in plaque psoriasis. Given the chronic nature of this disease, long-term follow-up is needed to evaluate psoriasis therapies fully. OBJECTIVES To determine the long-term (3-year) efficacy and safety of secukinumab in moderate-to-severe psoriasis. METHODS Patients completing 52 weeks of secukinumab treatment in the SCULPTURE core study entered an extension in which they continued the same double-blind regimens. Dosing regimens included a fixed-interval schedule (FI; every 4 weeks) and retreatment as needed (RAN), in which patients were withdrawn from secukinumab and received placebo until the start of relapse, at which time secukinumab every 4 weeks was reinitiated. The study was registered with number NCT01640951. RESULTS In total 168 patients receiving secukinumab 300 mg FI and 172 receiving secukinumab 300 mg RAN entered the extension. Secukinumab 300 mg FI sustained high efficacy: at the end of year 3, the proportion of responders achieving ≥ 90% improvement in Psoriasis Area and Severity Index (PASI 90) was 63·8%, and of PASI 100 responders it was 42·6%. The mean absolute PASI remained low (2-4) from week 52 to week 152 with 300 mg FI, with approximately two-thirds of patients reporting no impact of skin disease on their lives (Dermatology Life Quality Index of 0 or 1). Improvements in overall and subscale scores on all quality-of-life instruments were well sustained. As in the core study, FI dosing was consistently more efficacious than RAN. No new safety signals were identified to year 3. CONCLUSIONS Secukinumab 300 mg FI sustained high responses and improved quality of life with no new safety concerns through 3 years.
Collapse
Affiliation(s)
| | - T Luger
- Department of Dermatology, University of Münster, Münster, Germany
| | - D Thaçi
- Comprehensive Center for Inflammation Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - D Toth
- XLR8 Medical Research, Windsor, ON, Canada
| | - I Messina
- Novartis Pharmaceuticals, East Hanover, NJ, U.S.A
| | - R You
- Novartis Beijing Novartis Pharma Co. Ltd, Shanghai, China
| | - A Guana
- Novartis Pharmaceuticals, East Hanover, NJ, U.S.A
| | - T Fox
- Novartis Pharma AG, Basel, Switzerland
| | | | | | - U Mrowietz
- Psoriasis-Center, Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| |
Collapse
|
10
|
Blauvelt A, Reich K, Mehlis S, Vanaclocha F, Sofen H, Abramovits W, Zhao Y, Gilloteau I, Davenport E, Williams N, Guana A, Tyring S. Secukinumab demonstrates greater sustained improvements in daily activities and personal relationships than ustekinumab in patients with moderate-to-severe plaque psoriasis: 52-week results from the CLEAR study. J Eur Acad Dermatol Venereol 2017; 31:1693-1699. [PMID: 28602039 PMCID: PMC6084293 DOI: 10.1111/jdv.14391] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 05/18/2017] [Indexed: 12/14/2022]
Abstract
Background Psoriasis can greatly impact patients’ lives by influencing clothing worn as well as by impairing sexual functioning. Secukinumab, a human monoclonal antibody selectively neutralizing interleukin‐17A, has demonstrated good efficacy and safety in the treatment of moderate‐to‐severe psoriasis and psoriatic arthritis with a rapid onset of action and sustained response. Objective This analysis using the CLEAR study, a phase 3b double‐blind study comparing the efficacy and safety of secukinumab vs. ustekinumab in adults with moderate‐to‐severe plaque psoriasis, evaluated the treatment effects on patient's daily activities and personal relationships. Methods Impact on daily activities (interference with home/shopping/garden, and influence on clothes worn) and impact on personal relationships (problems with partner/others, and sexual difficulties) as well as their corresponding subscales were selected from the Dermatology Life Quality Index scale and evaluated for patients treated with secukinumab vs. ustekinumab from the CLEAR study. Treatment differences in mean scores and proportions of responders (score = 0, indicating no impact) were evaluated through 52 weeks. Time to response was evaluated through Week 16. Results Significant differences between secukinumab and ustekinumab were observed for daily activities and personal relationships at Week 16 and sustained through Week 52 (Week 52 response rates for daily activities: 82.9% vs. 73.5%, including interference with home/shopping/garden: 88.5% vs. 78.2%, and influence on clothes worn: 85.6% vs. 74.4%; personal relationships: 86.1% vs. 73.7%, including problems with partner/others: 86.6% vs. 74.8%, and sexual difficulties: 88.5% vs. 74.3%; all P < 0.01). The median time to response was 4 weeks for secukinumab vs. 8 weeks for ustekinumab for daily activities and personal relationships (both P < 0.05). Conclusion Secukinumab treatment helps patients with moderate‐to‐severe plaque psoriasis have a more normal life faster when compared to ustekinumab, by providing greater and sustained improvement in clothing choice and sexual functioning.
Collapse
Affiliation(s)
- A Blauvelt
- Oregon Medical Research Center, Portland, OR, USA
| | - K Reich
- Dermatologikum Hamburg and SCIderm GmbH, Hamburg, Germany
| | - S Mehlis
- NorthShore University Health System, Skokie, IL, USA
| | - F Vanaclocha
- Dermatology Department, Hospital Universitario, Madrid, Spain
| | - H Sofen
- Department of Medicine (Dermatology) UCLA, Los Angeles, CA, USA
| | - W Abramovits
- Baylor University Medical Center, Dallas, TX, USA
| | - Y Zhao
- Formerly with Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | | | - E Davenport
- RTI Health Solutions, Research Triangle Park, NC, USA
| | - N Williams
- RTI Health Solutions, Research Triangle Park, NC, USA
| | - A Guana
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - S Tyring
- University of Texas Health Science Center for Clinical Studies, Houston, TX, USA
| |
Collapse
|
11
|
Augustin M, Vietri J, Tian H, Gilloteau I. Incremental burden of cardiovascular comorbidity and psoriatic arthritis among adults with moderate-to-severe psoriasis in five European countries. J Eur Acad Dermatol Venereol 2017; 31:1316-1323. [PMID: 28426138 DOI: 10.1111/jdv.14286] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 03/27/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Moderate-to-severe psoriasis is associated with reduced health-related quality of life (HRQoL). Individuals with psoriasis are at increased risk for other medical conditions, but little information quantifies the incremental burden of psoriasis-associated comorbidity among European adults, and data have generally been limited to clinical samples. OBJECTIVE To quantify the incremental burden of cardiovascular comorbidity and psoriatic arthritis among adults with moderate-to-severe psoriasis in the general population of France, Germany, Italy, Spain and the United Kingdom (EU5). METHODS All measures were self-reported and came from the 2010-2013 EU5 National Health and Wellness Surveys (NHWS). Moderate-to-severe psoriasis was identified by >10% body surface area affected by psoriasis and/or use of therapies for moderate-severe disease. Outcomes were SF-12v2/SF-36v2 mental and physical component summary scores (MCS and PCS, respectively), SF-6D health utility, Work Productivity and Activity Impairment (WPAI) questionnaire and healthcare use in the past 6 months. Generalized linear models compared across cardiovascular comorbidity (CV) or psoriatic arthritis (PsA) groups vs. non-CV or non-PsA groups with appropriate link functions to adjust for covariates. RESULTS Among moderate-to-severe psoriasis respondents (n = 957), 19.8% (n = 190) reported CV comorbidity and 12.3% (n = 118) reported PsA. After adjustment for covariates, CV comorbidity was associated with 3.0 points lower MCS, 3.4 points lower PCS and 0.05 points lower SF-6D (all P < 0.01). Likewise, they had greater mean work impairment (48% vs. 33%), more activity impairment (48% vs. 37%), and more healthcare provider visits (8.8 vs. 6.9), emergency room visits (0.65 vs. 0.31) and hospitalizations (0.61 vs. 0.22) (all P < 0.05). Compared to non-PsA respondents, PsA respondents also had worse mean MCS (2.6 points), PCS (6.3 points) and SF-6D scores (0.07 points), and more work impairment (52% vs. 34%), activity impairment (54% vs. 38%) and healthcare provider visits (10.5 vs. 6.9) (all P < 0.05). CONCLUSION CV comorbidity and PsA were associated with significant incremental burden among EU5 adults with moderate-to-severe psoriasis.
Collapse
Affiliation(s)
- M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - J Vietri
- Health Outcomes Practice, Kantar Health, Horsham, PA, USA
| | - H Tian
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | | |
Collapse
|
12
|
Long GV, Atkinson V, Ascierto PA, Robert C, Hassel JC, Rutkowski P, Savage KJ, Taylor F, Coon C, Gilloteau I, Dastani HB, Waxman IM, Abernethy AP. Effect of nivolumab on health-related quality of life in patients with treatment-naïve advanced melanoma: results from the phase III CheckMate 066 study. Ann Oncol 2016; 27:1940-6. [PMID: 27405322 PMCID: PMC5035785 DOI: 10.1093/annonc/mdw265] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 06/29/2016] [Indexed: 01/14/2023] Open
Abstract
In patients with advanced melanoma in the CheckMate 066 study, baseline health-related quality of life (HRQoL) with nivolumab was maintained over time, with statistically significant and clinically meaningful improvements in some exploratory analyses, and no HRQoL improvements with dacarbazine. Added to the survival benefit of nivolumab, the benefit-to-risk ratio favors nivolumab over dacarbazine. Background Nivolumab has shown significant survival benefit and a favorable safety profile compared with dacarbazine chemotherapy among treatment-naïve patients with metastatic melanoma in the CheckMate 066 phase III study. Results from the health-related quality of life (HRQoL) analyses from CheckMate 066 are presented. Patients and methods HRQoL was evaluated at baseline and every 6 weeks while on treatment using the European Organisation for Research and Treatment of Care (EORTC) Core Quality of Life Questionnaire (QLQ-C30) and the EuroQoL Five Dimensions Questionnaire (EQ-5D). Via a multi-step statistical plan, data were analyzed descriptively, cross-sectionally, and longitudinally, adjusting for baseline covariates, in patients having baseline plus ≥1 post-baseline assessment. Results Baseline-adjusted completion rates for all HRQoL questionnaires across treatment arms were 65% and 70% for dacarbazine and nivolumab, respectively, and remained similar throughout treatment. The mean baseline HRQoL scores were similar for patients treated with nivolumab and dacarbazine. Baseline HRQoL levels with nivolumab were maintained over time. This exploratory analysis showed a between-arm difference in favor of nivolumab on the EQ-5D utility index and clinically meaningful EQ-5D improvements from baseline at several time points for patients receiving nivolumab. Patients treated with nivolumab did not show increased symptom burden as assessed by the EORTC QLQ-C30. No HRQoL change was noted with dacarbazine patients up to week 43, although the high attrition rate after week 13 did not allow any meaningful analyses. Patients receiving nivolumab deteriorated significantly later than those receiving dacarbazine on several EORTC QLQ-C30 scales and the EQ-5D utility index. Conclusions In addition to prolonged survival, these exploratory HRQoL results show that nivolumab maintains baseline HRQoL levels to provide long-term quality of survival benefit, compared with dacarbazine in patients with advanced melanoma.
Collapse
Affiliation(s)
- G V Long
- Melanoma Institute Australia, The University of Sydney, and Mater Hospital, Sydney, Australia
| | - V Atkinson
- Gallipoli Medical Research Foundation and Princess Alexandra Hospital, Greenslopes, Australia
| | - P A Ascierto
- Istituto Nazionale Tumori Fondazione Pascale, Napoli, Italy
| | | | - J C Hassel
- University Hospital Heidelberg and National Center for Tumor Diseases, Heidelberg, Germany
| | - P Rutkowski
- Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - K J Savage
- BC Cancer Agency, University of British Columbia, Vancouver, Canada
| | | | - C Coon
- Adelphi Values, Boston, MA, USA
| | | | | | - I M Waxman
- Bristol-Myers Squibb, Princeton, NJ, USA
| | | |
Collapse
|
13
|
Briggs A, Baker TM, Gilloteau I, Orsini L, Wagner S, Paly V. Partitioned Survival Versus State Transition Modeling in Oncology: a Case Study with Nivolumab in Advanced Melanoma. Value in Health 2015; 18:A338. [PMID: 0 DOI: 10.1016/j.jval.2015.09.130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
|
14
|
Long G, Atkinson V, Ascierto P, Robert C, Hassel J, Rutkowski P, Savage K, Taylor F, Coon C, Gilloteau I, Dastani H, Waxman I, Abernethy A. Effect of nivolumab (NIVO) on quality of life (QoL) in patients (pts) with treatment-naïve advanced melanoma (MEL): results of a phase III study (CheckMate 066). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv337.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
15
|
Fallowfield L, Nadler E, Abernethy A, Gilloteau I, Greaney M, Gater A, Orsini L, Subar M, Dastani H, Lyman G. 3331 Quality of survival (QoS) concept framework to assess the quality of prolonged life in advanced melanoma (MEL): Principles and application related to treatment with nivolumab (NIVO). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31849-4] [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: 11/30/2022]
|
16
|
Nadler E, Ashaye A, Stokes M, Yang S, Xu Y, Berger A, Shaw J, Gilloteau I, Abernethy A. 1222 Long-term clinical experiences of patients (pts) with non-small cell lung cancer (NSCLC), renal cell carcinoma (RCC) or metastatic melanoma (MEL): A SEER-Medicare analysis. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30526-3] [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: 11/25/2022]
|
17
|
Schiff M, Stam W, Gilloteau I, Poncet C, Hochberg M. AB1359 Systematic literature review of publications on indirect comparisons for biologic agents in RA. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1353] [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: 11/04/2022]
|
18
|
Mori A, Goren A, Gilloteau I, Dibonaventura M. Quantifying the Burden of Caregiving for Patients with Cancer in Europe. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34348-9] [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: 10/25/2022] Open
|