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Vilarrasa E, Rivera R, Eiris N, Carretero G, de la Cueva P, Carrascosa JM. [Translated article] Approach to the Epidemiology, Disease Management, and Current Challenges in the Management of Generalized Pustular Psoriasis Through a Survey Conducted Among Spanish Dermatologists. Actas Dermosifiliogr 2024; 115:T449-T457. [PMID: 38479699 DOI: 10.1016/j.ad.2024.03.013] [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: 07/31/2023] [Accepted: 10/22/2023] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Generalized pustular psoriasis (GPP) is a rare and severe inflammatory skin disease characterised by recurrent or intermittent flares. Epidemiological and disease management data in Spain are limited. Our goal was to estimate the epidemiology of GPP, explore its management, and reach consensus on the current challenges faced in Spain. METHODS An electronic survey was submitted to dermatologists from the Spanish Academy of Dermatology and Venereology Psoriasis Working Group. This group is experienced in the management of GPP. It included a Delphi consensus to establish the current challenges. RESULTS A total of 33 dermatologists responded to the survey. A 5-year prevalence and incidence of 13.05 and 7.01 cases per million inhabitants, respectively, were estimated. According to respondents, the most common GPP symptoms are pustules, erythema, and desquamation, while 45% of patients present > 1 annual flares. A total of 45% of respondents indicated that flares often require a length of stay between 1 and 2 weeks. In the presence of a flare, 67% of respondents often or always prescribe a non-biological systemic treatment as the first-line therapy [cyclosporine (55%); oral retinoid (30%)], and 45% a biological treatment [anti-TNFα (52%); anti-IL-17 (39%)]. The dermatologists agreed that the main challenges are to define and establish specific therapeutic goals to treat the disease including the patients' perspective on the management of the disease. CONCLUSION Our study describes the current situation on the management of GPP in Spain, increasing the present knowledge on the disease, and highlighting the current challenges faced at the moment.
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Affiliation(s)
- E Vilarrasa
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Universitat Autónoma de Barcelona, Barcelona, Spain.
| | - R Rivera
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain; Universidad Complutense, Madrid, Spain
| | - N Eiris
- Servicio de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - G Carretero
- Servicio de Dermatología, Hospital Universitario de Gran Canaria Doctor Negrin, Gran Canaria, Spain
| | - P de la Cueva
- Universidad Complutense, Madrid, Spain; Servicio de Dermatología, Hospital Infanta Leonor, Madrid, Spain
| | - J M Carrascosa
- Universitat Autónoma de Barcelona, Barcelona, Spain; Servicio de Dermatología, Hospital Germans Trias i Pujol, Barcelona, Spain; Instituto de Investigación Germans Trias i Pujol (IGTP), Barcelona, Spain
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Vilarrasa E, Rivera R, Eiris N, Carretero G, de la Cueva P, Carrascosa JM. Approach to the Epidemiology, Disease Management, and Current Challenges in the Management of Generalized Pustular Psoriasis Through a Survey Conducted Among Spanish Dermatologists. Actas Dermosifiliogr 2024; 115:449-457. [PMID: 37925068 DOI: 10.1016/j.ad.2023.10.022] [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: 07/31/2023] [Revised: 10/20/2023] [Accepted: 10/22/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Generalized pustular psoriasis (GPP) is a rare and severe inflammatory skin disease characterised by recurrent or intermittent flares. Epidemiological and disease management data in Spain are limited. Our goal was to estimate the epidemiology of GPP, explore its management, and reach consensus on the current challenges faced in Spain. METHODS An electronic survey was submitted to dermatologists from the Spanish Academy of Dermatology and Venereology Psoriasis Working Group. This group is experienced in the management of GPP. It included a Delphi consensus to establish the current challenges. RESULTS A total of 33 dermatologists responded to the survey. A 5-year prevalence and incidence of 13.05 and 7.01 cases per million inhabitants, respectively, were estimated. According to respondents, the most common GPP symptoms are pustules, erythema, and desquamation, while 45% of patients present > 1 annual flares. A total of 45% of respondents indicated that flares often require a length of stay between 1 and 2 weeks. In the presence of a flare, 67% of respondents often or always prescribe a non-biological systemic treatment as the first-line therapy [cyclosporine (55%); oral retinoid (30%)], and 45% a biological treatment [anti-TNFα (52%); anti-IL-17 (39%)]. The dermatologists agreed that the main challenges are to define and establish specific therapeutic goals to treat the disease including the patients' perspective on the management of the disease. CONCLUSION Our study describes the current situation on the management of GPP in Spain, increasing the present knowledge on the disease, and highlighting the current challenges faced at the moment.
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Affiliation(s)
- E Vilarrasa
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España; Universitat Autónoma de Barcelona, Barcelona, España.
| | - R Rivera
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España; Universidad Complutense, Madrid, España
| | - N Eiris
- Servicio de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - G Carretero
- Servicio de Dermatología, Hospital Universitario de Gran Canaria Doctor Negrin, Gran Canaria, España
| | - P de la Cueva
- Universidad Complutense, Madrid, España; Servicio de Dermatología, Hospital Infanta Leonor, Madrid, España
| | - J M Carrascosa
- Universitat Autónoma de Barcelona, Barcelona, España; Servicio de Dermatología, Hospital Germans Trias i Pujol, Barcelona, España; Instituto de Investigación Germans Trias i Pujol (IGTP), Barcelona, España
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Verdaguer-Faja J, Borrego L, Mercader-García P, González Pérez R, Córdoba-Guijarro S, Giménez-Arnau AM, Ruiz-González I, Miquel-Miquel J, Francisco Silvestre J, Ortiz de Frutos FJ, Tous-Romero F, Sanz Sánchez T, Rodríguez-Serna M, Sánchez-Pérez J, Serra Baldrich E, Zaragoza-Ninet V, Pastor-Nieto MA, Gatica-Ortega ME, Sánchez Gilo A, Melé-Ninot G, Sánchez-Pedreño Guillén P, Munera-Campos M, Descalzo MÁ, García-Doval I, Carrascosa JM. [[Translated article]]Epidemiological, Clinical, and Allergic Profile of Psoriatic Patients. Evaluation of the Spanish Registry of Contact Dermatitis and Cutaneous Allergy (REIDAC). Actas Dermosifiliogr 2024:S0001-7310(24)00353-3. [PMID: 38648935 DOI: 10.1016/j.ad.2024.04.013] [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] [Received: 09/07/2023] [Accepted: 02/06/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Psoriasis is a chronic inflammatory dermatosis whose clinical and topographic distribution requires differential diagnosis, or the possible association with allergic contact dermatitis (ACD), requiring patch testing (PT) as part of the diagnostic procedure. OBJECTIVES To describe the epidemiological, clinical, and allergic profile of patients with a primary or secondary diagnosis of psoriasis undergoing PT and compare them with patients with a diagnosis of ACD at the end of the diagnostic process. METHODS Cross-sectional study with data from REIDAC from 2018 through 2023 of selected patients with a diagnosis of psoriasis and/or ACD. RESULTS A total of 11 502 patients were included, 513 of whom had been diagnosed with primary or secondary psoriasis, 3640 with ACD, and 108 with both diseases. Men were more predominant in the groups of patients with psoriasis, psoriasis + ACD, and lesions were more predominantly seen in the hands with little association with atopic factors vs the ACD group. The rate of positivity in PT to the 2022 Spanish battery of allergens was lower in the group with psoriasis only in 27% of the patients. The most common allergens found in the psoriasis group were also the most common ones found in the overall ACD population. CONCLUSIONS Overall, 36.2% of psoriatic patients tested positive in PT to the 2022 Spanish battery of allergens, which proved that this association is not uncommon. Overall, psoriatic patients had a higher mean age, were more predominantly men, and showed more hand involvement.
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Affiliation(s)
- J Verdaguer-Faja
- Servicio de Dermatología del Hospital Universitari Germans Trias i Pujol, Spain.
| | - L Borrego
- Servicio de Dermatología del Complejo Hospitalario Universitario Insular. Universidad de Las Palmas de Gran Canaria, Spain
| | - P Mercader-García
- Servicio de Dermatología del Hospital General Universitario Morales Meseguer, Spain
| | - R González Pérez
- Hospital Universitario De Araba, Universidad del país vasco, Spain
| | | | - A M Giménez-Arnau
- Hospital del Mar. Research Institute. Universitat Pompeu Fabra, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Gemma Melé-Ninot
- Hospital Universitari Sagrat Cor, Grupo Quirónsalud, Barcelona, Spain
| | | | - M Munera-Campos
- Servicio de Dermatología del Hospital Universitari Germans Trias i Pujol, Spain
| | - M Á Descalzo
- Unidad de Investigación. Fundacion Piel Sana, Spain
| | | | - J M Carrascosa
- Servicio de Dermatología del Hospital Universitari Germans Trias i Pujol, Spain; Universitat Autònoma de Barcelona. UAB. IGTP, Spain
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Couselo-Rodríguez C, Batalla A, Carrascosa JM, Chicharro P, González-Quesada A, de la Cueva P, Giménez-Arnau AM, Gilaberte Y, Rodríguez-Serna M, Montero-Vilchez T, Ruiz-Villaverde R, Elosua-González M, Silvestre-Salvador JF, Munera-Campos M, Sánchez-Pérez J, Carretero G, Mauleón-Fernández C, Curto-Barredo L, Ballano-Ruiz A, Botella-Estrada R, Arias-Santiago S, Navarro-Triviño FJ, Roustan-Gullón G, Betlloch I, Del Alcázar E, Abalde-Pintos MT, Suárez-Perez J, García-Doval I, Descalzo MÁ, Flórez Á. [Translated article] Drug Survival in Cyclosporine Treatment for Moderate to Severe Atopic Dermatitis: Analysis of the Spanish Atopic Dermatitis Registry (BIOBADATOP). Actas Dermosifiliogr 2024; 115:T341-T346. [PMID: 38325545 DOI: 10.1016/j.ad.2023.07.028] [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: 05/02/2023] [Accepted: 07/03/2023] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND The past 5 years have seen a proliferation of new treatments for atopic dermatitis (AD). We analyzed recent drug survival data for cyclosporine in this setting. Because the Spanish National Healthcare system requires patients with AD to be treated with cyclosporine before they can be prescribed other systemic treatments, drug survival for cyclosporine may be shorter than in other diseases. MATERIAL AND METHOD Multicenter, observational, prospective cohort study using data from the Spanish Atopic Dermatitis Registry (BIOBADATOP). Data from the Spanish Registry of Systemic Treatments in Psoriasis (BIOBADADERM) were used to create a comparison cohort. RESULTS We analyzed data for 130 patients with AD treated with cyclosporine (median drug survival, 1 year). Median cyclosporine survival in the psoriasis comparison group (150 patients) was 0.37 years. Drug survival was significantly longer in AD than in psoriasis (P<.001). CONCLUSION Drug survival of cyclosporine in the BIOBADATOP registry is similar to that described in other series of patients with AD and longer than that observed in the BIOBADADERM psoriasis registry.
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Affiliation(s)
- C Couselo-Rodríguez
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain; Grupo de Investigación DIPO, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, Spain.
| | - A Batalla
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain; Grupo de Investigación DIPO, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, Spain
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol. Germans Trias I Pujol Research Institute (IGTP), Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - P Chicharro
- Servicio de Dermatología, Hospital Universitario de la Princesa, Madrid, Spain
| | - A González-Quesada
- Servicio de Dermatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - P de la Cueva
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - A M Giménez-Arnau
- Servicio de Dermatología, Hospital del Mar, IMIM, Universitat Pompeu Fabra, Barcelona, Spain
| | - Y Gilaberte
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - M Rodríguez-Serna
- Servicio de Dermatología, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - T Montero-Vilchez
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada. Instituto de Investigación IBS, Granada, Spain
| | - R Ruiz-Villaverde
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, Spain
| | - M Elosua-González
- Servicio de Dermatología, Hospital Universitario Puerta del Hierro, Madrid, Spain
| | - J F Silvestre-Salvador
- Servicio de Dermatología, Hospital General Universitario Dr. Balmis, Alicante. ISABIAL, Alicante, Spain
| | - M Munera-Campos
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol. Germans Trias I Pujol Research Institute (IGTP), Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - J Sánchez-Pérez
- Servicio de Dermatología, Hospital Universitario de la Princesa, Madrid, Spain
| | - G Carretero
- Servicio de Dermatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - C Mauleón-Fernández
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - L Curto-Barredo
- Servicio de Dermatología, Hospital del Mar, IMIM, Universitat Pompeu Fabra, Barcelona, Spain
| | - A Ballano-Ruiz
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - R Botella-Estrada
- Servicio de Dermatología, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - S Arias-Santiago
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada. Instituto de Investigación IBS, Granada, Spain
| | - F J Navarro-Triviño
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, Spain
| | - G Roustan-Gullón
- Servicio de Dermatología, Hospital Universitario Puerta del Hierro, Madrid, Spain
| | - I Betlloch
- Servicio de Dermatología, Hospital General Universitario Dr. Balmis, Alicante. ISABIAL, Alicante, Spain
| | - E Del Alcázar
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol. Germans Trias I Pujol Research Institute (IGTP), Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - M T Abalde-Pintos
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain; Grupo de Investigación DIPO, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, Spain
| | - J Suárez-Perez
- Servicio de Dermatología, Hospital Clínico de Málaga, Málaga, Spain
| | - I García-Doval
- Unidad de Investigación, Fundación Piel Sana AEDV, Spain; Servicio de Dermatología, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - M Á Descalzo
- Unidad de Investigación, Fundación Piel Sana AEDV, Spain
| | - Á Flórez
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain; Grupo de Investigación DIPO, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, Spain
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5
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Couselo-Rodríguez C, Batalla A, Carrascosa JM, Chicharro P, González-Quesada A, de la Cueva P, Giménez-Arnau AM, Gilaberte Y, Rodríguez-Serna M, Montero-Vilchez T, Ruiz-Villaverde R, Elosua-González M, Silvestre-Salvador JF, Munera-Campos M, Sánchez-Pérez J, Carretero G, Mauleón-Fernández C, Curto-Barredo L, Ballano-Ruiz A, Botella-Estrada R, Arias-Santiago S, Navarro-Triviño FJ, Roustan-Gullón G, Betlloch I, Del Alcázar E, Abalde-Pintos MT, Suárez-Perez J, García-Doval I, Descalzo MÁ, Flórez Á. Drug Survival in Cyclosporine Treatment for Moderate to Severe Atopic Dermatitis: Analysis of the Spanish Atopic Dermatitis Registry (BIOBADATOP). Actas Dermosifiliogr 2024; 115:341-346. [PMID: 37482292 DOI: 10.1016/j.ad.2023.07.014] [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: 05/02/2023] [Revised: 06/04/2023] [Accepted: 07/03/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND The past 5 years have seen a proliferation of new treatments for atopic dermatitis (AD). We analyzed recent drug survival data for cyclosporine in this setting. Because the Spanish National Healthcare system requires patients with AD to be treated with cyclosporine before they can be prescribed other systemic treatments, drug survival for cyclosporine may be shorter than in other diseases. MATERIAL AND METHOD Multicenter, observational, prospective cohort study using data from the Spanish Atopic Dermatitis Registry (BIOBADATOP). Data from the Spanish Registry of Systemic Treatments in Psoriasis (BIOBADADERM) were used to create a comparison cohort. RESULTS We analyzed data for 130 patients with AD treated with cyclosporine (median drug survival, 1 year). Median cyclosporine survival in the psoriasis comparison group (150 patients) was 0.37 years. Drug survival was significantly longer in AD than in psoriasis (P<.001). CONCLUSION Drug survival of cyclosporine in the BIOBADATOP registry is similar to that described in other series of patients with AD and longer than that observed in the BIOBADADERM psoriasis registry.
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Affiliation(s)
- C Couselo-Rodríguez
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España; Grupo de Investigación DIPO, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, España.
| | - A Batalla
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España; Grupo de Investigación DIPO, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, España
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol. Germans Trias I Pujol Research Institute (IGTP), Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - P Chicharro
- Servicio de Dermatología, Hospital Universitario de la Princesa, Madrid, España
| | - A González-Quesada
- Servicio de Dermatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España
| | - P de la Cueva
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, España
| | - A M Giménez-Arnau
- Servicio de Dermatología, Hospital del Mar, IMIM, Universitat Pompeu Fabra, Barcelona, España
| | - Y Gilaberte
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - M Rodríguez-Serna
- Servicio de Dermatología, Hospital Universitario y Politécnico la Fe, Valencia, España
| | - T Montero-Vilchez
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada. Instituto de Investigación IBS, Granada, España
| | - R Ruiz-Villaverde
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, España
| | - M Elosua-González
- Servicio de Dermatología, Hospital Universitario Puerta del Hierro, Madrid, España
| | - J F Silvestre-Salvador
- Servicio de Dermatología, Hospital General Universitario Dr. Balmis, Alicante. ISABIAL, Alicante, España
| | - M Munera-Campos
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol. Germans Trias I Pujol Research Institute (IGTP), Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - J Sánchez-Pérez
- Servicio de Dermatología, Hospital Universitario de la Princesa, Madrid, España
| | - G Carretero
- Servicio de Dermatología, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España
| | - C Mauleón-Fernández
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, España
| | - L Curto-Barredo
- Servicio de Dermatología, Hospital del Mar, IMIM, Universitat Pompeu Fabra, Barcelona, España
| | - A Ballano-Ruiz
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - R Botella-Estrada
- Servicio de Dermatología, Hospital Universitario y Politécnico la Fe, Valencia, España
| | - S Arias-Santiago
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada. Instituto de Investigación IBS, Granada, España
| | - F J Navarro-Triviño
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, España
| | - G Roustan-Gullón
- Servicio de Dermatología, Hospital Universitario Puerta del Hierro, Madrid, España
| | - I Betlloch
- Servicio de Dermatología, Hospital General Universitario Dr. Balmis, Alicante. ISABIAL, Alicante, España
| | - E Del Alcázar
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol. Germans Trias I Pujol Research Institute (IGTP), Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - M T Abalde-Pintos
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España; Grupo de Investigación DIPO, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, España
| | - J Suárez-Perez
- Servicio de Dermatología, Hospital Clínico de Málaga, Málaga, España
| | - I García-Doval
- Unidad de Investigación, Fundación Piel Sana AEDV, España; Servicio de Dermatología, Complexo Hospitalario Universitario de Vigo, Vigo, España
| | - M Á Descalzo
- Unidad de Investigación, Fundación Piel Sana AEDV, España
| | - Á Flórez
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España; Grupo de Investigación DIPO, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, España
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6
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Martorell A, Santos-Alarcón S, Sahuquillo-Torralba A, Rivera-Díaz R, Belinchón-Romero I, Ruiz-Genao D, Romero-Maté A, Ruiz-Villaverde R, Ferran-Farrés M, Gallardo-Hernández F, Almenara-Blasco M, Suarez-Perez JA, González-Cantero Á, Martínez-Lorenzo E, Fernández-Armenteros JM, Del Alcázar-Viladomiu E, García-Latasa J, Rocamora-Durant V, Ara-Martín M, Mateu-Puchades A, Llamas-Velasco M, Vilarrasa E, Velasco-Pastor M, De la Cueva P, Carrascosa JM, Magdaleno-Tapial J. Real-world Safety and Efficacy of Risankizumab in Psoriatic Patients: A Multicenter, Retrospective, and Not-interventional Study. Actas Dermosifiliogr 2024:S0001-7310(24)00187-X. [PMID: 38452889 DOI: 10.1016/j.ad.2024.02.030] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 02/24/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Risankizumab - a humanized monoclonal antibody that targets the p19 subunit of IL-23 - has been recently approved to treat moderate-to-severe plaque psoriasis. Real-world data based on a representative pool of patients are currently lacking. OBJECTIVE To assess the mid- and long-term safety and efficacy profile of risankizumab in patients with moderate-to-severe psoriasis in the routine clinical practice. METHODS This was a retrospective and multicenter study of consecutive psoriatic patients on risankizumab from April 2020 through November 2022. The primary endpoint was the number of patients who achieved a 100% improvement in their Psoriasis Area and Severity Index (PASI) (PASI100) on week 52. RESULTS A total of 510 patients, 198 (38.8%) women and 312 (61.2%) men were included in the study. The mean age was 51.7±14.4 years. A total of 227 (44.5%) study participants were obese (body mass index [BMI] >30kg/m2). The mean baseline PASI score was 11.4±7.2, and the rate of patients who achieved PASI100 on week 52, 67.0%. Throughout the study follow-up, 21%, 50.0%, 59.0%, and 66% of the patients achieved PASI100 on weeks 4, 16, 24, and 40, respectively. The number of patients who achieved a PASI ≤2 was greater in the group with a BMI ≤30kg/m2 on weeks 4 (P=.04), 16 (P=.001), and 52 (P=.002). A statistically significantly greater number of patients achieved PASI100 in the treatment-naïve group on weeks 16 and 52 (P=.001 each, respectively). On week 16 a significantly lower number of participants achieved PASI100 in the group with psoriatic arthropathy (P=.04). Among the overall study sample, 22 (4.3%) patients reported some type of adverse event and 20 (3.9%) discontinued treatment. CONCLUSIONS Risankizumab proved to be a safe and effective therapy for patients with moderate-to-severe psoriasis in the routine clinical practice.
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Affiliation(s)
- A Martorell
- Department of Dermatology, Hospital de Manises, Valencia, Spain.
| | - S Santos-Alarcón
- Department of Dermatology, Hospital Virgen de los Lirios, Alcoy, Alicante, Spain
| | - A Sahuquillo-Torralba
- Department of Dermatology, Hospital General Universitario Dr. Balmis-ISABIAL-UMH, Alicante, Spain
| | - R Rivera-Díaz
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - I Belinchón-Romero
- Department of Dermatology, Hospital General Universitario Dr. Balmis-ISABIAL-UMH, Alicante, Spain
| | - D Ruiz-Genao
- Department of Dermatology, Hospital Universitario de Alcorcón, Madrid, Spain
| | - A Romero-Maté
- Department of Dermatology, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - R Ruiz-Villaverde
- Department of Dermatology, Hospital Universitario PTS, Granada, Spain
| | - M Ferran-Farrés
- Department of Dermatology, Hospital del Mar, Barcelona, Spain
| | | | - M Almenara-Blasco
- Department of Dermatology, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - J A Suarez-Perez
- Department of Dermatology, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
| | - Á González-Cantero
- Department of Dermatology, Hospital Universitario Ramón y Cajal, Madrid, Spain; Faculty of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | | | | | | | - J García-Latasa
- Department of Dermatology, Hospital Royo Villanova, Zaragoza, Spain
| | | | - M Ara-Martín
- Department of Dermatology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - A Mateu-Puchades
- Department of Dermatology, Hospital Universitario Doctor Peset, Valencia, Spain
| | - M Llamas-Velasco
- Department of Dermatology, Hospital de la Princesa, Madrid, Spain
| | - E Vilarrasa
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - P De la Cueva
- Department of Dermatology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - J M Carrascosa
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, UAB, IGTP, Badalona, Barcelona, Spain
| | - J Magdaleno-Tapial
- Department of Dermatology, Hospital General Universitario de Valencia, Valencia, Spain
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7
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Verdaguer-Faja J, Borrego L, Mercader-García P, González Pérez R, Córdoba-Guijarro S, Giménez-Arnau AM, Ruiz-González I, Miquel-Miquel J, Silvestre JF, Ortiz de Frutos FJ, Tous-Romero F, Sanz Sánchez T, Rodríguez-Serna M, Sánchez-Pérez J, Serra Baldrich E, Zaragoza-Ninet V, Pastor-Nieto MA, Gática-Ortega ME, Sánchez Gilo A, Melé-Ninot G, Sánchez-Pedreño Guillén P, Munera-Campos M, Descalzo MÁ, García-Doval I, Carrascosa JM. Epidemiological, Clinical, and Allergic Profile of Psoriatic Patients. Evaluation of the Spanish Registry of Contact Dermatitis and Cutaneous Allergy (REIDAC). Actas Dermosifiliogr 2024:S0001-7310(24)00150-9. [PMID: 38382750 DOI: 10.1016/j.ad.2024.02.009] [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] [Received: 09/07/2023] [Revised: 12/18/2023] [Accepted: 02/06/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Psoriasis is a chronic inflammatory dermatosis whose clinical and topographic distribution requires differential diagnosis, or the possible association with allergic contact dermatitis (ACD), requiring patch testing (PT) as part of the diagnostic procedure. OBJECTIVES To describe the epidemiological, clinical, and allergic profile of patients with a primary or secondary diagnosis of psoriasis undergoing PT and compare them with patients with a diagnosis of ACD at the end of the diagnostic process. METHODS Cross-sectional study with data from REIDAC from 2018 through 2023 of selected patients with a diagnosis of psoriasis and/or ACD. RESULTS A total of 11 502 patients were included, 513 of whom had been diagnosed with primary or secondary psoriasis, 3640 with ACD, and 108 with both diseases. Men were more predominant in the groups of patients with psoriasis, psoriasis+ACD, and lesions were more predominantly seen in the hands with little association with atopic factors vs the ACD group. The rate of positivity in PT to the 2022 Spanish battery of allergens was lower in the group with psoriasis only in 27% of the patients. The most common allergens found in the psoriasis group were also the most common ones found in the overall ACD population. CONCLUSIONS Overall, 36.2% of psoriatic patients tested positive in PT to the 2022 Spanish battery of allergens, which proved that this association is not uncommon. Overall, psoriatic patients had a higher mean age, were more predominantly men, and showed more hand involvement.
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Affiliation(s)
- J Verdaguer-Faja
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, España.
| | - L Borrego
- Servicio de Dermatología, Complejo Hospitalario Universitario Insular, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Las Palmas, España
| | - P Mercader-García
- Servicio de Dermatología, Hospital General Universitario Morales Meseguer, Murcia, España
| | - R González Pérez
- Servicio de Dermatología, Hospital Universitario De Araba, Universidad del País Vasco, Vitoria-Gasteiz, España
| | - S Córdoba-Guijarro
- Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Fuenlabrada, España
| | - A M Giménez-Arnau
- Servicio de Dermatología, Hospital del Mar, Research Institute, Universitat Pompeu Fabra, Barcelona, España
| | - I Ruiz-González
- Servicio de Dermatología, Complejo Asistencial Universitario de León, León, España
| | - J Miquel-Miquel
- Servicio de Dermatología, Hospital Arnau de Vilanova, Valencia, España
| | - J F Silvestre
- Servicio de Dermatología, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, España
| | - F J Ortiz de Frutos
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - F Tous-Romero
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - T Sanz Sánchez
- Servicio de Dermatología, Hospital Universitario Infanta Sofía, Madrid, España
| | - M Rodríguez-Serna
- Servicio de Dermatología, Hospital Universitario La Fe, Valencia, España
| | - J Sánchez-Pérez
- Servicio de Dermatología, Hospital Universitario La Princesa, Madrid, España
| | - E Serra Baldrich
- Servicio de Dermatología, Hospital de La Santa Creu i San Pau, Barcelona, España
| | - V Zaragoza-Ninet
- Servicio de Dermatología, Consorcio Hospital General Universitario de Valencia, Valencia, España
| | - M A Pastor-Nieto
- Servicio de Dermatología, Hospital Universitario de Guadalajara, Guadalajara, España
| | - M E Gática-Ortega
- Servicio de Dermatología, Hospital Virgen del Valle Complejo Hospitalario de Toledo, Toledo, España
| | - A Sánchez Gilo
- Servicio de Dermatología, Hospital Universitario Rey Juan Carlos Móstoles, Móstoles, España
| | - G Melé-Ninot
- Servicio de Dermatología, Hospital Universitari Sagrat Cor, Grupo Quirónsalud, Barcelona, España
| | | | - M Munera-Campos
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, España
| | - M Á Descalzo
- Unidad de Investigación, Fundación Piel Sana, Madrid, España
| | - I García-Doval
- Unidad de Investigación, Fundación Piel Sana, Madrid, España
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, España; Departamento de Medicina, Universitat Autònoma de Barcelona (UAB), IGTP, Barcelona, España
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8
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Puig L, Notario J, López-Ferrer A, Scheneller-Pavelescu L, Pérez B, Galache C, de la Cueva P, Carrascosa JM. Recommendations from the Spanish Academy of Dermatology and Venereology Psoriasis Working Group on the Management of Patients with Cancer and Psoriasis. Actas Dermosifiliogr 2024:S0001-7310(24)00154-6. [PMID: 38382743 DOI: 10.1016/j.ad.2024.02.013] [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] [Received: 12/14/2023] [Revised: 01/31/2024] [Accepted: 02/11/2024] [Indexed: 02/23/2024] Open
Abstract
Several studies suggest that patients with psoriasis have a higher incidence of neoplasms, especially of the skin, which could be associated with the use of therapies to treat psoriasis. Furthermore, the evidence available on the safety profile of some treatments in this context, and the management of these patients is scarce, which is why clinical practice guidelines with recommendations on the management of psoriasis in cancer patients are ambiguous. This study provides recommendations on the management and use of the therapies currently available for these patients. They are the result of a Delphi consensus reached by 45 dermatologists of the Spanish Academy of Dermatology and Venereology Psoriasis Working Group, whose goal is to help specialists in the field in their decision-making processes.
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Affiliation(s)
- L Puig
- Servicio de Dermatología, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
| | - J Notario
- Servicio de Dermatología, Hospital Universitario de Bellvitge, Barcelona, España
| | - A López-Ferrer
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | | | - B Pérez
- Servicio de Dermatología, Hospital Morales Meseguer, Murcia, España; Facultad de Medicina, Universidad Católica San Antonio, Murcia, España
| | - C Galache
- Departamento de Dermatología, Hospital Universitario Central de Asturias, Oviedo, España
| | - P de la Cueva
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, España
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, IGTP, Badalona, España
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9
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Vilarrasa E, Nicolau J, de la Cueva P, Goday A, Gallardo F, Martorell-Calatayud A, Carrascosa JM. [Translated article] Glucagon-Like Peptide-1 Agonists for Treating Obesity in Patients With Immune-Mediated Skin Diseases. Actas Dermo-Sifiliográficas 2024; 115:T56-T65. [PMID: 37918631 DOI: 10.1016/j.ad.2023.10.019] [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: 05/11/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 11/04/2023] Open
Abstract
Psoriasis and hidradenitis suppurativa are often associated with obesity. Because chronic low-grade inflammation underlies these 2 diseases, they can progress to more severe forms in patients with obesity if weight-reduction measures are not taken. This review covers pharmacologic alternatives for treating obesity, with emphasis on the benefits associated with the novel use of glucagon-like peptide-1 (GLP-1) agonists that act on satiety receptors. These drugs have led to greater weight loss in clinical trials and real-world settings than orlistat, which until recently was the only drug approved for treating obesity in the European Union. Although experience with GLP-1 agonists in patients with obesity and inflammatory skin diseases is currently scarce, the promising results reported suggest they may offer a useful tool for managing obesity.
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Affiliation(s)
- E Vilarrasa
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - J Nicolau
- Servicio de Endocrinología y Nutrición, Hospital Universitario Son Llàtzer, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Clínica Rotger (Grupo Quirón), Palma de Mallorca, Baleares, Spain
| | - P de la Cueva
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Comunidad de Madrid, Spain
| | - A Goday
- Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona; Servicio de Endocrinología y Nutrición, Hospital del Mar, IMIM Institut Mar d'Investigacions Mediques, Parc de Salut Mar, Barcelona; CIBEROBN, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - F Gallardo
- Servicio de Dermatología, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | | | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
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10
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Martinez-Molina M, Munera-Campos M, Quer A, Carrascosa JM. [Translated article] Sustained Clinical Response of Acquired Epidermodysplasia Verruciformis to Human Papillomavirus Virus (VPH) Vaccination in a Kidney Transplant Recipient. Actas Dermo-Sifiliográficas 2024; 115:T110-T112. [PMID: 37923066 DOI: 10.1016/j.ad.2023.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/08/2023] [Indexed: 11/07/2023] Open
Affiliation(s)
- M Martinez-Molina
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol. Universidad Autónoma de Barcelona, IGTP, Barcelona, Spain
| | - M Munera-Campos
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol. Universidad Autónoma de Barcelona, IGTP, Barcelona, Spain.
| | - A Quer
- Servicio de Anatomía Patológica, Hospital Universitari Germans Trias i Pujol. Universidad Autónoma de Barcelona, IGTP, Barcelona, Spain
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol. Universidad Autónoma de Barcelona, IGTP, Barcelona, Spain
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11
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Pereyra-Rodríguez JJ, Poveda JL, Rivero A, Serra-Baldrich E, Silvestre JF, Armario-Hita JC, Calleja MÁ, Carrascosa JM, Flórez Á, Herranz P, Comellas M, Ortiz de Frutos FJ. Assessing the value of moderate-to-severe atopic dermatitis treatment using multi-criteria decision analysis (MCDA). J Eur Acad Dermatol Venereol 2024; 38:e59-e62. [PMID: 37594914 DOI: 10.1111/jdv.19432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/11/2023] [Indexed: 08/20/2023]
Affiliation(s)
| | - J L Poveda
- Pharmacy Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - A Rivero
- Independent Consultant Agustin Rivero, Madrid, Spain
| | - E Serra-Baldrich
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma, Barcelona, Spain
| | - J F Silvestre
- Dermatology Department, Hospital General Universitario Dr Balmis-ISABIAL-UMH, Alicante, Spain
| | - J C Armario-Hita
- Dermatology Department, Hospital Universitario de Puerto Real, University of Cádiz, Cádiz, Spain
| | - M Á Calleja
- Pharmacy Department, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - J M Carrascosa
- Dermatology Department, Hospital Universitari Germans Trias i Pujol, Autonomous University of Barcelona, Barcelona, Spain
| | - Á Flórez
- Dermatology Department, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - P Herranz
- Dermatology Department, Hospital Universitario La Paz, Madrid, Spain
| | - M Comellas
- Outcomes Research Department, Outcomes'10, Castellón de la Plana, Spain
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12
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Martinez-Molina M, Munera-Campos M, Quer A, Carrascosa JM. Sustained Clinical Response of Acquired Epidermodysplasia Verruciformis to Human Papillomavirus Virus (VPH) Vaccination in a Kidney Transplant Recipient. Actas Dermosifiliogr 2024; 115:110-112. [PMID: 37704170 DOI: 10.1016/j.ad.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/02/2023] [Accepted: 08/08/2023] [Indexed: 09/15/2023] Open
Affiliation(s)
- M Martinez-Molina
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol. Universidad Autónoma de Barcelona, IGTP, Barcelona, España
| | - M Munera-Campos
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol. Universidad Autónoma de Barcelona, IGTP, Barcelona, España.
| | - A Quer
- Servicio de Anatomía Patológica, Hospital Universitari Germans Trias i Pujol. Universidad Autónoma de Barcelona, IGTP, Barcelona, España
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol. Universidad Autónoma de Barcelona, IGTP, Barcelona, España
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13
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Vilarrasa E, Nicolau J, de la Cueva P, Goday A, Gallardo F, Martorell A, Carrascosa JM. Glucagon-Like Peptide-1 Agonists for Treating Obesity in Patients With Immune-Mediated Skin Diseases. Actas Dermosifiliogr 2024; 115:56-65. [PMID: 37451337 DOI: 10.1016/j.ad.2023.06.017] [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: 05/11/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023] Open
Abstract
Psoriasis and hidradenitis suppurativa are often associated with obesity. Because chronic low-grade inflammation underlies these 2 diseases, they can progress to more severe forms in patients with obesity if weight-reduction measures are not taken. This review covers pharmacologic alternatives for treating obesity, with emphasis on the benefits associated with the novel use of glucagon-like peptide-1 (GLP-1) agonists that act on satiety receptors. These drugs have led to greater weight loss in clinical trials and real-world settings than orlistat, which until recently was the only drug approved for treating obesity in the European Union. Although experience with GLP-1 agonists in patients with obesity and inflammatory skin diseases is currently scarce, the promising results reported suggest they may offer a useful tool for managing obesity.
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Affiliation(s)
- E Vilarrasa
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - J Nicolau
- Servicio de Endocrinología y Nutrición, Hospital Universitario Son Llàtzer, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Clínica Rotger (Grupo Quirón), Palma de Mallorca, Baleares, España
| | - P de la Cueva
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Comunidad de Madrid, España
| | - A Goday
- Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona; Servicio de Endocrinología y Nutrición, Hospital del Mar, IMIM Institut Mar d'Investigacions Mediques, Parc de Salut Mar, Barcelona; CIBEROBN, Instituto de Salud Carlos III (ISCIII), Madrid, España
| | - F Gallardo
- Servicio de Dermatología, Hospital del Mar, Parc de Salut Mar, Barcelona, España
| | - A Martorell
- Servicio de Dermatología y Venereología, Hospital de Manises, Valencia, España.
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, España
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14
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Pinter A, Costanzo A, Khattri S, Smith SD, Carrascosa JM, Tada Y, Riedl E, Reich A, Brnabic A, Haustrup N, Lampropoulou A, Lipkovich I, Kadziola Z, Paul C, Schuster C. Comparative Effectiveness and Durability of Biologics in Clinical Practice: Month 12 Outcomes from the International, Observational Psoriasis Study of Health Outcomes (PSoHO). Dermatol Ther (Heidelb) 2023:10.1007/s13555-023-01086-9. [PMID: 38113010 DOI: 10.1007/s13555-023-01086-9] [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] [Received: 11/09/2023] [Accepted: 12/08/2023] [Indexed: 12/21/2023] Open
Abstract
INTRODUCTION Given the chronic nature of psoriasis (PsO), more studies are needed that directly compare the effectiveness of different biologics over long observation periods. This study compares the effectiveness and durability through 12 months of anti-interleukin (IL)-17A biologics relative to other approved biologics in patients with moderate-to-severe psoriasis in a real-world setting. METHODS The Psoriasis Study of Health Outcomes (PSoHO) is an ongoing 3-year, prospective, non-interventional cohort study of 1981 adults with chronic moderate-to-severe plaque psoriasis initiating or switching to a new biologic. The study compares the effectiveness of anti-IL-17A biologics with other approved biologics and provides pairwise comparisons of seven individual biologics versus ixekizumab. The primary outcome was defined as the proportion of patients who had at least a 90% improvement in Psoriasis Area and Severity Index score (PASI90) and/or a score of 0 or 1 in static Physician Global Assessment (sPGA). Secondary objective comparisons included the proportion of patients who achieved PASI90, PASI100, a Dermatology Life Quality Index (DLQI) score of 0 or 1, and three different actions of durability of treatment response. Unadjusted response rates are presented alongside the primary analysis, which uses frequentist model averaging (FMA) to evaluate the adjusted comparative effectiveness. RESULTS Compared to the other biologics cohort, the anti-IL-17A cohort had a higher response rate (68.0% vs. 65.1%) and significantly higher odds of achieving the primary outcome at month 12. The two cohorts had similar response rates for PASI100 (40.5% and 37.1%) and PASI90 (53.9% and 51.7%) at month 12, with no significant differences between the cohorts in the adjusted analyses. At month 12, the response rates across the individual biologics were 53.5-72.6% for the primary outcome, 27.6-48.3% for PASI100, and 41.7-61.4% for PASI90. CONCLUSIONS These results show the comparative effectiveness of biologics at 6 and 12 months in the real-world setting. TRIAL REGISTRATION ClinicalTrials.gov identifier EUPAS24207.
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Affiliation(s)
- A Pinter
- University Hospital Frankfurt, Frankfurt am Main, Germany.
| | - A Costanzo
- Division of Dermatology, Humanitas Research Hospital, Pieve Emanuele, Milan, Italy
- Dermatology IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - S Khattri
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - S D Smith
- ANU Medical School, ANU College of Health and Medicine, The Australian National University, Canberra, Australia
| | - J M Carrascosa
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma of Barcelona, IGTP, Carretera de Canyet, S/N, 08916, Badalona, Barcelona, Spain
| | - Y Tada
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - E Riedl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - A Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | - A Brnabic
- Eli Lilly and Company, Indianapolis, USA
| | - N Haustrup
- Eli Lilly and Company, Indianapolis, USA
| | | | | | - Z Kadziola
- Eli Lilly and Company, Indianapolis, USA
| | - C Paul
- Université Paul Sabatier Toulouse III, Toulouse, France
| | - C Schuster
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
- Eli Lilly and Company, Indianapolis, USA
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15
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Sahuquillo-Torralba A, Hospital-Gil M, Vilarrasa-Rull E, Llamas-Velasco M, Rivera R, Carrascosa JM, de la Cueva-Dovao P, Armesto-Santos S, Ruíz-Villaverde R, Velasco-Pastor M, Magdaleno-Tapial J, Yanguas-Bayona JI, Ribera-Pibernat M, Salgado-Boquete L, Herranz-Pinto P, Romero-Mate A, Martínez-Lorenzo E, López-Estebaranz JL, Ballescá-López F, Botella-Estrada R. Effectiveness and safety of brodalumab in the treatment of plaque, scalp and palmoplantar psoriasis: A multicentre retrospective study in a Spanish population. Australas J Dermatol 2023; 64:e317-e326. [PMID: 37435962 DOI: 10.1111/ajd.14130] [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: 11/07/2022] [Revised: 03/26/2023] [Accepted: 06/26/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND AND OBJECTIVE The data in clinical practice regarding the effectiveness and safety of brodalumab in psoriasis are scarce, especially at scalp and palmoplantar locations. The main objective was the percentage of patients achieving absolute PASI ≤3/ ≤1/ =0 for plaque psoriasis and the percentage of patients achieving an IGA 0-1/IGA 0 for the special locations at Week 52 of treatment. PATIENTS AND METHODS Observational retrospective multicentre study in 28 Spanish Hospitals that included adult patients with plaque psoriasis treated with brodalumab, from September 2018 until March 2021. RESULTS A total of 200 patients were included. The mean baseline PASI was 10.97 (±6.28) with a mean basal scalp (n = 58) and palmoplantar (n = 40) IGA of 2.10 (±0.97) and 2.15 (±1.26), respectively. At Week 52, 93.98%/75.90%/68.67% of patients reached an absolute PASI ≤3/ ≤1/ =0 in plaque psoriasis (n = 83), with a percentage of patients achieving scalp (n = 27) and palmoplantar (n = 19) IGA 0-1/IGA 0 of 96.3%/88.9% and 100%/88.9%, respectively. Fifteen per cent of patients reported any adverse events with candidiasis being the most reported (6%), but only 6% of the adverse events required the withdrawal. CONCLUSIONS Brodalumab demonstrated high PASI and IGA responses and was well tolerated in clinical practice in plaque, scalp and palmoplantar psoriasis.
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Affiliation(s)
- A Sahuquillo-Torralba
- Department of Dermatology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - M Hospital-Gil
- Department of Dermatology, Hospital Universitario Puerta del Hierro, Madrid, Spain
| | - E Vilarrasa-Rull
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - M Llamas-Velasco
- Department of Dermatology, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain
| | - R Rivera
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - J M Carrascosa
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - P de la Cueva-Dovao
- Department of Dermatology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - S Armesto-Santos
- Department of Dermatology, Hospital Universitario Marques De Valdecilla, Santander, Spain
| | - R Ruíz-Villaverde
- Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain
| | - M Velasco-Pastor
- Department of Dermatology, Hospital Arnau de Vilanova, Valencia, Spain
| | - J Magdaleno-Tapial
- Department of Dermatology, Consorcio Hospital General Universitario de Valencia, Spain
| | | | - M Ribera-Pibernat
- Department of Dermatology, Hospital Universitari Parc Tauli de Sabadell, Barcelona, Spain
| | - L Salgado-Boquete
- Deparment of Dermatology, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - P Herranz-Pinto
- Department of Dermatology, Hospital Universitario La Paz, Madrid, Spain
| | - A Romero-Mate
- Department of Dermatology, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - E Martínez-Lorenzo
- Department of Dermatology, Hospital Universitario Virgen de la Salud, Toledo, Spain
| | | | | | - R Botella-Estrada
- Department of Dermatology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Facultad de Medicina, Universidad de Valencia, Valencia, Spain
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16
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Salgado-Boquete L, Arias-Santiago S, Belinchón-Romero I, de la Cuadra-Grande A, de la Cueva P, Gilaberte Y, Notario J, Rivera-Díaz R, Ruiz-Villaverde R, Carrascosa JM. Selection of Quality Indicators for the Certification of Psoriasis Units: The CUDERMA Project Delphi Consensus Study. Actas Dermosifiliogr 2023; 114:865-883. [PMID: 36796538 DOI: 10.1016/j.ad.2023.02.002] [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: 02/06/2023] [Accepted: 02/06/2023] [Indexed: 02/17/2023] Open
Abstract
Defining quality indicators is a key strategy for ensuring the quality and standardization of health care. The CUDERMA project, an initiative of the Spanish Academy of Dermatology and Venerology (AEDV), was undertaken to define quality indicators for the certification of specialized units in dermatology; the first 2 areas selected were psoriasis and dermato-oncology. The aim of this study was to reach a consensus on what should be assessed by the indicators used to certify psoriasis units. The structured process used to do this comprised a literature review to identify potential indicators, the selection of an initial set of indicators to be evaluated by a multidisciplinary group of experts and, finally, a Delphi consensus study. A panel of 39 dermatologists evaluated the selected indicators and classified them as either "essential" or "of excellence". Consensus was finally reached on 67 indicators, which will be standardized and used to develop the certification standard for psoriasis units.
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Affiliation(s)
- L Salgado-Boquete
- Servicio de Dermatología, Complejo Hospitalario de Pontevedra, Pontevedra, Galicia, España
| | - S Arias-Santiago
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Andalucía, España; Facultad de Medicina, Universidad de Granada, Granada, Andalucía, España; Instituto Biosanitario de Granada (IBS), Granada, Andalucía, España.
| | - I Belinchón-Romero
- Servicio de Dermatología, Hospital General Universitario Dr. Balmis, Alicante, Comunidad Valenciana, España; Facultad de Medicina, Universidad Miguel Hernández, Alicante, Comunidad Valenciana, España; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Comunidad Valenciana, España
| | - A de la Cuadra-Grande
- Pharmacoeconomics & Outcomes Research Iberia (PORIB), Pozuelo de Alarcón, Madrid, España
| | - P de la Cueva
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, España
| | - Y Gilaberte
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, Aragón, España
| | - J Notario
- Servicio de Dermatología, Hospital Universitario de Bellvitge, Barcelona, Catalunya, España
| | - R Rivera-Díaz
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España; Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, España
| | - R Ruiz-Villaverde
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, Andalucía, España; Instituto Biosanitario de Granada (IBS), Granada, Andalucía, España
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol (HUGTiP), Barcelona, Catalunya, España; Facultad de Medicina, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalunya, España; Institut d'Investigació en Ciènces de la Salut Germans Trias i Pujol (IGTP), Barcelona, Catalunya, España
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17
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Salgado-Boquete L, Arias-Santiago S, Belinchón-Romero I, de la Cuadra-Grande A, de la Cueva P, Gilaberte Y, Notario J, Rivera-Díaz R, Ruiz-Villaverde R, Carrascosa JM. [Translated article] Selection of Quality Indicators for the Certification of Psoriasis Units: The CUDERMA Project Delphi Consensus Study. Actas Dermosifiliogr 2023; 114:T865-T883. [PMID: 37678630 DOI: 10.1016/j.ad.2023.09.001] [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: 02/06/2023] [Accepted: 02/06/2023] [Indexed: 09/09/2023] Open
Abstract
Defining quality indicators is a key strategy for ensuring the quality and standardization of health care. The CUDERMA project, an initiative of the Spanish Academy of Dermatology and Venerology (AEDV), was undertaken to define quality indicators for the certification of specialized units in dermatology; the first 2 areas selected were psoriasis and dermato-oncology. The aim of this study was to reach a consensus on what should be assessed by the indicators used to certify psoriasis units. The structured process used to do this comprised a literature review to identify potential indicators, the selection of an initial set of indicators to be evaluated by a multidisciplinary group of experts and, finally, a Delphi consensus study. A panel of 39 dermatologists evaluated the selected indicators and classified them as either "essential" or "of excellence". Consensus was finally reached on 67 indicators, which will be standardized and used to develop the certification standard for psoriasis units.
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Affiliation(s)
- L Salgado-Boquete
- Servicio de Dermatología, Complejo Hospitalario de Pontevedra, Pontevedra, Galicia, Spain
| | - S Arias-Santiago
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Andalucía, Spain; Facultad de Medicina, Universidad de Granada, Granada, Andalucía, Spain; Instituto Biosanitario de Granada (IBS), Granada, Andalucía, Spain.
| | - I Belinchón-Romero
- Servicio de Dermatología, Hospital General Universitario Dr. Balmis, Alicante, Comunidad Valenciana, Spain; Facultad de Medicina, Universidad Miguel Hernández, Alicante, Comunidad Valenciana, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Comunidad Valenciana, Spain
| | - A de la Cuadra-Grande
- Pharmacoeconomics & Outcomes Research Iberia (PORIB), Pozuelo de Alarcón, Madrid, Spain
| | - P de la Cueva
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Y Gilaberte
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, Aragón, Spain
| | - J Notario
- Servicio de Dermatología, Hospital Universitario de Bellvitge, Barcelona, Catalunya, Spain
| | - R Rivera-Díaz
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - R Ruiz-Villaverde
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, Andalucía, Spain; Instituto Biosanitario de Granada (IBS), Granada, Andalucía, Spain
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol (HUGTiP), Barcelona, Catalunya, Spain; Facultad de Medicina, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalunya, Spain; Institut d'Investigació en Ciènces de la Salut Germans Trias i Pujol (IGTP), Barcelona, Catalunya, Spain
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18
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Mataix J, García L, Belinchón I, Ruiz Carrascosa JC, de la Cueva P, Carrascosa JM. Moderate to Severe Psoriasis in Older Adults: Recommendations on Management from the Psoriasis Working Group of the Spanish Academy of Dermatology and Venereology (AEDV). Actas Dermosifiliogr 2023; 114:802-811. [PMID: 37244396 DOI: 10.1016/j.ad.2023.05.016] [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: 04/25/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 05/29/2023] Open
Abstract
Managing moderate to severe psoriasis in older adults is complex due to factors characteristic of the later years of life, such as associated comorbidity, polypharmacy, and immunosenescence. This consensus statement discusses 17 recommendations for managing treatment for moderate to severe psoriasis in patients older than 65 years. The recommendations were proposed by a committee of 6 dermatologists who reviewed the literature. Fifty-one members of the Psoriasis Working Group of the Spanish Academy of Dermatology and Venereology (AEDV) then applied the Delphi process in 2 rounds to reach consensus on which principles to adopt. The recommendations can help to improve management, outcomes, and prognosis for older adults with moderate to severe psoriasis.
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Affiliation(s)
- J Mataix
- Departamento de Dermatología, Hospital Marina Baixa de Villajoyosa, Alicante, España
| | - L García
- Departamento de Dermatología, Hospital Universitario San Juan, Alicante, España
| | - I Belinchón
- Departamento de Dermatología, Hospital General Universitario Dr. Balmis- ISABIAL-UMH, Alicante, España.
| | - J C Ruiz Carrascosa
- Departamento de Dermatología, Hospital Universitario Clínico San Cecilio, Granada, España
| | - P de la Cueva
- Departamento de Dermatología, Hospital Universitario Infanta Leonor, Madrid, España
| | - J M Carrascosa
- Departamento de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, España
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19
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Mataix J, García L, Belinchón I, Ruiz Carrascosa JC, de la Cueva P, Carrascosa JM. [Translated article] Moderate to Severe Psoriasis in Older Adults: Recommendations on Management From the Psoriasis Working Group of the Spanish Academy of Dermatology and Venereology (AEDV). Actas Dermosifiliogr 2023; 114:T802-T811. [PMID: 37506825 DOI: 10.1016/j.ad.2023.07.016] [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: 04/25/2023] [Accepted: 05/06/2023] [Indexed: 07/30/2023] Open
Abstract
Managing moderate to severe psoriasis in older adults is complex due to factors characteristic of the later years of life, such as associated comorbidity, polypharmacy, and immunosenescence. This consensus statement discusses 17 recommendations for managing treatment for moderate to severe psoriasis in patients older than 65 years. The recommendations were proposed by a committee of 6 dermatologists who reviewed the literature. Fifty-one members of the Psoriasis Working Group of the Spanish Academy of Dermatology and Venereology (AEDV) then applied the Delphi process in 2 rounds to reach consensus on which principles to adopt. The recommendations can help to improve management, outcomes, and prognosis for older adults with moderate to severe psoriasis.
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Affiliation(s)
- J Mataix
- Departamento de Dermatología, Hospital Marina Baixa de Villajoyosa, Alicante, Spain
| | - L García
- Departamento de Dermatología, Hospital Universitario San Juan, Alicante, Spain
| | - I Belinchón
- Departamento de Dermatología, Hospital General Universitario Dr. Balmis - ISABIAL-UMH, Alicante, Spain.
| | - J C Ruiz Carrascosa
- Departamento de Dermatología, Hospital Universitario Clínico San Cecilio, Granada, Spain
| | - P de la Cueva
- Departamento de Dermatología, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - J M Carrascosa
- Departamento de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
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20
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Munera-Campos M, Carrascosa JM. Janus Kinase Inhibitors in Atopic Dermatitis: New Perspectives. Actas Dermosifiliogr 2023; 114:680-707. [PMID: 37105270 DOI: 10.1016/j.ad.2023.04.025] [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: 08/17/2022] [Revised: 04/10/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
The JAK/STAT (Janus kinase/signal transducer and activator of transcription) pathway is an essential final step in the signaling process of most interleukins with a critical role in the pathogenesis of atopic dermatitis. By achieving broad, intermittent inhibition of the activity of multiple cytokines, JAK inhibitors help modulate T helper 2 cell-mediated inflammation, epidermal barrier dysfunction, and itch signaling. This comprehensive blockade, however, can result in a wider range of adverse effects. We review a number of JAK inhibitors that have been recently approved for use in atopic dermatitis, such as baricitinib, upadacitinib, and abrocitinib, as well as others that are currently in the pipeline or under development, such as gusacitinib, delgocitinib, ruxolitinib, brepocitinib, tofacitinib, and cerdulatinib. The use of JAK inhibitors to block the signaling of numerous cytokines with a critical role in the pathogenesis of atopic dermatitis has revolutionized the treatment of this pathogenically complex, phenotypically heterogeneous skin disease.
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Affiliation(s)
- M Munera-Campos
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Instituto de Investigación Germans Trias i Pujol (IGTP), Badalona, Barcelona, España.
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Instituto de Investigación Germans Trias i Pujol (IGTP), Badalona, Barcelona, España
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21
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Munera-Campos M, Carrascosa JM. [Translated article] Janus Kinase Inhibitors in Atopic Dermatitis: New Perspectives. Actas Dermosifiliogr 2023; 114:T680-T707. [PMID: 37453538 DOI: 10.1016/j.ad.2023.07.006] [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: 08/17/2022] [Accepted: 04/13/2023] [Indexed: 07/18/2023] Open
Abstract
The JAK/STAT (Janus kinase/signal transducer and activator of transcription) pathway is an essential final step in the signaling process of most interleukins with a critical role in the pathogenesis of atopic dermatitis. By achieving broad, intermittent inhibition of the activity of multiple cytokines, JAK inhibitors help to modulate T helper 2 cell-mediated inflammation, epidermal barrier dysfunction, and itch signaling. This comprehensive blockade, however, can result in a wider range of adverse effects. We review a number of JAK inhibitors that have been recently approved for use in atopic dermatitis, such as baricitinib, upadacitinib, and abrocitinib, as well as others that are currently in the pipeline or under development, such as gusacitinib, delgocitinib, ruxolitinib, brepocitinib, tofacitinib, and cerdulatinib. The use of JAK inhibitors to block the signaling of numerous cytokines with a critical role in the pathogenesis of atopic dermatitis has revolutionized the treatment of this pathogenically complex, phenotypically heterogeneous skin disease.
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Affiliation(s)
- M Munera-Campos
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Instituto de Investigación Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain.
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Instituto de Investigación Germans Trias i Pujol (IGTP), Badalona, Barcelona, Spain
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22
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Chiricozzi A, Ferrucci SM, Di Nardo L, Gori N, Balato A, Ortoncelli M, Maurelli M, Galluzzo M, Munera Campos M, Seremet T, Caldarola G, De Simone C, Ippoliti E, Torres T, Gkalpakiotis S, Conrad C, Carrascosa JM, Bianchi L, Argenziano G, Ribero S, Girolomoni G, Marzano AV, Peris K. Current treatment goals are achieved by the majority of patients with atopic dermatitis treated with tralokinumab: results from a multicentric, multinational, retrospective, cohort study. Expert Opin Biol Ther 2023; 23:1307-1315. [PMID: 38108300 DOI: 10.1080/14712598.2023.2292627] [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: 09/25/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Tralokinumab is a human monoclonal antibody targeting interleukin-13 that is approved for the treatment of moderate-severe atopic dermatitis. Studies analyzing the efficacy and safety of tralokinumab in a real-world setting are scarce. RESEARCH DESIGN AND METHODS A European, multicentric, real-world, retrospective cohort study was defined to assess the effectiveness and safeness profile of tralokinumab, investigating the achievement of pre-specified treatment goals; and to detect potential differences in terms of effectiveness and safeness across some selected patient subcohorts. RESULTS A total of 194 adult patients were included in this study. A significant improvement in physician-assessed disease severity was detected at each follow-up visit as compared with baseline and similar trend was observed for patient-reported outcomes and quality of life. No meaningful difference in effectiveness was found when considering patient age (<65 versus ≥65 years), neither dissecting patient cohort in dupilumab-naive vs dupilumab-treated subjects. Among tralokinumab-treated patients, 88% achieved at least one currently identified real-world therapeutic goal at week 16. CONCLUSIONS This retrospective multicenter study confirmed the effectiveness and safeness of tralokinumab throughout 32 weeks of observation, showing the achievement of therapeutic goals identified in both trial and real-world settings in a large proportion of tralokinumab-treated patients.
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Affiliation(s)
- A Chiricozzi
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - S M Ferrucci
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - L Di Nardo
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - N Gori
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A Balato
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - M Ortoncelli
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - M Maurelli
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - M Galluzzo
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- Dermatology Unit, Fondazione Policlinico "Tor Vergata", Rome, Italy
| | - M Munera Campos
- Department of Dermatology, Germans Trias i Pujol University Hospital (HUGTP), Autonomous University of Barcelona (UAB), Badalona, Spain
| | - T Seremet
- Department of Dermatology, Lausanne University Hospital CHUV and University of Lausanne, Lausanne, Switzerland
| | - G Caldarola
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C De Simone
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - E Ippoliti
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - T Torres
- Department of Dermatology, Centro Hospitalar Universitário de Santo António, University of Porto, Porto, Portugal
| | - S Gkalpakiotis
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic
| | - C Conrad
- Department of Dermatology, Lausanne University Hospital CHUV and University of Lausanne, Lausanne, Switzerland
| | - J M Carrascosa
- Department of Dermatology, Germans Trias i Pujol University Hospital (HUGTP), Autonomous University of Barcelona (UAB), Badalona, Spain
| | - L Bianchi
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- Dermatology Unit, Fondazione Policlinico "Tor Vergata", Rome, Italy
| | - G Argenziano
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - S Ribero
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - G Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - A V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - K Peris
- Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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23
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Armario-Hita JC, Galán-Gutiérrez M, Dodero-Anillo JM, Carrascosa JM, Ruiz-Villaverde R. Updated Review on Treatment of Atopic Dermatitis. J Investig Allergol Clin Immunol 2023; 33:158-167. [PMID: 37318771 DOI: 10.18176/jiaci.0906] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
Atopic dermatitis (AD) is a chronic or chronically recurrent Inflammatory dermatosis associated with multiple triggers that has a complex pathophysiological mechanism. It is characterized by a heterogeneous clinical expression, signs, and symptoms. Its etiology and pathogenesis are complex and are influenced by multiple immune-mediated factors. Treatment of AD can also be complex, given the high number of available drugs and multiple therapeutic targets. In this review, we summarize current literature on the efficacy and safety of topical and systemic drugs to treat moderate-to-severe AD. We begin with topical treatments such as corticosteroids and calcineurin inhibitors and subsequently address the latest systemic treatments, such as Janus kinase inhibitors (upadacitinib, baricitinib, abrocitinib, gusacitinib) and interleukin (IL) inhibitors, which have proven efficacious in AD, namely, dupilumab (IL-4 and IL-13), tralokinumab (IL-13), lebrikizumab (IL-13), and nemolizumab (IL-31). Given the large number of drugs available, we summarize the pivotal clinical trials for each drug, evaluate recent real-world experience in terms of safety and efficacy for purposes of compilation, and provide evidence to guide the optimal choice of therapy.
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Affiliation(s)
- J C Armario-Hita
- Servicio de Dermatología, Hospital Universitario de Puerto Real, Universidad de Cádiz, Cadiz, Spain
| | - M Galán-Gutiérrez
- Servicio de Dermatología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - J M Dodero-Anillo
- Servicio de Farmacología Clínica, Hospital Universitario de Puerto Real, Cádiz, Spain
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
- Universitat Autònoma de Barcelona, Badalona, Spain
| | - R Ruiz-Villaverde
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, Spain
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24
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Ruiz-Villaverde R, Galán-Gutiérrez M, Llamas-Velasco M, Salgado-Boquete L, Puig L, De la Cueva P, Carrascosa JM. [[Translated article]]Updated Position of the Spanish Psoriasis Group (GPs) on the Use of Biosimilar Drugs in Moderate to Severe Psoriasis. Actas Dermosifiliogr 2023:S0001-7310(23)00346-0. [PMID: 37172891 DOI: 10.1016/j.ad.2023.02.022] [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] [Received: 12/27/2022] [Accepted: 02/17/2023] [Indexed: 05/15/2023] Open
Abstract
The advent of biosimilar drugs and their use in routine clinical practice has revolutionized the management of moderate to severe psoriasis and led to changes in the positioning of the existing molecules used to control this condition. Evidence from clinical trials complemented by real-world experience has helped to clarify concepts and has significantly changed the use and positioning of biologic agents in this setting. The present document is an update on the position of the Spanish Psoriasis Working Group regarding the use of biosimilar drugs, which takes into account this new situation.
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Affiliation(s)
- R Ruiz-Villaverde
- Hospital Universitario San Cecilio, Granada, Instituto Biosanitario de Granada (Ibs), Spain.
| | | | | | | | - L Puig
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - J M Carrascosa
- Hospital Universitari Germans Trias i Pujol. UAB. IGTP, Badalona, Spain
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25
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Munera-Campos M, Chicharro P, Gonzalez Quesada A, Florez Menendez A, de la Cueva Dovao P, Gimenez Arnau AM, Gilaberte Calzada Y, Rodríguez Serna M, Montero T, Silvestre Salvador JF, Elosua González M, Del Alcazar E, Santamaría C, Sánchez-Pérez J, Carretero Hernández G, Batalla Cebey A, Jin Suh Oh H, Mauleón Fernández C, Curto Barredo L, Bertolín M, Navarro Bielsa A, Ballano Ruiz A, Botella Estrada R, Arias Santiago S, Betlloch I, Roustan Gullón G, Rosell Díaz A, Descalzo MÁ, García-Doval I, Carrascosa JM. [[Translated article]]BIOBADATOP Spanish Atopic Dermatitis Registry: Description and Early Findings. Actas Dermosifiliogr 2023:S0001-7310(23)00349-6. [PMID: 37172898 DOI: 10.1016/j.ad.2023.05.010] [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] [Received: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND In recent years, remarkable improvements in our understanding of atopic dermatitis (AD) have revolutionized treatment perspectives, but access to reliable data from clinical practice is essential. MATERIALS AND METHOD The Spanish Atopic Dermatitis Registry, BIOBADATOP, is a prospective, multicenter database that collects information on patients of all ages with AD requiring systemic therapy with conventional or novel drugs. We analyzed the registry to describe patient characteristics, diagnoses, treatments, and adverse events (AEs). RESULTS We studied data entries for 258 patients who had received 347 systemic treatments for AD. Treatment was discontinued in 29.4% of cases, mostly due to a lack of effectiveness (in 10.7% of cases). A total of 132 AEs were described during follow-up. Eighty-six AEs (65%) were linked to a systemic treatment, most commonly dupilumab (39 AEs) and cyclosporine (38 AEs). The most common AEs were conjunctivitis (11 patients), headache (6), hypertrichosis (5), and nausea (4). There was 1 severe AE (acute mastoiditis) associated with cyclosporine. CONCLUSIONS Initial findings on AEs from the Spanish BIOBADATOP registry are limited by short follow-up times precluding comparisons or calculation of crude and adjusted incidence rates. At the time of our analysis, no severe AEs had been reported for novel systemic therapies. BIOBADATOP will help answer questions on the effectiveness and safety of conventional and novel systemic therapies in AD.
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Affiliation(s)
- M Munera-Campos
- Servicio de Dermatología. Hospital Universitari Germans Trias i Pujol. Universitat Autònoma de Barcelona. Germans Trias i Pujol Research Institute (IGTP). Badalona, Barcelona, Spain.
| | - P Chicharro
- Servicio de Dermatología. Hospital Universitario de la Princesa, Madrid, Spain
| | - A Gonzalez Quesada
- Servicio de Dermatología. Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - A Florez Menendez
- Servicio de Dermatología. Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | - P de la Cueva Dovao
- Servicio de Dermatología. Hospital Universitario Infanta Leonor, Madrid, Spain
| | - A M Gimenez Arnau
- Servicio de Dermatología. Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | - Y Gilaberte Calzada
- Servicio de Dermatología. Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - M Rodríguez Serna
- Servicio de Dermatología. Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - T Montero
- Servicio de Dermatología. Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | - M Elosua González
- Servicio de Dermatología. Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - E Del Alcazar
- Servicio de Dermatología. Hospital Universitari Germans Trias i Pujol. Universitat Autònoma de Barcelona. Germans Trias i Pujol Research Institute (IGTP). Badalona, Barcelona, Spain
| | - C Santamaría
- Servicio de Dermatología. Hospital Universitario de la Princesa, Madrid, Spain
| | - J Sánchez-Pérez
- Servicio de Dermatología. Hospital Universitario de la Princesa, Madrid, Spain
| | - G Carretero Hernández
- Servicio de Dermatología. Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - A Batalla Cebey
- Servicio de Dermatología. Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | - H Jin Suh Oh
- Servicio de Dermatología. Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | - C Mauleón Fernández
- Servicio de Dermatología. Hospital Universitario Infanta Leonor, Madrid, Spain
| | - L Curto Barredo
- Servicio de Dermatología. Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | - M Bertolín
- Servicio de Dermatología. Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | - A Navarro Bielsa
- Servicio de Dermatología. Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - A Ballano Ruiz
- Servicio de Dermatología. Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - R Botella Estrada
- Servicio de Dermatología. Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - S Arias Santiago
- Servicio de Dermatología. Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - I Betlloch
- Servicio de Dermatología. Hospital General Universitario Alicante, Alicante, Spain
| | - G Roustan Gullón
- Servicio de Dermatología. Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - A Rosell Díaz
- Servicio de Dermatología. Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - M Á Descalzo
- Unidad de Investigación. Fundación Piel Sana AEDV, Spain
| | - I García-Doval
- Unidad de Investigación. Fundación Piel Sana AEDV, Spain; Servicio de Dermatología. Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - J M Carrascosa
- Servicio de Dermatología. Hospital Universitari Germans Trias i Pujol. Universitat Autònoma de Barcelona. Germans Trias i Pujol Research Institute (IGTP). Badalona, Barcelona, Spain
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26
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Carrascosa JM, Vilarrasa E, Belinchón I, Herranz P, Crespo J, Guimerá F, Olveira A. Common Approach to Metabolic-Associated Fatty Liver Disease in Patients With Psoriasis: Consensus-Based Recommendations From a Multidisciplinary Group of Experts. Actas Dermosifiliogr 2023; 114:392-401. [PMID: 36720362 DOI: 10.1016/j.ad.2023.01.004] [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: 11/10/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 01/31/2023] Open
Abstract
Recent years have seen concerted efforts to understand the relation between psoriasis and metabolic-associated fatty liver disease (MAFLD). Not only is MALFD diagnosed more often in patients with psoriasis, but its clinical course is also more aggressive. A common approach is therefore needed to enable early detection of liver disease coincident with psoriasis. Especially important is an analysis of risks and benefits of potentially hepatotoxic treatments. This consensus paper presents the recommendations of a group of experts in dermatology and hepatology regarding screening for MALFD as well as criteria for monitoring patients and referring them to hepatologists when liver disease is suspected.
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Affiliation(s)
- J M Carrascosa
- Departamento de Dermatología, Hospital Universitario Germans Trias i Pujol, Universitat Autònoma de Barcelona. IGTP Badalona, Barcelona, España.
| | - E Vilarrasa
- Departamento de Dermatología, Hospital Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España
| | - I Belinchón
- Departamento de Dermatología, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica (ISABIAL), Universidad Miguel Hernández de Elche, Alicante, España
| | - P Herranz
- Departamento de Dermatología, Hospital Universitario La Paz, Madrid, España
| | - J Crespo
- Servicio de Gastroenterología y Hepatología, Hospital Universitario Marqués de Valdecilla. IDIVAL. Escuela de Medicina. Universidad de Cantabria, Santander, España
| | - F Guimerá
- Servicio de Dermatología y Patología, Hospital Universitario de Canarias, La Laguna, España
| | - A Olveira
- Servicio de Aparato Digestivo, Hospital Universitario La Paz, Madrid, España
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27
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Carrascosa JM, Vilarrasa E, Belinchón I, Herranz P, Crespo J, Guimerá F, Olveira A. [[Translated article]]Common Approach to Metabolic-Associated Fatty Liver Disease in Patients With Psoriasis: Consensus-Based Recommendations From a Multidisciplinary Group of Experts. Actas Dermosifiliogr 2023; 114:T392-T401. [PMID: 37068635 DOI: 10.1016/j.ad.2023.04.013] [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] [Received: 11/10/2022] [Accepted: 01/17/2023] [Indexed: 04/19/2023] Open
Abstract
Recent years have seen concerted efforts to understand the relation between psoriasis and metabolic-associated fatty liver disease (MAFLD). Not only is MALFD diagnosed more often in patients with psoriasis, but its clinical course is also more aggressive. A common approach is therefore needed to enable early detection of liver disease coincident with psoriasis. Especially important is an analysis of risks and benefits of potentially hepatotoxic treatments. This consensus paper presents the recommendations of a group of experts in dermatology and hepatology regarding screening for MALFD as well as criteria for monitoring patients and referring them to hepatologists when liver disease is suspected.
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Affiliation(s)
- J M Carrascosa
- Departamento de Dermatología. Hospital Universitario Germans Trias i Pujol. Universitat Autònoma de Barcelona. IGTP Badalona, España.
| | - E Vilarrasa
- Departamento de Dermatología, Hospital Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España
| | - I Belinchón
- Departamento de Dermatología, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica (ISABIAL), Universidad Miguel Hernández de Elche, Alicante, España
| | - P Herranz
- Departamento de Dermatología, Hospital Universitario La Paz, Madrid, España
| | - J Crespo
- Servicio de Gastroenterología y Hepatología. Hospital Universitario Marqués de Valdecilla. IDIVAL. Escuela de Medicina. Universidad de Cantabria, Santander, España
| | - F Guimerá
- Servicio de Dermatología y Patología, Hospital Universitario de Canarias, La Laguna, España
| | - A Olveira
- Servicio de Aparato Digestivo, Hospital Universitario La Paz, Madrid, España
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28
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Munera-Campos M, Chicharro P, Gonzalez Quesada A, Florez Menendez A, de la Cueva Dovao P, Gimenez Arnau AM, Gilaberte Calzada Y, Rodríguez Serna M, Montero T, Silvestre Salvador JF, Elosua González M, Del Alcazar E, Santamaría C, Sánchez-Pérez J, Carretero Hernández G, Batalla Cebey A, Jin Suh Oh H, Mauleón Fernández C, Curto Barredo L, Bertolín M, Navarro Bielsa A, Ballano Ruiz A, Botella Estrada R, Arias Santiago S, Betlloch I, Roustan Gullón G, Rosell Díaz A, Descalzo MÁ, García-Doval I, Carrascosa JM. BIOBADATOP Spanish Atopic Dermatitis Registry: Description and Early Findings. Actas Dermosifiliogr 2023:S0001-7310(23)00181-3. [PMID: 36935039 DOI: 10.1016/j.ad.2023.03.001] [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] [Received: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND In recent years, remarkable improvements in our understanding of atopic dermatitis (AD) have revolutionized treatment perspectives, but access to reliable data from clinical practice is essential. MATERIALS AND METHOD The Spanish Atopic Dermatitis Registry, BIOBADATOP, is a prospective, multicenter database that collects information on patients of all ages with AD requiring systemic therapy with conventional or novel drugs. We analyzed the registry to describe patient characteristics, diagnoses, treatments, and adverse events (AEs). RESULTS We studied data entries for 258 patients who had received 347 systemic treatments for AD. Treatment was discontinued in 29.4% of cases, mostly due to a lack of effectiveness (in 10.7% of cases). A total of 132 AEs were described during follow-up. Eighty-six AEs (65%) were linked to a systemic treatment, most commonly dupilumab (39 AEs) and cyclosporine (38 AEs). The most common AEs were conjunctivitis (11 patients), headache (6), hypertrichosis (5), and nausea (4). There was 1 severe AE (acute mastoiditis) associated with cyclosporine. CONCLUSIONS Initial findings on AEs from the Spanish BIOBADATOP registry are limited by short follow-up times precluding comparisons or calculation of crude and adjusted incidence rates. At the time of our analysis, no severe AEs had been reported for novel systemic therapies. BIOBADATOP will help answer questions on the effectiveness and safety of conventional and novel systemic therapies in AD.
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Affiliation(s)
- M Munera-Campos
- Servicio de Dermatología. Hospital Universitari Germans Trias i Pujol. Universitat Autònoma de Barcelona. Germans Trias i Pujol Research Institute (IGTP). Badalona, Barcelona, Spain.
| | - P Chicharro
- Servicio de Dermatología. Hospital Universitario de la Princesa, Madrid, Spain
| | - A Gonzalez Quesada
- Servicio de Dermatología. Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - A Florez Menendez
- Servicio de Dermatología. Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | - P de la Cueva Dovao
- Servicio de Dermatología. Hospital Universitario Infanta Leonor, Madrid, Spain
| | - A M Gimenez Arnau
- Servicio de Dermatología. Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | - Y Gilaberte Calzada
- Servicio de Dermatología. Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - M Rodríguez Serna
- Servicio de Dermatología. Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - T Montero
- Servicio de Dermatología. Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | - M Elosua González
- Servicio de Dermatología. Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - E Del Alcazar
- Servicio de Dermatología. Hospital Universitari Germans Trias i Pujol. Universitat Autònoma de Barcelona. Germans Trias i Pujol Research Institute (IGTP). Badalona, Barcelona, Spain
| | - C Santamaría
- Servicio de Dermatología. Hospital Universitario de la Princesa, Madrid, Spain
| | - J Sánchez-Pérez
- Servicio de Dermatología. Hospital Universitario de la Princesa, Madrid, Spain
| | - G Carretero Hernández
- Servicio de Dermatología. Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - A Batalla Cebey
- Servicio de Dermatología. Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | - H Jin Suh Oh
- Servicio de Dermatología. Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | - C Mauleón Fernández
- Servicio de Dermatología. Hospital Universitario Infanta Leonor, Madrid, Spain
| | - L Curto Barredo
- Servicio de Dermatología. Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | - M Bertolín
- Servicio de Dermatología. Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
| | - A Navarro Bielsa
- Servicio de Dermatología. Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - A Ballano Ruiz
- Servicio de Dermatología. Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - R Botella Estrada
- Servicio de Dermatología. Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - S Arias Santiago
- Servicio de Dermatología. Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - I Betlloch
- Servicio de Dermatología. Hospital General Universitario Alicante, Alicante, Spain
| | - G Roustan Gullón
- Servicio de Dermatología. Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - A Rosell Díaz
- Servicio de Dermatología. Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - M Á Descalzo
- Unidad de Investigación. Fundación Piel Sana AEDV, Spain
| | - I García-Doval
- Unidad de Investigación. Fundación Piel Sana AEDV, Spain; Servicio de Dermatología. Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - J M Carrascosa
- Servicio de Dermatología. Hospital Universitari Germans Trias i Pujol. Universitat Autònoma de Barcelona. Germans Trias i Pujol Research Institute (IGTP). Badalona, Barcelona, Spain
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Villaverde RR, Gutiérrez MG, Velasco ML, Boquete LS, Puig L, De la Cueva P, Carrascosa JM. Updated Position of the Spanish Psoriasis Group (GPs) on the Use of Biosimilar Drugs in Moderate to Severe Psoriasis. Actas Dermosifiliogr 2023:S0001-7310(23)00172-2. [PMID: 36906260 DOI: 10.1016/j.ad.2023.02.016] [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] [Received: 12/27/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 03/13/2023] Open
Abstract
The advent of biosimilar drugs and their use in routine clinical practice has revolutionized the management of moderate to severe psoriasis and led to changes in the positioning of the existing molecules used to control this condition. Evidence from clinical trials complemented by real-world experience has helped to clarify concepts and has significantly changed the use and positioning of biologic agents in this setting. The present document is an update on the position of the Spanish Psoriasis Working Group regarding the use of biosimilar drugs, which takes into account this new situation.
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Affiliation(s)
- R Ruiz Villaverde
- Hospital Universitario San Cecilio, Granada, Instituto Biosanitario de Granada (Ibs), Spain.
| | | | | | | | - L Puig
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - J M Carrascosa
- Hospital Universitari Germans Trias i Pujol. UAB. IGTP, Badalona, Spain
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Rivera-Diaz R, Carretero G, Carrascosa JM, García-Doval I. Erythrodermic Psoriasis Has Become Less Frequent: Results From the Biobadaderm Registry. Actas Dermosifiliogr 2023; 114:T366-T369. [PMID: 36738778 DOI: 10.1016/j.ad.2022.12.004] [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: 11/30/2022] [Accepted: 12/07/2022] [Indexed: 02/05/2023] Open
Affiliation(s)
- R Rivera-Diaz
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, España.
| | - G Carretero
- Servicio de Dermatología, Hospital Universitario Doctor Negrín, Gran Canaria, España
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitario Germans Trias i Pujol, Barcelona, España
| | - I García-Doval
- Unidad de investigación de la Academia Española de Dermatología y Venereología, Fundación Piel sana, Servicio de Dermatología, Complejo Hospitalario Universitario, Vigo, España
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31
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Lluch-Galcerá JJ, Carrascosa JM, Boada A. [Translated article] Epidemic Scabies: New Treatment Challenges in an Ancient Disease. Actas Dermosifiliogr 2023; 114:T132-T140. [PMID: 36462668 DOI: 10.1016/j.ad.2022.07.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 12/05/2022] Open
Abstract
Scabies which is among the most prevalent diseases worldwide, is becoming more frequent in Spain. The problems of this epidemic can be explained by several factors: improper application or prescription of treatments, resistance or reduced sensitivity to topical treatments, and poor understanding of the parasite and contagion. We require a new evidence-based approach to therapy that takes these problems into consideration. If symptoms persist after proper treatment, it is important to identify the reason for failure and standardize our approach. In refractory cases, the prescriber should prioritize oral medication, indicate a higher dose, combine treatments, or evaluate the use of off-label treatments in certain populations. The availability of new medications, such as spinosad or, especially, moxidectin, offer hope for bringing this disease under control.
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Affiliation(s)
- J J Lluch-Galcerá
- Servicio de Dermatología, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain.
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - A Boada
- Servicio de Dermatología, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
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32
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Lluch-Galcerá JJ, Carrascosa JM, Boada A. Epidemic Scabies: New Treatment Challenges in an Ancient Disease. Actas Dermosifiliogr 2023; 114:132-140. [PMID: 35963332 DOI: 10.1016/j.ad.2022.07.017] [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: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 02/06/2023] Open
Abstract
Scabies, which is among the most prevalent diseases worldwide, is becoming more frequent in Spain. The problems of this epidemic can be explained by several factors: improper application or prescription of treatments, resistance or reduced sensitivity to topical treatments, and poor understanding of the parasite and contagion. We require a new evidence-based approach to therapy that takes these problems into consideration. If symptoms persist after proper treatment, it is important to identify the reason for failure and standardize our approach. In refractory cases, the prescriber should prioritize oral medication, indicate a higher dose, combine treatments, or evaluate the use of off-label treatments in certain populations. The availability of new medications -such as spinosad or, especially, moxidectin- offer hope for bringing this disease under control.
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Affiliation(s)
- J J Lluch-Galcerá
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España.
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - A Boada
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
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33
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Rivera-Diaz R, Carretero G, Carrascosa JM, García-Doval I. Erythrodermic Psoriasis Has Become Less Frequent: Results From the Biobadaderm Registry. Actas Dermosifiliogr 2022; 114:366-369. [PMID: 36563780 DOI: 10.1016/j.ad.2022.12.001] [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: 11/30/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- R Rivera-Diaz
- Dermatology Department, University Hospital 12 de Octubre & Universidad Complutense, Madrid, Spain.
| | - G Carretero
- Dermatology Department, Universitary Hospital Gran Canaria Doctor Negrin, Gran Canaria, Spain
| | | | - I García-Doval
- Academia Española de Dermatología y Venereología, Research Unit, Fundación Piel Sana & Complexo Hospitalario Universitario de Vigo, Servicio de Dermatologia, Spain
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Carrascosa JM, Puig L, Romero IB, Salgado-Boquete L, Del Alcázar E, Lencina JJA, Moreno D, de la Cueva P. [Translated article] Practical Update of the Guidelines Published by the Psoriasis Group of the Spanish Academy of Dermatology and Venereology (GPs) on the Treatment of Psoriasis With Biologic Agents: Part 2-Management of Special Populations, Patients With Comorbid Conditions, and Risk. Actas Dermosifiliogr 2022; 113:T583-T609. [PMID: 35748004 DOI: 10.1016/j.ad.2022.01.040] [Citation(s) in RCA: 1] [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: 01/11/2022] [Accepted: 01/26/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Since its inception, the Psoriasis Group (GPs) of the Spanish Academy of Dermatology and Venereology (AEDV) has worked to continuously update recommendations for the treatment of psoriasis based on the best available evidence and incorporating proposals arising from and aimed at clinical practice. An updated GPs consensus document on the treatment of moderate to severe psoriasis was needed because of changes in the treatment paradigm and the approval in recent years of a large number of new biologic agents. METHODOLOGY The consensus document was developed using the nominal group technique complemented by a scoping review. First, a designated coordinator selected a group of GPs members for the panel based on their experience and knowledge of psoriasis. The coordinator defined the objectives and key points for the document and, with the help of a documentalist, conducted a scoping review of articles in Medline, Embase, and the Cochrane Library up to January 2021. The review included systematic reviews and meta-analyses as well as clinical trials not included in those studies and high-quality real-world studies. National and international clinical practice guidelines and consensus documents on the management of moderate to severe psoriasis were also reviewed. The coordinator then drew up a set of proposed recommendations, which were discussed and modified in a nominal group meeting. After several review processes, including external review by other GPs members, the final document was drafted. RESULTS The present guidelines include updated recommendations on assessing the severity of psoriasis and criteria for the indication of systemic treatment. They also include general principles for the treatment of patients with moderate to severe psoriasis and define treatment goals for these patients as well as criteria for the indication and selection of initial and subsequent therapies Practical issues, such as treatment failure and maintenance of response, are also addressed.
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Affiliation(s)
- J M Carrascosa
- Departamento de Dermatología, Hospital Universitari Germans Trias I Pujol, Badalona, Universitat Autònoma de Barcelona, IGTP, Barcelona, Spain.
| | - L Puig
- Departamento de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - I B Romero
- Departamento de Dermatología, Hospital General Universitario de Alicante-ISABIAL - Universidad Miguel Hernández de Elche, Alicante, Spain
| | - L Salgado-Boquete
- Departamento de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - E Del Alcázar
- Departamento de Dermatología, Hospital Universitari Germans Trias I Pujol, Badalona, Universitat Autònoma de Barcelona, IGTP, Barcelona, Spain
| | - J J A Lencina
- Servicio de Dermatología, Hospital Universitario Vega Baja, Alicante, Spain
| | - D Moreno
- Departamento de Dermatología, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Sevilla, Spain
| | - P de la Cueva
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Universidad Complutense de Madrid, Madrid, Spain
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Carrascosa JM, Puig L, Belinchón Romero I, Salgado-Boquete L, Del Alcázar E, Andrés Lencina JJ, Moreno D, de la Cueva P. Practical update of the Recommendations Published by the Psoriasis Group of the Spanish Academy of Dermatology and Venereology (GPS) on the Treatment of Psoriasis with Biologic Therapy. Part 1. Concepts and General Management of Psoriasis with Biologic Therapy. Actas Dermosifiliogr 2022; 113:261-277. [PMID: 35526919 DOI: 10.1016/j.ad.2021.10.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 10/04/2021] [Accepted: 10/04/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVES A new, updated AEDV Psoriasis Group consensus document on the treatment of moderate to severe psoriasis was needed owing to the approval, in recent years, of a large number of new drugs and changes in the treatment paradigm. METHODOLOGY The consensus document was developed using the nominal group technique and a scoping review. First, a designated coordinator selected a group of Psoriasis Group members for the panel. The coordinator defined the objectives and key points for the document and, with the help of a documentalist, conducted a scoping review of articles in Medline, Embase, and the Cochrane Library up to January 2021. The review included systematic reviews and meta-analyses as well as clinical trials not included in those studies and high-quality real-world studies. National and international clinical practice guidelines and consensus documents on the management of moderate to severe psoriasis were also reviewed. Based on these reviews, the coordinator drew up a set of proposed recommendations, which were then discussed and modified in a nominal group meeting. After several review processes, including external review by other GPs members, the final document was drafted. RESULTS The present guidelines include general principles for the treatment of patients with moderate to severe psoriasis and also define treatment goals and criteria for the indication of biologic therapy and the selection of initial and subsequent therapies. Practical issues, such as treatment failure and maintenance of response, are also addressed.
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Affiliation(s)
- J M Carrascosa
- Departamento de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona, IGTP, Barcelona, España.
| | - L Puig
- Departamento de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - I Belinchón Romero
- Departamento de Dermatología, Hospital General Universitario de Alicante-ISABIAL, Universidad Miguel Hernández de Elche, Alicante, España
| | - L Salgado-Boquete
- Departamento de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España
| | - E Del Alcázar
- Departamento de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona, IGTP, Barcelona, España
| | - J J Andrés Lencina
- Servicio de Dermatología, Hospital Universitario Vega Baja, Alicante, España
| | - D Moreno
- Departamento de Dermatología, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Sevilla, España
| | - P de la Cueva
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Universidad Complutense de Madrid, Madrid, España
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Thaçi D, Jullien D, Egeberg A, Carrascosa JM, Wu JJ, Pau-Charles I, Gisondi P. Low incidence rate of respiratory and viral infections over 5 years of treatment with tildrakizumab in patients with moderate-to-severe psoriasis: pooled analysis from reSURFACE 1 and reSURFACE 2 phase 3 trials. J Eur Acad Dermatol Venereol 2021; 35:e709-e711. [PMID: 34058035 DOI: 10.1111/jdv.17427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/28/2021] [Indexed: 11/26/2022]
Affiliation(s)
- D Thaçi
- Institute and Comprehensive Centre for Inflammation Medicine, University of Lübeck, Lübeck, Germany
| | - D Jullien
- Department of Dermatology, Edouard Herriot Hospital, Lyon, France
| | - A Egeberg
- Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark
| | - J M Carrascosa
- Department of Dermatology, Germans Trias i Pujol University Hospital (HUGTP), Autonomous University of Barcelona (UAB), Badalona, Spain
| | - J J Wu
- Dermatology Research and Education Foundation, Irvine, California, USA
| | | | - P Gisondi
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
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Munera-Campos M, Vilar-Alejo J, Rivera R, Carrascosa JM, Daudén E, Herrera-Acosta E, Sahuquillo-Torralba A, Gómez-García FJ, Baniandrés-Rodríguez O, de la Cueva P, López-Estebaranz JL, Belinchón I, Ferran M, Riera-Monroig J, Rodriguez L, Carretero G, García-Donoso C, Ballescá F, Llamas-Velasco M, Herrera-Ceballos E, Pujol-Marco C, Nieto-Benito LM, Ruiz-Genao DP, Alsina M, Descalzo MA, García-Doval I. The risk of hepatic adverse events of systemic medications for psoriasis: a prospective cohort study using the BIOBADADERM registry. J DERMATOL TREAT 2021; 33:2110-2117. [PMID: 33913796 DOI: 10.1080/09546634.2021.1922572] [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 Limited information is available regarding the risk of incident liver disease in patients with psoriasis receiving systemic therapies. OBJECTIVES To describe the liver safety findings of conventional and modern systemic therapies for moderate-to-severe psoriasis, and to compare the relative incidence rates of hepatic adverse events (AEs) for each drug. METHODS All the patients on the BIOBADADERM registry were included. Crude and adjusted incidence rate ratios (cIRR and aIRR, respectively) of hepatic AEs, using anti-TNF drugs as reference, were determined. Outcomes of interest were hypertransaminasemia, nonalcoholic fatty liver disease (NADFLD) and a group of other, less represented, hepatic AEs. RESULTS Our study included 3,171 patients exposed to systemic drugs (6279 treatment cycles). Incident hypertransaminasemia was the most frequent hepatic AE (incidence rate of 21 per 1000 patients-years [CI 95% CI 18-23]), followed by NAFLD (8 cases per 1000 patients-years [95% CI 6-10]). Methotrexate (aIRR 3.06 [2.31-4.4]; p = 0.000) and cyclosporine (aIRR 2.37 [1.05-5.35]; p = 0.0378) were associated with an increased risk for hypertransaminasemia when compared to anti-TNF-α agents. No differences were observed between different groups of biologics. Conventional therapies were not associated with new incident NAFLD. CONCLUSIONS Comparative information of the incidence of hepatic AEs could facilitate drug selection in moderate-to-severe psoriasis.
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Affiliation(s)
- M Munera-Campos
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J Vilar-Alejo
- Department of Dermatology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - R Rivera
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - J M Carrascosa
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - E Daudén
- Department of Dermatology. Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa (IIS-IP), Madrid, Spain
| | - E Herrera-Acosta
- Department of Dermatology, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - A Sahuquillo-Torralba
- Department of Dermatology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - F J Gómez-García
- Department of Dermatology, Hospital Universitario Reina Sofía, Cordoba, Spain
| | - O Baniandrés-Rodríguez
- Department of Dermatology, CEIMI Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - P de la Cueva
- Department of Dermatology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - J L López-Estebaranz
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - I Belinchón
- Department of Dermatology, Hospital General Universitario de Alicante-ISABIAL, Alicante, Spain
| | - M Ferran
- Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - J Riera-Monroig
- Department of Dermatology, Hospital Clínic de Barcelona, UB, Barcelona, Spain
| | - L Rodriguez
- Department of Dermatology, Hospital Virgen del Rocío, Sevilla, Spain
| | - G Carretero
- Department of Dermatology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - C García-Donoso
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - F Ballescá
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - M Llamas-Velasco
- Department of Dermatology. Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa (IIS-IP), Madrid, Spain
| | - E Herrera-Ceballos
- Department of Dermatology, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - C Pujol-Marco
- Department of Dermatology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - L M Nieto-Benito
- Department of Dermatology, CEIMI Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - D P Ruiz-Genao
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - M Alsina
- Department of Dermatology, Hospital Clínic de Barcelona, UB, Barcelona, Spain
| | - M A Descalzo
- Research Unit. Fundación Piel Sana AEDV, Madrid, Spain
| | - I García-Doval
- Research Unit. Fundación Piel Sana AEDV, Madrid, Spain.,Department of Dermatology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
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Belinchón I, Velasco M, Ara-Martín M, Armesto Alonso S, Baniandrés Rodríguez O, Ferrándiz Pulido L, García-Bustinduy M, Martínez-López JA, Martínez Sánchez N, Pérez Ferriols A, Pérez Pascual E, Rivera Díaz R, Ruiz-Villaverde R, Taberner Ferrer R, Vicente Villa A, Carrascosa JM. Management of Psoriasis During Preconception, Pregnancy, Postpartum, and Breastfeeding: A Consensus Statement. Actas Dermosifiliogr (Engl Ed) 2021; 112:225-241. [PMID: 33065101 DOI: 10.1016/j.ad.2020.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 04/17/2020] [Accepted: 10/02/2020] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To develop evidence- and experience-based recommendations for the management of psoriasis during preconception, pregnancy, postpartum, and breastfeeding. METHODS The nominal group technique and the Delphi method were used. Fifteen experts (12 dermatologists, 2 of whom were appointed coordinators; 1 rheumatologist; and 2 gynecologists) were selected to form an expert panel. Following a systematic review of the literature on fertility, pregnancy, postpartum, and breastfeeding in women with psoriasis, the coordinators drew up a series of preliminary recommendations for discussion by the panel at a nominal group meeting. The experts defined the scope, sections, and intended users of the statement and prepared a final list of recommendations. Consensus was obtained using a Delphi process in which an additional 51 dermatologists rated their level of agreement with each recommendation on a scale of 1 (total disagreement) to 10 (total agreement). Consensus was defined by a score of 7 or higher assigned by at least 70% of participants. Level of evidence and strength of recommendation were reported using the Oxford Center for Evidence-Based Medicine categories. The final statement was approved by the expert panel. RESULTS The resulting consensus statement includes 23 recommendations on preconception (fertility and contraception), pregnancy (planning, pharmacological management, and follow-up), and breastfeeding (management and follow-up). Consensus was achieved for all recommendations generated except one. CONCLUSIONS These recommendations for the better management of psoriasis in women of childbearing age could improve outcomes and prognosis.
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Affiliation(s)
- I Belinchón
- Servicio de Dermatología, Hospital General Universitario de Alicante-ISABIAL-UMH, Alicante, España.
| | - M Velasco
- Servicio de Dermatología, Hospital Universitario Arnau de Vilanova, Valencia, España
| | - M Ara-Martín
- Servicio de Dermatología, Hospital Clínico Lozano Blesa, Zaragoza, España
| | - S Armesto Alonso
- Servicio de Dermatología, Hospital Universitario Marqués de Valdecilla, Santander, España
| | | | - L Ferrándiz Pulido
- Servicio de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - M García-Bustinduy
- Servicio de Dermatología, Hospital Universitario de Canarias, Santa Cruz de Tenerife, España
| | - J A Martínez-López
- Servicio de Reumatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - N Martínez Sánchez
- Servicio de Ginecología-Obstetricia, Hospital Universitario La Paz, Madrid, España
| | - A Pérez Ferriols
- Servicio de Dermatología, Hospital General de Valencia, Valencia, España
| | - E Pérez Pascual
- Servicio de Ginecología-Obstetricia, Hospital General Universitario de Alicante-ISABIAL, Alicante, España
| | - R Rivera Díaz
- Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - R Ruiz-Villaverde
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, España
| | - R Taberner Ferrer
- Servicio de Dermatología, Hospital Son Llàtzer, Palma de Mallorca, España
| | - A Vicente Villa
- Servicio de Dermatología, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
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Arrieta A, Jaka A, Del Alcázar E, Blanco M, Carrascosa JM. Phototherapy for Prurigo Nodularis: Our Experience and a Review of the Literature. Actas Dermosifiliogr (Engl Ed) 2020; 112:339-344. [PMID: 33221272 DOI: 10.1016/j.ad.2020.11.007] [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: 09/18/2020] [Revised: 11/01/2020] [Accepted: 11/09/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Prurigo nodularis is a chronic inflammatory skin disease characterized by highly pruritic nodular lesions that cause constant itching and scratching and significant quality-of-life impairment. It has been described in a range of conditions, including skin diseases (mainly atopic dermatitis) and metabolic, neurological, and psychiatric disorders. The pathophysiological mechanisms are largely unknown. Various modalities of phototherapy have been described as appropriate and safe treatments for achieving clinical control and alleviating symptoms. In this article, we describe our experience with phototherapy in patients with prurigo nodularis. MATERIAL AND METHODS Retrospective observational study of patients who received their first cycle of phototherapy to treat prurigo nodularis between March 2011 and October 2019. Information was collected on epidemiological and clinical characteristics, concomitant treatments, type and duration of phototherapy, maximum dose reached, and response to treatment. RESULTS We studied 44 patients (30 women and 14 men) with a median age of 65.5years. The most common form of phototherapy used was narrowband UV-B phototherapy (34 cycles, 77.27%) followed by a combination of UV-B and UV-A phototherapy (8 cycles). Response to treatment was considered satisfactory (clearance rate of ≥75%) in 24 patients (55.4%). CONCLUSIONS Phototherapy is a suitable treatment for prurigo nodularis in a considerable proportion of patients. It can be used as monotherapy or combined with other treatments.
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Affiliation(s)
- A Arrieta
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España.
| | - A Jaka
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - E Del Alcázar
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - M Blanco
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
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Warren RB, Carrascosa JM, Fumero E, Schoenenberger A, Lebwohl MG, Szepietowski JC, Reich K. Time to relapse after tildrakizumab withdrawal in patients with moderate-to-severe psoriasis who were responders at week 28: post hoc analysis through 64 weeks from reSURFACE 1 trial. J Eur Acad Dermatol Venereol 2020; 35:919-927. [PMID: 32979235 DOI: 10.1111/jdv.16964] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/10/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND As treatment interruptions occur during psoriasis management in clinical practice, it is important to know the duration of clinical response after treatment withdrawal. OBJECTIVES To report time to and predictors of relapse in patients who were tildrakizumab 100 and 200 mg responders (≥75% improvement in Psoriasis Area and Severity Index, PASI 75) at week 28 re-randomized to placebo from reSURFACE 1 trial. METHODS Post hoc analysis of adult patients with moderate-to-severe plaque psoriasis from a 64-week phase 3 trial. Relapse was primarily defined as loss of PASI 75 response. Both relapses defined as loss of PASI 90 and loss of absolute PASI < 2 response were included as sensitivity analyses. PASI 75, PASI 90 and PASI < 2 responders re-randomized to placebo at week 28 and followed up until week 64 were included. The Kaplan-Meier (KM) estimates of the 64-week relapse rate were calculated. The log-rank test to compare KM curves from responders to tildrakizumab 100 and 200 mg was used. Independent predictors of relapse were explored. RESULTS Median time to loss of PASI 75/PASI 90/PASI < 2 response from week 28 was 142/111/112 days with tildrakizumab 100 mg and 172/140/113 days with tildrakizumab 200 mg, respectively (all not significant). Around 20% of patients did not relapse (either maintained a PASI 75 response or were lost to follow-up) during the 36-week period. Increase in body mass index (BMI) (hazard ratio, HR [95% confidence interval, CI] for loss of PASI 75 response: 1.0345 [1.0112-1.0582]) and increase in disease duration (HR [95% CI]: 1.0151 [1.0028-1.0275] for loss of PASI 75 response) were associated with an increased risk of relapse, regardless of the relapse definition. CONCLUSIONS When treatment is interrupted, tildrakizumab provides durable maintenance of efficacy with a median time to loss of PASI 75 response of 5-6 months, irrespective of the dose. Interventions on modifiable risk factors for relapse, such as BMI, may improve personalized long-term psoriasis management.
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Affiliation(s)
- R B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, The University of Manchester, Manchester, UK
| | - J M Carrascosa
- Department of Dermatology, Germans Trias i Pujol University Hospital (HUGTP), Autonomous University of Barcelona (UAB), Badalona, Spain
| | | | | | - M G Lebwohl
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, Skinflammation® Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Carrascosa JM, Morillas V, Bielsa I, Munera-Campos M. Cutaneous Manifestations in the Context of SARS-CoV-2 Infection (COVID-19). Actas Dermosifiliogr 2020. [PMID: 34012157 PMCID: PMC7560260 DOI: 10.1016/j.adengl.2020.10.001] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The coronavirus 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had enormous health, economic, and social consequences. The clinical spectrum of cutaneous manifestations observed in patients with COVID-19 is both heterogeneous and complex. To date, reports have identified 5 main categories: acral lesions, vesicular rashes, urticarial rashes, maculopapular rashes, and livedoid and necrotic lesions. However, these will probably be modified as new information comes to light. Cutaneous manifestations associated with COVID-19 probably reflect the activation of pathogenic pathways by the virus or a response to inflammatory processes, vascular or systemic complications, or even treatments. Familiarity with the cutaneous manifestations of COVID-19 may enable early diagnosis or help guide prognosis.
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Affiliation(s)
- J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - V Morillas
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - I Bielsa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - M Munera-Campos
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
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Carrascosa JM, Pastor-Nieto MA, Ruiz-González I, Silvestre JF, Borrego L, Gatica-Ortega ME, Giménez-Arnau AM. Patch Testing During the COVID-19 Pandemic: Recommendations of the AEDV's Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC). Actas Dermosifiliogr (Engl Ed) 2020; 111:650-654. [PMID: 32622869 PMCID: PMC7331509 DOI: 10.1016/j.ad.2020.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 06/13/2020] [Indexed: 12/03/2022] Open
Abstract
As the COVID-19 pandemic gradually comes under control, the members of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) have drawn up a proposed list of the requirements, limitations, and conditioning factors affecting the resumption of work in contact dermatitis units. The assumption is that the severe acute respiratory syndrome coronavirus2 is still circulating and that occasional or seasonal outbreaks will occur. They recommend that the first step should be to assess how many patch tests each clinic can handle and review the waiting list to prioritize cases according to disease severity and urgency. Digital technologies can, where possible, be used to send and receive the documentation necessary for the patch test (information, instructions, informed consent, etc.). If the necessary infrastructure is available, patients can be offered the option of a remote initial consultation. Likewise, in selected cases, the patch test results can be read in a virtual visit using photographs taken by the patient or a video visit can be scheduled to allow the physician to evaluate the site of application remotely. These measures will reduce the number of face-to-face visits required, but will not affect the time spent on each case, which must be scheduled in the normal manner. All of these recommendations are suggestions and should be adapted to the needs and possibilities of each health centre.
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Affiliation(s)
- J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España.
| | - M A Pastor-Nieto
- Servicio de Dermatología, Hospital Universitario de Guadalajara, Guadalajara, España
| | - I Ruiz-González
- Servicio de Dermatología, Complejo Asistencial Universitario de León, León, España
| | - J F Silvestre
- Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España
| | - L Borrego
- Servicio de Dermatología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España
| | - M E Gatica-Ortega
- Servicio de Dermatología. Complejo Hospitalario Universitario de Toledo, Toledo, España
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43
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Rivera R, Velasco M, Vidal D, Carrascosa JM, Daudén E, Vilarrasa E, Notario J, Ruíz‐Villaverde R, Yanguas I, García‐Latasa FJ, Ferrán M, Lázaro‐Simó A, Cueva P, Salgado‐Boquete L, Belinchón I. The effectiveness and safety of ixekizumab in psoriasis patients under clinical practice conditions: A Spanish multicentre retrospective study. Dermatol Ther 2020; 33:e14066. [DOI: 10.1111/dth.14066] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/12/2020] [Accepted: 07/18/2020] [Indexed: 12/29/2022]
Affiliation(s)
- Raquel Rivera
- Dermatology Department Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid Madrid Spain
| | - Manuel Velasco
- Dermatology Department Hospital Arnau de Vilanova Valencia Spain
| | - David Vidal
- Dermatology Department Hospital Sant Joan Despi Moises Broggi Barcelona Spain
| | - J. Manuel Carrascosa
- Dermatology Department Hospital Universitari Germans Trias i Pujol, Badalona, Universidad Autónoma de Barcelona Barcelona Spain
| | - Esteban Daudén
- Dermatology Department Hospital Univesitario La Princesa Madrid Spain
| | - E Vilarrasa
- Dermatology Department Hospital de la Santa Creu i Sant Pau. Universitat Autònoma de Barcelona Barcelona Spain
| | - Jaime Notario
- Dermatology Department Hospital Universitario de Bellvitge. Hospitalet de Llobregat Barcelona Spain
| | | | - Ignacio Yanguas
- Dermatology Department Complejo Hospitalario de Navarra Pamplona Spain
| | | | - Marta Ferrán
- Dermatology Department Hospital del Mar, Parc de Salut Mar Barcelona Spain
| | - Anna Lázaro‐Simó
- Dermatology Department Hospital Universitario Sagrat Cor Barcelona Spain
| | - Pablo Cueva
- Dermatology Department Hospital Universitario Infanta Leonor Madrid Spain
| | - Laura Salgado‐Boquete
- Dermatology Department Complejo Hospitalario Universitario de Pontevedra Pontevedra Spain
| | - Isabel Belinchón
- Dermatology Department Hospital General Universitario de Alicante Alicante Spain
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44
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Puig L, Carrascosa JM, Notario J. Biosimilars in the Treatment of Psoriasis: An Update. Actas Dermosifiliogr (Engl Ed) 2020; 111:809-814. [PMID: 32860750 DOI: 10.1016/j.ad.2020.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 03/02/2020] [Indexed: 02/08/2023] Open
Affiliation(s)
- L Puig
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, España
| | - J Notario
- Servicio de Dermatología, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, España
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45
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Aguilera P, Gilaberte Y, Pérez-Ferriols A, de Argila D, Aguilera J, de Galvez MV, Granados MT, Gardeazabal J, Carrascosa JM. Management of Phototherapy Units During the COVID-19 Pandemic: Recommendations of the AEDV's Spanish Photobiology Group. Actas Dermosifiliogr (Engl Ed) 2020; 112:73-75. [PMID: 32679122 PMCID: PMC7361086 DOI: 10.1016/j.ad.2020.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/19/2020] [Accepted: 07/04/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- P Aguilera
- Servicio de Dermatología, Hospital Clínic, Barcelona, España.
| | - Y Gilaberte
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - A Pérez-Ferriols
- Servicio de Dermatología, Hospital General Universitario, Valencia, España
| | - D de Argila
- Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, España
| | - J Aguilera
- Unidad de Fotobiología Dermatológica y Oncología Cutánea, Departamento de Dermatología y Medicina, Universidad de Málaga, Málaga, España
| | - M V de Galvez
- Unidad de Fotobiología Dermatológica y Oncología Cutánea, Departamento de Dermatología y Medicina, Universidad de Málaga, Málaga, España
| | - M T Granados
- Facultad de Medicina, Complejo Hospital Universitario, Santiago de Compostela, La Coruña, España
| | - J Gardeazabal
- Servicio de Dermatología, Hospital Universitario Cruces, Baracaldo, Vizcaya, España
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
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46
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Rivera R, Martorell A, López A, Salgado L, Sahuquillo A, de la Cueva P, Herranz P, Ratón JA, Ferrán M, Izu R, Ruiz-Genao D, García-Donoso C, Carrascosa JM. Maintenance of response following discontinuation of guselkumab and secukinumab in Spanish patients who participated in the ECLIPSE study. J Eur Acad Dermatol Venereol 2020; 35:e65-e67. [PMID: 32648955 DOI: 10.1111/jdv.16809] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- R Rivera
- Dermatology Department, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
| | - A Martorell
- Dermatology Department, Hospital de Manises, Valencia, Spain
| | - A López
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Salgado
- Dermatology Department, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - A Sahuquillo
- Dermatology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - P de la Cueva
- Dermatology Department, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - P Herranz
- Dermatology Department, Hospital Universitario La Paz, Madrid, Spain
| | - J A Ratón
- Dermatology Department, Hospital Universitario de Cruces, Bilbao, Spain
| | - M Ferrán
- Dermatology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - R Izu
- Dermatology Department, Hospital de Basurto, Bilbao, Spain
| | - D Ruiz-Genao
- Dermatology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - C García-Donoso
- Dermatology Department, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
| | - J M Carrascosa
- Dermatology Department, Hospital Universitari Germans Trias i Pujol, Universidad Autónoma de Barcelona, Badalona, Barcelona, Spain
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Del Alcázar E, Suárez-Pérez JA, Armesto S, Rivera R, Herrera-Acosta E, Herranz P, Martín I, Montesinos E, Hospital M, Vilarrasa E, Ferran M, Ruiz-Villaverde R, Sahuquillo-Torralba A, Ruiz-Genao DP, Pérez-Barrio S, Muñoz C, Llamas M, Valentí F, Mitxelena MJ, López-Ferrer A, Carretero G, Vidal D, Mollet J, Belinchón I, Carrascosa JM. Real-world effectiveness and safety of apremilast in psoriasis at 52 weeks: a retrospective, observational, multicentre study by the Spanish Psoriasis Group. J Eur Acad Dermatol Venereol 2020; 34:2821-2829. [PMID: 32271966 DOI: 10.1111/jdv.16439] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 03/16/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Little has been published on the real-world effectiveness and safety of apremilast in psoriasis. OBJECTIVES To evaluate the effectiveness, safety and drug survival of apremilast at 52 weeks in patients with moderate to severe plaque psoriasis or palmoplantar psoriasis in routine clinical practice. METHODS Retrospective, multicentre study of adult patients with moderate to severe plaque psoriasis or palmoplantar psoriasis treated with apremilast from March 2016 to March 2018. RESULTS We studied 292 patients with plaque psoriasis and 85 patients with palmoplantar psoriasis. The mean (SD) Psoriasis Area and Severity Index (PASI) score was 10.7 (7.0) at baseline and 3.0 (4.2) at 52 weeks. After 12 months of treatment, 73.6% of patients had a PASI score of 3 or less. In terms of relative improvement by week 52, 49.7% of patients achieved PASI-75 (≥75% reduction in PASI score) and 26.5% achieved PASI-90. The mean physician global assessment score for palmoplantar psoriasis fell from 4.2 (5.2) at baseline to 1.3 (1.3) at week 52. Overall drug survival after 1 year of treatment with apremilast was 54.9 %. The main reasons for treatment discontinuation were loss of efficacy (23.9%) and adverse events (15.9%). Almost half of the patients in our series (47%) experienced at least one adverse event. The most common events were gastrointestinal problems. CONCLUSIONS Apremilast may be a suitable alternative for the treatment of moderate to severe psoriasis and palmoplantar psoriasis. Although the drug has a good safety profile, adverse gastrointestinal effects are common.
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Affiliation(s)
- E Del Alcázar
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain
| | - J A Suárez-Pérez
- Department of Dermatology, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - S Armesto
- Department of Dermatology, Hospital Universitario de Valdecilla, Santander, Spain
| | - R Rivera
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - E Herrera-Acosta
- Department of Dermatology, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - P Herranz
- Department of Dermatology, Hospital Universitario La Paz, Madrid, Spain
| | - I Martín
- Department of Dermatology, Hospital Universitario Getafe, Madrid, Spain
| | - E Montesinos
- Department of Dermatology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - M Hospital
- Department of Dermatology, Hospital Universitario Puerta de Hierro Majadahonda Madrid, Spain
| | - E Vilarrasa
- Department of Dermatology, Hospital Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - M Ferran
- Department of Dermatology, Hospital del Mar-Institut Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - R Ruiz-Villaverde
- Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain
| | - A Sahuquillo-Torralba
- Department of Dermatology, Hospital Universitario y Politécnico La Fe - Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - D P Ruiz-Genao
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - S Pérez-Barrio
- Department of Dermatology, Hospital Universitario Basurto, Bilbao, Spain
| | - C Muñoz
- Department of Dermatology, Hospital de Granollers, Granollers, Spain
| | - M Llamas
- Department of Dermatology, Hospital Universitario La Princesa, Madrid, Spain
| | - F Valentí
- Department of Dermatology, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - M J Mitxelena
- Department of Dermatology, Hospital Universitario de Navarra, Pamplona, Spain
| | - A López-Ferrer
- Department of Dermatology, Hospital Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - G Carretero
- Department of Dermatology, Hospital Universitario Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - D Vidal
- Department of Dermatology, Hospital Moisès Broggi, Sant Joan Despí, Spain
| | - J Mollet
- Department of Dermatology, Hospital Universitari Vall d'Hebrón, Barcelona, Spain
| | - I Belinchón
- Department of Dermatology, Hospital Universitario de Alicante -ISABIAL, UMH Alicante, Alicante, Spain
| | - J M Carrascosa
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain
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48
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Belinchón I, Puig L, Ferrándiz L, de la Cueva P, Carrascosa JM. Managing Psoriasis Consultations During the COVID-19 Pandemic: Recommendations From the Psoriasis Group of the Spanish Academy of Dermatology and Venereology (AEDV). Actas Dermosifiliogr (Engl Ed) 2020; 111:802-804. [PMID: 32522413 PMCID: PMC7833719 DOI: 10.1016/j.ad.2020.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 05/26/2020] [Indexed: 12/20/2022] Open
Affiliation(s)
- I Belinchón
- Servicio de Dermatología, Hospital General Universitario de Alicante-ISABIAL-UMH, Alicante, España.
| | - L Puig
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - L Ferrándiz
- Servicio de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - P de la Cueva
- Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, España
| | - J M Carrascosa
- Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, IGTP, Barcelona, España
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Carrascosa JM, Morillas-Lahuerta V. Comorbidities in Atopic Dermatitis: An Update and Review of Controversies. Actas Dermosifiliogr (Engl Ed) 2020; 111:481-486. [PMID: 32401719 DOI: 10.1016/j.ad.2020.04.009] [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: 01/01/2020] [Revised: 03/28/2020] [Accepted: 04/21/2020] [Indexed: 12/20/2022] Open
Abstract
Early onset of atopic dermatitis is considered a risk factor for any atopic disease, especially when the skin manifestations are persistent, and there is sensitization to multiple allergens and a family history. Atopic dermatitis is also thought to exert a synergistic effect with inflammation present in other organs and systems, as is the case in other immune-mediated inflammatory diseases. Most studies show a statistical relationship between obesity, various cardiometabolic comorbid conditions, and atopic dermatitis; this relationship is more marked when the disease is more severe or active over a longer period of time. However, other than epidemiological assessments, few studies provide in-depth evidence of functional mechanisms. Furthermore, various confounders, such as deterioration of quality of life and the psychological aspects of atopic dermatitis, could favor unhealthy habits, including a sedentary lifestyle and smoking, which could in turn increase the risk of morbidity and mortality. Chronic inflammation with differentiation toward a type 2 helper T cell pattern and the long-term use of immunosuppressants could be risk factors for some hematologic diseases, although they could exert a protective effect in others. The presence of proinflammatory cytokines capable of crossing the blood-brain barrier could favor an increase in the frequency of psychological diseases (eg, depression, anxiety, and suicidal ideation) and attention disorders (eg, attention deficit or hyperactivity). However, other factors, such as chronic pruritus and sleep disorders, could also play roles.
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Affiliation(s)
- J M Carrascosa
- Servicio de Dermatología. Hospital Universitari Germans Trias i Pujol. Universitat Autònoma de Barcelona, España.
| | - V Morillas-Lahuerta
- Servicio de Dermatología. Hospital Universitari Germans Trias i Pujol. Universitat Autònoma de Barcelona, España
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50
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Carretero G, Carrascosa JM, Puig L, Sánchez-Carazo JL, López-Ferrer A, Cueva P, Soria C, Rivera R, Belinchón I. Definition of minimal disease activity in psoriasis. J Eur Acad Dermatol Venereol 2020; 35:422-430. [PMID: 32367536 DOI: 10.1111/jdv.16564] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/03/2020] [Accepted: 04/10/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To generate an operational definition to adequately reflect the construct 'Minimal Disease Activity (MDA)' in psoriasis. METHODS A systematic review of domains included in clinical trials of psoriasis was presented to a panel of dermatologists and patients. Further domains were elicited by panel discussions. Domains (and instruments measuring these) were items of two consecutive Delphi rounds targeting dermatologists from the Psoriasis Group of the Spanish Academy of Dermatology and Venereology and patients from the Acción Psoriasis association. The instruments selected were used to generate 388 patient vignettes. The expert group then classified these vignettes as 'No MDA/MDA/Unclassifiable'. The items were further reduced by factorial analysis. Using the classification variable as gold standard, several operational constructions were tested in regression models and ROC curves and accuracy was evaluated with area under the curve (AUC). RESULTS The following domains were included: itching, scaling, erythema and visibility by 0-10 scales, extension by BSA, impact on quality of life by DLQI, special location and presence of arthritis as yes/no. The definition with the highest AUC and best balance between sensitivity and specificity was the one including no presence of arthritis plus at least three others below the upper limit of the 95% confidence interval (AUC, 0.897; sensitivity, 95.2%, specificity, 84.1%). CONCLUSION This study provides, for the very first time, the construct of 'Minimal Disease Activity' in psoriasis as agreed by dermatologists and patients. MDA is defined as absence of active arthritis plus 3 out of 6: itching ≤ 1/10; scaling ≤ 2/10; redness ≤ 2/10; visibility ≤ 2/10; BSA ≤ 2; DLQI ≤ 2; and no lesions in special locations. By design, domains are representative of disease impact. This MDA definition may be used as a measure of adequate management and replace other subjective or restrictive tools.
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Affiliation(s)
- G Carretero
- Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - J M Carrascosa
- Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - L Puig
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | - P Cueva
- Hospital Universitario Infanta Leonor, Madrid, Spain
| | - C Soria
- Hospital General Universitario Reina Sofía de Murcia, Murcia, Spain
| | - R Rivera
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | - I Belinchón
- Hospital General Universitario de Alicante, Alicante, Spain
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