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von Kiedrowski R, Hinz T, Mauer G, Schwinn A, Timmel A, Hutt HJ, Augustin M. Management of moderate to severe psoriasis with brodalumab-Real-world evidence from the LIBERO study. J Eur Acad Dermatol Venereol 2024. [PMID: 38572773 DOI: 10.1111/jdv.19974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 02/20/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Brodalumab, a fully human monoclonal immunoglobulin IgG2 antibody that binds the human interleukin 17 receptor subunit A, is available for the treatment of moderate-to-severe plaque psoriasis in Europe since September 2017, but so far there are only a few studies on its use in real-world conditions. OBJECTIVES To assess the management of moderate-to-severe psoriasis with brodalumab 210 mg in daily practice after 12 and 52 weeks (W). In addition, patient profiles and treatment pathways are described. METHODS LIBERO is a prospective, multicenter, non-interventional study including adult patients with plaque psoriasis treated with brodalumab 210 mg. RESULTS In total, 638 patients (65% male, mean age: 49.3 ± 14.4 years) from 148 sites in Germany were enrolled. The majority suffered from severe (51.1%) or very severe (13.1%) psoriasis according to physician global assessment (PGA0-5). When starting with brodalumab, 58.5% were biologic naïve and 41.5% were previously treated with another biologic, mainly adalimumab (18.5%) and secukinumab (17.9%). About 74.0% of patients met the primary endpoint of an absolute PASI ≤3 at ~W12 (n = 618, LOCF). The mean PASI was reduced significantly as of ~W2 from 17.2 (±11.7) to 9.7 (±8.8) and improved further to 3.3 (±6.3) at ~W12 (p < 0.001). At ~W52 85.5% of patients reached a PGA0/1-response (primary endpoint) and 54.1% patients were assessed as completely clear (PGA0) (both n = 399, as observed). Effectiveness of brodalumab was confirmed in relevant subgroup analysis by previous treatment regimen. Most frequently reported adverse events were nasopharyngitis (4.6%), psoriasis (4.6%) and arthralgia (4.1%), new safety signals were not detected. CONCLUSION This representative, non-interventional study confirms the short- and long-term effectiveness and safety profile of brodalumab in the management of psoriasis in daily practice as well as in relevant treatment pathways.
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Affiliation(s)
- R von Kiedrowski
- Medical Study & Service Selters GmbH, Selters (Westerwald), Germany
| | - T Hinz
- Zentrum für Hautgesundheit, Neuwied, Germany
| | - G Mauer
- Hautarztpraxis, Bad Kreuznach, Germany
| | | | - A Timmel
- Hautzentrum Rügen, Bergen, Germany
| | - H J Hutt
- LEO Pharma GmbH, Neu-Isenburg, Germany
| | - M Augustin
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Klein C, Oji V, Sommer R, Augustin M, Ständer S, Salzmann S, Kiekbusch K, Bodes J, Danzer MF, Traupe H, Fischer J, Steinke S, Süßmuth K. Personal, financial and time burden in inherited ichthyoses: A survey of 144 patients in a university-based setting. J Eur Acad Dermatol Venereol 2024. [PMID: 38523469 DOI: 10.1111/jdv.19804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 11/14/2023] [Indexed: 03/26/2024]
Abstract
BACKGROUND Patients with inherited ichthyosis suffer from scaling due to mutations affecting the epidermal barrier. Symptomatic treatment with ointments, bathing and mechanical scale removal can alleviate the disease, but therapy is time and cost intensive. OBJECTIVES We investigated costs, time and disease burden of ichthyoses. The study addresses difficulties of the healthcare situation for patients with ichthyoses and reveals potential improvements. MATERIALS AND METHODS We developed a questionnaire addressing time and financial effort for the treatment. Additionally, we collected data of the Dermatology Life Quality Index (DLQI) and the Pruritus Life Quality (5PLQ) questionnaires to determine the impact of ichthyosis and associated pruritus on quality of life (QoL). RESULTS We recruited 144 patients with ichthyosis (median age: 23; 53.5% female) from the Department of Dermatology in Muenster (Germany) and the German patient support group including common, rare and syndromic subtypes. Eighty-seven percent reported applying topical therapeutics at least once per day, 66.4% several times with an overall median duration of 15 min. Highest single expenditure of time was due to balneotherapy (n = 115; median bathing time: 40 min). In 81.9%, the health insurance did not completely cover the costs for topical treatment causing additional financial burden to the patient with a median of 71 € per quarter, herein creams being the largest cost factor (50 €). Patients with Netherton syndrome showed the highest median expenditure (170 €). The QoL impairment under treatment was moderate (median DLQI: 8.5 points). Pruritus was prevalent in 79.9% and showed a distinct impact on QoL (median 5PLQ: 7.5 points) without any significant difference between the subtypes (p = 0.37). CONCLUSION Patients suffering from ichthyoses have a large and lifelong overall burden in mild and severe subtypes. Since continuous topical treatment is required, financial and psychosocial support needs to be considered beyond dermatological care.
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Affiliation(s)
- C Klein
- Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - V Oji
- Department of Dermatology, University Hospital of Münster, Münster, Germany
- Hautarztpraxis am Buddenturm, Münster, Germany
| | - R Sommer
- German Centre for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - M Augustin
- German Centre for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - S Ständer
- Department of Dermatology, University Hospital of Münster, Münster, Germany
- Center of Chronic Pruritus, University Hospital of Münster, Münster, Germany
- Section Pruritus Medicine, Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - S Salzmann
- Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - K Kiekbusch
- Support Group "Selbsthilfe Ichthyose e. V.", Mittenwalde, Germany
| | - J Bodes
- Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - M F Danzer
- Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany
| | - H Traupe
- Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - J Fischer
- Medical Center, Faculty of Medicine, Institute of Human Genetics, University of Freiburg, Freiburg, Germany
| | - S Steinke
- Department of Dermatology, University Hospital of Münster, Münster, Germany
- Hautarztpraxis am Hohenzollernring, Münster, Germany
- Medical School OWL, University of Bielefeld, Bielefeld, Germany
| | - K Süßmuth
- Department of Dermatology and Allergology, Helios Klinikum Berlin-Buch, Campus of Medical School Berlin, Berlin, Germany
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Chernyshov PV, Finlay AY, Tomas-Aragones L, Tognetti L, Moscarella E, Pasquali P, Manolache L, Pustisek N, Svensson A, Marron SE, Bewley A, Salavastru C, Suru A, Koumaki D, Linder D, Abeni D, Augustin M, Blome C, Salek SS, Evers AWM, Poot F, Sampogna F, Szepietowski JС. Quality of life measurement in teledermatology. Position statement of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Teledermatology. J Eur Acad Dermatol Venereol 2024; 38:254-264. [PMID: 37877648 DOI: 10.1111/jdv.19570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/29/2023] [Indexed: 10/26/2023]
Abstract
Many events, including the COVID-19 pandemic, have accelerated the implementation of teledermatology pathways within dermatology departments and across healthcare organizations. Quality of Life (QoL) assessment in dermatology is also a rapidly developing field with a gradual shift from theory to practice. The purpose of this paper organized jointly by the European Academy of Dermatology and Venereology (EADV) Task Force (TF) on QoL and patient-oriented outcomes and the EADV TF on teledermatology is to present current knowledge about QoL assessment during the use of teledermatology approaches, including data on health-related (HR) QoL instruments used in teledermatology, comparison of influence of different treatment methods on HRQoL after face-to-face and teledermatology consultations and to make practical recommendations concerning the assessment of QoL in teledermatology. The EADV TFs made the following position statements: HRQoL assessment may be an important part in most of teledermatology activities; HRQoL assessment may be easily and effectively performed during teledermatology consultations. It is especially important to monitor HRQoL of patients with chronic skin diseases during lockdowns or in areas where it is difficult to reach a hospital for face-to-face consultation; regular assessment of HRQoL of patients with skin diseases during teledermatology consultations may help to monitor therapy efficacy and visualize individual patient's needs; we recommend the use of the DLQI in teledermatology, including the use of the DLQI app which is available in seven languages; it is important to develop apps for dermatology-specific HRQoL instruments for use in children (for example the CDLQI and InToDermQoL) and for disease-specific instruments.
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Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - L Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - E Moscarella
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - P Pasquali
- Dermatology Department, Pius Hospital de Valls, Tarragona, Spain
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - N Pustisek
- Children's Hospital Zagreb, Zagreb, Croatia
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - S E Marron
- Department of Dermatology, University Hospital Miguel Servet, Aragon Psychodermatology Research Group (GAI+PD), Zaragoza, Spain
| | - A Bewley
- Whipps Cross University Hospital, London, UK
- The Royal London Hospital, London, UK
| | - C Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - A Suru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - D Koumaki
- Department of Dermatology and Venereology, University Hospital of Heraklion, Crete, Greece
| | - D Linder
- University Clinic for Medical Psychology and Psychotherapy, Medical University of Graz, Austria
| | - D Abeni
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Blome
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - A W M Evers
- Institute of Psychology, Health, Medical, and Neuropsychology unit, Leiden University, Leiden, The Netherlands
| | - F Poot
- Department of Dermatology, University Hospital Erasme, Brussels, Belgium
| | - F Sampogna
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
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Otten M, Greis C, Reinders P, Fleyder A, Reich K, Augustin M. Patient and physician outcomes of a store-and-forward teledermatology application in Germany. J Eur Acad Dermatol Venereol 2024; 38:e148-e151. [PMID: 37669866 DOI: 10.1111/jdv.19501] [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: 05/11/2023] [Accepted: 08/31/2023] [Indexed: 09/07/2023]
Affiliation(s)
- M Otten
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - C Greis
- Department of Dermatology, University Hospital Zurich, Zürich, Switzerland
| | - P Reinders
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - A Fleyder
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - K Reich
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Kasper B, Pink D, Rothermundt C, Richter S, Augustin M, Kollar A, Kunitz A, Eisterer W, Gaidzik V, Brodowicz T, Egerer G, Reichardt P, Hohenberger P, Schuler MK. Geriatric Assessment of Older Patients Receiving Trabectedin in First-Line Treatment for Advanced Soft Tissue Sarcomas: The E-TRAB Study from The German Interdisciplinary Sarcoma Group (GISG-13). Cancers (Basel) 2024; 16:558. [PMID: 38339308 PMCID: PMC10854510 DOI: 10.3390/cancers16030558] [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: 12/29/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
E-TRAB was a non-interventional, prospective trial investigating the feasibility and predictive value of geriatric assessments (GA) in older STS patients treated with trabectedin as first-line therapy. Primary endpoints were overall survival (OS), quality of life and individual clinical benefit assessed by the patient-reported outcome measures QLQ-C30 and PRO-CTCAE. Further, several GA tools were applied and correlated with clinical outcomes and treatment-related toxicities. The final analyses included 69 patients from 12 German-speaking sites. The median age of patients was 78 years (range: 55 to 88). Baseline data on PROs and GA identified a diverse population of older patients with respect to their global health status, although a large proportion of them suffered from limitations, required geriatric help and had a high risk of morbidity. The Cancer and Age Research Group (CARG) score classified 38%, 29% and 23% of the patients with low, intermediate and high risks for therapy-related side effects, respectively. Median OS was 11.2 months [95%CI: 5.6; 19.4]. The study confirmed that trabectedin as first-line treatment in older patients with STS has an acceptable and manageable safety profile. Potential prognostic factors for clinical outcome and therapy-related toxicity were identified among the GA tools. Long Timed Up and Go (TUG) showed a significant correlation to OS and early death, whereas a high CARG score (>9) was associated with an increase in unplanned hospitalizations and the incidence of toxicities grade ≥ 3.
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Affiliation(s)
- Bernd Kasper
- Sarcoma Unit, Mannheim Cancer Center (MCC), Mannheim University Medical Center, University of Heidelberg, 68167 Mannheim, Germany
| | - Daniel Pink
- Department of Oncology and Palliative Care, HELIOS Klinikum Bad Saarow, 15526 Bad Saarow, Germany;
- Department of Internal Medicine C, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Christian Rothermundt
- Department of Medical Oncology and Hematology, Kantonsspital St. Gallen, 9007 St. Gallen, Switzerland;
| | - Stephan Richter
- Medical Department I, University Hospital Carl Gustav Carus, Dresden University of Technology, 01307 Dresden, Germany
| | - Marinela Augustin
- Department of Hematology and Oncology, Paracelsus Medical University, 90419 Nuremberg, Germany;
| | - Attila Kollar
- Department of Medical Oncology, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;
| | - Annegret Kunitz
- Department of Hematology, Oncology and Palliative Medicine, Vivantes Klinikum Spandau, 13585 Berlin, Germany;
| | - Wolfgang Eisterer
- Clinical Division of Oncology, Department of Internal Medicine, Medical University Graz, 8036 Graz, Austria;
| | - Verena Gaidzik
- Clinic for Internal Medicine III, University Hospital Ulm, 89081 Ulm, Germany;
| | - Thomas Brodowicz
- Vienna General Hospital (AKH), Medizinische Universität Wien, 1090 Vienna, Austria;
| | - Gerlinde Egerer
- Department of Internal Medicine V, Heidelberg University Hospital, 69120 Heidelberg, Germany;
| | - Peter Reichardt
- Department of Oncology, Helios Klinikum Berlin-Buch, 13125 Berlin, Germany;
| | - Peter Hohenberger
- Division of Surgical Oncology and Thoracic Surgery, University Medical Center Mannheim, Mannheim Medical Faculty, University of Heidelberg, 68167 Mannheim, Germany
| | - Markus K. Schuler
- Medical Department I, University Hospital Carl Gustav Carus, Dresden University of Technology, 01307 Dresden, Germany
- Onkologischer Schwerpunkt am Oskar-Helene Heim, 14195 Berlin, Germany
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Staplin N, Haynes R, Judge PK, Wanner C, Green JB, Emberson J, Preiss D, Mayne KJ, Ng SYA, Sammons E, Zhu D, Hill M, Stevens W, Wallendszus K, Brenner S, Cheung AK, Liu ZH, Li J, Hooi LS, Liu WJ, Kadowaki T, Nangaku M, Levin A, Cherney D, Maggioni AP, Pontremoli R, Deo R, Goto S, Rossello X, Tuttle KR, Steubl D, Petrini M, Seidi S, Landray MJ, Baigent C, Herrington WG, Abat S, Abd Rahman R, Abdul Cader R, Abdul Hafidz MI, Abdul Wahab MZ, Abdullah NK, Abdul-Samad T, Abe M, Abraham N, Acheampong S, Achiri P, Acosta JA, Adeleke A, Adell V, Adewuyi-Dalton R, Adnan N, Africano A, Agharazii M, Aguilar F, Aguilera A, Ahmad M, Ahmad MK, Ahmad NA, Ahmad NH, Ahmad NI, Ahmad Miswan N, Ahmad Rosdi H, Ahmed I, Ahmed S, Ahmed S, Aiello J, Aitken A, AitSadi R, Aker S, Akimoto S, Akinfolarin A, Akram S, Alberici F, Albert C, Aldrich L, Alegata M, Alexander L, Alfaress S, Alhadj Ali M, Ali A, Ali A, Alicic R, Aliu A, Almaraz R, Almasarwah R, Almeida J, Aloisi A, Al-Rabadi L, Alscher D, Alvarez P, Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim 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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Pinter A, Reich A, Arenberger P, Gold LS, Armstrong A, Iversen L, Praestegaard M, Augustin M. Randomized Phase 3 trial demonstrating high efficacy, favourable safety and convenience of a novel calcipotriol and betamethasone dipropionate cream for the treatment of psoriasis. J Eur Acad Dermatol Venereol 2023; 37:2327-2335. [PMID: 37432045 DOI: 10.1111/jdv.19330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/12/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND The fixed dose combination of calcipotriene (CAL) and betamethasone dipropionate (BDP) is a well-established topical treatment option for psoriasis based on strong scientific rationale for the single agents having complementary efficacy and safety. CAL/BDP PAD-cream is an easily spreadable cream based on PAD Technology™, an innovative formulation and drug delivery system. OBJECTIVES AND METHODS A Phase 3, multicentre, randomized, investigator-blind, active and vehicle-controlled trial enrolling 490 patients with mild to moderate psoriasis according to the Physician Global Assessment (PGA) scale was conducted in three European countries. Products were applied once daily for 8 weeks. The aim of the trial was to evaluate the efficacy and safety of CAL/BDP PAD-cream as well as treatment acceptability compared to CAL/BDP gel and PAD-cream vehicle. Primary endpoint was percentage change in modified Psoriasis Area and Severity Index (mPASI) from baseline to Week 8. RESULTS The percentage mean change from baseline to Week 8 in mPASI for CAL/BDP PAD-cream (67.5%) was superior compared to PAD-cream vehicle (11.7%; p < 0.0001) and non-inferior to CAL/BDP gel (63.5%). The proportion of patients achieving PGA treatment success (at least two-step improvement to clear or almost clear) after 8 weeks was superior for CAL/BDP PAD-cream (50.7%) compared to PAD-cream vehicle (6.1%, p < 0.0001) and statistically significantly greater than CAL/BDP gel (42.7%, p = 0.0442). Patient-reported psoriasis treatment convenience score (PTCS) for CAL/BDP PAD-cream was rated superior to CAL/BDP gel at Week 8 (p < 0.0001) and the mean change in DLQI from baseline to Week 8 improved statistically significantly more in the CAL/BDP PAD-cream group compared to both PAD-cream vehicle (p < 0.0001) and CAL/BDP gel (p = 0.0110). Safety assessments during the trial demonstrated that CAL/BDP PAD-cream was well-tolerated. CONCLUSION CAL/BDP PAD-cream is a novel topical treatment of psoriasis that has a high efficacy and a favourable safety profile combined with a superior patient-reported treatment convenience.
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Affiliation(s)
- A Pinter
- Department of Dermatology, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
| | - A Reich
- Department of Dermatology, University of Rzeszow, Rzeszów, Poland
| | | | - L S Gold
- Dermatology Clinical Research, Henry Ford Health System, Detroit, Michigan, USA
| | - A Armstrong
- University of Southern California, Los Angeles, California, USA
| | | | | | - M Augustin
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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9
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Trialonis-Suthakharan N, Pattinson R, Tahmasebi Gandomkari N, Austin J, Janus C, Courtier N, Hewitt RM, Bundy C, Augustin M. Patient prioritisation of impact items to develop the patient-reported impact of dermatological diseases (PRIDD) measure: European Delphi data. J Eur Acad Dermatol Venereol 2023; 37 Suppl 7:40-50. [PMID: 37805995 DOI: 10.1111/jdv.19266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 06/12/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND The Global Research on the Impact of Dermatological Diseases (GRIDD) project is developing a patient-reported measure of the impact of dermatological disease on the patient's life called Patient Reported Impact of Dermatological Diseases (PRIDD). We developed a list of 263 potential impact items through a global qualitative interview study with 68 patients. We next conducted a Delphi study to seek consensus on which of these items to prioritize for inclusion in PRIDD. This study aims to explore patterns in demographic (e.g. country) and clinical variables (e.g. disease group) across the impacts ranked as most important to European dermatology patients. METHODS We conducted a modified, two rounds Delphi study, testing the outcomes from the previous qualitative interview study. Adults (≥18 years) living with a dermatological disease were recruited through the International Alliance of Dermatology Patient Organizations' (GlobalSkin) membership network. The survey consisted of a demographic questionnaire and 263 impact items and was available in six languages. Quantitative data were collected using ranking scales and analysed against a priori consensus criteria. Qualitative data were collected using free-text responses and a Framework Analysis was conducted. European data were obtained, and descriptive statistics, including multiple subgroup analyses, were performed. RESULTS Out of 1154 participants, 441 Europeans representing 46 dermatological disease from 25 countries participated. The results produced a list of the top 20 impacts reported by European patients, with psychological impacts accounting for the greatest proportion. CONCLUSION This study identified what patients consider to be the most important issues impacting their lives as a result of their dermatological disease. The data support previous evidence that patients experience profound psychological impacts and require psychological support. The findings can inform research, clinical practice and policy by indicating research questions and initiatives that are of most benefit to patients.
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Affiliation(s)
- N Trialonis-Suthakharan
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - R Pattinson
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - N Tahmasebi Gandomkari
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - J Austin
- International Alliance of Dermatology Patient Organizations, Ottawa, Canada
| | - C Janus
- International Alliance of Dermatology Patient Organizations, Ottawa, Canada
| | - N Courtier
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - R M Hewitt
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - C Bundy
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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10
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Ganjuur N, D'Urso DF, Girbig GM, Booken N, Augustin M. SARS-CoV-2 infection associated with severe oral, conjunctival and genital lesions (Fuchs syndrome). J Eur Acad Dermatol Venereol 2023; 37:e1089-e1090. [PMID: 37102340 DOI: 10.1111/jdv.19131] [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: 01/30/2023] [Accepted: 04/21/2023] [Indexed: 04/28/2023]
Affiliation(s)
- N Ganjuur
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - D F D'Urso
- Institute of Dermatology, Università Cattolica, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
| | - G M Girbig
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - N Booken
- Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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11
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Valencia López M, Meineke A, Stephan B, Rustenbach S, Kis A, Thaci D, Mrowietz U, Reich K, Staubach-Renz P, von Kiedrowski R, Bogena H, Augustin M. SARS-CoV-2 vaccination status and adverse events among patients with psoriasis - data from the German Registries PsoBest and CoronaBest. J Eur Acad Dermatol Venereol 2023. [PMID: 36914370 DOI: 10.1111/jdv.19039] [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: 11/22/2022] [Accepted: 03/08/2023] [Indexed: 03/16/2023]
Affiliation(s)
- M Valencia López
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - A Meineke
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - B Stephan
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - S Rustenbach
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - A Kis
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - D Thaci
- Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany
| | - U Mrowietz
- Psoriasis Center Kiel, Department of Dermatology, Venereology and Allergology University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - K Reich
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - P Staubach-Renz
- Department of Dermatology and Allergy, University Medical Center Mainz, Mainz, Germany
| | | | - H Bogena
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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12
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Yu EY, Piulats JM, Gravis G, Fong PCC, Todenhöfer T, Laguerre B, Arranz JA, Oudard S, Massard C, Heinzelbecker J, Nordquist LT, Carles J, Kolinsky MP, Augustin M, Gurney H, Tafreshi A, Li XT, Qiu P, Poehlein CH, Schloss C, de Bono JS. Corrigendum to "Pembrolizumab plus Olaparib in Patients with Metastatic Castration-resistant Prostate Cancer: Long-term Results from the Phase 1b/2 KEYNOTE-365 Cohort A Study" [Eur Urol 83 (2023) 15-26]. Eur Urol 2023; 83:e87. [PMID: 36528479 DOI: 10.1016/j.eururo.2022.11.025] [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] [Indexed: 12/23/2022]
Affiliation(s)
- Evan Y Yu
- University of Washington and Fred Hutchinson Cancer Center, Seattle, WA, USA.
| | | | | | - Peter C C Fong
- Auckland City Hospital, Auckland, New Zealand; University of Auckland, Auckland, New Zealand
| | | | | | - Jose A Arranz
- General University Hospital Gregorio Marañón, Madrid, Spain
| | - Stephane Oudard
- Hôpital Européen Georges Pompidou, University of Paris, Paris, France
| | - Christophe Massard
- Gustave Roussy, Cancer Campus, Villejuif, France; Paris-Saclay University, Villejuif, France
| | - Julia Heinzelbecker
- Saarland University Medical Center, Homburg, Germany; Faculty of Medicine, Saarland University, Homburg, Germany
| | | | - Joan Carles
- Vall d'Hebron Institute of Oncology, Vall d'Hebron, Barcelona, Spain
| | | | | | | | - Ali Tafreshi
- University of Wollongong, Wollongong, NSW, Australia
| | | | - Ping Qiu
- Merck & Co., Inc., Rahway, NJ, USA
| | | | | | - Johann S de Bono
- The Institute of Cancer Research and the Royal Marsden, London, UK
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13
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Chernyshov PV, Finlay AY, Tomas-Aragones L, Steinhoff M, Manolache L, Pustisek N, Dessinioti C, Svensson A, Marron SE, Bewley A, Salavastru C, Dréno B, Suru A, Koumaki D, Linder D, Evers AWM, Abeni D, Augustin M, Salek SS, Nassif A, Bettoli V, Szepietowski JС, Zouboulis CC. Quality of life measurement in rosacea. Position statement of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa. J Eur Acad Dermatol Venereol 2023; 37:954-964. [PMID: 36744752 DOI: 10.1111/jdv.18918] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/16/2023] [Indexed: 02/07/2023]
Abstract
The European Academy of Dermatology and Venereology (EADV) Task Forces (TFs) on Quality of Life (QoL) and Patient-Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa (ARHS) do not recommend the use of any generic instrument as a single method of Health Related (HR) QoL assessment in rosacea, except when comparing quimp (quality of life impairment) in rosacea patients with that in other non-dermatologic skin diseases and/or healthy controls. The EADV TFs on QoL and Patient-Oriented Outcomes and ARHS recommend the use of the dermatology-specific HRQoL instrument the Dermatology Life Quality Index (DLQI) and the rosacea-specific HRQoL instrument RosaQoL in rosacea patients. The DLQI minimal clinically important difference may be used as a marker of clinical efficacy of the treatment and DLQI score banding of 0 or 1 corresponding to no effect on patients' HRQoL could be an important treatment goal. This information may be added to consensuses and guidelines for rosacea.
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Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - M Steinhoff
- Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar.,Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar.,Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar.,Weill Cornell Medicine-Qatar, Doha, Qatar.,Medical School, Qatar University, Doha, Qatar.,School of Medicine, Weill Cornell University, New York, New York, USA
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - N Pustisek
- Children's Hospital Zagreb, Zagreb, Croatia
| | - C Dessinioti
- Department of Dermatology, Andreas Syggros Hospital, University of Athens, Athens, Greece
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - S E Marron
- Department of Dermatology, Royo Villanova Hospital, Aragon Psychodermatology Research Group (GAI+PD), Zaragoza, Spain
| | - A Bewley
- Whipps Cross University Hospital, London, UK.,The Royal London Hospital, London, UK
| | - C Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - B Dréno
- INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, Nantes Université, Univ Angers, Nantes, France
| | - A Suru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - D Koumaki
- Department of Dermatology and Venereology, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - D Linder
- University Clinic for Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria
| | - A W M Evers
- Institute of Psychology, Health, Medical, and Neuropsychology Unit, Leiden University, Leiden, The Netherlands
| | - D Abeni
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | | | - V Bettoli
- Department of Medical Sciences, Section of Dermatology, University of Ferrara, Ferrara, Italy
| | - J С Szepietowski
- Department of Dermatology, Wroclaw Medical University, Wroclaw, Poland
| | - C C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
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14
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da Silva N, Augustin M, Hilbring C, von Stülpnagel C, Sommer R. Patient-physician (dis)agreement on their reports of body surface area affected by psoriasis and its associations with disease burden. J Eur Acad Dermatol Venereol 2022; 36:e995-e997. [PMID: 35788989 PMCID: PMC9796906 DOI: 10.1111/jdv.18400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- N. da Silva
- German Center for Health Services Research in Dermatology (CVderm)Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg‐Eppendorf (UKE)HamburgGermany
| | - M. Augustin
- German Center for Health Services Research in Dermatology (CVderm)Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg‐Eppendorf (UKE)HamburgGermany
| | - C. Hilbring
- German Center for Health Services Research in Dermatology (CVderm)Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg‐Eppendorf (UKE)HamburgGermany
| | - C.C. von Stülpnagel
- German Center for Health Services Research in Dermatology (CVderm)Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg‐Eppendorf (UKE)HamburgGermany
| | - R. Sommer
- German Center for Health Services Research in Dermatology (CVderm)Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg‐Eppendorf (UKE)HamburgGermany
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15
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Stephan B, Girbig G, Scherer M, Blozik E, Augustin M. [Dermatological video consultations for German prisons : Experiences from teledermatological consultations 2020 to 2022]. Dermatologie (Heidelb) 2022; 73:859-865. [PMID: 36149473 DOI: 10.1007/s00105-022-05060-y] [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] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND With increasing shortage of medical personnel also in the medical care in German correctional facilities, telemedicine has been used since 2016, initially in projects and then for regular medical care. Since 2019, there is the possibility of dermatological expertise in regular video consultations. OBJECTIVE The benefits of an interdisciplinary online consultation with video and store and forward technology for dermatological issues are highlighted in terms of efficiency and feasibility. MATERIAL AND METHODS A descriptive analysis of 450 dermatological video consultations for German correctional facilities from February 2020 to July 2022 was carried out with respect to procedures, indications and demand. RESULTS Requests were made via a standardised form with optional photographs, which were sent via a secure cloud to the dermatology department in store and forward mode. The majority of cases could be presented live in a regular weekly video consultation and only single cases required an acute presentation within 24 h. The spectrum of skin diseases was comparable to cases presenting to a dermatology outpatient clinic. The interdisciplinary consultation management together with colleagues from general medicine enabled the transfer of the cases to the medical personnel at the correctional facility on site for follow-up and further medical procedures. Treatment could be started in all cases without delay. CONCLUSION Teledermatology represents an important contribution to medical care in German correctional facilities and the interdisciplinary cooperation saves time and resources in the presentation and treatment of skin diseases.
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Affiliation(s)
- B Stephan
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland.
| | - G Girbig
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | - M Scherer
- A+ Videoclinic GmbH, München, Deutschland
- Institut und Poliklinik für Allgemeinmedizin (IPA), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland
| | - E Blozik
- A+ Videoclinic GmbH, München, Deutschland
- Institut für Hausarztmedizin, Universitätsspital Zürich (USZ), Zürich, Schweiz
| | - M Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
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16
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Knorr MS, Neyazi M, Bremer JP, Brederecke J, Ojeda FM, Ohm F, Augustin M, Blankenberg S, Kirsten N, Schnabel RB. Predicting cardiovascular risk factors from facial & full body photography using deep learning. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The early and easy detection of pathological cardiovascular phenotypes can lead to an early medical intervention and thus slow or limit the development of cardiovascular diseases. As full body photographs are easily obtainable without the need of medical expertise, this modality holds the potential to be viable for screening of populations.
Purpose
Utilizing data from a population-based study, we examined the possibility to detect cardiovascular risk factors from total body photographs using deep learning.
Methods
A population-based cohort study was utilized. The first data release provides facial and full body photographs in dermatologic standard poses of 6500 participants (median age 62.0 years, 49.6% men) and corresponding cardiovascular risk factors. Here, we focus on the most prevalent ones: smoking status (prevalence: 19.0%), hypertension (35.3%) and diabetes (8.2%). Here we employ a 2D-Convolutional Resnet-18 Neural Network for predicting the risk factors. It receives the full body image, the facial image and age and sex as input. We compare this to a logistic regression model only including sex and age. Logistic Regression and Neural Network are employed in a 5-fold validation scheme and t-tested for significance.
Results
Our model provided a good detection of arterial hypertension (AUC 0.711, CI 0.684–0.739), while a logistic regression on age and sex yielded a significantly worse prediction (AUC 0.681, CI 0.679– 0.683, p<0.05). Additionally, it made a good detection of a positive smoking status (AUC 0.733, CI 0.711–0.754), being significantly better than a respective logistic regression on age and sex (AUC 0.598, CI 0.597–0.6, p<0.001). Lastly, it classified diabetes well (AUC 0.744, CI 0.724–0.764, p<0.001) in comparison to the logistic regression (AUC 0.681, CI 0.679–0.683, p<0.001).
Conclusion
The presence of cardiovascular risk factors can be detected from a total body photograph. As total body photographs can be easily obtained with a majority of digital cameras, including smart phones, this model represents a potentially widely applicable diagnostic tool to easily screen large parts of the population for relevant cardiovascular risk factors, making an early medical intervention possible.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M S Knorr
- University Medical Center Hamburg Eppendorf, Department of Cardiology, University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - M Neyazi
- University Medical Center Hamburg Eppendorf, Department of Cardiology, University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - J P Bremer
- University Medical Center Hamburg Eppendorf, Department of Cardiology, University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - J Brederecke
- University Medical Center Hamburg Eppendorf, Department of Cardiology, University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - F M Ojeda
- University Medical Center Hamburg Eppendorf, Department of Cardiology, University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - F Ohm
- University Medical Center Hamburg Eppendorf, Institute for Health Services Research in Dermatology and Nursing (IVDP) , Hamburg , Germany
| | - M Augustin
- University Medical Center Hamburg Eppendorf, Institute for Health Services Research in Dermatology and Nursing (IVDP) , Hamburg , Germany
| | - S Blankenberg
- University Medical Center Hamburg Eppendorf, Department of Cardiology, University Heart & Vascular Center Hamburg , Hamburg , Germany
| | - N Kirsten
- University Medical Center Hamburg Eppendorf, Institute for Health Services Research in Dermatology and Nursing (IVDP) , Hamburg , Germany
| | - R B Schnabel
- University Medical Center Hamburg Eppendorf, Department of Cardiology, University Heart & Vascular Center Hamburg , Hamburg , Germany
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17
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Schneider L, Albrecht C, Grehn C, Gryc T, Knop S, Siegler G, Bott A, Rottmann M, Blos M, Linnemann U, Köhler J, Jakob J, Hohenberger P, Papadopoulos T, Meyer C, Mordstein V, B. Stein, Gazdag L, Reichert B, Augustin M. 1500P Radiochemotherapy with gemcitabine as a radiosensitizer in patients with soft tissue sarcomas. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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18
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Grünwald V, Pink D, Egerer G, Schalk E, Augustin M, Deinzer C, Kob V, Reichert D, Kebenko M, Brandl S, Hahn D, Lindner L, Hoiczyk M, Ringsdorf U, Hanker L, Hempel D, Pontes M, Wismann T, Ivanyi P. 1496P Trabectedin for patients with advanced soft tissue sarcoma: A non-interventional, prospective, multicenter study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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19
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Reich K, Mrowietz U, Sorbe C, von Kiedrowski R, Diemert S, Schaeffer L, Kirsten N, Ben-Anaya N, Augustin M. Response to fumaric acid esters for plaque type psoriasis in real-world practice is largely independent of patient characteristics at baseline - a multivariable regression analysis from the German psoriasis registry PsoBest. J DERMATOL TREAT 2022; 33:3170-3177. [PMID: 35981144 DOI: 10.1080/09546634.2022.2115285] [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: 10/15/2022]
Abstract
OBJECTIVES Fumaric acid esters (FAEs) are a well-established treatment option for long-term therapy of moderate to severe plaque psoriasis. This study examines effectiveness of FAEs for the treatment of plaque psoriasis in real-world practice at 12 months and if patient characteristics affect the odds of clinical response. METHODS A descriptive, multivariable logistic regression analysis was conducted in a cohort drawn from the German registry PsoBest. Baseline patient characteristics were assessed as potential treatment effect modifiers. RESULTS 444 patients (mean age 47.0 years, 39.0% female) were eligible for response analysis using nonresponder imputation at month 12. Of these, 39.6% achieved clinical response, i.e., Psoriasis Area and Severity Index (PASI) ≤3 or skin clearance. In logistic regression analysis (R2 = 0.114), only baseline PASI was a significant factor: patients with PASI <10 had a 4 times higher odds (p ≤ 0.001, OR 4.088), patients with PASI of 10-20 a twofold higher odds of response (p ≤ 0.044, OR 1.961) compared to those with PASI >20. Neither sex, age, body weight, disease duration, comorbidity nor pre-treatment had an impact on the odds of response (p > 0.05). CONCLUSIONS FAEs showed a favorable response at 12 months, largely independent of patient characteristics.
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Affiliation(s)
- K Reich
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - U Mrowietz
- Psoriasis-Center Kiel, Department of Dermatology, Venerology and Allergology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - C Sorbe
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - S Diemert
- Almirall Hermal GmbH, Reinbek, Germany
| | - L Schaeffer
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - N Kirsten
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - N Ben-Anaya
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Augustin M, Misery L, Kobyletzski LV, Mealing S, Redding M, Chuang CC, Massey R, Cawkwell M, Bego Le-Bagousse G, Haddy L, Rout R. Systematic literature review assessing the overall costs and societal impacts of moderate-to-severe atopic dermatitis in Europe. J Eur Acad Dermatol Venereol 2022; 36:2316-2324. [PMID: 35920758 DOI: 10.1111/jdv.18481] [Citation(s) in RCA: 6] [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: 03/11/2022] [Accepted: 07/11/2022] [Indexed: 11/29/2022]
Abstract
Atopic dermatitis (AD) is a chronic inflammatory disease, driven by type 2 inflammation. The condition manifests as moderate-to-severe disease in approximately 20% of adults with AD across Europe, and is associated with a substantial burden on patients, society, and healthcare systems. However, systematic assessments capturing the totality of disease burden associated with moderate-to-severe AD are limited; therefore, the overall impacts of the disease may be underestimated. A systematic literature review was carried out to assess the overall costs of moderate-to-severe AD across Europe, including the financial, societal, and humanistic impacts. PubMed, Embase and Cochrane databases were searched to identify relevant studies published between 1 January 2010 and 2 June 2020. Scientific conference proceedings, health technology assessment websites and patient association group websites were also searched for relevant information. Twenty-seven publications, corresponding to 22 unique studies, were included in the analysis. Total costs (direct and productivity losses) reached €20 695 per-person-per-year (PPPY) for adults with uncontrolled symptoms of moderate-to-severe AD. Direct medical costs ranged between €307 and €6993 PPPY; prescription medications and specialist dermatologist visits were the main contributors. Costs increased with disease severity or with uncontrolled disease. Patients with AD also incurred personal costs of €927 per year for healthcare items not reimbursed, which increased by 9% for those with moderate-to-severe forms. Annual work productivity losses comprised most of the total costs reported for adults with moderate-to-severe AD (up to 60.8% of the total burden) and were highest in those with uncontrolled disease (€13 702 PPPY). Patients with moderate-to-severe disease also experienced physical, emotional, and social impacts. The overall costs of moderate-to-severe AD greatly impact on healthcare systems, patients, and society. Sustained control of moderate-to-severe AD, through effective treatment and care management, is essential to limit the burden caused by the disease.
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Affiliation(s)
- M Augustin
- University Medical Center Hamburg, Hamburg, Germany
| | - L Misery
- University Hospital of Brest, Brest, France
| | | | - S Mealing
- York Health Economics Consortium (YHEC), York, UK
| | - M Redding
- Eczema Outreach Support, Linlithgow, Scotland
| | | | | | | | | | - L Haddy
- Aixial on behalf of Sanofi, Chilly-Mazarin, France
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Sommer R, Westphal L, Mrowietz U, Gerdes S, Augustin M. Measuring well-being in psoriasis: Psychometric properties of the WHO-5 questionnaire. J Eur Acad Dermatol Venereol 2022; 36:e986-e987. [PMID: 35788987 DOI: 10.1111/jdv.18396] [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] [Indexed: 11/26/2022]
Affiliation(s)
- R Sommer
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - L Westphal
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - U Mrowietz
- Psoriasis-Center Kiel, Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - S Gerdes
- Psoriasis-Center Kiel, Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Augustin M, Misery L, von Kobyletzki L, Armario-Hita JC, Mealing S, Redding M. Unveiling the true costs and societal impacts of moderate-to-severe atopic dermatitis in Europe. J Eur Acad Dermatol Venereol 2022; 36 Suppl 7:3-16. [PMID: 35801296 DOI: 10.1111/jdv.18168] [Citation(s) in RCA: 6] [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: 09/24/2021] [Revised: 04/01/2022] [Accepted: 04/21/2022] [Indexed: 11/26/2022]
Abstract
Atopic dermatitis (AD) is a chronic, auto-immune condition that imposes a high burden on individuals, society, and the healthcare system. Approximately 4.4% of adults and up to 18.6% of children/adolescents have AD in Europe, with 20% of all cases accounting for moderate-to-severe forms. This form of the condition in adults results in annual societal costs across Europe of an estimated €30 billion; €15.2 billion related to missed workdays or reduced work productivity, €10.1 billion related to direct medical costs and €4.7 billion related to personal expenditure of patients/families. AD can also substantially impact physical, emotional, and social quality-of-life. Several studies have shown the debilitating itch-scratch cycle is the main cause of the multifaceted burden, as it causes substantial sleep deprivation and stigmatisation due to the physical appearance of the skin, and confidence issues. These factors lead to psychosocial issues and can cumulate over time and prohibit patients reaching their 'full life potential'. Despite this, many patients with the condition are undertreated, resulting in uncontrolled symptoms and a further strain placed on patients, society, and the economy. The authors of this White Paper comprise the European Atopic Dermatitis Working Group, which is a network of international specialists with expertise in dermatology and healthcare policy decisions. Their programme of action is focused on harnessing their expertise to build consensus, advance research, share knowledge, and ultimately seek to improve AD care outcomes through achieving long-term symptom control. This White Paper presents a systematic evaluation of the overall financial and humanistic burden of moderate-to-severe AD and the current challenges that exist with AD care. It introduces recommendations for how, collaboratively, key stakeholders and policy makers can support improvements in AD management to achieve better disease control, thus reducing the costs and associated burden placed on individuals, society, and the economy.
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Affiliation(s)
- M Augustin
- University Medical Center Hamburg, Hamburg, Germany
| | - L Misery
- University Hospital of Brest, Brest, France
| | | | | | - S Mealing
- York Health Economics Consortium (YHEC), York, UK
| | - M Redding
- Eczema Outreach Support, Linlithgow, UK
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Augustin M, Sator PG, von Kiedrowski R, Conrad C, Rigopoulos D, Romanelli M, Ghislain PD, Torres T, Ioannides D, Aassi M, Schulz B, Jagiello P. Secukinumab demonstrated sustained retention, effectiveness and safety in a real-world setting in patients with moderate to severe plaque psoriasis: long-term results from an interim analysis of the SERENA study. J Eur Acad Dermatol Venereol 2022; 36:1796-1804. [PMID: 35696305 DOI: 10.1111/jdv.18329] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 11/09/2021] [Accepted: 04/29/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Randomised controlled trials of secukinumab have shown sustained efficacy and a favourable safety profile in multiple manifestations of psoriatic disease. OBJECTIVES To assess the long-term, real-world retention, effectiveness, and safety of secukinumab in routine clinical practice for the treatment of moderate to severe plaque-type psoriasis (PsO). METHODS SERENA (CAIN457A3403) is a large, ongoing, longitudinal, observational study conducted at 438 sites and 19 countries across Europe for an expected duration of up to 5 years in adult patients with moderate to severe PsO, psoriatic arthritis, and ankylosing spondylitis. Patients received ≥16 weeks of secukinumab treatment before enrolment. This interim analysis presents data from PsO patients, who were enrolled in the study between October-2016-October-2018 and were observed for ≥2 years. RESULTS In total, 1756 patients (67.3% male) with a mean age of 48.4 years and body mass index of 28.8 kg/m2 were included in the analysis. The secukinumab treatment retention rates after 1, 2 and 3 years in the study were 88.0%, 76.4% and 60.5%, respectively. Out of the 648 patients who discontinued the study, the most common reasons included lack of efficacy (42.6%), adverse event (17.4%), physician decision (12.2%) and subject decision (11.6%). Mean±SD absolute PASI was 21.0±13.0 at the start of treatment (n=1,564). At Baseline, the mean±SD PASI score reduced to 2.6±4.8 and remained low at Year 1 (2.3±4.3), Year 2 (1.9±3.6) and Year 3 (1.9±3.5). The safety profile of secukinumab during the SERENA study was consistent with its known safety profile, with no new safety signals reported. Particularly low rates of inflammatory bowel disease (0.3%; Incidence Rate [IR]:0.15), candida infections (3.1%; IR:1.43) and MACE (0.9%; IR:0.37) were observed. CONCLUSIONS Secukinumab showed high treatment persistence, sustained effectiveness and a favourable safety profile up to 3 years of follow-up in the real-world population of PsO patients observed in SERENA.
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Affiliation(s)
- M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P G Sator
- Department of Dermatology, Municipal Hospital Hietzing, Vienna, Austria
| | - R von Kiedrowski
- Company for Medical Study & Service Selters (CMS3) GmbH, Selters, Germany
| | - C Conrad
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - D Rigopoulos
- Dermatology and Venerology, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - M Romanelli
- Dermatology Department, University of Pisa, Pisa, Italy
| | - P-D Ghislain
- Dermatology, Cliniques Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - T Torres
- Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - D Ioannides
- First Department of Dermatology and Venereology, School of Medicine, Aristotle University, Thessaloniki, Greece
| | - M Aassi
- Novartis Pharma AG, Basel, Switzerland
| | - B Schulz
- Novartis Pharma AG, Basel, Switzerland
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Lindner L, Augustin M, Kühl L, Weiß A, Rustenbach SJ, Behrens F, Feuchtenberger M, Schwarze I, Mrowietz U, Thaçi D, Reich K, Strangfeld A, Regierer A. AB0952 Characterization of patients with psoriatic arthritis in dermatologic and rheumatologic care: an analysis of two disease registries. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPsoriatic arthritis (PsA) is a chronic inflammatory disease affecting the musculoskeletal system, skin and nails. Therapeutic management in Germany is usually provided by a dermatologist or rheumatologist.ObjectivesThe aim is to characterize the socioeconomic and clinical patient profiles in dermatologic and rheumatologic settings.MethodsBaseline data of patients with PsA from [1] the dermatological German Psoriasis Registry PsoBest (PB) and [2] the rheumatological German disease register RABBIT-SpA (RS) [2] were analyzed. For this purpose, comparable anamnestic and clinical variables collected in the period 10/2017 to 12/2020 were identified and descriptively analyzed. The analysis was carried out in each of the data-holding registers.Results1066 RS patients and 704 PB patients were included in the analysis (Table 1). The proportion of women was higher in the rheumatology setting (RS) (60% vs. 49%). Disease duration of psoriasis was longer in the dermatology setting (PB). Cutaneous severity was higher in PB, including affected body surface area and nail psoriasis. However, more patients in RS had tender joints and swollen joints. The physician-reported global disease activity was higher in RS. The mean DLQI (Dermatology Life Quality Index) was higher in PB and the mean HAQ (Health Assessment Questionnaire) was higher in RS. Patient reported global disease activity and pain were lower in PB.Table 1.Baseline data of patients with PsA from the registers PsoBest and RABBIT-SpA included 10/2017 to 12/2020.RABBIT-SpA(Rheumatology setting)PsoBest(Dermatology setting)N1066704Age, mean (SD)51.9 (12.2)51.7 (13.2)Female, n (%)637 (60)346 (49)Disease duration skin, mean (SD)14.3 (13.9)21.6 (16.0)Body surface area, mean (SD)8.5 (15.0)20.8 (19.8)Nail psoriasis, n (%)434 (41)407 (58)Tender joints, n (%)905 (85)498 (71)Swollen joints, n (%)708 (67)387 (55)Physician reported disease activity, mean (SD)5.2 (1.9)4.6 (2.7)DLQI, mean (SD)5.6 (6.2)12.2 (7.6)HAQ, mean (SD)0.9 (0.7)0.7 (0.6)Patient reported disease activity, mean (SD)5.7 (2.4)4.9 (2.9)Patient reported pain, mean (SD)5.5 (2.4)5.2 (2.8)bDMARD, n (%)751 (71)514 (73)TNF, n (%)346 (46)117 (23)IL17, n (%)351 (47)246 (48)IL23, n (%)54 (7)151 (29)tsDMARD, n (%)109 (10)47 (7)csDMARD, n (%)195 (18)142 (20)Most of the patients received biologics at inclusion (RS: 71% and PB: 73%). In the dermatology setting IL23 inhibitors were used more frequently, whereas TNF inhibitors were used more frequently in the rheumatology setting.ConclusionThe clinical specialization of the treating physician was associated with a different treatment and clinical status of patients with PsA. Our analysis showed that patients in the rheumatology setting more frequently had joint affections and lower functional status, whereas skin severity was worse in the dermatology setting, indicating selection effects of health care access. We hypothesize out that these differences may be biased due to different diagnostic and therapeutic routines in the specialized health care settings. Psoriatic arthritis should be treated in a multidisciplinary approach to take into account all facets of this complex disease.References[1]PMID: 24393314[2]PMID: 30874933Disclosure of InterestsLisa Lindner Grant/research support from: RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris., Matthias Augustin Grant/research support from: The PsoBest registry is/was supported by AbbVie, Almirall Hermal, Amgen, Biogen, BMS, Celgene, Hexal, Janssen-Cilag, LEO Pharma, Eli Lilly, Medac, Novartis, Pfizer, UCB and Viatris. These companies do not have influence on the design of the registry, data collection, analyses, the publication decisions or development., Laura Kühl Grant/research support from: The PsoBest registry is/was supported by AbbVie, Almirall Hermal, Amgen, Biogen, BMS, Celgene, Hexal, Janssen-Cilag, LEO Pharma, Eli Lilly, Medac, Novartis, Pfizer, UCB and Viatris. These companies do not have influence on the design of the registry, data collection, analyses, the publication decisions or development., Anja Weiß Grant/research support from: RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris., Stephan Jeff Rustenbach Grant/research support from: The PsoBest registry is/was supported by AbbVie, Almirall Hermal, Amgen, Biogen, BMS, Celgene, Hexal, Janssen-Cilag, LEO Pharma, Eli Lilly, Medac, Novartis, Pfizer, UCB and Viatris. These companies do not have influence on the design of the registry, data collection, analyses, the publication decisions or development., Frank Behrens: None declared, Martin Feuchtenberger: None declared, Ilka Schwarze: None declared, Ulrich Mrowietz: None declared, Diamant Thaçi: None declared, Kristian Reich Grant/research support from: The PsoBest registry is/was supported by AbbVie, Almirall Hermal, Amgen, Biogen, BMS, Celgene, Hexal, Janssen-Cilag, LEO Pharma, Eli Lilly, Medac, Novartis, Pfizer, UCB and Viatris. These companies do not have influence on the design of the registry, data collection, analyses, the publication decisions or development., Anja Strangfeld Grant/research support from: RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris., Anne Regierer Grant/research support from: RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris.
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Jemec GBE, Del Marmol V, Bettoli V, Augustin M, Prens EP, Zouboulis CC. Register, multicenter and genome-wide association studies in hidradenitis suppurativa. Exp Dermatol 2022; 31 Suppl 1:22-28. [PMID: 35582836 DOI: 10.1111/exd.14610] [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: 03/17/2022] [Revised: 05/04/2022] [Accepted: 05/15/2022] [Indexed: 11/28/2022]
Abstract
The European Hidradenitis Suppurativa Foundation (EHSF) e.V. has taken several initiatives to collaborative studies. They result from the data of the European Registry of Hidradenitis Suppurativa (ERHS) based on the knowledge obtained from the regional Northern countries (HISREG) and Italian (IRHIS) registries and the real-world data generated from claims data from insurance databases. Multicenter studies, such as the Hidradenitis Suppurativa collaborative study of subtypes (HORUS) and the Global Hidradenitis Suppurativa Atlas (GHISA) are planned to provide an ideal complement to the register studies. Most recently, the role of EHSF as a coordinator or key player is being explored in multiple genetic studies, such as a genome-wide association study (GWAS) and the exome sequencing and cellular/molecular profiling project, which will speed up gene and drug discovery in HS.
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Affiliation(s)
- G B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| | - V Del Marmol
- Department of Dermatology, Hopital Erasme, Université Libre de Bruxelles, Belgium.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| | - V Bettoli
- Department of Dermatology, University of Ferrara, Ferrara, Italy.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing, University Hospital Hamburg-Eppendorf, Hamburg, Germany.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| | - E P Prens
- Department of Dermatology, Erasmus Medical Center, University of Rotterdam, Rotterdam, Netherlands.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| | - C C Zouboulis
- Departments of Dermatology, Venereology, Allergollogy and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
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van Straalen KR, Ingram JR, Augustin M, Zouboulis CC. New treatments and new assessment instruments for hidradenitis suppurativa. Exp Dermatol 2022; 31 Suppl 1:33-39. [PMID: 35582833 PMCID: PMC9542859 DOI: 10.1111/exd.14609] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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] [Received: 03/23/2022] [Revised: 05/08/2022] [Accepted: 05/15/2022] [Indexed: 11/26/2022]
Abstract
Research interest in Hidradenitis Suppurativa (HS) has grown exponentially over the past decades. Several groups have worked to develop novel scores that address the drawbacks of existing investigator assessed and patient reported outcome measures currently used in HS trials, clinical practice and research. In clinical trial settings, the drawbacks of the HiSCR have become apparent; mainly it's lack of a dynamic measurement of draining tunnels. The newly developed (dichotomous) IHS4 and HASI-R are backed up by adequate validation data and are good contenders to become the new primary outcome measure in HS clinical trials. Patient reported outcomes, as well as physician reported measures, are being developed by the HIdradenitis SuppuraTiva cORe outcomes set International Collaboration (HISTORIC). For example, the Hidradenitis Suppurativa Quality of Life (HiSQOL) score is a validated measure of HS-specific quality of life and is already being used in many HS trials. Magnitude of pain measurement via a 0-10 numerical rating scale is well-established, however consensus is still required to ensure consistent administration and interpretation of the instrument. A longitudinal measurement over multiple days rather than at one time point, such as for example the Pain Index could provide increased reliability and reduced recall bias. Ultimately, these newly developed scores and tools can be included in a standardized registry to be used in routine clinical practice.
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Affiliation(s)
- K R van Straalen
- Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| | - J R Ingram
- Department of Dermatology, Division of Infection & Immunity, Cardiff University, Cardiff, UK.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| | - M Augustin
- Institute for Health Care Services Research in Dermatology and Nursing, University Hospital Medical Center Hamburg-Eppendorf, Hamburg, Germany.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| | - C C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
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Augustin M, Hallek M, Nitschmann S. [Antibody therapy in patients with COVID-19]. Internist (Berl) 2022; 63:573-576. [PMID: 35376974 PMCID: PMC8977562 DOI: 10.1007/s00108-022-01321-z] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2022] [Indexed: 11/30/2022]
Affiliation(s)
- M Augustin
- Klinik I für Innere Medizin, Universitätsklinikum Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland.
| | - M Hallek
- Klinik I für Innere Medizin, Universitätsklinikum Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland
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von Stuelpnagel CC, Petersen J, Augustin M, Sommer R. [Dermatological care of elderly people with psoriasis before and after entering a nursing home : A qualitative analysis from the perspective of medical providers]. Hautarzt 2022; 73:627-633. [PMID: 35482046 PMCID: PMC9047578 DOI: 10.1007/s00105-022-04989-4] [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] [Accepted: 03/28/2022] [Indexed: 11/22/2022]
Abstract
Hintergrund Demografische Veränderungen bewirken einen steilen Anstieg der Anzahl der über 65-Jährigen. Damit verbunden ist die Zunahme der Anzahl pflegebedürftiger, multimorbid Erkrankter. National wie auch international gibt es keine Informationen insbesondere zur Versorgung von Psoriasiserkrankten im Setting Pflegeheim und zur Frage, wie diese durch den Eintritt in ein Pflegeheim beeinflusst wird. Fragestellung Ziel war es, anhand von Interviews bzw. Fokusgruppen die Ergebnisse vorausgehender Routinedatenanalysen zur Versorgung Psoriasiserkrankter in Pflegeheimen mit medizinischen Versorgern (Dermatologen, Allgemeinmediziner, Pflegedienstleitungen und Pflegekräfte) zu diskutieren, Schwierigkeiten der Versorgung aufzudecken und abschließend Handlungsempfehlungen für eine zukunftsfähige gerontodermatologische Versorgung abzuleiten. Material und Methoden Durchgeführt wurden qualitative Leitfaden-gestützte Interviews und Fokusgruppen mit Dermatologen (n = 5), Allgemeinmedizinern (n = 7), Pflegekräften (n = 7) und Pflegedienstleitungen (n = 2). Die Daten wurden inhaltsanalytisch ausgewertet. Ergebnisse Die Auswertung ergab insgesamt 344 Aussagen, die insgesamt 14 Hauptkategorien zugeordnet werden konnten. Die Ergebnisse zeigen, dass für die Versorgungsqualität von Menschen mit Hautkrankheiten, insbesondere Psoriasis, in Pflegeinrichtungen ein Verbesserungsbedarf besteht. Dieser zeigt sich sowohl auf ärztlicher als auch auf pflegerischer Ebene. Laut der Versorger (N = 21) kann dies insbesondere durch eine verstärkte digitale Versorgung, dermatologische Schulungen für Hausärzte und Pflegefachkräfte sowie engere Kooperationen zwischen den einzelnen Disziplinen adressiert werden. Schlussfolgerung Digitale Pflegekonsile, aber auch eine spezifische Leitlinie zur „Haut des alternden Menschen“ können von Nutzen sein, um die dermatologische Versorgungssituation im Pflegeheim zu verbessern und somit das Wohlbefinden der Betroffenen zu steigern.
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Affiliation(s)
- C C von Stuelpnagel
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | - J Petersen
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | - M Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | - R Sommer
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland.
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Kirsten N, Augustin M, Strömer K. [Digital health applications and date protection]. Hautarzt 2022; 73:391-397. [PMID: 35471235 DOI: 10.1007/s00105-022-04980-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2022] [Indexed: 11/30/2022]
Abstract
Digital health applications represent a new form of care. The basis for the approval of digital health applications is the Digital Healthcare Act. In order to be included in the directory, the digital health applications must undergo an extensive evaluation process by the Federal Institute for Drugs and Medical Devices. The focus is on proving added value for care, but also on the technical aspects. This strictly differentiates the digital health applications from the health apps. Cutting-edge apps enable a simple output of collected data to make doctor-patient interactions efficient. Appropriate remuneration and education could increase the acceptance by the medical profession and thus accelerate implementation; however, such instruments and incentives are not currently provided for in the system.
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Affiliation(s)
- N Kirsten
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland.
| | - M Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | - K Strömer
- Dermatologische Privatpraxis, Ahaus, Deutschland
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Mohr N, Augustin M, Zeervi L, Bieber T, Werfel T, Wollenberg A, Langenbruch A. Determinants of costs and benefits in atopic dermatitis routine care in Germany. J Eur Acad Dermatol Venereol 2022; 36:1450-1455. [PMID: 35460522 DOI: 10.1111/jdv.18169] [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: 11/03/2021] [Accepted: 04/05/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES The economic burden of atopic dermatitis (AD) is of particular interest. The present study aims to analyse the association of disease-related characteristics, annual costs and treatment benefits in AD. METHODS Between August 2017 and June 2019, a cross-sectional observational study in patients with AD was conducted in Germany. Cost-of-illness data were assessed from the societal perspective. Disease characteristics included severity, time since diagnosis, therapy, as well as atopic comorbidity and the implementation of prevention measures. Subgroup analyses of the total costs were conducted for these characteristics. A linear regression model was applied to analyse the impact of disease characteristics on the costs. Furthermore, associations of biologic treatment with outcome parameters were analysed. RESULTS 1,291 patients from 111 centres were included in the analyses. The total costs amounted on average to € 3,660 ± € 6,428 per patient and year. Higher costs were shown in various patient groups, for example in patients using biologics (€ 20,983 vs. € 2,470). In a regression analysis, gender, education, and the number of implemented prevention measures were identified as significant predictors of costs. Patients treated with biologics showed consistently better outcome parameters and were more often satisfied with their treatment. CONCLUSIONS Gender, education, and implemented prevention measures are significant cost determinants in AD. The results confirm that treatment with biologics is the main cost driver in AD. However, incremental patient-relevant benefits of high-priced therapy are reflected by the significantly better clinical outcomes in the group treated with biologics.
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Affiliation(s)
- N Mohr
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - L Zeervi
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - T Bieber
- Department of Dermatology and Allergy, University Hospital Bonn, Bonn, Germany
| | - T Werfel
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - A Wollenberg
- Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
| | - A Langenbruch
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Augustin M, Hallek M, Nitschmann S. [Risk of myocarditis associated with mRNA vaccines for prevention of COVID-19]. Internist (Berl) 2022; 63:461-464. [PMID: 35262745 PMCID: PMC8906115 DOI: 10.1007/s00108-022-01293-0] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2022] [Indexed: 11/08/2022]
Affiliation(s)
- M Augustin
- Klinik I für Innere Medizin, Universitätsklinikum Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland.
| | - M Hallek
- Klinik I für Innere Medizin, Universitätsklinikum Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland
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Affiliation(s)
- M Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland.
| | - J Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland.
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Ständer S, Zeidler C, Pereira M, Szepietowski JC, McLeod L, Qin S, Williams N, Sciascia T, Augustin M. Worst Itch Numerical Rating Scale for Prurigo Nodularis: A Psychometric Evaluation. J Eur Acad Dermatol Venereol 2021; 36:573-581. [PMID: 34908192 DOI: 10.1111/jdv.17870] [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: 09/16/2021] [Revised: 11/03/2021] [Accepted: 11/11/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Study TR03 evaluated the safety and efficacy of nalbuphine ER for prurigo nodularis (PN) (NCT02174419). OBJECTIVE We conducted supplementary analyses to assess the psychometric properties of the Worst Itch Numeric Rating Scale (WI-NRS), the TR03 primary endpoint. METHODS Study TR03 was a double-blind, placebo-controlled, phase 2 trial in PN patients with documented scores ≥5 on the WI-NRS (0 [no itch]-10 [worst itch imaginable]) on ≥5 of 7 days before baseline. Using TR03 data, the WI-NRS's psychometric properties, including reliability, validity, and ability to detect change, were evaluated. A responder threshold was estimated to facilitate interpretation of WI-NRS score changes. RESULTS Among 62 treated patients, improvements in mean [SD] (median) WI-NRS scores were observed between baseline (8.2 [1.21] (8.1)) and Week 10 (5.8 [2.43] (6.0)). The WI-NRS had an intraclass correlation coefficient of 0.96 (95% confidence interval, 0.93-0.98) in 42 patients who had stable Itch verbal rating scale (VRS) scores from Week 9-10, supporting strong test-retest reliability. Construct validity was supported, with strong correlations at Week 10 with Average Itch NRS (r=0.87) and Itch VRS single-day/weekly mean scores (r=0.81/0.89) and moderate correlations with ItchyQoLTM total/domain scores (r=0.41-0.43). The WI-NRS discriminated between predefined severity subgroups based on the Itch VRS and detected changes in itching severity (effect-size estimate: -2.05; standardized response mean: -1.21). An anchor-based threshold based on a two-category improvement in the single-day Itch VRS suggests a responder threshold of ≥3.8 points (~40% improvement). CONCLUSIONS The WI-NRS demonstrates good measurement properties, supporting its use in evaluating treatment change in PN.
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Affiliation(s)
- S Ständer
- University Hospital Münster, Münster
| | - C Zeidler
- University Hospital Münster, Münster
| | - M Pereira
- University Hospital Münster, Münster
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | | | | | | | | | - M Augustin
- University Medical Center Hamburg-Eppendorf
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Augustin J, Sander M, Bei der Kellen R, Augustin M. [Analysis of the skin cancer incidence in Hamburg]. Hautarzt 2021; 73:21-26. [PMID: 34842936 DOI: 10.1007/s00105-021-04915-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim of health geographical research is to identify regional variations in health and care and their causes. Regional differences are also evident in skin cancer incidence, but knowledge about small-scale, inner-city variations is not yet available. OBJECTIVES How can the inner-city variations in skin cancer incidence in Hamburg, Germany, be described and how can initial indications of their causes be identified? METHODS The study area is the city of Hamburg and the data source is the Hamburg City Health Study with N = 10,000 persons aged 45-74 years. Descriptive methods are used to characterise the regional variation in skin cancer prevalence adjusted for age and sex. A correlation analysis provides information on possible associations with sociodemographic conditions in the city districts and district clusters. RESULTS Skin cancer prevalence varies within the urban area with high prevalences (maximum 13.8%) in the north-east and south-west of Hamburg. Weak to medium correlations with selected sociodemographic variables are found. For example, the higher the living space per inhabitant (r = 0.35), the higher the skin cancer prevalence in the district. CONCLUSIONS The Hamburg City Health Study shows regional and inner-city disparities and possible associations between skin cancer prevalence and local sociodemographic conditions. However, further and methodologically more extensive studies are necessary in order to make detailed statements.
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Affiliation(s)
- J Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), CVderm
- CPW 3, Martinistr. 52, 20246, Hamburg, Deutschland.
| | - M Sander
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), CVderm
- CPW 3, Martinistr. 52, 20246, Hamburg, Deutschland
| | - R Bei der Kellen
- Studienzentrum Hamburg City Health Study, Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland
| | - M Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), CVderm
- CPW 3, Martinistr. 52, 20246, Hamburg, Deutschland
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Augustin M, Garbe C, Neitemeier S, Steimle T, Schwarz S, Augustin J, von Kiedrowski R, Hagenström K. [Regional variations in healthcare for patients with psoriasis and atopic dermatitis in Germany]. Hautarzt 2021; 73:27-39. [PMID: 34821976 DOI: 10.1007/s00105-021-04913-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Psoriasis (Pso) and atopic dermatitis (AD) are chronic skin diseases that result in significant physical and psychological impairment, financial burden, and loss of quality of life. According to previous data, there are regional differences in healthcare. OBJECTIVES The aim was to analyse the epidemiology as well as the treatment of insured people with Pso and AD in Germany in a regional comparison. METHODS Data of the insurance company Techniker Krankenkasse for the year 2019 regarding treatment prevalences as well as drug prescriptions on the regional level for all physicians were examined. RESULTS In 2019 the overall prevalence of Pso was 2.5% (about 2 million insured people in Germany) and AD was 4.2% (about 3.6 million insured people). In Pso, new guideline-compliant drugs were frequently utilised, yet systemic glucocorticosteroids (GCS) were still disproportionally prescribed. Regionally, there were pronounced disparities with higher prescription rates of the new drugs in the north and east. Insured people with AD most frequently received topical GCS (approx. 88%), of which most were class III (66%), and significantly less frequently calcineurin inhibitors (< 10%), which also conform to guidelines. Systemically, GCS were by far most commonly used (about 25% of all insured people with drug prescriptions). Dupilumab, the only long-term drug approved in 2019, was very rarely prescribed, accounting for less than 1%. Again, large regional differences similar to Pso were found. CONCLUSION Pso and AD show relevant disparities and gaps in drug care in the regional comparison despite uniform national guidelines and patient needs. The barriers to appropriate modern pharmaceuticals need to be clarified and mitigated.
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Affiliation(s)
- M Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | - C Garbe
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | | | - T Steimle
- Techniker Krankenkasse, Hamburg, Deutschland
| | - S Schwarz
- Techniker Krankenkasse, Hamburg, Deutschland
| | - J Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | - R von Kiedrowski
- Dermatologische Spezial- und Schwerpunktpraxis Selters, Selters, Deutschland
| | - K Hagenström
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland.
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Luck-Sikorski C, Roßmann P, Topp J, Augustin M, Sommer R, Weinberger NA. Assessment of stigma related to visible skin diseases: a systematic review and evaluation of patient-reported outcome measures. J Eur Acad Dermatol Venereol 2021; 36:499-525. [PMID: 34817889 DOI: 10.1111/jdv.17833] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/03/2021] [Indexed: 11/30/2022]
Abstract
Misconceptions about visible skin diseases are widespread, and patients often face discrimination and stigmatization due to their condition. The associated negative health and psychosocial consequences of stigmatization in skin diseases have prompted an increase in research activity in recent times, resulting in a wide variety of assessment measures. This study aimed at aggregating and evaluating evidence of psychometric properties and methodological quality of published measures to assess stigma in visible skin diseases. Studies assessing stigmatization in visible skin diseases were searched in four databases (Medline, PsycINFO, Web of Science and Embase) until February 2021. The review followed PRISMA guidelines. Papers regarding development and/or validation of measures were identified by two independent researchers. Inclusion criteria were defined as follows: (i) quantitative studies in (ii) populations with skin diseases using (iii) questionnaires explicitly assessing (iv) perceived or public stigmatization or discrimination available in (iv) English or German language. The COnsensus-based Standards of health Measurement INstruments (COSMIN) checklist was used to evaluate their psychometric properties and risk of bias. 35 studies using 21 instruments were identified. Twenty instruments focused on assessing the perceived reality of those affected by visible skin diseases, while public stigma was only assessed by two instruments. Twelve scales could be recommended for use, while nine instruments had the potential to be recommended after further studies have assessed their quality. Some limitations are to be noted. Only studies in English and German were included. Research on self-constructed instruments can lead to new validated instruments, but they were not included in the review at this point. Several validated instruments could be recommended for use. Future research is needed regarding the assessment of stigma across different visible skin diseases, in children and adolescents, and in the general public.
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Affiliation(s)
- C Luck-Sikorski
- Research Group: Chronic Diseases and Psychological health (COPE), University of Applied Health Sciences SRH Gera, Gera, Germany
| | - P Roßmann
- Research Group: Chronic Diseases and Psychological health (COPE), University of Applied Health Sciences SRH Gera, Gera, Germany
| | - J Topp
- Institute for Health Services Research in Dermatology and Nursing (IVDP), German Centre for Health Services Research in Dermatology (CVderm), University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), German Centre for Health Services Research in Dermatology (CVderm), University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - R Sommer
- Institute for Health Services Research in Dermatology and Nursing (IVDP), German Centre for Health Services Research in Dermatology (CVderm), University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - N A Weinberger
- Research Group: Chronic Diseases and Psychological health (COPE), University of Applied Health Sciences SRH Gera, Gera, Germany
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van Ee I, Deprez E, Egeberg A, Augustin M, Conrad C, Corazza V, Donati L, Lambert J, Lăpădatu R, Meyer A, Paul C, Penzer-Hick R, Stephen K, van der Zon J, Bewley A. Freedom from disease in psoriasis: a Delphi consensus definition by patients, nurses and physicians. J Eur Acad Dermatol Venereol 2021; 36:403-412. [PMID: 34816508 PMCID: PMC9303201 DOI: 10.1111/jdv.17829] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 11/03/2021] [Indexed: 12/22/2022]
Abstract
Background Physician‐reported clinical outcome and quality of life (QoL) measures are currently used to assess outcomes and direct treatment of plaque psoriasis. However, people with psoriasis may have different criteria for judging treatment success. Objectives To build a unified consensus on the definition of ‘freedom from disease’ from a European stakeholder group, including people with psoriasis, dermatologists and nurses. Methods The modified Delphi consensus methodology was used to define ‘freedom from disease’, with a consensus group consisting of people with psoriasis, nurses and dermatologists. This methodology involved people with psoriasis during the entire process and consisted of a 15‐member Facilitating Consensus Panel to drive the programme content and a larger Voting Consensus Panel to vote on defining ‘freedom from disease’. The Facilitating Panel agreed on disease domains, and aspects of each domain were put forward to the Voting Consensus Panel to establish relative importance. Following two voting rounds, a meeting was held to agree on a final consensus statement. Results The Facilitating Panel consisted of six patient advocacy group representatives, three specialist nurses and six dermatologists. Voting rounds 1 and 2 were completed by 166 and 130 respondents from the Voting Consensus Panel, respectively. The outputs from both rounds of voting were similar, focusing on normality of living, symptom control, and a relationship of mutual respect and trust between the individual with psoriasis and their healthcare professional. The consensus statement emphasizes that ‘freedom from disease’ is multifaceted and includes the following domains ‘management of clinical symptoms’, ‘psychosocial elements’, ‘QoL and well‐being’, ‘treatment’ and ‘healthcare team support’. ‘Freedom from disease’ means all aspects are addressed. Conclusions Freedom from disease in psoriasis is a multicomponent concept including five main domains. This diverse and multifaceted patient perspective will help us to improve understanding of the outcomes of treatment interventions in people with psoriasis.
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Affiliation(s)
- I van Ee
- Psoriasispatiënten Nederland (PN), Nijkerk, The Netherlands
| | - E Deprez
- Ghent University Hospital, Ghent, Belgium
| | - A Egeberg
- Department of Dermatology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - M Augustin
- IVDP Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - C Conrad
- Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - V Corazza
- Fondazione Natalino Corazza Onlus Psoriasis & Co, Bologna, Italy
| | - L Donati
- Fondazione Natalino Corazza Onlus Psoriasis & Co, Bologna, Italy
| | - J Lambert
- Ghent University Hospital, Ghent, Belgium
| | - R Lăpădatu
- Associaţia Pacienţilor cu Afecţiuni Autoimune (APAA), Bucharest, Romania
| | - A Meyer
- Deutscher Psoriasis Bund e.V. (DPB), Hamburg, Germany
| | - C Paul
- Paul Sabatier University, Toulouse, France.,Centre Hospitalier Universitaire, Toulouse, France
| | | | | | - J van der Zon
- Psoriasispatiënten Nederland (PN), Nijkerk, The Netherlands
| | - A Bewley
- Barts Health NHS Trust & Queen Mary University, London, UK
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Helmert C, Haufe E, Heinrich L, Siegels D, Abraham S, Heratizadeh A, Harder I, Kleinheinz A, Wollenberg A, Wiemers F, Weisshaar E, Augustin M, von Kiedrowski R, Zink A, Pawlak M, Schäkel K, Wildberger J, Weidinger S, Werfel T, Schmitt J. Atopic dermatitis and depressive symptoms. Results of the German national AD Registry TREATgermany. J Eur Acad Dermatol Venereol 2021; 36:e279-e282. [PMID: 34779054 DOI: 10.1111/jdv.17812] [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] [Indexed: 11/28/2022]
Affiliation(s)
- C Helmert
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - E Haufe
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - L Heinrich
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - D Siegels
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - S Abraham
- Department of Dermatology, University Allergy Center, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - A Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - I Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - A Kleinheinz
- Clinics for Dermatology, Elbe Klinikum Buxtehude, Buxtehude, Germany
| | - A Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich, Munich, Germany
| | - F Wiemers
- Practice Dr. med. Franca Wiemers, Leipzig, Germany
| | - E Weisshaar
- Occupational Dermatology, Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - R von Kiedrowski
- CMSS - Company for Medical Study and Service, Selters/Westerwald, Germany
| | - A Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - M Pawlak
- Practice Dr. med, Anika Hünermund and Mario Pawlak, Heilbad Heiligenstadt, Germany
| | - K Schäkel
- Department of Dermatology, Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | | | - S Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - J Schmitt
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Duell J, Obr A, Augustin M, Endell J, Liu H, Geiger S, Silverman IM, Ambarkhane S, Rosenwald A. CD19 expression is maintained in DLBCL patients after treatment with tafasitamab plus lenalidomide in the L-MIND study. Leuk Lymphoma 2021; 63:468-472. [PMID: 34779360 DOI: 10.1080/10428194.2021.1986219] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Johannes Duell
- Medizinische Klinik und Poliklinik II, Universitätsklinik Würzburg, Würzburg, Germany
| | - Aleš Obr
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Marinela Augustin
- Klinik für Innere Medizin 5, Universitätsklinik der Paracelsus Medizinischen Privatuniversität, Nürnberg, Germany
| | | | - Hao Liu
- Incyte Research Institute, Wilmington, DE, USA
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Pilz AC, Schielein MC, Schuster B, Heinrich L, Haufe E, Abraham S, Heratizadeh A, Harder I, Kleinheinz A, Wollenberg A, Wiemers F, Weisshaar E, Augustin M, von Kiedrowski R, Pawlak M, Schäkel K, Wildberger J, Hilgers M, Werfel T, Weidinger S, Schmitt J, Biedermann T, Zink A. Atopic Dermatitis: Disease Characteristics and Comorbidities in Smoking and Nonsmoking Patients from the TREATgermany Registry. J Eur Acad Dermatol Venereol 2021; 36:413-421. [PMID: 34743344 DOI: 10.1111/jdv.17789] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 07/08/2021] [Revised: 09/15/2021] [Accepted: 10/22/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin disease with a multifactorial genesis including genetic predispositions and environmental risk and trigger factors. One of the latter possibly is smoking, indicated by an increased prevalence of AD in adults and children that are actively or passively exposed to cigarette smoke. OBJECTIVES In this study AD characteristics and its atopic comorbidities are compared in smoking and nonsmoking AD patients. METHODS TREATgermany is a non-interventional clinical registry which includes patients with moderate to severe AD in Germany. Baseline data of patients included into TREATgermany from inception in June 2016 to April 2020 in 39 sites across Germany was analyzed comparing AD disease characteristics and comorbidities in smokers versus non-smokers. RESULTS Of 921 patients, 908 (male: 58.7%) with a mean age of 41.9 ± 14.4 reported their smoking status. The objective Scoring of Atopic Dermatitis (oSCORAD) did not differ between smokers (n=352; 38.8%) and nonsmokers, however lesions' intensity of oozing/crusts and excoriations as well as patient global assessment scores (PGA) of AD severity were higher in smoking as opposed to nonsmoking patients. Smokers reported a lower number of weeks with well-controlled AD and more severe pruritus than nonsmokers. Total IgE levels were more elevated in smokers and they displayed a younger age at initial diagnosis of bronchial asthma. After adjustment for potential confounders, the increased intensity of oozing/crusts, the reduced number of weeks with well-controlled AD and the greater pruritus remained different in smokers compared to nonsmokers. In addition, smoking patients with adult-onset AD showed a 2.5 times higher chance of involvement of the feet. CONCLUSIONS German registry data indicate that AD patients who smoke have a higher disease burden with a different distribution pattern of lesions in adult-onset AD.
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Affiliation(s)
- A C Pilz
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - M C Schielein
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - B Schuster
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - L Heinrich
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden
| | - E Haufe
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden
| | - S Abraham
- Department of Dermatology, University Allergy Center, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden
| | - A Heratizadeh
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover
| | - I Harder
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel
| | - A Kleinheinz
- Clinics for Dermatology, Elbe Klinikum Buxtehude
| | - A Wollenberg
- Clinics and Outpatient Clinics for Dermatology and Allergy, LMU Munich
| | - F Wiemers
- Practice Dr. med. Franca Wiemers, Leipzig
| | - E Weisshaar
- Occupational Dermatology, Department of Dermatology, University of Heidelberg
| | - M Augustin
- Institute for Health Services Research in Dermatology Hamburg, University Medical Center Hamburg Eppendorf
| | | | - M Pawlak
- Practice Dr. med, Anika Hünermund and Mario Pawlak, Heilbad Heiligenstadt
| | - K Schäkel
- Department of Dermatology, Ruprecht-Karls University Heidelberg
| | | | - M Hilgers
- Clinics for Dermatology and Allergy, University Hospital Aachen
| | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover
| | - S Weidinger
- Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel
| | - J Schmitt
- Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden
| | - T Biedermann
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - A Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
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Augustin M, Hallek M, Nitschmann S, Nitschmann S, Augustin M, Hallek M. [Development of vaccines for prevention of COVID-19 in adolescents]. Internist (Berl) 2021; 62:1360-1363. [PMID: 34698876 PMCID: PMC8547124 DOI: 10.1007/s00108-021-01195-7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2021] [Indexed: 11/29/2022]
Affiliation(s)
- M Augustin
- Klinik I für Innere Medizin, AG Lehmann, Universitätsklinikum Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland.
| | - M Hallek
- Klinik I für Innere Medizin, AG Lehmann, Universitätsklinikum Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland
| | | | | | - M Augustin
- Klinik I für Innere Medizin, AG Lehmann, Universitätsklinikum Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland
| | - M Hallek
- Klinik I für Innere Medizin, AG Lehmann, Universitätsklinikum Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland
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Pinter A, Green LJ, Selmer J, Praestegaard M, Gold LS, Augustin M. A pooled analysis of randomized, controlled, phase 3 trials investigating the efficacy and safety of a novel, fixed dose calcipotriene and betamethasone dipropionate cream for the topical treatment of plaque psoriasis. J Eur Acad Dermatol Venereol 2021; 36:228-236. [PMID: 34628687 DOI: 10.1111/jdv.17734] [Citation(s) in RCA: 7] [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: 05/21/2021] [Accepted: 09/02/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Plaque psoriasis is a common, chronic and relapsing inflammatory skin disease clinically characterized by erythema and scaling desquamation. As over 90% of psoriasis patients benefit from topical therapies, local treatments continue to play an eminent role in management strategies. One such topical treatment is the fixed dose combination of calcipotriol (CAL) and betamethasone dipropionate (BDP). OBJECTIVES Pooled analysis of two different phase 3 clinical trails to compare superiority regarding efficacy, safety and quality of life (QoL) between CAL/BDP PAD-cream and CAL/BDP TS. METHODS The data from two phase 3, multicentre, randomized, investigator-blind, active and vehicle-controlled trials enrolling patients with psoriasis were pooled and analysed. Investigational products included a CAL/BDP cream based on PAD™ Technology (PAD-cream) designed for high skin penetration and increased patient preference, an active control (marketed CAL/BDP topical suspension/gel, in the following abbreviated as CAL/BDP TS) and cream vehicle, which were applied once daily for 8 weeks. RESULTS Efficacy and safety of the novel CAL/BDP PAD-cream formulation for the topical treatment of psoriasis demonstrated superiority for all efficacy end points after 8 weeks of treatment. PGA treatment success for CAL/BDP PAD-cream (43.2%) was greater than CAL/BDP TS (31.9%; P < 0.0001), the mean per cent reduction in mPASI for CAL/BDP PAD-cream was 64.6% compared to 56.4% for CAL/BDP TS (P < 0.0001) and DLQI 0/1 was obtained by 43.8% in the CAL/BDP PAD-cream group versus 34.2% in the CAL/BDP TS group (P = 0.0005). There was no adverse drug reaction reported with a frequency of >1%, associated with the CAL/BDP PAD-cream. CONCLUSIONS The novel fixed dose combination CAL/BDP PAD-cream offers greater efficacy, superior patient QoL and equivalent favourable safety for the topical treatment of psoriasis, in comparison to the currently available topical suspension/gel.
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Affiliation(s)
- A Pinter
- Department of Dermatology, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
| | - L J Green
- George Washington University School of Medicine, Washington, DC, USA
| | - J Selmer
- MC2 Therapeutics, Hørsholm, Denmark
| | | | - L S Gold
- Dermatology Clinical Research, Henry Ford Health System, Detroit, MI, USA
| | - M Augustin
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Thyssen JP, Lio P, Ball S, Pierce E, Sun L, Chen Y, Tan JKL, Augustin M. Improvement in symptoms of anxiety and depression in patients with atopic dermatitis after treatment with baricitinib. J Eur Acad Dermatol Venereol 2021; 36:e147-e150. [PMID: 34553429 DOI: 10.1111/jdv.17704] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 09/17/2021] [Indexed: 11/29/2022]
Affiliation(s)
- J P Thyssen
- Department of Dermatology and Venereology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - P Lio
- Medical Dermatology Associates of Chicago, Chicago, IL, USA
| | - S Ball
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
| | - E Pierce
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
| | - L Sun
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
| | - Y Chen
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA
| | - J K L Tan
- University of Western Ontario and Windsor Clinical Research Inc., Windsor, ON, Canada
| | - M Augustin
- University Medical Centre Hamburg, Hamburg, Germany
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Augustin M, Valencia López M, Reich K. Network meta-analyses in psoriasis: overview and critical discussion. J Eur Acad Dermatol Venereol 2021; 35:2367-2376. [PMID: 34506643 DOI: 10.1111/jdv.17650] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/30/2021] [Indexed: 01/23/2023]
Abstract
Network meta-analyses (NMAs) increasingly assist in treatment decisions in disease areas such as psoriasis, where data from multiple clinical trials (CTs) on a growing number of different drugs become available. This study aimed to characterize NMAs published in psoriasis. A systematic literature search in PubMed was conducted using a structured search protocol based on the PRISMA criteria. Twenty-seven NMAs were identified, including an average of 43 CTs per NMA. Only eight of 27 NMAs (29.6%) were documented in the PROSPERO registry and only 17 (63%) reported following the PRISMA criteria. The mean number of patients per NMA was 19 624 (range: 6113-51 749). Across all NMAs, the drugs most frequently included were ustekinumab (n = 27 NMAs), followed by adalimumab (n = 25), infliximab and etanercept (n = 24 each). In all n = 27 NMAs, placebo comparisons and in n = 25, comparisons with active controls were used for bridging. Effect estimates were performed in all cases, SUCRA in 14. Most frequently used outcomes were Psoriasis Area and Severity Index (PASI) 75 (n = 25) and PASI 90 (n = 24), and Dermatology Life Quality Index (n = 10). NMAs mostly measured induction efficacy (weeks 10-16, n = 25) but rarely long-term outcomes (weeks 48-56, n = 4). Sensitivity analyses were performed in n = 17 (63%) of the studies. Main results varied considerably between studies and depended on the year of publication and thus the number of available drugs and studies. However, the concordance between NMA efficacy rankings based on PASI 75 was high. Although a large number of NMAs have been published on psoriasis showing highly comparable results on efficacy, no sufficient information on the quality criteria was reported, and PROSPERO registry criteria were not followed. This argues in favour of greater standardization of NMA methodology and reporting.
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Affiliation(s)
- M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M Valencia López
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - K Reich
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Sommer R, Augustin M, da Silva N, von Stülpnagel CC. Development and validation of an outcome instrument measuring dry skin - the Xerosis Area and Severity Index (XASI). J Eur Acad Dermatol Venereol 2021; 36:e70-e72. [PMID: 34482583 DOI: 10.1111/jdv.17636] [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: 06/03/2021] [Accepted: 09/02/2021] [Indexed: 11/28/2022]
Affiliation(s)
- R Sommer
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - N da Silva
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - C C von Stülpnagel
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Heinrich L, Haufe E, Abraham S, Heratizadeh A, Harder I, Kleinheinz A, Wollenberg A, Weisshaar E, Wiemers F, Ertner K, Schäkel K, Augustin M, Wildberger J, von Kiedrowski R, Zink A, Pawlak M, Worm M, Sticherling M, Effendy I, Hilgers M, Quist S, Asmussen A, Handrick C, Bell M, Staubauch-Renz P, Schwarz B, Hong-Weldemann SH, Homey B, Werfel T, Weidinger S, Schmitt J. Einschätzung der Erkrankungsschwere der Neurodermitis durch Ärzte und Patienten in Abhängigkeit vom Geschlecht: Ergebnisse aus dem Deutschen Neurodermitisregister TREATgermany+. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732223] [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] [Indexed: 10/20/2022]
Affiliation(s)
- L Heinrich
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, TU Dresden
| | - E Haufe
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, TU Dresden
| | - S Abraham
- Universitäts AllergieCentrum Dresden, Klinik für Dermatologie, Universitätsklinikum Carl Gustav Carus
| | - A Heratizadeh
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - I Harder
- Zentrum für Entzündliche Hauterkrankungen, Klinik für Dermatologie und Allergologie, Universitäts-klinikum Schleswig-Holstein, Campus Kiel
| | | | - A Wollenberg
- Klinik und Poliklinik für Dermatologie und Allergologie, LMU München
| | - E Weisshaar
- Berufsdermatologie, Klinik für Dermatologie, Universität Heidelberg
| | - F Wiemers
- Praxis Dr. Ulrike Wiemers/Dr. Franca Wiemers
| | | | - K Schäkel
- Klinik für Dermatologie, Universität Heidelberg
| | - M Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf
| | | | | | - A Zink
- Klinik für Dermatologie und Allergologie, TU München & Zentrum für Umweltmedizin GmbH
| | - M Pawlak
- Praxis Dr. Anika Hünermund, Mario Pawlak
| | - M Worm
- Klinik für Dermatologie, Venerologie und Allergologie, Charité Berlin
| | - M Sticherling
- Klinik für Dermatologie, Universität Erlangen-Nürnberg
| | - I Effendy
- Klinik für Dermatologie, Klinikum Rosenhöhe
| | - M Hilgers
- Universitätsklinikum Aachen, Uniklinik RWTH Aachen
| | | | - A Asmussen
- Praxis Dr. Andrea Asmussen, Dermatologie an der Lesum
| | | | - M Bell
- Praxis Dr. Magnus Bell, Thomas Kaiser
| | - P Staubauch-Renz
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Mainz
| | | | | | - B Homey
- Klinik für Dermatologie, Universität Düsseldorf
| | - T Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - S Weidinger
- Zentrum für Entzündliche Hauterkrankungen, Klinik für Dermatologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - J Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, TU Dresden
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Helmert C, Haufe E, Abraham S, Heratizadeh A, Harder I, Kleinheinz A, Wollenberg A, Wiemers F, Weisshaar E, Augustin M, von Kiedrowski R, Wildberg J, Pawlak M, Hilgers M, Worm M, Schäkel K, Sticherling M, Effendy I, Staubach-Renz P, Handrick C, Bell M, Asmussen A, Schwarz B, Werfel T, Weidinger S, Schmitt J. Fatigue und Neurodermitis: Ergebnisse aus dem deutschen Neurodermitisregister TREATgermany. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732225] [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] [Indexed: 10/20/2022]
Affiliation(s)
- C Helmert
- Zentrum für evidenzbasierte Gesundheitsversorgung, Medizinische Fakultät Carl Gustav Carus, TU Dresden
| | - E Haufe
- Zentrum für evidenzbasierte Gesundheitsversorgung, Medizinische Fakultät Carl Gustav Carus, TU Dresden
| | - S Abraham
- UniversitätsAllergieZentrum, Klinik für Dermatologie, Universitätsklinikum Carl Gustav Carus
| | - A Heratizadeh
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - I Harder
- Zentrum für entzündliche Hauterkrankungen an der Klinik für Dermatologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | | | - A Wollenberg
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München
| | | | - E Weisshaar
- Berufsdermatologie, Universitätsklinikum Heidelberg
| | - M Augustin
- Institut für Versorgugnsforschung in der Dermatologie und Pflegeberufe, Universitätsklinikum Hamburg-Eppendorf
| | - R von Kiedrowski
- CMSS - Company for Medical Study and Service Selters, Dermatologische Spezialpraxis
| | | | | | - M Hilgers
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Aachen
| | - M Worm
- Klinik für Dermatologie, Venerologie und Allergologie, Charité Universitätsmedizin Berlin
| | | | | | - I Effendy
- Hautklinik, Klinikum Bielefeld Rosenhöhe
| | - P Staubach-Renz
- Universitätshautklinik und poliklinik, Universitätsmedizin Mainz
| | - C Handrick
- Praxis, für Haut- und Geschlechtskrankheiten
| | | | | | - B Schwarz
- Praxis, Dermatologie und Allergologie
| | - T Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover
| | - S Weidinger
- Zentrum für entzündliche Hauterkrankungen an der Klinik für Dermatologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| | - J Schmitt
- Zentrum für evidenzbasierte Gesundheitsversorgung, Medizinische Fakultät Carl Gustav Carus, TU Dresden
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Duell J, Maddocks KJ, González-Barca E, Jurczak W, Liberati AM, De Vos S, Nagy Z, Obr A, Gaidano G, Abrisqueta P, Kalakonda N, André M, Dreyling M, Menne T, Tournilhac O, Augustin M, Rosenwald A, Dirnberger-Hertweck M, Weirather J, Ambarkhane S, Salles G. Long-term outcomes from the Phase II L-MIND study of tafasitamab (MOR208) plus lenalidomide in patients with relapsed or refractory diffuse large B-cell lymphoma. Haematologica 2021; 106:2417-2426. [PMID: 34196165 PMCID: PMC8409029 DOI: 10.3324/haematol.2020.275958] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Indexed: 12/03/2022] Open
Abstract
Tafasitamab (MOR208), an Fc-modified, humanized, anti-CD19 monoclonal antibody, combined with the immunomodulatory drug lenalidomide was clinically active with a good tolerability profile in the open-label, single-arm, phase II L-MIND study of patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL) ineligible for autologous stem-cell transplantation. To assess long-term outcomes, we report an updated analysis with ≥35 months’ follow-up. Patients were aged >18 years, had received one to three prior systemic therapies (including ≥1 CD20-targeting regimen) and Eastern Cooperative Oncology Group performance status 0-2. Patients received 28-day cycles of tafasitamab (12 mg/kg intravenously), once weekly during cycles 1-3, then every 2 weeks during cycles 4-12. Lenalidomide (25 mg orally) was administered on days 1-21 of cycles 1-12. After cycle 12, progression-free patients received tafasitamab every 2 weeks until disease progression. The primary endpoint was best objective response rate. After ≥35 months’ follow-up (data cut-off: October 30, 2020), the objective response rate was 57.5% (n=46/80), including a complete response in 40.0% of patients (n=32/80) and a partial response in 17.5% of patients (n=14/80). The median duration of response was 43.9 months (95% confidence interval [95% CI]: 26.1-not reached), the median overall survival was 33.5 months (95% CI: 18.3-not reached) and the median progression-free survival was 11.6 months (95% CI: 6.3-45.7). There were no unexpected toxicities. Subgroup analyses revealed consistent long-term efficacy results across most subgroups of patients. This extended follow-up of L-MIND confirms the long duration of response, meaningful overall survival, and well-defined safety profile of tafasitamab plus lenalidomide followed by tafasitamab monotherapy in patients with relapsed/refractory diffuse large B-cell lymphoma ineligible for autologous stem cell transplantation. ClinicalTrials.gov identifier: NCT02399085.
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Affiliation(s)
- Johannes Duell
- Medizinische Klinik und Poliklinik II, Universitätsklinik Würzburg, Würzburg, Germany
| | - Kami J Maddocks
- Department of Internal Medicine, Arthur G James Comprehensive Cancer Center, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Eva González-Barca
- Department of Hematology, Institut Catalá d'Oncologia (ICO), Hospital Duran i Reynals, Universitat de Barcelona, Barcelona, Spain
| | - Wojciech Jurczak
- Maria Sklodowska-Curie National Research Institute of Oncology, Kraków, Poland
| | - Anna Marina Liberati
- Università degli Studi di Perugia, Azienda Ospedaliera Santa Maria di Terni, Terni, Italy
| | - Sven De Vos
- Department of Medicine, Ronald Reagan UCLA Medical Center, Santa Monica, CA, USA
| | - Zsolt Nagy
- 1st Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Aleš Obr
- Department of Hemato-Oncology, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Gianluca Gaidano
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Pau Abrisqueta
- Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital, Barcelona, Spain
| | - Nagesh Kalakonda
- Molecular and Clinical Cancer Medicine, University of Liverpool and The Clatterbridge Cancer Centre, Liverpool, United Kingdom
| | - Marc André
- Department of Haematology, Université Catholique de Louvain, CHU UCL Namur, Yvoir, Belgium
| | - Martin Dreyling
- Department of Medicine III, LMU University Hospital, Munich, Germany
| | - Tobias Menne
- Department of Haematology, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
| | - Olivier Tournilhac
- Service d'Hématologie Clinique et de Thérapie Cellulaire, CHU Estaing, Clermont-Ferrand, France
| | - Marinela Augustin
- Department of Hematology and Oncology, Paracelcus Medical University, Klinikum Nürnberg, Nürnberg, Germany
| | | | | | | | | | - Gilles Salles
- Hématologie, Hospices Civils de Lyon and Université de Lyon, Lyon, France.
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Duell J, Maddocks KJ, González-Barca E, Jurczak W, Liberati AM, De Vos S, Nagy Z, Obr A, Gaidano G, Abrisqueta P, Kalakonda N, André M, Dreyling M, Menne T, Tournilhac O, Augustin M, Rosenwald A, Dirnberger-Hertweck M, Weirather J, Ambarkhane S, Salles G. Long-term outcomes from the phase II L-MIND study of tafasitamab (MOR208) plus lenalidomide in patients with relapsed or refractory diffuse large B-cell lymphoma. Haematologica 2021. [PMID: 34407608 DOI: 10.3324/haematol.2021.279802] [Citation(s) in RCA: 7] [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: 08/19/2021] [Indexed: 11/09/2022] Open
Abstract
Not available.
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Affiliation(s)
- Johannes Duell
- Medizinische Klinik und Poliklinik II, Universitätsklinik Würzburg, Würzburg
| | - Kami J. Maddocks
- Department of Internal Medicine, Arthur G James Comprehensive Cancer Center, Ohio State University Wexner Medical Center, Columbus, OH
| | - Eva González-Barca
- Department of Hematology, Institut Catalá d'Oncologia (ICO), Hospital Duran i Reynals, Universitat de Barcelona, Barcelona
| | - Wojciech Jurczak
- Maria Sklodowska-Curie National Research Institute of Oncology, Kraków
| | - Anna Marina Liberati
- Università degli Studi di Perugia, Azienda Ospedaliera Santa Maria di Terni, Terni
| | - Sven De Vos
- Department of Medicine, Ronald Reagan UCLA Medical Center, Santa Monica, CA
| | - Zsolt Nagy
- 1st Department of Internal Medicine, Semmelweis University, Budapest
| | - Aleš Obr
- Department of Hemato-Oncology, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Gianluca Gaidano
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara
| | - Pau Abrisqueta
- Department of Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital, Barcelona
| | - Nagesh Kalakonda
- Molecular and Clinical Cancer Medicine, University of Liverpool and The Clatterbridge Cancer Centre, Liverpool
| | - Marc André
- Department of Haematology, Université Catholique de Louvain, CHU UCL Namur, Yvoir
| | | | - Tobias Menne
- Department of Haematology, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne
| | - Olivier Tournilhac
- Service d'Hématologie Clinique et de Thérapie Cellulaire, CHU Estaing, Clermont-Ferrand
| | - Marinela Augustin
- Department of Hematology and Oncology, Paracelcus Medical University, Klinikum Nürnberg, Nürnberg
| | | | | | | | | | - Gilles Salles
- Hématologie, Hospices Civils de Lyon and Université de Lyon, Lyon
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da Silva N, Sommer R, Ortmann CE, Jagiello P, Bachhuber T, Augustin M. Secukinumab effects on disease burden, patient needs and benefits, and treatment satisfaction in patients with plaque psoriasis across European regions: patient perspective data from the PROSE study. J Eur Acad Dermatol Venereol 2021; 35:2241-2249. [PMID: 34273904 DOI: 10.1111/jdv.17525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/02/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cross-cultural differences in healthcare policies and patient-physician communication may influence the quality of care and patients' perceived benefits and satisfaction with psoriasis treatment. OBJECTIVES To compare the disease burden and patient needs at baseline, and patient benefits and satisfaction with secukinumab treatment across Europe. METHODS PROSE was an open-label, prospective, non-randomized, stratified multicentre study of 52 weeks of secukinumab treatment, in 16 European countries. Secondary analysis of the PROSE study data by European regions was performed to identify cross-cultural differences in disease burden and patient needs at baseline, and in clinical improvement, patient-reported treatment benefits and satisfaction at 52 weeks post-treatment. RESULTS At baseline, Dermatology Life Quality Index impairment was reported to be greater in patients from Eastern Europe (EE: 15.4 ± 7.1) vs. Northern Europe (NE: 13.3 ± 6.7) and Western Europe (WE: 13.6 ± 6.9), but while differences were statistically significant (F-test = 5.5, P < 0.001), their clinical significance is uncertain. There were no significant differences between regions in Psoriasis Area and Severity Index at baseline (F-test = 1.6). There were considerable differences in patients' needs (Patient Need Questionnaire) between geographical regions, with WE focused more on reducing physical impairment [vs. Southern Europe (SE)/EE], EE on reducing social impairment (vs. NE/WE) and SE on reducing impairment due to therapy (vs. NE/WE). At Week 52, patients from EE reported more benefits (Patient Benefit Index) with secukinumab treatment (vs. WE/SE), while patients from NE reported higher global treatment satisfaction (vs. SE). CONCLUSIONS Differences in patients' needs and treatment satisfaction across Europe are likely a result of diverse medical systems, socio-economic status and infrastructural access. A patient-centred approach to treating psoriasis may fulfil patient needs and maximize treatment satisfaction. (NCT02752776).
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Affiliation(s)
- N da Silva
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - R Sommer
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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