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Schaarschmidt ML, Kromer D, Wellmann P, Peitsch WK, Kromer C. Patients' preferences for systemic treatment of atopic dermatitis: safety and efficacy count the most. J DERMATOL TREAT 2024; 35:2308682. [PMID: 38297480 DOI: 10.1080/09546634.2024.2308682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 01/17/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND The advent of biologics and janus kinase inhibitors has revolutionized treatment of atopic dermatitis (AD). OBJECTIVE To investigate preferences of patients with AD for attributes of currently approved systemic treatments and assess influencing factors. METHODS An online discrete choice experiment was conducted in patients with AD throughout Germany to analyze preferences for outcome (probability of (almost) clear skin at week 16, probability of significant itch improvement, time to onset of itch relief and type of side effects) and process attributes (application method and frequency of laboratory tests). RESULTS Participants (n = 182, 75.3% female) considered side effects (Relative Importance Score (RIS): 31.2), (almost) clear skin (RIS: 24.2) and probability of itch improvement (RIS: 16.0) most important. Application method (RIS: 14.4), time to onset of itch relief (RIS: 7.4) and frequency of laboratory tests (RIS: 6.8) were less relevant. Preferences were significantly influenced by sex, age, psychiatric comorbidity, current therapy and health-related quality of life according to multivariate regression analysis. CONCLUSIONS Participants attached great importance to safety and symptom control. However, preferences were also dependent on individual characteristics, underscoring the importance of personal counseling. Conjoined with medical considerations, patients' preferences have fundamental impact on shared decisions for treatment of AD.
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Affiliation(s)
- Marthe-Lisa Schaarschmidt
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Daniel Kromer
- Real-World and Advanced Analytics, Ingress-Health HWM GmbH - A Cytel Company, Berlin, Germany
| | - Phoebe Wellmann
- Department of Dermatology, Venereology, and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Wiebke K Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Christian Kromer
- Department of Dermatology, Venereology, and Allergology, University Medical Center Göttingen, Göttingen, Germany
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2
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Weilandt J, Peitsch WK. Moderne Diagnostik und Therapie des Merkelzellkarzinoms. J Dtsch Dermatol Ges 2023; 21:1524-1548. [PMID: 38082520 DOI: 10.1111/ddg.15214_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/21/2023] [Indexed: 12/18/2023]
Abstract
ZusammenfassungDas Merkelzellkarzinom (MCC) ist ein seltener, aggressiver Hauttumor mit epithelialer und neuroendokriner Differenzierung, dessen Inzidenz in den letzten Jahrzehnten deutlich zugenommen hat. Risikofaktoren sind fortgeschrittenes Lebensalter, heller Hauttyp, UV‐Exposition und Immunsuppression. Pathogenetisch wird ein durch das Merkelzell‐Polyomavirus (MCPyV) hervorgerufener Typ von einem UV‐induzierten Typ mit hoher Tumormutationslast unterschieden.Klinisch präsentiert sich das MCC als meist schmerzloser, schnell wachsender, rötlich‐violetter Tumor mit glänzender Oberfläche, der bevorzugt im Kopf‐Hals‐Bereich und an den distalen Extremitäten lokalisiert ist. Eine sichere Diagnose kann nur anhand histologischer und immunhistochemischer Merkmale gestellt werden. Bei Erstdiagnose weisen 20%–26% der Patienten lokoregionäre Metastasen und 8%–14% Fernmetastasen auf, weshalb eine Ausbreitungsdiagnostik unabdingbar ist. Bei fehlenden klinischen Hinweisen auf Metastasen wird eine Sentinel‐Lymphknotenbiopsie empfohlen.Wesentliche Säulen der Therapie sind die Operation, die adjuvante oder palliative Strahlentherapie und in fortgeschrittenen inoperablen Stadien die medikamentöse Tumortherapie. Die Einführung von Immuncheckpoint‐Inhibitoren führte zu einem Paradigmenwechsel, da sich hiermit ein wesentlich langfristigeres Ansprechen und bessere Überlebensraten als mit Chemotherapie erreichen lassen. Zur Therapie des metastasierten MCC ist in Deutschland der PD‐L1‐Inhibitor Avelumab zugelassen, aber auch die PD‐1‐Antikörper Pembrolizumab und Nivolumab werden mit Erfolg eingesetzt. Adjuvante und neoadjuvante Therapiekonzepte, Immunkombinationstherapien und zielgerichtete Therapien als Monotherapie oder in Kombination mit Immuncheckpoint‐Inhibitoren befinden sich in klinischer Prüfung.
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Affiliation(s)
- Juliane Weilandt
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Wiebke K Peitsch
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin, Germany
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3
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Weilandt J, Peitsch WK. Modern diagnostics and treatment of Merkel cell carcinoma. J Dtsch Dermatol Ges 2023; 21:1524-1546. [PMID: 37875785 DOI: 10.1111/ddg.15214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/21/2023] [Indexed: 10/26/2023]
Abstract
Merkel cell carcinoma (MCC) is a rare, aggressive skin cancer with epithelial and neuroendocrine differentiation, the incidence of which has increased substantially during the last decades. Risk factors include advanced age, fair skin type, UV exposure, and immunosuppression. Pathogenetically, a type caused by the Merkel cell polyomavirus is distinguished from a UV-induced type with a high tumor mutational burden. Clinically, MCC presents as a mostly painless, rapidly growing, reddish-violet tumor with a shiny surface, which is preferentially localized in the head-neck region and at the distal extremities. A reliable diagnosis can only be made based on histological and immunohistochemical features. At initial diagnosis, 20-26% of patients show locoregional metastases and 8-14% distant metastases, making staging examinations indispensable. If there is no clinical evidence of metastases, a sentinel lymph node biopsy is recommended. Essential columns of therapy are surgery, adjuvant or palliative radiotherapy and, in advanced inoperable stages, medicamentous tumor therapy. The introduction of immune checkpoint inhibitors has led to a paradigm shift, as they provide a considerably longer duration of response and better survival rates than chemotherapy. The PD-L1 inhibitor avelumab is approved for treatment of metastatic MCC in Germany, but the PD-1 antibodies pembrolizumab and nivolumab are also used with success. Adjuvant and neoadjuvant treatment concepts, immune combination therapies and targeted therapies as monotherapy or in combination with immune checkpoint inhibitors are in the clinical trial phase.
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Affiliation(s)
- Juliane Weilandt
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Wiebke K Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
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4
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Gugelmeier M, Kostron A, Poser T, Schneider LC, Peitsch WK, Fuchs T. [Acute soft Tissue Infection with impending Loss of Finger in amniotic Band Syndrome of a 22-years-old Patient with palmoplantar Keratoderma congenital Alopecia Syndrome Type II]. HANDCHIR MIKROCHIR P 2023; 55:368-372. [PMID: 36972588 DOI: 10.1055/a-2013-2131] [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] [Indexed: 03/29/2023] Open
Abstract
We report on the treatment of a 22-year-old female patient with an acute soft tissue infection in the area of an amniotic band due to palmoplantar keratoderma congenital alopecia syndrome (PPKCA) type II, a very rare genodermatosis with less than 20 cases described in literature. An acute soft tissue infection distal from the pre-existing constriction ring with hyperkeratosis on the right small finger led to a decompensation of the venous and lymphatic drain with imminent loss of the finger. Due to urgent surgical treatment with decompression and debridement of the dorsal soft tissue infection, microsurgical circular resection of the constriction ring and primary wound closure the finger could be preserved. After soft tissue consolidation and hand therapy, the patient achieved free movement of the small finger with subjective freedom of symptoms and good aesthetic results.
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Affiliation(s)
- Moritz Gugelmeier
- Zentrum für Muskuloskelettale Medizin Klinik für Orthopädie, Unfall-, Hand- und Wiederherstellungschirurgie , Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Arthur Kostron
- Zentrum für Muskuloskelettale Medizin Klinik für Orthopädie, Unfall-, Hand- und Wiederherstellungschirurgie , Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Thomas Poser
- Zentrum für Muskuloskelettale Medizin Klinik für Orthopädie, Unfall-, Hand- und Wiederherstellungschirurgie , Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Lisa C Schneider
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Wiebke K Peitsch
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Thomas Fuchs
- Zentrum für Muskuloskelettale Medizin Klinik für Orthopädie, Unfall-, Hand- und Wiederherstellungschirurgie , Vivantes Klinikum im Friedrichshain, Berlin, Germany
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5
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Ninosu N, Hoelker S, Kappenstein M, Buettner S, Peitsch WK, Schaarschmidt ML. Treatment satisfaction of patients with psoriasis with topical therapy in a real-world setting: unmet need for higher effectiveness. J DERMATOL TREAT 2023; 34:2200570. [PMID: 37026416 DOI: 10.1080/09546634.2023.2200570] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
BACKGROUND Topical medication is the mainstay for treatment of mild psoriasis. However, dissatisfaction with topicals is common and rates of non-adherence are high. Assessing patients' perspectives can help to identify unmet needs. OBJECTIVE Our aim was to investigate satisfaction of patients with psoriasis with topical therapy and to determine influencing factors. METHODS Patients were recruited from the Department of Dermatology, University Medical Center Mannheim, Germany. Satisfaction was assessed using the Treatment Satisfaction Questionnaire for Medication version 1.4 with the domains effectiveness, side effects, convenience, and global satisfaction (scale 0-100 each). The impact of sociodemographic and disease characteristics was determined by multivariate regression. RESULTS Averaged across the cohort (n = 122, mean age 52.5 years, 58.2% male), the side effects domain had the highest mean satisfaction score (89.7), followed by convenience (72.5), global satisfaction (60.8) and effectiveness (55.0). Comparing specific medications, combinations of corticosteroids and vitamin D analogues were rated best in effectiveness. Treatment satisfaction was influenced by age, partnership, ability to apply topicals independently, disease-related quality-of-life impairment, sole or adjunctive use of topicals and pruritus. CONCLUSIONS Participants were particularly satisfied with safety but rather dissatisfied with effectiveness of topicals. Topical therapy should be adapted to individual needs with special attention to effectiveness.
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Affiliation(s)
- Nadia Ninosu
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Suna Hoelker
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Max Kappenstein
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Sylvia Buettner
- Department for Biomathematics and Medical Statistics, Faculty of Medicine Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Wiebke K Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Marthe-Lisa Schaarschmidt
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
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6
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Weilandt J, Hoffmann V, Zahn A, Guski S, Mroß M, Peitsch WK. Iatrogenes Kaposi-Sarkom unter Vedolizumab bei Colitis ulcerosa. J Dtsch Dermatol Ges 2023; 21 Suppl 2:22-24. [PMID: 37099011 DOI: 10.1111/ddg.15099_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Affiliation(s)
- Juliane Weilandt
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
| | - Vincent Hoffmann
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
- Haut- und Laserzentrum Lichterfelde, Berlin
| | - Axel Zahn
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
| | - Silja Guski
- Fachbereich Pathologie, Vivantes Klinikum Neukölln, Berlin
| | | | - Wiebke K Peitsch
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
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7
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Riedel F, Aparicio-Soto M, Curato C, Münch L, Abbas A, Thierse HJ, Peitsch WK, Luch A, Siewert K. Unique and common TCR repertoire features of Ni 2+ -, Co 2+ -, and Pd 2+ -specific human CD154 + CD4+ T cells. Allergy 2023; 78:270-282. [PMID: 36005389 DOI: 10.1111/all.15494] [Citation(s) in RCA: 2] [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: 03/28/2022] [Revised: 07/21/2022] [Accepted: 08/08/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Apart from Ni2+ , Co2+ , and Pd2+ ions commonly trigger T cell-mediated allergic contact dermatitis. However, in vitro frequencies of metal-specific T cells and the mechanisms of antigen recognition remain unclear. METHODS Here, we utilized a CD154 upregulation assay to quantify Ni2+ -, Co2+ -, and Pd2+ -specific CD4+ T cells in peripheral blood mononuclear cells (PBMC). Involved αβ T cell receptor (TCR) repertoires were analyzed by high-throughput sequencing. RESULTS Peripheral blood mononuclear cells incubation with NiSO4 , CoCl2 , and PdCl2 increased frequencies of CD154 + CD4+ memory T cells that peaked at ~400 μM. Activation was TCR-mediated as shown by the metal-specific restimulation of T cell clones. Most abundant were Pd2+ -specific T cells (mean 3.5%, n = 19), followed by Co2+ - and Ni2+ -specific cells (0.6%, n = 18 and 0.3%, n = 20) in both allergic and non-allergic individuals. A strong overrepresentation of the gene segment TRAV9-2 was unique for Ni2+ -specific TCR (28% of TCR) while Co2+ and Pd2+ -specific TCR favorably expressed TRAV2 (8%) and the TRBV4 gene segment family (21%), respectively. As a second, independent mechanism of metal ion recognition, all analyzed metal-specific TCR showed a common overrepresentation of a histidine in the complementarity determining region 3 (CDR3; 15% of α-chains, 34% of β-chains). The positions of the CDR3 histidine among metal-specific TCR mirrored those in random repertoires and were conserved among cross-reactive clonotypes. CONCLUSIONS Induced CD154 expression allows a fast and comprehensive detection of Ni2+ -, Co2+ -, and Pd2+ -specific CD4+ T cells. Distinct TCR repertoire features underlie the frequent activation and cross-reactivity of human metal-specific T cells.
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Affiliation(s)
- Franziska Riedel
- Dermatotoxicology Study Centre, German Federal Institute for Risk Assessment, Berlin, Germany.,Department of Chemical and Product Safety, German Federal Institute for Risk Assessment, Berlin, Germany.,Institute of Pharmacy, Freie Universität Berlin, Berlin, Germany
| | - Marina Aparicio-Soto
- Dermatotoxicology Study Centre, German Federal Institute for Risk Assessment, Berlin, Germany.,Department of Chemical and Product Safety, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Caterina Curato
- Dermatotoxicology Study Centre, German Federal Institute for Risk Assessment, Berlin, Germany.,Department of Chemical and Product Safety, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Lucas Münch
- Dermatotoxicology Study Centre, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Amro Abbas
- Dermatotoxicology Study Centre, German Federal Institute for Risk Assessment, Berlin, Germany.,German Rheumatism Research Center (DRFZ), Berlin, Germany
| | - Hermann-Josef Thierse
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Wiebke K Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Andreas Luch
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment, Berlin, Germany.,Institute of Pharmacy, Freie Universität Berlin, Berlin, Germany
| | - Katherina Siewert
- Dermatotoxicology Study Centre, German Federal Institute for Risk Assessment, Berlin, Germany.,Department of Chemical and Product Safety, German Federal Institute for Risk Assessment, Berlin, Germany
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8
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Schaarschmidt ML, Kromer C, Herr R, Schmieder A, Goerdt S, Peitsch WK. Corrigendum: Treatment Satisfaction of Patients with Psoriasis. Acta Derm Venereol 2022; 102:adv00832. [PMID: 36510390 DOI: 10.2340/actadv.v102.5920] [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] [Indexed: 12/15/2022] Open
Abstract
Abstract is missing (Corrigendum)
This Corrigendum relates to the following article: https://doi.org/10.2340/00015555-2011
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9
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Schumann K, Mauch C, Klespe KC, Loquai C, Nikfarjam U, Schlaak M, Akçetin L, Kölblinger P, Hoellwerth M, Meissner M, Mengi G, Braun AD, Mengoni M, Dummer R, Mangana J, Sindrilaru MA, Radmann D, Hafner C, Freund J, Rappersberger K, Weihsengruber F, Meiss F, Reinhardt L, Meier F, Rainer B, Richtig E, Ressler JM, Höller C, Eigentler T, Amaral T, Peitsch WK, Hillen U, Harth W, Ziller F, Schatton K, Gambichler T, Susok L, Maul LV, Läubli H, Debus D, Weishaupt C, Börger S, Sievers K, Haferkamp S, Zenderowski V, Nguyen VA, Wanner M, Gutzmer R, Terheyden P, Kähler K, Emmert S, Thiem A, Sachse M, Gercken-Riedel S, Kaune KM, Thoms KM, Heinzerling L, Heppt MV, Tratzmiller S, Hoetzenecker W, Öllinger A, Steiner A, Peinhaupt T, Podda M, Schmid S, Wollina U, Biedermann T, Posch C. Real-world outcomes using PD-1 antibodies and BRAF + MEK inhibitors for adjuvant melanoma treatment from 39 skin cancer centers in Germany, Austria and Switzerland. J Eur Acad Dermatol Venereol 2022; 37:894-906. [PMID: 36433688 DOI: 10.1111/jdv.18779] [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: 06/09/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Programmed death-1 (PD-1) antibodies and BRAF + MEK inhibitors are widely used for adjuvant therapy of fully resected high-risk melanoma. Little is known about treatment efficacy outside of phase III trials. This real-world study reports on clinical outcomes of modern adjuvant melanoma treatment in specialized skin cancer centers in Germany, Austria and Switzerland. METHODS Multicenter, retrospective study investigating stage III-IV melanoma patients receiving adjuvant nivolumab (NIV), pembrolizumab (PEM) or dabrafenib + trametinib (D + T) between 1/2017 and 10/2021. The primary endpoint was 12-month recurrence-free survival (RFS). Further analyses included descriptive and correlative statistics, and a multivariate linear-regression machine learning model to assess the risk of early melanoma recurrence. RESULTS In total, 1198 patients from 39 skin cancer centers from Germany, Austria and Switzerland were analysed. The vast majority received anti PD-1 therapies (n = 1003). Twelve-month RFS for anti PD-1 and BRAF + MEK inhibitor-treated patients were 78.1% and 86.5%, respectively (hazard ratio [HR] 1.998 [95% CI 1.335-2.991]; p = 0.001). There was no statistically significant difference in overall survival (OS) in anti PD-1 (95.8%) and BRAF + MEK inhibitor (96.9%) treated patients (p > 0.05) during the median follow-up of 17 months. Data indicates that anti PD-1 treated patients who develop immune-related adverse events (irAEs) have lower recurrence rates compared to patients with no irAEs (HR 0.578 [95% CI 0.443-0.754], p = 0.001). BRAF mutation status did not affect overall efficacy of anti PD-1 treatment (p > 0.05). In both, anti PD-1 and BRAF + MEK inhibitor treated cohorts, data did not show any difference in 12-month RFS and 12-month OS comparing patients receiving total lymph node dissection (TLND) versus sentinel lymph node biopsy only (p > 0.05). The recurrence prediction model reached high specificity but only low sensitivity with an AUC = 0.65. No new safety signals were detected. Overall, recorded numbers and severity of adverse events were lower than reported in pivotal phase III trials. CONCLUSIONS Despite recent advances in adjuvant melanoma treatment, early recurrence remains a significant clinical challenge. This study shows that TLND does not reduce the risk of early melanoma recurrence and should only be considered in selected patients. Data further highlight that variables collected during clinical routine are unlikely to allow for a clinically relevant prediction of individual recurrence risk.
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Affiliation(s)
- Katharina Schumann
- Department of Dermatology and Allergy, School of Medicine, German Cancer Consortium (DKTK), Technical University of Munich, Munich, Germany
| | - Cornelia Mauch
- Department for Dermatology and Venereology and CIO ABCD, University Hospital Köln, Köln, Germany
| | - Kai-Christian Klespe
- Department for Dermatology and Venereology and CIO ABCD, University Hospital Köln, Köln, Germany
| | - Carmen Loquai
- Department for Dermatology, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Ulrike Nikfarjam
- Department for Dermatology, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Max Schlaak
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Larissa Akçetin
- Department for Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany
| | - Peter Kölblinger
- Department for Dermatology and Allergology, Paracelsus Medical University, Salzburg, Austria
| | - Magdalena Hoellwerth
- Department for Dermatology and Allergology, Paracelsus Medical University, Salzburg, Austria
| | - Markus Meissner
- Department for Dermatology, University Clinic Frankfurt, Frankfurt, Germany
| | - Guelcin Mengi
- Department for Dermatology, University Clinic Frankfurt, Frankfurt, Germany
| | | | - Miriam Mengoni
- Department of Dermatology, University Hospital Magdeburg, Magdeburg, Germany
| | - Reinhard Dummer
- Dermatology Clinic, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Joanna Mangana
- Dermatology Clinic, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | | | - Dan Radmann
- Department for Dermatology and Allergy, University Clinic Ulm, Ulm, Germany
| | - Christine Hafner
- Department of Dermatology, University Hospital St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | - Johann Freund
- Department of Dermatology, University Hospital St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | | | | | - Frank Meiss
- Department for Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Lydia Reinhardt
- Skin Cancer Center at the University Cancer Centre Dresden and National Center for Tumor Diseases, Dresden, Germany.,Department of Dermatology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Friedegund Meier
- Skin Cancer Center at the University Cancer Centre Dresden and National Center for Tumor Diseases, Dresden, Germany.,Department of Dermatology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Barbara Rainer
- Department of Dermatology and Venereology, Medical University Graz, Graz, Austria
| | - Erika Richtig
- Department of Dermatology and Venereology, Medical University Graz, Graz, Austria
| | | | - Christoph Höller
- Department of Dermatology, Medical University Vienna, Vienna, Austria
| | - Thomas Eigentler
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Dermatology, Interdisciplinary Skin Cancer Center, University Medical Center Tuebingen, Tuebingen, Germany
| | - Teresa Amaral
- Department of Dermatology, Interdisciplinary Skin Cancer Center, University Medical Center Tuebingen, Tuebingen, Germany
| | - Wiebke K Peitsch
- Departments of Dermatology and Phlebology, Vivantes Skin Cancer Center, Vivantes Clinic Friedrichshain, Neukölln and Spandau, Berlin, Germany
| | - Uwe Hillen
- Department of Dermatology and Venereology, Vivantes Skin Cancer Center, Klinikum Neukölln, Berlin, Germany
| | - Wolfgang Harth
- Department of Dermatology and Allergology, Vivantes Skin Cancer Center, Klinikum Spandau, Berlin, Germany
| | - Fabian Ziller
- Department for Dermatology, DRK Hospital Chemnitz-Rabenstein, Chemnitz, Germany
| | - Kerstin Schatton
- Department for Dermatology, University Clinic Düsseldorf, Düsseldorf, Germany
| | - Thilo Gambichler
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
| | - Laura Susok
- Department of Dermatology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany
| | - Lara Valeska Maul
- Department for Dermatology, University Hospital Basel, Basel, Switzerland
| | - Heinz Läubli
- Department for Oncology, University Hospital Basel, Basel, Switzerland
| | - Dirk Debus
- Department of Dermatology, Nuremberg General Hospital - Paracelsus Medical University, Nuremberg, Germany
| | - Carsten Weishaupt
- Department for Dermatology and Venereology, University Clinic Münster, Münster, Germany
| | | | | | - Sebastian Haferkamp
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | | | - Van Anh Nguyen
- Department for Dermatology, Venereology and Allergology, Medical University Innsbruck, Innsbruck, Austria
| | - Mariana Wanner
- Department for Dermatology, Venereology and Allergology, Medical University Innsbruck, Innsbruck, Austria
| | - Ralf Gutzmer
- Department of Dermatology, Mühlenkreiskliniken Minden und Ruhr University Bochum, Minden, Germany
| | - Patrick Terheyden
- Department for Dermatology and Venereology, University Clinic Schleswig-Holstein, Lübeck, Germany
| | - Katharina Kähler
- Department for Dermatology and Venereology, University Clinic Schleswig-Holstein, Kiel, Germany
| | - Steffen Emmert
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Alexander Thiem
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Michael Sachse
- Department for Dermatology, Clinic Bremerhaven Reinkenheide, Bremerhaven, Germany
| | - Silke Gercken-Riedel
- Department for Dermatology, Clinic Bremerhaven Reinkenheide, Bremerhaven, Germany
| | - Kjell Matthias Kaune
- Dermatology, Dermatosurgery and Allergology Clinic, Bremen-Mitte Hospital, Bremen, Germany
| | - Kai-Martin Thoms
- Department for Dermatology, University Hospital Göttingen, Georg-August-University, Göttingen, Germany
| | - Lucie Heinzerling
- Department for Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany.,Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander University Erlangen-Nürnberg and Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg, Erlangen, Germany
| | - Markus Vincent Heppt
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander University Erlangen-Nürnberg and Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg, Erlangen, Germany
| | - Sabine Tratzmiller
- Department for Dermatology, Municipal Hospital Karlsruhe, Karlsruhe, Germany
| | - Wolfram Hoetzenecker
- Department of Dermatology, University Hospital Linz, Johannes Kepler University, Linz, Austria
| | - Angela Öllinger
- Department of Dermatology, University Hospital Linz, Johannes Kepler University, Linz, Austria
| | | | | | - Maurizio Podda
- Department for Dermatology, Clinic Darmstadt, Darmstadt, Germany
| | - Sabine Schmid
- Department for Dermatology, Clinic Darmstadt, Darmstadt, Germany
| | - Uwe Wollina
- Department for Dermatology and Allergology, Municipal Hospital Dresden, Dresden, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy, School of Medicine, German Cancer Consortium (DKTK), Technical University of Munich, Munich, Germany
| | - Christian Posch
- Department of Dermatology and Allergy, School of Medicine, German Cancer Consortium (DKTK), Technical University of Munich, Munich, Germany.,Faculty of Medicine, Sigmund Freud University Vienna, Vienna, Austria.,Department for Dermatology, Clinic Hietzing, Vienna Healthcare Group, Vienna, Austria
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10
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Faverio K, Peitsch WK, Görig T, Schneider‐Burrus S, Benzel F, Goebeler M, Schummer P, Badran A, Schaarschmidt M, Harth W, Mössner R, Kromer C. Patient Preferences in Hidradenitis Suppurativa (APProach‐HS): a discrete choice experiment. J Dtsch Dermatol Ges 2022; 20:1441-1452. [DOI: 10.1111/ddg.14886] [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: 01/26/2022] [Accepted: 08/02/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Kristin Faverio
- Department of Dermatology and Phlebology Vivantes Klinikum im Friedrichshain Berlin Germany
- Faculty of Medicine Charité – University Medicine Berlin Berlin Germany
| | - Wiebke K. Peitsch
- Department of Dermatology and Phlebology Vivantes Klinikum im Friedrichshain Berlin Germany
| | - Tatiana Görig
- Department of Medical Informatics Biometry and Epidemiology Friedrich‐Alexander‐University of Erlangen‐Nuremberg Erlangen Germany
| | | | - Friderike Benzel
- Department of Dermatology and Phlebology Vivantes Klinikum im Friedrichshain Berlin Germany
| | - Matthias Goebeler
- Department of Dermatology Venereology and Allergology University Hospital Würzburg Würzburg Germany
| | - Patrick Schummer
- Department of Dermatology Venereology and Allergology University Hospital Würzburg Würzburg Germany
| | - Alaa Badran
- Department of Dermatology Venereology and Allergology University Hospital Würzburg Würzburg Germany
| | - Marthe‐Lisa Schaarschmidt
- Department of Dermatology Venereology and Allergology University Medical Center Mannheim Heidelberg University Mannheim Germany
| | - Wolfgang Harth
- Department of Dermatology and Allergology Vivantes Klinikum Spandau Berlin Germany
| | - Rotraut Mössner
- Department of Dermatology Venereology and Allergology University Medical Center Göttingen Göttingen Germany
| | - Christian Kromer
- Department of Dermatology Venereology and Allergology University Medical Center Göttingen Göttingen Germany
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11
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Faverio K, Peitsch WK, Görig T, Schneider‐Burrus S, Benzel F, Goebeler M, Schummer P, Badran A, Schaarschmidt M, Harth W, Mössner R, Kromer C. Patientenpräferenzen bei Hidradenitis suppurativa (APProach‐HS): ein “Discrete‐Choice”‐Experiment. J Dtsch Dermatol Ges 2022; 20:1441-1454. [DOI: 10.1111/ddg.14886_g] [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: 01/26/2022] [Accepted: 08/02/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Kristin Faverio
- Klinik für Dermatologie und Phlebologie Vivantes Klinikum im Friedrichshain Berlin Deutschland
- Medizinische Fakultät Charité –Universitätsmedizin Berlin Deutschland
| | - Wiebke K. Peitsch
- Klinik für Dermatologie und Phlebologie Vivantes Klinikum im Friedrichshain Berlin Deutschland
| | - Tatiana Görig
- Institut für Medizininformatik Biometrie und Epidemiologie (IMBE) Friedrich‐Alexander‐Universität Erlangen‐Nürnberg Erlangen Deutschland
| | | | - Friderike Benzel
- Klinik für Dermatologie und Phlebologie Vivantes Klinikum im Friedrichshain Berlin Deutschland
| | - Matthias Goebeler
- Klinik und Poliklinik für Dermatologie Venerologie und Allergologie Universitätsklinikum Würzburg Würzburg Deutschland
| | - Patrick Schummer
- Klinik und Poliklinik für Dermatologie Venerologie und Allergologie Universitätsklinikum Würzburg Würzburg Deutschland
| | - Alaa Badran
- Klinik und Poliklinik für Dermatologie Venerologie und Allergologie Universitätsklinikum Würzburg Würzburg Deutschland
| | - Marthe‐Lisa Schaarschmidt
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Mannheim Universität Heidelberg Mannheim Deutschland
| | - Wolfgang Harth
- Klinik für Dermatologie und Allergologie Vivantes Klinikum Spandau Berlin Deutschland
| | - Rotraut Mössner
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Göttingen Göttingen Deutschland
| | - Christian Kromer
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Göttingen Göttingen Deutschland
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12
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Mladenov A, Diehl K, Müller O, von Heymann C, Kopp S, Peitsch WK. Outcome of necrotizing fasciitis and Fournier's gangrene with and without hyperbaric oxygen therapy: a retrospective analysis over 10 years. World J Emerg Surg 2022; 17:43. [PMID: 35932075 PMCID: PMC9356491 DOI: 10.1186/s13017-022-00448-6] [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] [Received: 05/19/2022] [Accepted: 07/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Necrotizing soft tissue infections (NSTI) require immediate radical debridement, broad-spectrum antibiotics and intensive care. Hyperbaric oxygen therapy (HBOT) may be performed adjunctively, but unequivocal evidence for its benefits is still lacking. METHODS We performed a retrospective single-center study including 192 patients with necrotizing fasciitis or Fournier's gangrene to assess in-hospital mortality and outcome dependent on patient, disease and treatment characteristics with or without HBOT. RESULTS The in-hospital mortality rate was 27.6%. Factors associated with increased mortality according to multivariate analysis were higher age, affection of multiple or problem localizations (odds ratio (OR) = 2.88, P = 0.003), ineligibility for HBOT despite clinical indication (OR = 8.59, P = 0.005), pathogens in blood cultures (OR = 3.36, P = 0.002), complications (OR = 10.35, P < 0.001) and sepsis/organ dysfunction (OR = 19.58, P < 0.001). Factors associated with better survival included vacuum-assisted wound closure (OR = 0.17, P < 0.001), larger number of debridements (OR = 0.83, P < 0.001) and defect closure with mesh graft (OR = 0.06, P < 0.001) or flap (OR = 0.09, P = 0.024). When participants were stratified into subgroups without requirement of HBOT (n = 98), treated with HBOT (n = 83) and ineligible for HBOT due to contraindications (n = 11), the first two groups had similar survival rates (75.5% vs. 73.5%) and comparable outcome, although patients with HBOT suffered from more severe NSTI, reflected by more frequent affection of multiple localizations (P < 0.001), sepsis at admission (P < 0.001) and intensive care treatment (P < 0.001), more debridements (P < 0.001) and a larger number of antibiotics (P = 0.001). In the subgroup ineligible for HBOT, survival was significantly worse (36.4%, P = 0.022). CONCLUSION These results point to a benefit from HBOT for treatment of NSTI in critically ill patients.
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Affiliation(s)
- Assen Mladenov
- Department of Plastic, Reconstructive and Aesthetic Surgery - Center of Wound Medicine, Vivantes Klinikum im Friedrichshain, Berlin, Germany.,Faculty of Medicine, Charité - University Medicine, Berlin, Germany
| | - Katharina Diehl
- Mannheim Institute of Public Health, Social and Preventive Medicine, Heidelberg University, Mannheim, Germany.,Department of Medical Informatics, Biometry and Epidemiology, Professorship of Epidemiology and Public Health, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Oliver Müller
- Center of Hyperbaric Oxygen Therapy and Diving Medicine, Vivantes Klinikum im Friedrichshain, Berlin, Germany.,Department of Anaesthesiology, Intensive Care Medicine, Emergency Care Medicine and Pain Therapy, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Christian von Heymann
- Center of Hyperbaric Oxygen Therapy and Diving Medicine, Vivantes Klinikum im Friedrichshain, Berlin, Germany.,Department of Anaesthesiology, Intensive Care Medicine, Emergency Care Medicine and Pain Therapy, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Susanne Kopp
- Department of Plastic, Reconstructive and Aesthetic Surgery - Center of Wound Medicine, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Wiebke K Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany.
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13
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Micek A, Diehl K, Teuscher M, Schaarschmidt M, Sasama B, Ohletz J, Burbach G, Kiecker F, Hillen U, Harth W, Peitsch WK. Melanoma care during one year pandemic in Berlin: decreasing appointment cancellations despite increasing COVID-19 concern. J Dtsch Dermatol Ges 2022; 20:962-978. [PMID: 35665996 PMCID: PMC9348098 DOI: 10.1111/ddg.14799] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 03/22/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND OBJECTIVES The COVID-19 pandemic poses a great challenge for cancer patients. Our aim was to assess its influence on treatment and appointments of melanoma patients after one year of pandemic. METHODS Melanoma patients treated in the Vivantes Skin Cancer Centre in Berlin, Germany completed a postal survey on pandemic-related alterations in melanoma care. Impact factors on changes of appointments were examined with descriptive analyses and multivariate logistic regression. Data after one year of pandemic were compared to those after its first wave. RESULTS Among 366 participants (57.7 % males; mean age 69.2 years, response rate: 36.1 %), 38 (10.1 %) reported postponed or missed appointments, mostly on their own demand (71.1 %) due to fear of COVID-19 (52.6 %). Current treatment was associated with a lower risk of changing appointments (Odds Ratio [OR]: 0.194, p = 0.002), higher age (OR: 1.037, p = 0.039), longer disease duration (OR: 1.007, p = 0.028), and higher school degree (OR: 2.263, p = 0.043) with higher probability. Among 177 patients currently receiving therapy, only 1.7 % experienced pandemic-related treatment alterations. Concern about COVID-19 was significantly higher after one year of pandemic than after its first wave, but the number of missed appointments was lower. CONCLUSIONS Pandemic-related changes were rare in our cohort and decreased over time despite increasing concern.
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Affiliation(s)
- Aleksandra Micek
- Department of Dermatology and AllergologyVivantes Klinikum SpandauBerlinGermany,Faculty of Medicine, CharitéUniversity Medicine BerlinBerlinGermany
| | - Katharina Diehl
- Mannheim Institute of Public HealthSocial and Preventive MedicineMedical Faculty MannheimHeidelberg UniversityMannheimGermany,Department of Medical InformaticsBiometry and EpidemiologyFriedrich‐Alexander‐University Erlangen‐Nürnberg (FAU)ErlangenGermany
| | - Miriam Teuscher
- Department of Dermatology and PhlebologyVivantes Klinikum im FriedrichshainBerlinGermany
| | - Marthe‐Lisa Schaarschmidt
- Department of DermatologyVenereology and AllergologyUniversity Medical Center MannheimHeidelberg UniversityMannheimGermany
| | - Bianca Sasama
- Department of Dermatology and PhlebologyVivantes Klinikum im FriedrichshainBerlinGermany
| | - Jan Ohletz
- Department of Dermatology and AllergologyVivantes Klinikum SpandauBerlinGermany
| | - Guido Burbach
- Department of Dermatology and AllergologyVivantes Klinikum SpandauBerlinGermany
| | - Felix Kiecker
- Department of Dermatology and VenereologyVivantes Klinikum NeuköllnBerlinGermany
| | - Uwe Hillen
- Department of Dermatology and VenereologyVivantes Klinikum NeuköllnBerlinGermany
| | - Wolfgang Harth
- Department of Dermatology and AllergologyVivantes Klinikum SpandauBerlinGermany
| | - Wiebke K. Peitsch
- Department of Dermatology and PhlebologyVivantes Klinikum im FriedrichshainBerlinGermany
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14
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Micek A, Diehl K, Teuscher M, Schaarschmidt ML, Sasama B, Ohletz J, Burbach G, Kiecker F, Hillen U, Harth W, Peitsch WK. Melanomversorgung während eines Jahres Pandemie in Berlin: abnehmende Terminstornierungen trotz zunehmender Besorgnis über COVID-19. J Dtsch Dermatol Ges 2022; 20:962-979. [PMID: 35881087 PMCID: PMC9350167 DOI: 10.1111/ddg.14799_g] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 03/22/2022] [Indexed: 11/30/2022]
Abstract
HINTERGRUND UND ZIELE Die COVID-19-Pandemie stellt für Krebspatienten eine große Herausforderung dar. Unser Ziel war es, ihren Einfluss auf die Behandlung und auf Arzttermine von Melanompatienten nach einem Jahr Pandemie zu untersuchen. PATIENTEN UND METHODIK Melanompatienten, die im Vivantes Hauttumorzentrum in Berlin behandelt wurden, beantworteten eine postalische Umfrage zu Pandemie-bedingten Änderungen ihrer Melanomversorgung. Einflussfaktoren auf Terminänderungen wurden mit deskriptiven Analysen und multivariater logistischer Regression untersucht. Daten nach einem Jahr Pandemie wurden mit Daten nach der ersten Welle verglichen. ERGEBNISSE Von den 366 Teilnehmern (57,7 % Männer; Durchschnittsalter 69,2 Jahre, Rücklaufquote: 36,1 %) berichteten 38 (10,1 %) über verschobene oder verpasste Arzttermine, meist auf eigenen Wunsch (71,1 %) aus Angst vor COVID-19 (52,6 %). Eine aktuelle Therapie war mit einem geringeren Risiko, Termine zu verpassen, assoziiert (Odds Ratio [OR]: 0,194, p = 0,002), höheres Alter (OR: 1,037, p = 0,039), längere Krankheitsdauer (OR: 1,007, p = 0,028) und ein höherer Schulabschluss (OR: 2,263, p = 0,043) mit höherer Wahrscheinlichkeit. Von den 177 Patienten, die aktuell eine Therapie erhielten, erfuhren nur 1,7 % Pandemie-bedingte Behandlungsänderungen. Die Besorgnis über COVID-19 war nach einem Jahr Pandemie signifikant größer als nach der ersten Welle, die Zahl der verpassten Arzttermine jedoch niedriger. SCHLUSSFOLGERUNGEN Pandemie-bedingte Änderungen waren in unserer Kohorte selten und nahmen trotz zunehmender Besorgnis mit der Zeit ab.
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Affiliation(s)
- Aleksandra Micek
- Klinik für Dermatologie und Allergologie, Vivantes Klinikum Spandau, Berlin.,Medizinische Fakultät, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Katharina Diehl
- Mannheimer Institut für Public Health, Sozial- und Präventivmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim.,Institut für Medizininformatik, Biometrie und Epidemiologie, Professur für Epidemiologie und Public Health, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen
| | - Miriam Teuscher
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
| | - Marthe-Lisa Schaarschmidt
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Mannheim, Universität Heidelberg, Mannheim
| | - Bianca Sasama
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
| | - Jan Ohletz
- Klinik für Dermatologie und Allergologie, Vivantes Klinikum Spandau, Berlin
| | - Guido Burbach
- Klinik für Dermatologie und Allergologie, Vivantes Klinikum Spandau, Berlin
| | - Felix Kiecker
- Klinik für Dermatologie und Venerologie, Vivantes Klinikum Neukölln, Berlin
| | - Uwe Hillen
- Klinik für Dermatologie und Venerologie, Vivantes Klinikum Neukölln, Berlin
| | - Wolfgang Harth
- Klinik für Dermatologie und Allergologie, Vivantes Klinikum Spandau, Berlin
| | - Wiebke K Peitsch
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
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15
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Hoelker S, Ninosu N, Buettner S, Peitsch WK, Schaarschmidt ML. Patient preferences for topical psoriasis treatments: a discrete choice experiment. J DERMATOL TREAT 2022; 33:2595-2604. [DOI: 10.1080/09546634.2022.2059052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Suna Hoelker
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Nadia Ninosu
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Sylvia Buettner
- Department for Biomathematics and Medical Statistics, Faculty of Medicine Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Wiebke K. Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Marthe-Lisa Schaarschmidt
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
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16
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Peitsch WK, Zahn A, Barkibin P, Guski S, Schmidt E, Girschick HJ. A teenager with blisters and crusts. J Dtsch Dermatol Ges 2022; 20:533-536. [PMID: 35166451 DOI: 10.1111/ddg.14714] [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: 11/27/2022]
Affiliation(s)
- Wiebke K Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Axel Zahn
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Payman Barkibin
- Department of Pediatrics, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Silja Guski
- Department of Pathology, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Enno Schmidt
- Department of Dermatology, Venereology and Allergology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - Hermann J Girschick
- Department of Pediatrics, Vivantes Klinikum im Friedrichshain, Berlin, Germany
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17
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Hoffmann V, Wetzel S, Schmitter J, Guski S, Zahn A, Peitsch WK. [Blisters on the lower legs and toenail dystrophy]. Hautarzt 2021; 73:408-410. [PMID: 34223940 DOI: 10.1007/s00105-021-04854-w] [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] [Accepted: 06/04/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Vincent Hoffmann
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Landsberger Allee 49, 10249, Berlin, Deutschland
| | - Sabine Wetzel
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Landsberger Allee 49, 10249, Berlin, Deutschland
| | - Julia Schmitter
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Landsberger Allee 49, 10249, Berlin, Deutschland.,Dermatologische Praxis Dr. Schmitter, Ärztehaus Potsdam, Potsdam, Deutschland
| | - Silja Guski
- Fachbereich Pathologie, Vivantes Klinikum Neukölln, Berlin, Deutschland
| | - Axel Zahn
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Landsberger Allee 49, 10249, Berlin, Deutschland
| | - Wiebke K Peitsch
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Landsberger Allee 49, 10249, Berlin, Deutschland.
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18
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Hoffmann V, Husak R, Maiwirth F, Sasama B, Zahn A, Guski S, Peitsch WK. Sonidegib bei einem Patienten mit multiplen Basalzellkarzinomen und HIV‐Infektion. J Dtsch Dermatol Ges 2021; 19:592-594. [PMID: 33861013 DOI: 10.1111/ddg.14355_g] [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: 10/21/2022]
Affiliation(s)
- Vincent Hoffmann
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
| | - Ralf Husak
- Dermatologie am Kaiserdamm, Hautarztpraxis Husak & Bartels, Berlin
| | | | - Bianca Sasama
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
| | - Axel Zahn
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
| | - Silja Guski
- Fachbereich Pathologie, Vivantes Klinikum Neukölln, Berlin
| | - Wiebke K Peitsch
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
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19
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Mellerowicz EJ, Hoffmann V, Peitsch WK. Subkutane Knoten an den Oberschenkeln einer jungen Frau. J Dtsch Dermatol Ges 2021; 19 Suppl 1:20-22. [PMID: 33835660 DOI: 10.1111/ddg.14475] [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: 12/01/2022]
Affiliation(s)
- Emilia J Mellerowicz
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
| | - Vincent Hoffmann
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
| | - Wiebke K Peitsch
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
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20
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Ninosu N, Roehrich F, Diehl K, Peitsch WK, Schaarschmidt ML. Psoriasis care during the time of COVID-19: real-world data on changes in treatments and appointments from a German university hospital. Eur J Dermatol 2021; 31:183-191. [PMID: 33871361 PMCID: PMC8356542 DOI: 10.1684/ejd.2021.4016] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND COVID-19 poses significant challenges for care of patients with chronic inflammatory skin diseases including psoriasis. OBJECTIVES To investigate changes in treatment and/or appointments for psoriasis patients in a German university hospital due to the pandemic. MATERIALS & METHODS A postal survey was conducted between May 15 and June 15, 2020. Potential determinants of changes were analysed with descriptive statistics and multivariate logistic regression. RESULTS Out of 205 respondents, 19.5% missed an appointment and 9.8% changed therapy due to the pandemic. Treatment alterations were encouraged by patients (50%) and physicians (40%), whereas cancellations of appointments mostly occurred on patients' request (70%). Several patient-related key drivers of changes, including sociodemographic, disease- and health-related characteristics were identified. Changes in treatment and appointments were associated with higher psoriasis severity scores and more frequent disease aggravations. CONCLUSION It is particularly crucial to tailor psoriasis care to individual needs in order to protect the physical and mental well-being of patients during the pandemic.
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Affiliation(s)
- Nadia Ninosu
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Fabio Roehrich
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Katharina Diehl
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Str. 7-11, 68167 Mannheim, Germany
| | - Wiebke K. Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Landsberger Allee 49, 10249 Berlin, Germany
| | - Marthe-Lisa Schaarschmidt
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
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Weilandt J, Diehl K, Schaarschmidt ML, Kiecker F, Sasama B, Pronk M, Ohletz J, Könnecke A, Müller V, Utikal J, Hillen U, Harth W, Peitsch WK. Patientenpräferenzen für die Therapie fortgeschrittener Melanome: Einfluss von Komorbidität. J Dtsch Dermatol Ges 2021; 19:58-72. [PMID: 33491889 DOI: 10.1111/ddg.14293_g] [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: 11/27/2022]
Affiliation(s)
- Juliane Weilandt
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
| | - Katharina Diehl
- Mannheimer Institut für Public Health, Sozial- und Präventivmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim
| | - Marthe-Lisa Schaarschmidt
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim
| | - Felix Kiecker
- Klinik für Dermatologie, Venerologie und Allergologie, Charité Universitätsmedizin Berlin, Berlin.,Klinik für Dermatologie und Venerologie, Vivantes Klinikum Neukölln, Berlin
| | - Bianca Sasama
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
| | - Melanie Pronk
- Klinik für Dermatologie und Allergologie, Vivantes Klinikum Spandau, Berlin
| | - Jan Ohletz
- Klinik für Dermatologie und Allergologie, Vivantes Klinikum Spandau, Berlin
| | - Andreas Könnecke
- Klinik für Dermatologie und Venerologie, Vivantes Klinikum Neukölln, Berlin
| | - Verena Müller
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim.,Klinische Kooperationseinheit Dermato-Onkologie, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
| | - Jochen Utikal
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim.,Klinische Kooperationseinheit Dermato-Onkologie, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
| | - Uwe Hillen
- Klinik für Dermatologie und Venerologie, Vivantes Klinikum Neukölln, Berlin
| | - Wolfgang Harth
- Klinik für Dermatologie und Allergologie, Vivantes Klinikum Spandau, Berlin
| | - Wiebke K Peitsch
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin
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22
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Hoffmann V, Husak R, Maiwirth F, Sasama B, Zahn A, Guski S, Peitsch WK. Sonidegib in a patient with multiple basal cell carcinomas and HIV infection. J Dtsch Dermatol Ges 2021; 19:592-594. [PMID: 33448149 DOI: 10.1111/ddg.14355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Vincent Hoffmann
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Ralf Husak
- Dermatologie am Kaiserdamm, Hautarztpraxis Husak & Bartels, Berlin, Germany
| | - Fritz Maiwirth
- Onkologisches Versorgungszentrum Friedrichshain, Berlin, Germany
| | - Bianca Sasama
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Axel Zahn
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Silja Guski
- Institute of Pathology, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Wiebke K Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
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23
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Weilandt J, Diehl K, Schaarschmidt ML, Kiecker F, Sasama B, Pronk M, Ohletz J, Könnecke A, Müller V, Utikal J, Hillen U, Harth W, Peitsch WK. Patient preferences for treatment of advanced melanoma: impact of comorbidities. J Dtsch Dermatol Ges 2020; 19:58-70. [PMID: 33015933 DOI: 10.1111/ddg.14293] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 06/15/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Choice of treatment for advanced melanoma is crucially influenced by comorbidities and patient preferences. Our study aimed to investigate the impact of comorbidities on preferences. PATIENTS AND METHODS 150 patients with melanoma stage IIC-IV completed a discrete choice experiment to determine preferences for outcome (overall response rate [ORR], 2-year survival, progression-free survival [PFS], time to response [TTR], kind of adverse events [AE], AE-related treatment discontinuation) and process attributes (frequency and route of administration [RoA], frequency of consultations) of systemic melanoma treatments. The impact of comorbidities was assessed by analysis of variance and multivariate regression. RESULTS Participants with hypertension and other cardiovascular diseases attached significantly greater importance to TTR and RoA than others. Respondents with arthropathy cared more about TTR (β = 0.179, P = 0.047) and RoA, but less about ORR (β = -0.209, P = 0.021). Individuals with diabetes considered AE (β = 0.185, P = 0.039) and frequency of consultations more essential, but ORR less relevant. Those with other malignancies were particularly worried about treatment discontinuation (β = 0.219, P = 0.008), but less about ORR (β = -0.202, P = 0.015). Participants with depression focused more on PFS (β = 0.201, P = 0.025) and less on TTR (β = -0.201, P = 0.023) and RoA (β = -0.167, P = 0.050). CONCLUSIONS Treatment preferences of melanoma patients vary significantly dependent on comorbidities.
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Affiliation(s)
- Juliane Weilandt
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Katharina Diehl
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marthe-Lisa Schaarschmidt
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Felix Kiecker
- Department of Dermatology, Venereology und Allergology, Charité University Medicine Berlin, Berlin, Germany.,Department of Dermatology and Venereology, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Bianca Sasama
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Melanie Pronk
- Department of Dermatology and Allergology, Vivantes Klinikum Spandau, Berlin, Germany
| | - Jan Ohletz
- Department of Dermatology and Allergology, Vivantes Klinikum Spandau, Berlin, Germany
| | - Andreas Könnecke
- Department of Dermatology and Venereology, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Verena Müller
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.,Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jochen Utikal
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.,Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Uwe Hillen
- Department of Dermatology and Venereology, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Wolfgang Harth
- Department of Dermatology and Allergology, Vivantes Klinikum Spandau, Berlin, Germany
| | - Wiebke K Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
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24
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Hoffmann V, Schleuter L, Wetzel S, Guski S, Zahn A, Peitsch WK. Generalisierte symmetrische Teleangiektasien. J Dtsch Dermatol Ges 2020; 18:916-919. [DOI: 10.1111/ddg.14090_g] [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: 11/30/2022]
Affiliation(s)
- Vincent Hoffmann
- Klinik für Dermatologie und Phlebologie Vivantes Klinikum im Friedrichshain Berlin
| | - Leonie Schleuter
- Klinik für Dermatologie und Phlebologie Vivantes Klinikum im Friedrichshain Berlin
| | - Sabine Wetzel
- Klinik für Dermatologie und Phlebologie Vivantes Klinikum im Friedrichshain Berlin
| | - Silja Guski
- Fachbereich Pathologie Vivantes Klinikum Neukölln Berlin
| | - Axel Zahn
- Klinik für Dermatologie und Phlebologie Vivantes Klinikum im Friedrichshain Berlin
| | - Wiebke K. Peitsch
- Klinik für Dermatologie und Phlebologie Vivantes Klinikum im Friedrichshain Berlin
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25
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Peitsch WK, Zahn A, Guski S, Girschick HJ. Anuläre Erytheme bei einem 7‐jährigen Jungen mit systemischem Inflammationssyndrom. J Dtsch Dermatol Ges 2020; 18:769-773. [DOI: 10.1111/ddg.14052_g] [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: 11/29/2022]
Affiliation(s)
- Wiebke K. Peitsch
- Klinik für Dermatologie und Phlebologie Vivantes Klinikum im Friedrichshain Berlin
| | - Axel Zahn
- Klinik für Dermatologie und Phlebologie Vivantes Klinikum im Friedrichshain Berlin
| | - Silja Guski
- Fachbereich Pathologie Vivantes Klinikum Neukölln Berlin
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Hoffmann V, Schleuter L, Wetzel S, Guski S, Zahn A, Peitsch WK. Generalized symmetric telangiectasias. J Dtsch Dermatol Ges 2020; 18:916-919. [PMID: 32346969 DOI: 10.1111/ddg.14090] [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: 11/30/2022]
Affiliation(s)
- Vincent Hoffmann
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Leonie Schleuter
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Sabine Wetzel
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Silja Guski
- Institute of Pathology, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Axel Zahn
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Wiebke K Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
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Orouji E, Peitsch WK, Orouji A, Houben R, Utikal J. Unique Role of Histone Methyltransferase PRDM8 in the Tumorigenesis of Virus-Negative Merkel Cell Carcinoma. Cancers (Basel) 2020; 12:cancers12041057. [PMID: 32344701 PMCID: PMC7226539 DOI: 10.3390/cancers12041057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 03/23/2020] [Revised: 04/22/2020] [Accepted: 04/22/2020] [Indexed: 12/14/2022] Open
Abstract
Merkel cell carcinoma (MCC) is a deadly skin cancer, and about 80% of its cases have been shown to harbor integrated Merkel polyomavirus in the tumor cell genome. Viral oncoproteins expressed in the tumor cells are considered as the oncogenic factors of these virus-positive Merkel cell carcinoma (VP-MCC). In contrast, the molecular pathogenesis of virus-negative MCC (VN-MCC) is less well understood. Using gene expression analysis of MCC cell lines, we found histone methyltransferase PRDM8 to be elevated in VN-MCC. This finding was confirmed by immunohistochemical analysis of MCC tumors, revealing that increased PRDM8 expression in VN-MCC is also associated with increased H3K9 methylation. CRISPR-mediated silencing of PRDM8 in MCC cells further supported the histone methylating role of this protein in VN-MCC. We also identified miR-20a-5p as a negative regulator of PRDM8. Taken together, our findings provide insights into the role of PRDM8 as a histone methyltransferase in VN-MCC tumorigenesis.
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Affiliation(s)
- Elias Orouji
- Skin Cancer Unit, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, 68167 Mannheim, Germany
- Department of Genomic Medicine, University of Texas MD Anderson Cancer Center, Houston, TX 77054, USA
- Correspondence: (E.O.); (J.U.); Tel.: +1-(917)647-2202 (E.O.); +49-(621)383-4461 (J.U.)
| | - Wiebke K. Peitsch
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, 68167 Mannheim, Germany
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, 10249 Berlin, Germany
| | - Azadeh Orouji
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, 68167 Mannheim, Germany
| | - Roland Houben
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Jochen Utikal
- Skin Cancer Unit, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, 68167 Mannheim, Germany
- Correspondence: (E.O.); (J.U.); Tel.: +1-(917)647-2202 (E.O.); +49-(621)383-4461 (J.U.)
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Weilandt J, Diehl K, Schaarschmidt ML, Kieker F, Sasama B, Pronk M, Ohletz J, Könnecke A, Müller V, Utikal J, Hillen U, Harth W, Peitsch WK. Patient Preferences in Adjuvant and Palliative Treatment of Advanced Melanoma: A Discrete Choice Experiment. Acta Derm Venereol 2020; 100:adv00083. [PMID: 32057087 PMCID: PMC9128976 DOI: 10.2340/00015555-3422] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2020] [Indexed: 11/16/2022] Open
Abstract
Treatment paradigms for advanced melanoma have changed fundamentally over recent years. A discrete choice experiment was performed to explore patient preferences regarding outcome (overall response rate, 2-year survival rate, progression-free survival, time to response, type of adverse events, probability of adverse event-related treatment discontinuation) and process attributes (frequency and route of administration, frequency of consultations) of modern treatments for melanoma. Mean preferences of 150 patients with melanoma stage IIC-IV were highest for overall response rate (relative importance score (RIS) 26.8) and 2-year survival (RIS 21.6), followed by type of adverse events (RIS 11.7) and probability of adverse event-related treatment discontinuation (RIS 9.2). Interest in overall response rate and 2-year survival declined with increasing age, whereas process attributes gained importance. Participants who had experienced treatment with immune checkpoint inhibitors valued overall response rate more highly and worried less about the type of adverse events. In conclusion, patients with advanced melanoma consider efficacy of treatment options most important, followed by safety, but preferences vary with individual and disease-related characteristics.
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Affiliation(s)
- Juliane Weilandt
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
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Peitsch WK, Zahn A, Guski S, Girschick HJ. Annular erythemas in a 7-year-old boy with systemic inflammation syndrome. J Dtsch Dermatol Ges 2020; 18:769-772. [PMID: 32115856 DOI: 10.1111/ddg.14052] [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)
- Wiebke K Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Axel Zahn
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Silja Guski
- Department of Pathology, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Hermann J Girschick
- Department of Pediatrics, Vivantes Klinikum im Friedrichshain, Berlin, Germany
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Hekler A, Utikal JS, Enk AH, Hauschild A, Weichenthal M, Maron RC, Berking C, Haferkamp S, Klode J, Schadendorf D, Schilling B, Holland-Letz T, Izar B, von Kalle C, Fröhling S, Brinker TJ, Schmitt L, Peitsch WK, Hoffmann F, Becker JC, Drusio C, Jansen P, Klode J, Lodde G, Sammet S, Schadendorf D, Sondermann W, Ugurel S, Zader J, Enk A, Salzmann M, Schäfer S, Schäkel K, Winkler J, Wölbing P, Asper H, Bohne AS, Brown V, Burba B, Deffaa S, Dietrich C, Dietrich M, Drerup KA, Egberts F, Erkens AS, Greven S, Harde V, Jost M, Kaeding M, Kosova K, Lischner S, Maagk M, Messinger AL, Metzner M, Motamedi R, Rosenthal AC, Seidl U, Stemmermann J, Torz K, Velez JG, Haiduk J, Alter M, Bär C, Bergenthal P, Gerlach A, Holtorf C, Karoglan A, Kindermann S, Kraas L, Felcht M, Gaiser MR, Klemke CD, Kurzen H, Leibing T, Müller V, Reinhard RR, Utikal J, Winter F, Berking C, Eicher L, Hartmann D, Heppt M, Kilian K, Krammer S, Lill D, Niesert AC, Oppel E, Sattler E, Senner S, Wallmichrath J, Wolff H, Gesierich A, Giner T, Glutsch V, Kerstan A, Presser D, Schrüfer P, Schummer P, Stolze I, Weber J, Drexler K, Haferkamp S, Mickler M, Stauner CT, Thiem A. Superior skin cancer classification by the combination of human and artificial intelligence. Eur J Cancer 2019; 120:114-121. [DOI: 10.1016/j.ejca.2019.07.019] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 07/18/2019] [Indexed: 10/26/2022]
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Maron RC, Weichenthal M, Utikal JS, Hekler A, Berking C, Hauschild A, Enk AH, Haferkamp S, Klode J, Schadendorf D, Jansen P, Holland-Letz T, Schilling B, von Kalle C, Fröhling S, Gaiser MR, Hartmann D, Gesierich A, Kähler KC, Wehkamp U, Karoglan A, Bär C, Brinker TJ, Schmitt L, Peitsch WK, Hoffmann F, Becker JC, Drusio C, Jansen P, Klode J, Lodde G, Sammet S, Schadendorf D, Sondermann W, Ugurel S, Zader J, Enk A, Salzmann M, Schäfer S, Schäkel K, Winkler J, Wölbing P, Asper H, Bohne AS, Brown V, Burba B, Deffaa S, Dietrich C, Dietrich M, Drerup KA, Egberts F, Erkens AS, Greven S, Harde V, Jost M, Kaeding M, Kosova K, Lischner S, Maagk M, Messinger AL, Metzner M, Motamedi R, Rosenthal AC, Seidl U, Stemmermann J, Torz K, Velez JG, Haiduk J, Alter M, Bär C, Bergenthal P, Gerlach A, Holtorf C, Karoglan A, Kindermann S, Kraas L, Felcht M, Gaiser MR, Klemke CD, Kurzen H, Leibing T, Müller V, Reinhard RR, Utikal J, Winter F, Berking C, Eicher L, Hartmann D, Heppt M, Kilian K, Krammer S, Lill D, Niesert AC, Oppel E, Sattler E, Senner S, Wallmichrath J, Wolff H, Giner T, Glutsch V, Kerstan A, Presser D, Schrüfer P, Schummer P, Stolze I, Weber J, Drexler K, Haferkamp S, Mickler M, Stauner CT, Thiem A. Systematic outperformance of 112 dermatologists in multiclass skin cancer image classification by convolutional neural networks. Eur J Cancer 2019; 119:57-65. [DOI: 10.1016/j.ejca.2019.06.013] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 06/19/2019] [Accepted: 06/21/2019] [Indexed: 01/07/2023]
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Mahlich J, Alba A, Hadad LE, Leisten MK, Peitsch WK. Drug Survival of Biological Therapies for Psoriasis Treatment in Germany and Associated Costs: A Retrospective Claims Database Analysis. Adv Ther 2019; 36:1684-1699. [PMID: 31102203 DOI: 10.1007/s12325-019-00969-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Our aim was to study drug survival and associated costs of biologic treatment in a German real-world cohort of biologic-naïve psoriasis patients. METHODS We utilized a German claims database base with 3,682,561 enrolled patients between 2001 and 2015. Kaplan-Meier curves were plotted to show the persistence of different biologics. To determine factors that influence persistence, a Cox regression analysis was performed. In addition, associated costs were calculated 12 months before and after treatment start with biologics. RESULTS Among 75,561 patients with a diagnosis of psoriasis, we identified 347 patients who received a biologic; 176 of them were biologic-naïve prior to initiating therapy. Overall, the 1-year persistence rate was 56%. The highest persistence rate was observed for ustekinumab (80%). Younger patients, and those with a high comorbidity index, had a numerically increased risk of treatment discontinuation. However, parameter values were not statistically significant. While the overall costs after treatment start increased due to the acquisition costs of biologics, we found a strong decrease (- 41%) in sick leave after treatment with biologics had been initiated. CONCLUSION Observed drug survival rates in this real-world setting were relatively low. In line with previous studies, ustekinumab had a higher persistence rate than other biologics. FUNDING Janssen-Cilag.
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Affiliation(s)
- Jörg Mahlich
- Health Economics and Outcomes Research, Janssen-Cilag, Neuss, Germany.
- Düsseldorf Institute for Competition Economics (DICE), University of Düsseldorf, Düsseldorf, Germany.
| | | | | | | | - Wiebke K Peitsch
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Berlin, Germany
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Peitsch WK. Apremilast bei einem Patienten mit Psoriasis und Mantelzelllymphom unter Erhaltungstherapie mit Rituximab. J Dtsch Dermatol Ges 2019; 17:330-332. [DOI: 10.1111/ddg.13771_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Wiebke K. Peitsch
- Klinik für Dermatologie und PhlebologieVivantes Klinikum im Friedrichshain Berlin Deutschland
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Pinter A, Wilsmann‐Theis D, Peitsch WK, Mössner R. Interleukin‐17 receptorAblockade with brodalumab in palmoplantar pustular psoriasis: Report on four cases. J Dermatol 2019; 46:426-430. [DOI: 10.1111/1346-8138.14815] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 01/15/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Andreas Pinter
- Department of Dermatology, Venereology and Allergology University Hospital Frankfurt am Main Frankfurt am Main Germany
| | | | - Wiebke K. Peitsch
- Department of Dermatology and Phlebology Vivantes Klinikum im Friedrichshain Berlin Germany
| | - Rotraut Mössner
- Department of Dermatology, Venereology and Allergology University Clinic Göttingen Göttingen Germany
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Peitsch WK. Apremilast in a patient with psoriasis and mantle cell lymphoma under maintenance treatment with rituximab. J Dtsch Dermatol Ges 2019; 17:330-332. [PMID: 30775841 DOI: 10.1111/ddg.13771] [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: 11/29/2022]
Affiliation(s)
- Wiebke K Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
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Recke A, Konitzer S, Lemcke S, Freitag M, Sommer NM, Abdelhady M, Amoli MM, Benoit S, El-Chennawy F, Eldarouti M, Eming R, Gläser R, Günther C, Hadaschik E, Homey B, Lieb W, Peitsch WK, Pföhler C, Robati RM, Saeedi M, Sárdy M, Sticherling M, Uzun S, Worm M, Zillikens D, Ibrahim S, Vidarsson G, Schmidt E. The p.Arg435His Variation of IgG3 With High Affinity to FcRn Is Associated With Susceptibility for Pemphigus Vulgaris-Analysis of Four Different Ethnic Cohorts. Front Immunol 2018; 9:1788. [PMID: 30116249 PMCID: PMC6082936 DOI: 10.3389/fimmu.2018.01788] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 07/19/2018] [Indexed: 01/15/2023] Open
Abstract
IgG3 is the IgG subclass with the strongest effector functions among all four IgG subclasses and the highest degree of allelic variability among all constant immunoglobulin genes. Due to its genetic position, IgG3 is often the first isotype an antibody switches to before IgG1 or IgG4. Compared with the other IgG subclasses, it has a reduced half-life which is probably connected to a decreased affinity to the neonatal Fc receptor (FcRn). However, a few allelic variants harbor an amino acid replacement of His435 to Arg that reverts the half-life of the resulting IgG3 to the same level as the other IgG subclasses. Because of its functional impact, we hypothesized that the p.Arg435His variation could be associated with susceptibility to autoantibody-mediated diseases like pemphigus vulgaris (PV) and bullous pemphigoid (BP). Using a set of samples from German, Turkish, Egyptian, and Iranian patients and controls, we were able to demonstrate a genetic association of the p.Arg435His variation with PV risk, but not with BP risk. Our results suggest a hitherto unknown role for the function of IgG3 in the pathogenesis of PV.
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Affiliation(s)
- Andreas Recke
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany.,Department of Dermatology, Allergology and Venereology, University of Lübeck, Lübeck, Germany
| | - Sarah Konitzer
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - Susanne Lemcke
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - Miriam Freitag
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - Nele Maxi Sommer
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - Mohammad Abdelhady
- Department of Dermatology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mahsa M Amoli
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular - Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sandrine Benoit
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - Farha El-Chennawy
- Department of Clinical Pathology, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohammad Eldarouti
- Department of Dermatology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Rüdiger Eming
- Department of Dermatology and Allergology, Phillips-Universität Marburg, Marburg, Germany
| | - Regine Gläser
- Department of Dermatology, Venereology and Allergology, Christian Albrecht University, Kiel, Germany
| | - Claudia Günther
- Department of Dermatology, University Hospital of Dresden, Dresden, Germany
| | - Eva Hadaschik
- Department of Dermatology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
| | - Bernhard Homey
- Department of Dermatology, Heinrich Heine University, Düsseldorf, Germany
| | - Wolfgang Lieb
- Institute of Epidemiology, Christian-Albrechts-University, Kiel, Germany.,Popgen Biobank, Christian-Albrechts-University, Kiel, Germany
| | - Wiebke K Peitsch
- Department of Dermatology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.,Department of Dermatology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Claudia Pföhler
- Department of Dermatology, Saarland University Medical School, Homburg/Saar, Germany
| | - Reza M Robati
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marjan Saeedi
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Miklós Sárdy
- Department of Dermatology, Ludwig Maximilian University Munich, Munich, Germany
| | - Michael Sticherling
- Department of Dermatology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Soner Uzun
- Department of Dermatology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Margitta Worm
- Department of Dermatology, Venerology and Allergology, Allergy Center Charité, Charité-Medical University Berlin, Berlin, Germany
| | - Detlef Zillikens
- Department of Dermatology, Allergology and Venereology, University of Lübeck, Lübeck, Germany
| | - Saleh Ibrahim
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - Gestur Vidarsson
- Department of Experimental Hematology, Sanquin Research Institute, Amsterdam, Netherlands
| | - Enno Schmidt
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
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Almustafa ZZ, Sasama B, Peitsch WK. Perichondritis am Ohr eines afghanischen Immigranten. J Dtsch Dermatol Ges 2018; 16:500-503. [DOI: 10.1111/ddg.13384_g] [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: 11/30/2022]
Affiliation(s)
- Zaid Z. Almustafa
- Klinik für Dermatologie und Phlebologie; Vivantes Klinikum im Friedrichshain; Berlin
- Klinik für Dermatologie; Venerologie und Allergologie; Charité - Universitätsmedizin; Berlin
| | - Bianca Sasama
- Klinik für Dermatologie und Phlebologie; Vivantes Klinikum im Friedrichshain; Berlin
| | - Wiebke K. Peitsch
- Klinik für Dermatologie und Phlebologie; Vivantes Klinikum im Friedrichshain; Berlin
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38
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Schaarschmidt ML, Herr R, Gutknecht M, Wroblewska K, Gerdes S, Sticherling M, Augustin M, Peitsch WK. Patients' and Physicians' Preferences for Systemic Psoriasis Treatments: A Nationwide Comparative Discrete Choice Experiment (PsoCompare). Acta Derm Venereol 2018; 98:200-205. [PMID: 29110022 DOI: 10.2340/00015555-2834] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Systemic antipsoriatic treatment options are increasing rapidly. The aim of this nationwide discrete choice experiment was to compare patients' (n = 222) and physicians' (n = 78) preferences for outcome and process attributes of systemic antipsoriatics using Relative Importance Scores (RIS). Both groups considered Psoriasis Area and Severity Index 90 (PASI 90) to be most important (RIS 21.4 and 20.8, respectively). Moreover, patients were highly concerned about mild and severe adverse events (RIS = 18.2 and 14.2), physicians about severe adverse events (RIS = 14.9) and cost (RIS = 13.8). Compared to physicians, patients worried more about mild adverse events and treatment location, but less about cost and frequency of laboratory tests. Physicians' preferences were influenced by work experience and percentage of biological prescriptions, patients' preferences by age, disease duration and severity. Older and less severely affected patients recruited via a patient organization focused more on safety, but less on efficacy and time until response than did patients from study centres. In conclusion, these differences in trade-offs should be integrated into a shared decision-making.
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Affiliation(s)
- Marthe-Lisa Schaarschmidt
- Department of Dermatology, University Medical Center Mannheim, Heidelberg University, DE-68135 Mannheim, Germany
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Arnold T, Schaarschmidt ML, Herr R, Fischer JE, Goerdt S, Peitsch WK. Drug survival rates and reasons for drug discontinuation in psoriasis. J Dtsch Dermatol Ges 2018; 14:1089-1099. [PMID: 27879076 DOI: 10.1111/ddg.13152] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 06/04/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND OBJECTIVES Moderate-to-severe psoriasis frequently requires long-term systemic therapy. Reflecting efficacy, safety, and treatment satisfaction, drug survival is an indicator of therapeutic success. The objective of the present study was to assess drug survival rates and reasons for discontinuation of fumaric acid esters (FAE), methotrexate (MTX), acitretin (ACI), cyclosporine A (CyA), adalimumab (ADA), etanercept (ETA), infliximab (INF), and ustekinumab (UST) in patients with moderate-to-severe psoriasis. PATIENTS AND METHODS We performed a retrospective analysis of 373 patients who had received a total of 696 treatment courses at a German university hospital in the period 1/2003-5/2014. RESULTS The crude probability of survival was highest for UST, followed by ADA, ETA, INF, FAE, MTX, ACI, and CyA. In multivariate regression analysis using FAE as reference, hazard ratios (HR) for discontinuation were 0.14 (95 % confidence interval: 0.06-0.35) for UST, 0.43 (0.26-0.73) for ADA, 2.11 (1.14-3.91) for ACI, and 3.26 (1.44-7.39) for CyA. INF showed longer survival when combined with MTX (HR 2.87, 1.21-6.81). Traditional systemic antipsoriatic agents as well as INF were most frequently discontinued due to adverse events; all other biologics, due to inefficacy with respect to cutaneous lesions. CONCLUSIONS Drug survival rates should be integrated into therapeutic decisions in order to provide patients with an optimal long-term strategy.
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Affiliation(s)
- Tobias Arnold
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Marthe-Lisa Schaarschmidt
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Raphael Herr
- Mannheim Institute of Public Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Joachim E Fischer
- Mannheim Institute of Public Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Sergij Goerdt
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Wiebke K Peitsch
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
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Kromer C, Celis D, Sonntag D, Peitsch WK. Biologicals and small molecules in psoriasis: A systematic review of economic evaluations. PLoS One 2018; 13:e0189765. [PMID: 29298315 PMCID: PMC5751984 DOI: 10.1371/journal.pone.0189765] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 11/24/2017] [Indexed: 11/18/2022] Open
Abstract
Biological therapy for moderate-to-severe psoriasis is highly effective but cost-intensive. This systematic review aimed at analyzing evidence on the cost-effectiveness of biological treatment of moderate-to-severe psoriasis. A literature search was conducted until 30/06/2017 in PubMed, Cochrane Library, LILACS, and EconLit. The quality of identified studies was assessed with the checklist by the Centre for Reviews and Dissemination guidance. Out of 482 records, 53 publications were eligible for inclusion. Half of the studies met between 20 and 25 of the quality checklist items, displaying moderate quality. Due to heterogeneity of studies, a qualitative synthesis was conducted. Cost ranges per outcome were enormous across different studies due to diversity in assumptions and model design. Pairwise comparisons of biologicals revealed conflicting results. Overall, adalimumab appeared to be most cost-effective (100% of all aggregated pairwise comparisons), followed by ustekinumab (66.7%), and infliximab (60%). However, in study conclusions most recent publications favored secukinumab and apremilast (75% and 60% of the studies investigating these medications). Accepted willingness-to-pay thresholds varied between 30,000 and 50,000 USD/Quality-Adjusted Life Year (QALY). Three-quarters of studies were financially supported, and in 90% of those, results were consistent with the funder's interest. Economic evaluation of biologicals is crucial for responsible allocation of health care resources. In addition to summarizing the actual evidence this review highlights gaps and needs for future research.
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Affiliation(s)
- Christian Kromer
- Department of Dermatology, University Medical Center Göttingen, Göttingen University, Göttingen, Germany
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Daniel Celis
- Faculty of Economic Sciences, Göttingen University, Göttingen, Germany
| | - Diana Sonntag
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Health Science, University of York, Heslington, York, United Kingdom
| | - Wiebke K. Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
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41
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Almustafa ZZ, Sasama B, Peitsch WK. Perichondritis of the ear in an Afghan immigrant. J Dtsch Dermatol Ges 2017; 16:501-503. [PMID: 29211334 DOI: 10.1111/ddg.13384] [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: 11/29/2022]
Affiliation(s)
- Zaid Z Almustafa
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany.,Department of Dermatology, Venereology, and Allergology, Charité - Universitätsmedizin, Berlin, Germany
| | - Bianca Sasama
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Wiebke K Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
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42
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Kromer C, Peitsch WK, Herr R, Schmieder A, Sonntag D, Schaarschmidt ML. Treatment preferences for biologicals in psoriasis: experienced patients appreciate sustainability. J Dtsch Dermatol Ges 2017; 15:189-200. [PMID: 28214326 DOI: 10.1111/ddg.12919] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 11/14/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVES Treatment satisfaction can be improved by integrating patients' preferences into shared decision-making. We recently investigated patients' preferences for attributes of biologicals, and showed high preferences for safety and efficacy. The objective of the present study was to assess the impact of treatment experience on these preferences. PATIENTS AND METHODS Preferences for outcome (probability of 50 % and 90 % improvement, time until response, sustainability of success, probability of mild and severe adverse events, probability of ACR 20 response) and process attributes (treatment location, frequency, duration, and delivery method) were analyzed in 200 participants with moderate-to-severe psoriasis using conjoint analysis. The impact of current and previous therapies, disease duration, and treatment satisfaction on 'Relative Importance Scores' was determined by analysis of variance, post hoc tests, and multivariate regression. RESULTS Participants presently on topical therapy (p = 0.02) or phototherapy (p = 0.032) placed more importance on treatment duration than others. Individuals who had previously been given traditional systemic agents (p = 0.028) or biologicals (p = 0.044) favored sustainability more than others. With an increasing number of systemic agents ever received (p = 0.045) and longer disease duration (p = 0.018), the latter attribute became increasingly important. CONCLUSIONS Patients' preferences for biologicals vary in correlation with treatment experience and disease duration, aspects to be addressed in the context of shared decision-making.
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Affiliation(s)
- Christian Kromer
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Wiebke K Peitsch
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Raphael Herr
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Astrid Schmieder
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Diana Sonntag
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marthe-Lisa Schaarschmidt
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Schaarschmidt ML, Schlich M, Staub J, Schmieder A, Goerdt S, Peitsch WK. Lupus Miliaris Disseminatus Faciei: Not Only a Facial Dermatosis. Acta Derm Venereol 2017; 97:655-656. [PMID: 28119995 DOI: 10.2340/00015555-2616] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Marthe-Lisa Schaarschmidt
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
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Kromer C, Peitsch WK, Herr R, Schmieder A, Sonntag D, Schaarschmidt M. Behandlungspräferenzen für Biologika bei Psoriasis: erfahrene Patienten legen Wert auf Nachhaltigkeit. J Dtsch Dermatol Ges 2017; 15:189-201. [DOI: 10.1111/ddg.12919_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 11/14/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Christian Kromer
- Klinik für Dermatologie, Venerologie und AllergologieUniversitätsmedizin Mannheim, Universität Heidelberg Mannheim
| | - Wiebke K. Peitsch
- Klinik für Dermatologie, Venerologie und AllergologieUniversitätsmedizin Mannheim, Universität Heidelberg Mannheim
| | - Raphael Herr
- Mannheimer Institut für Public Health, Sozial‐ und PräventivmedizinMedizinische Fakultät Mannheim, Universität Heidelberg Mannheim
| | - Astrid Schmieder
- Klinik für Dermatologie, Venerologie und AllergologieUniversitätsmedizin Mannheim, Universität Heidelberg Mannheim
| | - Diana Sonntag
- Mannheimer Institut für Public Health, Sozial‐ und PräventivmedizinMedizinische Fakultät Mannheim, Universität Heidelberg Mannheim
| | - Marthe‐Lisa Schaarschmidt
- Klinik für Dermatologie, Venerologie und AllergologieUniversitätsmedizin Mannheim, Universität Heidelberg Mannheim
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45
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Arnold T, Schaarschmidt M, Herr R, Fischer JE, Goerdt S, Peitsch WK. „Drug‐Survival“‐Raten und Gründe für den Abbruch von Systemtherapien bei Psoriasis. J Dtsch Dermatol Ges 2016; 14:1090-1101. [DOI: 10.1111/ddg.13152_g] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 06/04/2016] [Indexed: 12/29/2022]
Affiliation(s)
- Tobias Arnold
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg Mannheim
| | - Marthe‐Lisa Schaarschmidt
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg Mannheim
| | - Raphael Herr
- Mannheimer Institut für Public Health, Sozial‐ und Präventivmedizin Medizinische Fakultät Mannheim, Universität Heidelberg Mannheim
| | - Joachim E. Fischer
- Mannheimer Institut für Public Health, Sozial‐ und Präventivmedizin Medizinische Fakultät Mannheim, Universität Heidelberg Mannheim
| | - Sergij Goerdt
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg Mannheim
| | - Wiebke K. Peitsch
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg Mannheim
- Klinik für Dermatologie und Phlebologie Vivantes Klinikum im Friedrichshain Berlin
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Abstract
A large proportion of patients with plaque psoriasis suffer from psoriatic lesions of the scalp, nails, and intertrigines. These locations can also be soley or predominantly affected. Scalp psoriasis, nail psoriasis, and inverse psoriasis are often perceived as particularly stigmatizing. Involvement of these parts of the body is associated with an increased risk of psoriatic arthritis. Location-specific features must be considered when choosing treatment. Evidence for topical therapy of scalp psoriasis with steroids and combinations of steroids and vitamin D analogues is high. These agents are regarded as safe and effective treatments of first choice. Efficacy of TNF antagonists and apremilast is well documented for refractory scalp psoriasis. Nail psoriasis often responds insufficiently to topical therapy. Several effective systemic medications including methotrexate and TNF antagonists are available for treatment of severe forms. Controlled trials for treatment of inverse psoriasis are scarce. Topical steroids, vitamin D analogues, dithranol, and off-label calcineurin inhibitors are used in clinical practice. This review provides a survey on the clinical presentation and current evidence for treatment of psoriasis in challenging locations.
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Affiliation(s)
- A Schmieder
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Deutschland
| | - W K Peitsch
- Klinik für Dermatologie und Phlebologie, Vivantes Klinikum im Friedrichshain, Landsberger Allee 49, 10249, Berlin, Deutschland.
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47
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Martin I, Schaarschmidt ML, Glocker A, Herr R, Schmieder A, Goerdt S, Peitsch WK. Patient Preferences for Treatment of Basal Cell Carcinoma: Importance of Cure and Cosmetic Outcome. Acta Derm Venereol 2016; 96:355-60. [PMID: 26537095 DOI: 10.2340/00015555-2273] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Treatment options for localized resectable basal cell carcinoma (BCC) include micrographically controlled surgery, simple excision, curettage, laser ablation, cryosurgery, imiquimod, 5-fluorouracil, photodynamic therapy and radiotherapy. The aim of this study was to assess the preferences of patients with BCC for outcome (cure and recurrence rate, cosmetic outcome, risk of temporary and permanent complications) and process attributes (type of therapy, treatment location, anaesthesia, method of wound closure, duration of wound healing, out-of-pocket costs) of these treatments with conjoint analysis. Participants (n = 124) attached greatest importance to recurrence rate (relative importance score (RIS) = 17.28), followed by cosmetic outcome (RIS = 16.90) and cure rate (RIS = 15.02). Participants with BCC on the head or neck were particularly interested in cosmetic outcome. Those with a recurrence were willing to trade risk of recurrence, treatment location and duration of wound healing for a better cosmetic result. In summary, participants particularly valued cure and cosmetic outcome, although preferences varied with individual and tumour-associated characteristics.
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Affiliation(s)
- Isabelle Martin
- Department of Dermatology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
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48
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Schaarschmidt ML, Kromer C, Herr R, Schmieder A, Sonntag D, Goerdt S, Peitsch WK. Patient Preferences for Biologicals in Psoriasis: Top Priority of Safety for Cardiovascular Patients. PLoS One 2015; 10:e0144335. [PMID: 26633680 PMCID: PMC4669171 DOI: 10.1371/journal.pone.0144335] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 11/17/2015] [Indexed: 02/08/2023] Open
Abstract
Patients with psoriasis are often affected by comorbidities, which largely influence treatment decisions. Here we performed conjoint analysis to assess the impact of comorbidities on preferences of patients with moderate-to-severe psoriasis for outcome (probability of 50% and 90% improvement, time until response, sustainability of success, probability of mild and severe adverse events (AE), probability of ACR 20 response) and process attributes (treatment location, frequency, duration and delivery method) of biologicals. The influence of comorbidities on Relative Importance Scores (RIS) was determined with analysis of variance and multivariate regression. Among the 200 participants completing the study, 22.5% suffered from psoriatic arthritis, 31.5% from arterial hypertension, 15% from cardiovascular disease (myocardial infarction, stroke, coronary artery disease, and/or arterial occlusive disease), 14.5% from diabetes, 11% from hyperlipidemia, 26% from chronic bronchitis or asthma and 12.5% from depression. Participants with psoriatic arthritis attached greater importance to ACR 20 response (RIS = 10.3 vs. 5.0, p<0.001; β = 0.278, p<0.001) and sustainability (RIS = 5.8 vs. 5.0, p = 0.032) but less value to time until response (RIS = 3.4 vs. 4.8, p = 0.045) than those without arthritis. Participants with arterial hypertension were particularly interested in a low risk of mild AE (RIS 9.7 vs. 12.1; p = 0.033) and a short treatment duration (RIS = 8.0 vs. 9.6, p = 0.002). Those with cardiovascular disease worried more about mild AE (RIS = 12.8 vs. 10, p = 0.027; β = 0.170, p = 0.027) and severe AE (RIS = 23.2 vs. 16.2, p = 0.001; β = 0.203, p = 0.007) but cared less about time until response (β = -0.189, p = 0.013), treatment location (β = -0.153, p = 0.049), frequency (β = -0.20, p = 0.008) and delivery method (β = -0.175, p = 0.023) than others. Patients’ concerns should be addressed in-depth when prescribing biologicals to comorbid patients, keeping in mind that TNF antagonists may favourably influence cardiovascular risk.
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Affiliation(s)
- Marthe-Lisa Schaarschmidt
- Department of Dermatology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Christian Kromer
- Department of Dermatology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Raphael Herr
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Astrid Schmieder
- Department of Dermatology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Diana Sonntag
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sergij Goerdt
- Department of Dermatology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Wiebke K. Peitsch
- Department of Dermatology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
- * E-mail:
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Schober SM, Peitsch WK, Bonsmann G, Metze D, Thomas K, Goerge T, Luger TA, Schneider SW. Early treatment with rutoside and ascorbic acid is highly effective for progressive pigmented purpuric dermatosis. J Dtsch Dermatol Ges 2015; 12:1112-9. [PMID: 25482694 DOI: 10.1111/ddg.12520] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Progressive pigmented purpuric dermatosis (PPPD, Schamberg disease) is a rare benign, but chronic dermatosis frequently misdiagnosed as vasculitis or bleeding disorder. Although affected patients experience significant impairment in quality of life no effective treatment has been established. The aim of our two center case series was to evaluate efficacy and tolerability of the antioxidants rutoside and ascorbic acid as combination treatment for PPPD. PATIENTS AND METHODS A retrospective review was performed on 35 patients with PPPD treated with 2 × 50 mg rutoside and 1,000 mg ascorbic acid daily between 2004 until 2011. The mean treatment duration was 8.2 months. RESULTS 71.4% of the participants experienced complete clearance and 20.0% an improvement of more than 50%, accompanied by increased quality of life. Nine participants (25.1%) relapsed after discontinuation. In seven, rutoside and ascorbic acid was re-initiated, and all responded again. Only three participants reported mild adverse effects. Participants with shorter disease duration showed better therapeutic success, shorter time to response and lower risk of recurrence. CONCLUSION Oral rutoside and ascorbic acid may be an efficient and well tolerated treatment for PPPD. Early treatment is recommended to achieve best clinical outcome.
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Affiliation(s)
- Sarah M Schober
- Department of Dermatology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
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Ziegler B, Peitsch WK, Reiter A, Marx A, Goerdt S, Géraud C. Generalized Eruptive Histiocytosis Associated WithFIP1L1-PDGFRA–Positive Chronic Eosinophilic Leukemia. JAMA Dermatol 2015; 151:766-9. [DOI: 10.1001/jamadermatol.2015.0154] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Birgit Ziegler
- Department of Dermatology, Venereology, and Allergology, University Medical Center, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany2Center of Excellence in Dermatology, Mannheim, Germany
| | - Wiebke K. Peitsch
- Department of Dermatology, Venereology, and Allergology, University Medical Center, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany2Center of Excellence in Dermatology, Mannheim, Germany
| | - Andreas Reiter
- Department of Hematology and Oncology, University Medical Center, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Alexander Marx
- Institute of Pathology, University Medical Center, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Sergij Goerdt
- Department of Dermatology, Venereology, and Allergology, University Medical Center, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany2Center of Excellence in Dermatology, Mannheim, Germany
| | - Cyrill Géraud
- Department of Dermatology, Venereology, and Allergology, University Medical Center, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany2Center of Excellence in Dermatology, Mannheim, Germany
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