Clinical Severity of Psoriasis in Last 20 Years of PUVA Study

Nijsten, Tamar; Looman, Caspar W. N.; Stern, Robert S.

doi:10.1001/archderm.143.9.1113

Cited by 29 publications

(22 citation statements)

References 18 publications

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“…The present study used hard end points, such as hard CHD and CT-confirmed stroke, to minimize the effect of overdetection of softer end points, such as angina or transient ischemic attack, and therefore the outcomes are less likely to be affected by subject status or psoriatic disease. Psoriasis patients were identified using medical files, pharmacy data, and, in a subset, clinical examinations, resulting in the expected prevalence of 3% (of which 24% had moderate to severe disease), confirming the validity of the exposure definition (Nijsten et al, 2007;Kurd and Gelfand, 2009). For all psoriasis patients, a reliable date of onset of disease was available.…”

Section: Strengths and Limitationsmentioning

confidence: 76%

Psoriasis Is Not Associated with Atherosclerosis and Incident Cardiovascular Events: The Rotterdam Study

Dowlatshahi

Kavousi

Nijsten

et al. 2013

Journal of Investigative Dermatology

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111

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Psoriasis has been suggested to be an independent risk factor for cardiovascular disease (CVD); however, available studies have shown inconsistent results. In this study, embedded within the population-based Rotterdam Study, we aimed to assess the association between psoriasis and cardiovascular outcomes. Adjusted means were calculated for subclinical atherosclerosis using general linear models. Using Cox regression, the hazards of cardiovascular events for psoriasis, as a time-dependent variable, were calculated. A total of 262 psoriasis (24% systemic/UV treatment) and 8,009 reference subjects were followed up for a mean of 11 years. Psoriasis patients were significantly younger, smoked more, and had higher diastolic blood pressure and body mass index levels. The adjusted carotid intima-media thickness was 1.02±0.18 mm for psoriasis and 1.02±0.16 mm for reference subjects. Similarly, crude and adjusted ankle-brachial index, pulse-wave velocity, and coronary artery calcium scores did not differ between the two groups. The risk of incident CVD was not increased in psoriasis (adjusted hazard ratio 0.73, 95% confidence interval 0.50-1.06). The results were similar when coronary heart disease, stroke, and heart failure were analyzed separately. Psoriasis patients with predominantly mild disease from the general population are as likely to develop atherosclerosis and cardiovascular events as subjects without psoriasis.

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Section: Strengths and Limitationsmentioning

confidence: 76%

Psoriasis Is Not Associated with Atherosclerosis and Incident Cardiovascular Events: The Rotterdam Study

Dowlatshahi

Kavousi

Nijsten

et al. 2013

Journal of Investigative Dermatology

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111

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“…The US Food and Drug Administration prefers static IGA/PGA; thus, clinical research generally uses static IGA/PGA instruments. However, multiple versions of the static IGA/PGA exist, ranging from a 4-point to an 11-point scale, with varying descriptions of each point value [20, 21]. The static 5-point IGA scale, which was modified from the 6-point IGA/PGA scale [22], has become the standard form used in many phase 3 clinical trials [16-18].…”

Section: Discussionmentioning

confidence: 99%

Exploration of the Product of the 5-Point Investigator’s Global Assessment and Body Surface Area (IGA × BSA) as a Practical Minimal Disease Activity Goal in Patients with Moderate-to-Severe Psoriasis

et al. 2019

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Background/Aims: In the treat-to-target era, psoriasis disease activity measures that can be easily performed in routine clinical practice are needed. This retrospective pooled analysis explored cutoff values of the product of the 5-point Investigator’s Global Assessment and percentage of affected body surface area (IGA × BSA) correlating with achievement of minimal disease activity (MDA). Methods: Post hoc analysis of the phase 3 clinical trials ERASURE, FIXTURE, FEATURE, and JUNCTURE was conducted to determine associations between IGA × BSA and 2 MDA definitions (Psoriasis Area and Severity Index [PASI] 90 and Dermatology Life Quality Index [DLQI] 0/1, or PASI score ≤1 or BSA <3%) in patients with moderate-to-severe psoriasis receiving secukinumab 300 mg. For each definition of MDA, a range of possible cutoff values of IGA × BSA was examined at each time point. The optimal cutoff value was determined using Youden index (YI), calculated as (sensitivity + specificity – 1). Results: For MDA defined as PASI 90 and DLQI 0/1, optimal IGA × BSA cutoffs were 2.10 at week 12 (YI, 0.60; sensitivity, 0.78; specificity, 0.82), 1.02 at week 24 (YI, 0.55; sensitivity, 0.73; specificity, 0.82), and 1.00 at week 52 (YI, 0.65; sensitivity, 0.79; specificity, 0.86). For MDA defined as PASI score ≤1 or BSA <3%, optimal IGA × BSA cutoffs were 2.98 at week 12 (YI, 0.91; sensitivity, 0.99; specificity, 0.92), 2.80 at week 24 (YI, 0.94; sensitivity, 0.99; specificity, 0.95), and 3.00 at week 52 (YI, 0.96; sensitivity, 1.00; specificity, 0.96). Conclusion: IGA × BSA could be a valid measure highly associated with achievement of MDA.

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“…Therefore, the potential risks associated with truly long-term treatment of psoriasis remain to be further defined for serious end points such as malignancy. 19 The current PUVA Follow-up Study, as analyzed by Nijsten et al, 20 also provides unique data regarding the effectiveness of long-term treatment of severe psoriasis. During the follow-up of 815 patients who underwent 2378 skin examinations from 1985 to 2005, approximately 50% of such examinations demonstrated that patients had mild to no skin disease.…”

mentioning

confidence: 99%

Long-term Treatment for Severe Psoriasis

Gelfand¹

2007

Arch Dermatol

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Clinical Severity of Psoriasis in Last 20 Years of PUVA Study

Cited by 29 publications

References 18 publications

Psoriasis Is Not Associated with Atherosclerosis and Incident Cardiovascular Events: The Rotterdam Study

Psoriasis Is Not Associated with Atherosclerosis and Incident Cardiovascular Events: The Rotterdam Study

Exploration of the Product of the 5-Point Investigator’s Global Assessment and Body Surface Area (IGA × BSA) as a Practical Minimal Disease Activity Goal in Patients with Moderate-to-Severe Psoriasis

Long-term Treatment for Severe Psoriasis

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