Pattern of response in patients with moderate-to-severe psoriasis treated with etanercept

Griffiths, C.E.M.; Sterry, Wolfram; Brock, F; Dilleen, M.; Stefanidis, D.; Germain, Jean-Michel; Mallbris, Lotus

doi:10.1111/bjd.13139

Cited by 20 publications

(13 citation statements)

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“…Griffiths and colleagues reported weak to moderate correlations between DLQI and PASI total scores and noted that changes in QoL do not appear to be captured by PASI or its subscales. We confirm this assumption, highlighting the role of patient‐assessed psoriasis symptoms on top of PASI in affecting HRQoL and work productivity and activity impairment outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…The Dermatology Life Quality Index (DLQI) is the most commonly used instrument to assess the health‐related quality of life (HRQoL) of patients with psoriasis . However, increasing evidence confirms only weak to moderate correlations between the PASI and DLQI . This suggests that factors other than objective disease severity may play a role in patients’ evaluations of their HRQoL.…”

mentioning

confidence: 99%

“…7,9 However, increasing evidence confirms only weak to moderate correlations between the PASI and DLQI. 10,11 This suggests that factors other than objective disease severity may play a role in patients' evaluations of their HRQoL. Previous research has shown that patients perceive pain, itching and scaling to be the most troubling aspects of their psoriasis.…”

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confidence: 99%

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Differential effects of secukinumab vs. ustekinumab for treatment of psoriasis on quality of life, work productivity and activity impairment: a structural equation modelling analysis

et al. 2018

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Differential effects of secukinumab vs. ustekinumab for treatment of psoriasis on quality of life, work productivity and activity impairment: a structural equation modelling analysis

et al. 2018

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“…In clinical practice, physicians focus on elements of the PASI (e.g., size and appearance of lesions), whereas patients tend to focus on the location of lesions and impact of the disease on their lives. The correlation between improvements in psoriasis lesions (as measured by PASI) and improvements in quality of life (as measured by DLQI) varies, with some studies showing weak correlations [16, 17].…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Utility of the Psoriasis Symptom Inventory (PSI) in Clinical Care Settings: A Study from the International Psoriasis Council

et al. 2019

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BackgroundThe Psoriasis Symptom Inventory (PSI) is a patient-reported outcome measure designed to assess psoriasis signs and symptoms.ObjectivesThe aim was to assess the usefulness of the PSI in enhancing patient care in the clinical setting.MethodsEight dermatology clinics in six countries enrolled adults representing the full spectrum of psoriasis severity who regularly received care at the clinic. Patients were administered the eight-item PSI (score range 0–32; higher scores indicate greater severity) while waiting for the physician; the physician conducted a static physician global assessment (sPGA) and estimated psoriasis-affected body surface area (BSA) at the same visit. Physicians completed a brief questionnaire after each patient visit, and were interviewed about the PSI after all patients were seen.ResultsThe clinics enrolled 278 patients; mean [standard deviation (SD)] psoriasis-affected BSA was 7.6% (11.4). Based on BSA, 47.8% had mild psoriasis, 29.1% had moderate psoriasis, and 23.0% had severe psoriasis. Based on sPGA, 18.7% were clear/almost clear, 67.3% were mild/moderate, and 14.0% were severe/very severe. The mean (SD) PSI total score was 12.2 (8.3). Physicians spent a mean (SD) 4.9 (4.8) min discussing PSI findings with their patients (range 0–20 min). Key benefits of PSI discussions included the following: new information regarding symptom location and severity for physicians; prompting of quality-of-life discussions; better understanding of patient treatment priorities; change in treatment regimens to target specific symptoms or areas; and improvement of patient–physician relationship.ConclusionsThe PSI was useful for treated and untreated patients to enhance patient–physician communication, and influenced treatment decisions.Electronic supplementary materialThe online version of this article (10.1007/s40257-019-00458-2) contains supplementary material, which is available to authorized users.

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“…In these studies, as well as in clinical practice, it has been observed that biologic treatment response typically starts on the head and upper body and progresses downward to lower body regions and extremities [13, 14]. For example, after 16 weeks of treatment with the tumor necrosis factor-alpha inhibitor adalimumab, the greatest PASI 100 subscore response rates were reported on the head and neck (55.7%) and the trunk (49.1%) compared with the upper limbs (33.3%) and the lower limbs (30.6%) [14].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Secukinumab on Moderate-to-severe Plaque Psoriasis Affecting Different Body Regions: a Pooled Analysis of Four Phase 3 Studies

Menter

Cather²,

Jarratt

et al. 2016

Dermatol Ther (Heidelb)

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IntroductionThe impact of psoriasis varies with the body region affected. In addition, patients have different perceptions of disease improvement and treatment satisfaction based on the location of skin clearance with treatment. The monoclonal antibody secukinumab selectively targets interleukin-17A—a central cytokine of psoriasis—and provides rapid and sustained clearance for moderate-to-severe psoriasis affecting all body regions. The objective of this study was to evaluate the efficacy of secukinumab on moderate-to-severe psoriasis affecting the trunk, upper limbs, and lower limbs.MethodsData were pooled from four phase 3 studies. To be included in the analysis for each body region, patients were required to have a Psoriasis Area and Severity Index (PASI) score ≥12 for that body region and psoriasis covering ≥10% of the surface area of that region. Secukinumab was administered at Baseline, Weeks 1, 2 and 3, and then every 4 weeks from Week 4 to 48.ResultsAcross the trunk, upper limbs, and lower limbs, initial PASI subscore responses were sustained to Week 52. At Week 52, trunk (T) PASI 90/100 responses were achieved by 78.4%/71.1% of patients receiving secukinumab 300 mg, respectively, and by 66.3%/56.9% of patients receiving secukinumab 150 mg, respectively. At Week 52, upper limb (UL) PASI 90/100 responses were achieved by 67.3%/59.1% of patients receiving secukinumab 300 mg, respectively, and by 50.3%/43.3% of patients receiving secukinumab 150 mg, respectively. At Week 52, lower limb (LL) PASI 90/100 responses were achieved by 63.9%/55.3% of patients receiving secukinumab 300 mg, respectively, and by 45.1%/36.4% of patients receiving secukinumab 150 mg, respectively. A 50% reduction in mean PASI subscore occurred after 2.8, 2.9, and 3.4 weeks with secukinumab 300 mg on the trunk, upper limbs, and lower limbs, respectively.ConclusionSecukinumab provided robust and sustained efficacy for moderate-to-severe psoriasis affecting the trunk, upper limbs, and lower limbs.FundingNovartis Pharmaceuticals Corporation.Trial registrationClinicalTrials.gov identifiers: NCT01365455, NCT01358578, NCT01555125, and NCT01636687.

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Pattern of response in patients with moderate-to-severe psoriasis treated with etanercept

Abstract: Etanercept treatment-response appears to occur in a body- and component-specific manner. Changes in quality of life are not captured by PASI or its subscales.

Cited by 20 publications

References 35 publications

Differential effects of secukinumab vs. ustekinumab for treatment of psoriasis on quality of life, work productivity and activity impairment: a structural equation modelling analysis

Differential effects of secukinumab vs. ustekinumab for treatment of psoriasis on quality of life, work productivity and activity impairment: a structural equation modelling analysis

Feasibility and Utility of the Psoriasis Symptom Inventory (PSI) in Clinical Care Settings: A Study from the International Psoriasis Council

Efficacy of Secukinumab on Moderate-to-severe Plaque Psoriasis Affecting Different Body Regions: a Pooled Analysis of Four Phase 3 Studies

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