Recomendaciones de la Sociedad Española de Reumatología sobre el tratamiento y uso de terapias sistémicas biológicas y no biológicas en artritis psoriásica

Alonso, Juan Carlos; Fontecha, Petra Díaz del Campo; Almodóvar, Raquel; Cañete, Juan D.; Morales, Carlos; Moreno, Mireia; Plasencia-Rodríguez, Chamaida; García, Julio Ramírez; Queiró, Rubén

doi:10.1016/j.reuma.2017.08.007

Cited by 32 publications

(6 citation statements)

References 98 publications

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“…Below, we summarise the findings of the SLR and the experts' opinion and attitude towards each particular clinical situations in PsA. As recommended by international organisations and societies, initial treatment considerations in PsA should be based on discrete clinical manifestations, symptom severity and their impact on patients [4,[10][11][12][13]. The selection of initial treatment should also take into account comorbidities associated with PsA.…”

Section: Resultsmentioning

confidence: 99%

“…Despite current therapeutic armamentarium and T2T strategy for PsA patients, there is still a great variability in the clinical practice regarding to the management of patients with PsA [144]. As a consequence, different national and international societies have published recommendations for the management of these patients in recent years [4,[10][11][12][13]. However, most of these recommendations are focused on a limited definition of the target populations and might not cover all clinical scenarios for which clinicians still seek guidance.…”

Section: Discussionmentioning

confidence: 99%

“…Retrieved references were managed in Endnote X5 (Thomson Reuters). The abstracts of the 2018 and 2019 annual scientific meetings of the American College of Rheumatology (ACR) and the European Alliance of Associations for Rheumatology (EULAR) were also examined, along with national and international consensus documents and guidelines [4,[10][11][12][13].…”

Section: Systematic Literature Reviewmentioning

confidence: 99%

“…On the other hand, consensus documents and clinical guidelines aim to analyse the best evidence to provide some guidance in treatment decision-making, even in situations where evidence is insufficient or even absent [4,[10][11][12][13]. They are usually focused on the most relevant patient's profiles.…”

Section: Introductionmentioning

confidence: 99%

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Management of particular clinical situations in psoriatic arthritis: an expert’s recommendation document based on systematic literature review and extended Delphi process

et al. 2021

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To establish practical recommendations for the management of patients with psoriatic arthritis (PsA) with particular clinical situations that might lead to doubts in the pharmacological decision-making. A group of six expert rheumatologists on PsA identified particular clinical situations in PsA. Then, a systematic literature review (SLR) was performed to analyse the efficacy and safety of csDMARDs, b/tsDMARDs in PsA. In a nominal group meeting, the results of the SLR were discussed and a set of recommendations were proposed for a Delphi process. A total of 65 rheumatologists were invited to participate in the Delphi. Agreement was defined if ≥ 70% of the participants voted ≥ 7 (from 1, totally disagree to 10, totally agree). For each recommendation, the level of evidence and grade of recommendation was established based on the Oxford Evidence-Based Medicine categorisation. Particular clinical situations included monoarthritis, axial disease, or non-musculoskeletal manifestations. The SLR finally comprised 131 articles. A total of 16 recommendations were generated, all but 1 reached consensus. According to them, it is crucial to carefully analyse the impact of individual manifestations on patients (disability, quality of life, etc.), but also to recognise the impact of each drug singularities on selected clinical phenotypes to adopt the most appropriate treatment strategy. Early diagnosis and treatment to target approach, along with a close risk management, is also necessary. These recommendations are intended to complement gaps in national and international guidelines by helping health professionals address and manage particular clinical situations in PsA.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Systematic Literature Reviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Management of particular clinical situations in psoriatic arthritis: an expert’s recommendation document based on systematic literature review and extended Delphi process

et al. 2021

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“…The induction period was chosen to reflect the time at which treatment efficacy is usually followed up in clinical practice (approximately 3 months in Spain). 21 22 The difference in the length of induction period between the two drugs also acknowledges a degree of difference in the availability of clinical trial data for ixekizumab and secukinumab (ie, across the included studies, more week 16 than week 12 data are available for secukinumab). The PsARC response to treatment was defined as an improvement from baseline in two of four criteria without worsening in any measure: tender/swollen joints and physician/patient global assessment of disease activity (one of which must be a joint count).…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness analysis of ixekizumab versus secukinumab in patients with psoriatic arthritis and concomitant moderate-to-severe psoriasis in Spain

Schweikert¹,

Malmberg

Núñez

et al. 2020

BMJ Open

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ObjectiveTo conduct a cost-effectiveness analysis from the perspective of the Spanish National Health System (NHS) comparing ixekizumab versus secukinumab.DesignA Markov model with a lifetime horizon and monthly cycles was developed based on the York model. Four health states were included: a biological disease-modifying antirheumatic drug (bDMARD) induction period of 12 or 16 weeks, maintenance therapy, best supportive care (BSC) and death. Treatment response was assessed based on both Psoriatic Arthritis Response Criteria (PsARC) and ≥90% improvement in the Psoriasis Area Severity Index score (PASI90). At the end of the induction period, responders transitioned to maintenance therapy. Non-responders and patients who discontinued maintenance therapy transitioned to BSC. Clinical efficacy data were derived from a network meta-analysis. Health utilities were generated by applying a regression analysis to Psoriasis Area Severity Index and Health Assessment Questionnaire‒Disability Index scores collected in the ixekizumab SPIRIT studies. Results were subject to extensive sensitivity and scenario analysis.SettingSpanish NHS.ParticipantsA hypothetical cohort of bDMARD-naïve patients with psoriatic arthritis and concomitant moderate-to-severe psoriasis was modelled.InterventionsIxekizumab and secukinumab.ResultsIxekizumab performed favourably over secukinumab in the base-case analysis, although cost savings and quality-adjusted life-year (QALY) gains were modest. Total costs were €153 901 compared with €156 559 for secukinumab (difference −€2658). Total QALYs were 9.175 vs 9.082 (difference 0.093). Base-case results were most sensitive to the annual bDMARD discontinuation rate and the modification of PsARC and PASI90 response to ixekizumab or secukinumab.ConclusionIxekizumab provided more QALYs at a lower cost than secukinumab, with differences being on a relatively small scale. Sensitivity analysis showed that base-case results were generally robust to changes in most input parameters.Trial registration numberSPIRIT-P1: NCT01695239; Post-results, SPIRIT-P2: NCT02349295; Post-results.

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Core items to be included in a definition of moderate psoriatic arthritis: literature review and expert opinion

Urruticoechea-Arana,

Álvarez-Vega,

García-Vivar

et al. 2024

Rheumatol Int

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Recomendaciones de la Sociedad Española de Reumatología sobre el tratamiento y uso de terapias sistémicas biológicas y no biológicas en artritis psoriásica

Cited by 32 publications

References 98 publications

Management of particular clinical situations in psoriatic arthritis: an expert’s recommendation document based on systematic literature review and extended Delphi process

Management of particular clinical situations in psoriatic arthritis: an expert’s recommendation document based on systematic literature review and extended Delphi process

Cost-effectiveness analysis of ixekizumab versus secukinumab in patients with psoriatic arthritis and concomitant moderate-to-severe psoriasis in Spain

Core items to be included in a definition of moderate psoriatic arthritis: literature review and expert opinion

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