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Patient-reported outcomes for psoriasis patients with clear versus almost clear skin in the clinical setting - 17/09/14

Doi : 10.1016/j.jaad.2014.05.001 
Junko Takeshita, MD, PhD a, b, , Kristina Callis Duffin, MD, MS c, Daniel B. Shin, MS a, b, Gerald G. Krueger, MD c, Andrew D. Robertson, PhD d, Andrea B. Troxel, ScD b, Abby S. Van Voorhees, MD a, Joel M. Gelfand, MD, MSCE a, b
a Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 
b Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 
c Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah 
d National Psoriasis Foundation, Portland, Oregon 

Reprint requests: Junko Takeshita, MD, PhD, Department of Dermatology, University of Pennsylvania, 1463 Penn Tower, One Convention Ave, Philadelphia, PA 19104.

Abstract

Background

There is little evidence to guide the establishment of treatment goals for moderate to severe psoriasis in the clinical setting.

Objective

We sought to compare Dermatology Life Quality Index scores and prescription topical medication use between patients with clear versus almost clear skin.

Methods

This was a multicenter cross-sectional study of 97 patients with clear skin and 441 patients with almost clear skin receiving current systemic therapy or phototherapy for a primary indication of plaque psoriasis evaluated at 1 of 10 US outpatient dermatology sites participating in the Dermatology Clinical Effectiveness Research Network.

Results

In adjusted analyses, patients with clear versus almost clear skin were more likely to report no impact of psoriasis on quality of life (relative risk 1.60; 95% confidence interval 1.37-1.86). Patients with clear versus almost clear skin were also more likely to report no prescription topical medication use in the preceding week (relative risk 2.08; 95% confidence interval 1.73-2.49).

Limitations

Cross-sectional design prohibits longitudinal assessment of outcomes.

Conclusions

Clinically important differences in quality of life and prescription topical medication use exist between patients with clear versus almost clear skin. Collectively, our results indicate that achievement of clear skin may be an important clinical distinction among patients with moderate to severe psoriasis.

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Key words : Dermatology Life Quality Index, patient-reported outcome, Physician Global Assessment, psoriasis, Psoriasis Area and Severity Index, quality of life

Abbreviations used : BSA, CI, DLQI, HRQoL, IQR, NNT, PASI, PGA, QoL, RR


Plan


 This study was supported by grant RC1-AR058204 and K24-AR064310 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (Dr Gelfand), Dermatology Foundation Career Development Award (Dr Takeshita), National Psoriasis Foundation Fellowship Award (Dr Takeshita), Training Grants T32-GM 075766-6 (Dr Takeshita) and T32-AR07465 (Dr Shin) from the National Institutes of Health, and an unrestricted grant from Eli Lilly. The sponsors had no role in the design and conduct of the study; in the collection, management, analysis, and interpretation of the data; in the preparation or approval of the manuscript; or in the decision to submit the manuscript for publication. Eli Lilly participated in reviewing the manuscript only. All other sponsors had no role in review of the manuscript.
 Disclosure: Dr Callis Duffin was an investigator, consultant, and/or speaker for Abbvie, Amgen Inc, ApoPharma, Bristol-Myers Squibb, Celgene, Eli Lilly and Co, Genzyme, Incyte, Janssen Biologics (formerly Centocor), NovoNordisk, Pfizer, and Wyeth, receiving honoraria and/or salary; served on the advisory board of Amgen; and received residency/fellowship program funding from Abbvie Laboratories and Amgen Inc. Dr Gelfand served as a consultant for Abbvie, Amgen Inc, Celgene Corp, Eli Lilly and Co, Merck, Janssen Biologics (formerly Centocor), Novartis Corp, and Pfizer Inc, receiving honoraria; had grants or has pending grants from Abbvie, Amgen Inc, Eli Lilly and Co, Genentech Inc, Novartis Corp, and Pfizer Inc; and received payment for continuing medical education work related to psoriasis. Dr Krueger served as a consultant for Abbvie, Amgen Inc, and Janssen Biologics; had grants or has pending grants from Abbvie and Amgen Inc; and received payment for lectures and travel-related expenses from Abbvie, Amgen Inc, and Janssen Biologics. Dr Robertson is employed by the National Psoriasis Foundation, which receives unrestricted financial support from companies that make products used to treat psoriasis and psoriatic arthritis, including Abbvie, Amgen Inc, Celgene, Eli Lilly and Co, Galderma Laboratories LP, Janssen Biotech Inc, Leo Pharma Inc, Novartis, Pfizer Inc, and Stiefel, a GSK Company. Dr Robertson has also served as an uncompensated member of advisory boards at Abbvie and Merck. Dr Takeshita has received payment for continuing medical education work related to psoriasis. Dr Van Voorhees served on advisory boards for Amgen Inc, Abbvie, Genentech Inc, Warner Chilcott, Leo, and Janssen Biologics; served as an investigator for Amgen Inc and Abbvie, receiving grants; and served as a consultant for Amgen Inc. Mr Shin and Dr Troxel have no conflicts of interest to declare.


© 2014  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 71 - N° 4

P. 633-641 - octobre 2014 Retour au numéro
Article précédent Article précédent
  • Palmoplantar psoriasis is associated with greater impairment of health-related quality of life compared with moderate to severe plaque psoriasis
  • Jina Chung, Kristina Callis Duffin, Junko Takeshita, Daniel B. Shin, Gerald G. Krueger, Andrew D. Robertson, Andrea B. Troxel, Abby S. Van Voorhees, Emily Edson-Heredia, Joel M. Gelfand
| Article suivant Article suivant
  • Increased serum leptin and resistin levels and increased carotid intima-media wall thickness in patients with psoriasis: Is psoriasis associated with atherosclerosis?
  • Reza M. Robati, Masoud Partovi-Kia, Hamid Reza Haghighatkhah, Shima Younespour, Fahimeh Abdollahimajd

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