Effect Of Psoriasis Treatment Research Articles

Economic Burden and Cost-Effectiveness of Moderate to Severe Psoriasis Treatment in Asian Region: A Systematic Review

Psoriasis poses a significant economic burden. A systematic review of psoriasis treatments cost and effectiveness has been performed extensively in the United States (US) and Europe, but such review is limited in Asia. This review aims to analyze all previous literature on the cost and effectiveness of systemic and biological treatment for moderate to severe psoriasis. Cost of illness and cost-effectiveness studies that examined the economic burden, cost, and effectiveness of psoriasis treatments (systemic and biological) in Asian region from 2010 to 2020 were published in English language. All costs were converted into 2020 US Dollar. All COIs included found that direct medical costs were greater than indirect costs. Adalimumab, ustekinumab, risankizumab, secukinumab 150 mg were cost-effective treatments and of the lowest cost per PASI-75/PASI1 and/or QALY. When comparing the different treatments, topical and systemic psoriasis treatments were observed to be the most cost-effective compared with other modalities. Given the tremendous economic effects of psoriasis on patients and hospitals, economic analysis, clinicians, and policymakers should consider cost and effectiveness evidence, as this systematic literature review was conducted to analyze previous documentation regarding the cost and effectiveness of systemics and biologics in Asian countries.

Treatment of psoriasis in end-stage renal disease patients is associated with decreased mortality: A retrospective cohort study

BackgroundPsoriasis impairs the quality of life of approximately 7.5 million Americans and is associated with serious comorbidities. Because of chronic vascular access and epidermal dysfunction, end-stage renal disease (ESRD) patients with psoriasis may be at greater risk for infection, and psoriasis treatment could affect this risk. MethodsA retrospective cohort analysis was performed using the United States Renal Data System from 2004-2011 to investigate the association of psoriasis with infections common to ESRD patients, as well as the effect of psoriasis treatment on infection risk as well as mortality. ResultsA total of 8,911 psoriasis patients were identified. Psoriasis was associated with a significantly increased risk for all queried infections, especially cellulitis (adjusted relative risk = 1.55), conjunctivitis (1.47), and onychomycosis (1.36). Psoriasis treatment (systemic, local, and light) was associated with a significantly decreased risk of some infections. Psoriasis treatment was also correlated with a significantly decreased risk of mortality, with systemic therapies (biologics and other immunosuppressants) showing the greatest reduction (adjusted hazard ratio = 0.55). ConclusionsThese results suggest that psoriasis-ESRD patients may have an increased risk of infection and treatment of psoriasis is associated with a reduced risk of some infections and improved survival.

Prevalence of nail changes in patients with psoriasis and correlation of NAPSI (Nail area psoriasis severity index) with BSA (Body surface area)

Introduction: Nail involvement is an often-overlooked clinical symptom of Psoriasis. It causes psychologic stress, pain, impairment of manual dexterity and a significant negative impact on a patient’s quality of life. Objective: The present study was conducted to study the prevalence of nail changes in psoriasis patients, assessment of the severity of nail involvement using NAPSI score and to correlate the relationship between NAPSI and BSA in those patients. Materials and Methods: This was a cross sectional study, conducted in Dermatology department in a tertiary care hospital between January 2016-August 2017. A total of 100 psoriasis patients were included in the study. The severity of nail involvement was assessed with NAPSI. Cutaneous disease severity was assessed with BSA. Data were coded and analyzed. Results: Most common nail change in our study was Nail pitting (83.1%), followed by onycholysis (73.8%), subungual hyperkeratosis (23.1%), Longitudinal ridges (23.1%) and Beau’s lines (21.5%). We observed that BSA showed a positive and statistically significant correlation with NAPSI, demonstrating worsening of nail involvement with increased severity of skin disease. Conclusion: Nail psoriasis seems to be an ignored feature of the disease and further research must focus on the effect of psoriasis treatment on the nails. This study is the first to compare NAPSI in correlation with body surface area (BSA), leading to lesser inter observer variability in assessing the severity of skin and nail involvement when compared with PASI. Keywords: Body surface area, Nail area psoriasis severity index, Nail psoriasis, Psoriasis vulgaris, Pitting.

The prevalence of anxiety in patients with psoriasis: a systematic review of observational studies and clinical trials.

Psoriasis and anxiety are chronic conditions with significant morbidity and there is evidence that they may exacerbate one another. There is little data on the prevalence of anxiety in psoriasis and the effect of psoriasis treatment on comorbid anxiety. The objective of this study was to perform a systematic review of the literature to describe the prevalence and severity of clinical anxiety disorders or anxiety symptoms among adult patients with psoriasis and characterize the effect of anti-psoriatic interventions on clinical anxiety disorders or anxiety symptoms. We searched PubMed, EMBASE, and the Cochrane Database using search terms 'psoriasis' and 'anxiety'. Results were tabulated and verified by two independent reviewers. Meta-analyses were not performed due to heterogeneity of data. Of 213 publications identified, 938 194 patients from 15 papers were included. The mean age ranged from 31.9-59.4 years old, with a mean PASI score of 7.65-22.8 (reported by nine studies) and a body surface area involvement of 25.9-39.8% (reported by two studies). The prevalence of anxiety in patients with psoriasis was 7-48%, which was significantly higher than healthy controls in two of three studies (HR 1.29-1.31, P = 0.001 and OR 2.91 [95% CI, 2.01-4.21], P < 0.001). Four of five studies (n = 2029) demonstrated an improvement in anxiety symptoms with psoriasis treatment. This review demonstrates a high prevalence of anxiety of adult patients with psoriasis suggesting that patients would benefit from systematic screening. Although the data suggest that anxiety may be improved through various psoriasis treatments, larger prospective randomized trials are needed to confirm this effect.

The effect of psoriasis treatment on body composition, components of metabolic syndrome and psoriatic arthritis

The effect of psoriasis treatment on body composition, components of metabolic syndrome and psoriatic arthritis

Variation in dermatologist beliefs about the safety and effectiveness of treatments for moderate to severe psoriasis

Multiple systemic treatments are available for moderate to severe psoriasis, but dermatologists' perceptions of these treatments are unknown. Physician perceptions can influence prescribing patterns and patient outcomes, and may help to explain variations in clinical practice. We sought to describe the variation in dermatologist's beliefs about the safety and effectiveness of psoriasis treatments and evaluate how these relate to dermatologist characteristics and treatment preferences. We conducted a cross-sectional mail survey of a random sample of 500 National Psoriasis Foundation (NPF) members and 500 American Academy of Dermatology (AAD) members who treat psoriasis. Of 989 clinicians who could be contacted, 246 NPF members and 141 AAD members returned the survey (39% response rate). Respondents perceived infliximab, ustekinumab, cyclosporine, and adalimumab to have the highest likelihood of skin clearance in 3 months (67%-75%). Etanercept, adalimumab, ultraviolet B, and ustekinumab had the lowest perceived likelihood of side effects requiring treatment discontinuation (9%-11%). Up to 49% of respondents "didn't know" the effectiveness or likelihood of side effects; calculated coefficients of variation were higher for perceived likelihood of side effects than perceived effectiveness. There were few significant associations between safety and effectiveness perceptions and respondent characteristics, and treatment preferences were not consistently predictive of perceptions. Only dermatologists with interest in treating psoriasis were surveyed and general perceptions were elicited via survey format. Perceptions may differ between survey respondents and nonrespondents. Psoriasis providers demonstrate wide variation in their perception of the effectiveness and especially safety of systemic treatments.

Treatments for mild-to-moderate recalcitrant plaque psoriasis: Expected clinical and economic outcomes for first-line and second-line care

The cost effectiveness of treatments for psoriasis has been evaluated previously by several different investigators. Such evaluations should be updated as new products or data become available. To this end, a comparison of expected treatment-related clinical and economic outcomes is undertaken from the payer perspective using a disease-intervention model, decision analyses, and newly emergent information. The model is based on academy guidelines and recommended clinical practice. Model inputs (clinical and cost data) are culled from the medical literature and advisory clinical assessment surveys. Comparable therapies are various topical pharmacotherapies and phototherapies, including the 308-nm excimer laser (XTRAC, PhotoMedex, Montgomeryville, PA). Analytic results indicate that clinical and economic outcomes are influenced by treatment selections but are muted by the rotational nature of treatment regimens. Multiple analyses are required to reveal individual product performance. On the basis of these analyses, the addition of the 308-nm excimer laser to the rotational mix of treatments commonly utilized as second-line therapies for mild-to-moderate plaque psoriasis is expected to add incremental clinical benefit for patients without incremental cost for payers, because the laser can replace both more costly and less costly alternatives for appropriately selected patients who require a different therapeutic modality to maintain or improve their responsiveness.

New studies show cost effectiveness of psoriasis treatments

Psoriasis is common, incurable and often psychologically devastating. For example, between 2 and 4% of Caucasians suffer from psoriasis. Some patients learn to live with the disfiguring plaques. However, psoriasis dramatically undermines other patients’ quality of life - especially among women and younger sufferers. 1 Moreover, psoriasis imposes a heavy economic burden. In the US, annual outpatient costs for psoriasis range from $US1100 to $US6600 per patient depending on the treatment, with the total outpatient cost reaching $US3.2 billion in 1993 alone. 2

Hospitalization for Skin Disease Improves Quality of Life

Inpatient dermatologic services are diminishing. A recent survey¹of dermatology residents reports that 17% do not care for hospitalized patients and that less than 1% of residents care for 60 or more hospitalized patients per month. One reason for this decrease is the increasing pressure to contain medical costs. Stringent guidelines have been set up for hospital admission, length of stay, and intensity of care, all encompassed in a specific diagnostic related group that represents a certain sum for a given diagnosis. Despite these firm criteria, few objective tests are used routinely to assess the outcome, effectiveness, or cost of dermatologic hospitalization. One outcome measure is the Psoriasis Area and Severity Index, which is often used to quantify the effectiveness of treatments for psoriasis.²In addition, a patient-oriented measure of outcome, the Dermatology Life Quality Index, and other depression and anxiety tests can be used to measure objectively