Mean Psoriasis Area Severity Index Score Research Articles

Quality of Life in Psoriasis: A Cross-Sectional Study from North India.

Psoriasis is a chronic inflammatory papulo-squamous disease characterized by multiple remissions and relapses. This study aimed to assess the impact of psoriasis on the quality of life of patients. A hospital-based, cross-sectional study was conducted enrolling 198 adult patients of psoriasis. The STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for observational studies were followed. Clinical severity of psoriasis was measured using Psoriasis Area Severity Index (PASI), and quality of life was measured by EuroQoL 5D (EQ-5D-5L, EQ-VAS) and Psoriasis Quality-Of-Life-12 (PQOL-12) Questionniares. Of the 198 patients, 71.7% (n = 142/198) were males with a mean age of 41.65 ± 13.19 years. The mean PASI score was 12.46 ± 11.51, and the mean PQOL-12 score was 50.18 ± 23.36. Up to 22.7% (n = 45) cases had 'severe' and 6.1% (n = 12) cases has 'very severe' PQOL-12 scores. Statistically significant correlation (P < 0.05) was observed between PASI scores and almost all domains of EQ-5D-5L and PQOL-12. Psoriasis affects most psycho-social domains of a patient's life. Coping with these QOL issues remains a challenge to the patients in everyday life. The goal of management of psoriasis therefore must include measures to improve quality of life along with long-lasting remittance of physical symptoms.

The effect of secukinumab treatment for psoriasis on serum cytokines and correlation with disease severity.

To investigate the effects of secukinumab treatment for psoriasis on different functional cytokines and inflammatory mediators in patients' serum METHODS: Enzyme-linked immunosorbent assay was used to detect interleukin (IL)-1β and IL-1RA associated with intrinsic immunity; IL-6, IL-18, and growth regulated oncogene alpha (GROα) associated with neutrophils;IL-12, tumour necrosis factor (TNF)-α, and interferon (IFN)-γ associated with Th1; IL-23, IL-17A, and IL-22 associated with Th17; Thymus activation regulated chemokine (TARC), IL-13, and defensin beta 2 (DEFB2) associated with Th2; Vascular endothelial growth factor (VEGF)-A and IL-10 associated with angiogenesis; and IFN-γ associated with sepsis in the peripheral blood of 12 patients with common psoriasis treated with secukinumab and 15 healthy controls. IL-23, IL-17A, IL-22 associated with Th17; TARC, IL-13, DEFB2 associated with Th2; VEGF-A, IL-10 associated with angiogenesis and procalcitonin (PCT) associated with sepsis. The differences in expression of the above cytokines before and after treatment and the correlation with psoriasis disease severity［Psoriasis Area Severity Index(PASI) score］, age, and disease duration were analyzed. The mean PASI score of the enrolled patients with moderate to severe psoriasis was 21.6±11.0 before treatment and decreased to below 1 after treatment. Serum IL-6; IL-18, GROα, IFN-γ, TNF-α, VEGF-A, and IL-17A were significantly higher than normal. And IL-17A and IFN-γ were positively correlated with disease duration and age, and IL-18 was positively correlated with PASI score. The expression levels of IL-6, GROα, VEGF-A, IFN-γ, TNF-α, IL-17A and IL-23 were significantly lower after secukinumab treatment compared with those before treatment, but the expression levels of IFN-γ, VEGF-A, TARC, IL-13, and DEFB2 were still significantly higher than those of normal subjects after treatment CONCLUSIONS: secukinumab clears skin lesions by antagonizing IL-17A and simultaneously decreasing the expression levels of IL-6, GRO α, VEGF-A, IFN-γ, TNF-α, IL-17A, and IL-23.

Apremilast Use in Severe Psoriasis: Real-World Data from Central and Eastern Europe.

The broad and sustained efficacy of apremilast for psoriasis has been demonstrated in randomized and real-world observational studies. Data from Central and Eastern Europe (CEE) are lacking. Moreover, apremilast use in this region is limited by country-specific reimbursement criteria. This is the first study to report data on the real-world use of apremilast in the region. APPRECIATE (NCT02740218) was an observational, retrospective, cross-sectional study assessing psoriasis patients 6 (± 1) months after apremilast treatment initiation. The study aimed to describe the characteristics of patients with psoriasis receiving apremilast, estimate treatment outcomes, including Psoriasis Area Severity Index (PASI), Body Surface Area (BSA), and Dermatology Life Quality Index (DLQI), and assess dermatologists' and patients' perspectives on treatment using questionnaires including the Patient Benefit Index (PBI). Adverse event reports were taken from the medical records. Fifty patients (Croatia: 25; Czech Republic: 20; Slovenia: 5) were enrolled. In patients continuing apremilast at 6 (± 1) months, mean (± SD) PASI score was reduced from 16.2 ± 8.7 points at treatment initiation to 3.1 ± 5.2 at 6 (± 1) months; BSA from 11.9% ± 10.3% to 0.8% ± 0.9%; DLQI from 13.7 ± 7.4 points to 1.6 ± 3.2. PASI 75 was reached by 81% of patients. Physicians reported that the overall treatment success fulfilled their expectations in more than two thirds of patients (68%). At least three-quarters of patients reported apremilast had a quite or very high benefit on the needs they identified as being most important. Apremilast was well tolerated; no serious or fatal adverse events were identified. Apremilast was effective in reducing skin involvement and improving quality of life in CEE patients having severe disease. Treatment satisfaction among physicians and patients was very high. These data add to the growing body of evidence showing consistent effectiveness of apremilast across the continuum of psoriasis disease severity and manifestations. ClinicalTrials.gov identifier, NCT02740218.

Treatment Persistence of Ixekizumab in Adults with Moderate-to-Severe Plaque Psoriasis Participating in the Canadian Patient Support Program.

Patients with psoriasis (PsO) should adhere to and be persistent with treatment to maintain disease control. Patient support programs (PSPs) are useful to support patients with disease management. We aimed to understand the real-world patient profile and persistence of ixekizumab-initiating Canadian patients with moderate-to-severe PsO using PSP data. This retrospective observational study was conducted utilizing a Canadian PSP database (May 2016 to March 2020). Inclusion criteria were: age ≥ 18years with moderate-to-severe PsO, initiated ixekizumab, enrolled in the PSP for ≥ 6months, and provided informed consent. Psoriasis Area Severity Index (PASI), body surface area (BSA) involvement, and Dermatology Life Quality Index (DLQI) were collected at PSP entry. Adherence [using the proportion of days covered (PDC)] and persistence (using Kaplan-Meier curves) were assessed after 1-year and 2-year follow-ups. Differences in persistence between biologic-naïve and biologic-experienced patients were compared using Cox proportional hazards model after adjusting baseline parameters. In total, 1891 ixekizumab-treated moderate-to-severe patients with PsO were included. The mean [standard deviation (SD)] age was 52.3 (13.3) years; 51.1% of patients were 45-65years old and 61.4% were male. At baseline, the mean (SD) PASI score was 14.3 (8.1), the DLQI score was 16.5 (7.7), and BSA % was 17.4 (15.1). PsO lesions were commonly located on the hands (33.4%), face (28.6%), and feet (23.8%). Ixekizumab-treated patients were highly adherent [PDC ≥ 80%: 1-year (92.0%), 2-year (87.7%)] and persistent [1-year (90.4%), 2-year (85.6%)]. Biologic-naïve patients were more adherent (1-year, 94.6% versus 87.3%; 2-year, 90.3% versus 83.5%) than biologic-experienced patients. Significantly higher persistence in biologic-naïve versus biologic-experienced patients for 1-year (p < 0.01) and 2-year (p = 0.010) follow-up periods was observed after adjusting for baseline parameters. Patients with moderate-to-severe PsO overwhelmingly remained on ixekizumab treatment for more than 2years while participating in a PSP.

Comparison of the Complications and Efficacy of Topical Clobetasol Ointment with Salvia officinalis Ointment in the Treatment of Plaque Psoriasis

Background: Psoriasis is an autoimmune and common disease that affects 1 to 3% of the world’s population. The appearance and progress of psoriasis are influenced by genetic and environmental factors. Topical steroids have remained the first-line treatment for psoriasis. Long-term use of topical corticosteroids is associated with the risk of side effects. The purpose of this study was to compare the complications and efficacy of topical clobetasol ointment with Salvia officinalis ointment in the treatment of plaque psoriasis. Methods: A topical ointment containing 20% Salvia officinalis was prepared in the pharmaceutical laboratory of Hormozgan University of Medical Sciences. After standardization, this experimental study was performed on 84 voluntary patients with mild plaque psoriasis for two weeks. One group was treated with the prepared S. officinalis ointment twice daily and the other group was treated with topical clobetasol ointment twice daily. In each group, psoriasis severity was assessed using the Psoriasis Area Severity Index (PASI) at determined time points including baseline and one and two weeks after treatment initiation. Results: At the end of treatment (2 weeks), the mean PASI score changed from 2.36 to 1.55 in patients who received topical clobetasol ointment and this score reduced from 2.74 to 2.23 in patients who applied topical S. officinalis ointment. After 14 days of treatment, the mean percentage decrease in mean PASI score was greater in patients who applied topical clobetasol ointment. Conclusion: This study provides evidence that topical clobetasol ointment is more effective than 20% S. officinalis ointment in the treatment of psoriasis. However, S. officinalis ointment can be used as an adjuvant therapy to the main treatments of mild plaque psoriasis.

Patient Use of Complementary and Alternative Medicine for Psoriasis Vulgaris and Factors Believed to Trigger the Disease: a Multicenter Cross-Sectional Study With 1621 Patients.

Due to the chronic recurrent nature of psoriasis vulgaris (PV) and lack of definitive treatment for the disease, patients often resort to alternative treatments. Physicians seem to have low awareness of this issue. To elicit the perceptions of 1,621 PV patients on complementary and alternative medicine (CAM) and examine factors reported to worsen PV. The patients sociodemographic characteristics, Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index (DLQI), disease duration, and severity were recorded, and the patients CAM use was questioned in detail. The patients were also asked about factors that worsened PV and their experiences with a gluten-free diet. Of the patients, 56.51% had used CAM. The mean age, illness duration, PASI scores and DLQI of those using CAM were significantly higher. CAM use was significantly higher in those with facial, genital involvement, and arthralgia/arthritis. The patients mostly referred to CAM when PV became severe (46.4%). Of the CAM users, 45.52% used herbal topicals. The physicians of 67.03% did not inquire whether they used CAM. Of the participants, 37.73% considered that stress worsened their disease. Gluten-free diet did not affect PV symptoms in 52.22%. Patients CAM use is often overlooked by dermatologists. Our results showed that more than half the patients used CAM and did not share this information with their physicians. Therefore, the awareness of physicians should be increased and patients should be asked about the use of CAM and directed to the appropriate medical treatment options by physicians.

P271 To what extent are baseline characteristics in biologic-experienced patients with psoriatic arthritis associated with achievement of minimal disease activity at week 24 of guselkumab treatment: a post hoc analysis of the phase IIIb COSMOS clinical trial

Abstract Background/Aims Guselkumab (GUS), a human monoclonal antibody targeting the interleukin-23p19-subunit, has demonstrated efficacy at Week 24 (W24) in the Phase IIIb COSMOS clinical trial of patients with active psoriatic arthritis (PsA) and inadequate response or intolerance to one or two tumour necrosis factor inhibitors (TNFis). This post hoc analysis aimed to identify predictors of minimal disease activity (MDA) with GUS at W24 in this population. Methods Multiple logistic regression analysis was performed to identify potential predictors of MDA with GUS at W24 in TNFi-refractory patients with PsA; odds ratios, 95% confidence intervals and p-values were calculated. Baseline characteristics assessed as predictors included sex, body mass index (BMI), C-reactive protein (CRP), other medication use and disease duration; clinical features included tender and swollen joint counts (TJC/SJC), affected joint location, dactylitis, enthesitis, spondylitis, Psoriasis Area Severity Index (PASI) score and psoriasis (PsO) localisation (Table). Missing data for MDA at W24 were imputed as non-response; missing baseline values were imputed for two patients. Results Patients (n = 187; female, 54.6%; mean disease duration, 8.3 years) had mean TJC 0-68 and SJC 0-66 of 21.0 and 10.3, respectively, mean PASI score of 11.6, and mean BMI of 28.9; 67.9% had enthesitis and 35.8% had dactylitis at baseline. One prior TNFi had been received by 88.2% of patients, with two received by 11.8%. At W24, 17.1% (32/187) of patients achieved MDA. Wrist involvement (p = 0.031) and scalp PsO (p = 0.049) were positive predictors of MDA. Women were significantly less likely to achieve MDA vs. men; other negative predictors included hand small joints or shoulder involvement and hand/foot PsO (all p &amp;lt; 0.05). Age, BMI, CRP, TJC/SJC, HAQ-DI, PASI, spondylitis, enthesitis, dactylitis, other medication and number of prior TNFis were not predictive of MDA (Table). Conclusion Baseline characteristics and clinical features may be positively (wrist involvement, scalp PsO) or negatively (female sex, hand small joints or shoulder involvement, hand/foot PsO) associated with achieving MDA with GUS at W24 in a TNFi-refractory population. Though the low patient number limits the generalisability of this analysis, assessment of Week 48 data may further elucidate potential predictors of MDA after longer-term treatment. Disclosure W. Tillett: Other; William Tillett has received research grants and consulting or speaker fees from AbbVie, Amgen, Celgene, Eli Lilly, Janssen, MSD, Novartis, Pfizer and UCB. S. Ohrndorf: Other; Sarah Ohrndorf has received fees from AbbVie, BMS, Janssen, Novartis and Pfizer. J. Ramírez: Other; Julio Ramírez has received consulting or speaker fees from AbbVie, Amgen, Eli Lilly, Janssen, Novartis and UCB. M. Neuhold: Other; Marlies Neuhold is an employee of Janssen and owns stocks in Johnson &amp; Johnson. R. Wapenaar: Other; Robert Wapenaar is an employee of Janssen and owns stocks in Johnson &amp; Johnson. E. Theander: Other; Elke Theander is an employee of Janssen and owns stocks in Johnson &amp; Johnson. C. Contre: Other; Christine Contre is an employee of Janssen and owns stocks in Johnson &amp; Johnson. M. Sharaf: Other; Mohamed Sharaf is an employee of Janssen and owns stocks in Johnson &amp; Johnson. M. Shawi: Other; May Shawi is an employee of Janssen and owns stocks in Johnson &amp; Johnson. M. Vis: Other; Marijn Vis has received research grants and consulting or speaker fees from AbbVie, Amgen, Eli Lilly, Janssen, Novartis, Pfizer, UCB and the Dutch Arthritis Foundation.

Risankizumab shows high efficacy and maintenance in improvement of response until week 52.

Risankizumab has been recently approved for moderate‐to‐severe plaque psoriasis; however, real‐life studies are scarce. Analysis of possible predictor factors of treatment response are limited to body mass index (BMI) and previous biologic experience. Our objectives were to evaluate the effectiveness and safety of Risankizumab and to investigate on possible predictor factors response. We retrospectively analyzed 166 patients from two centers in Italy who undergone Risankizumab for psoriasis. The proportion of patients achieving a 100%, 90%, 75% of improvement in Psoriasis Area Severity Index (PASI) and PASI <3 were collected at weeks 16, 28, 40, and 52. Study population was analyzed in subgroups to investigate possible predictors of response to Risankizumab since week 40. At the time of analysis 165, 103, 30, and 11 patients had completed 16, 28, 40, and 52 weeks of treatment, respectively. The mean PASI score decreased from 12.5 ± 5.1 at baseline to 1.9 ± 2.4 at week 16. Similar reductions were observed when considering PASI <3, PASI 75, PASI 90, and PASI 100. Previous biologics failure, different smoking habits, obesity, and joint involvement resulted in a lower response to risankizumab. In particular, significant differences in mean PASI at any time‐points was observed between psoriatic arthritis (PSA) and non‐PSA patients: 2.7 versus 1.7 (p = 0.036), 1.9 versus 0.4 (p = 0.006), and 4.1 versus 0.5 (p = 0.016) at 16, 28, and 40 weeks, respectively. No difference in response to risankizumab occurred in the case of involvement of difficult‐to‐treat areas. In this population, Risankizumab was effective and safe. Smoking habits, joint involvement, obese status, and previous biologic experience may negatively affect treatment response, while difficult body sites involvement have minor impact.

Effects of disease severity on quality of life in patients with psoriasis.

Psoriasis is one of the leading dermatological diseases that can result in degradation in quality of life (QOL). We aimed to evaluate the effects of disease severity on QOL in psoriasis patients living in our region. Fifty-nine female and 41 male patients diagnosed with psoriasis were included in the study. The Psoriasis Area Severity Index (PASI) was used to determine disease severity. The Psoriasis Quality of Life Questionnaire (PQLQ) was used to evaluate QOL. The mean PASI score was 14.3 ± 10.1. The PQLQ and subscale scores were not affected by age, marital status, educational status, or age at onset of the disease etc. parameters (P > .05). Additional drug use, joint involvement, and lesion site exposure were found to increase psychosocial negativity scores significantly (P < .05). The mean scores for difficulties in daily life and treatment problems were significantly higher in men than in women (P < .05). There was a positive correlation between PASI scores and PQLQ, PQLQ subgroup scores. We found that QOL decreased with increasing severity of the disease. QOL as well as clinical severity should be considered in the planning and follow-up of psoriasis treatment. To evaluate the QOL, we believe that the PQLQ can be used as demonstrated in our study.

Efficacy of certolizumab pegol in naïve versus multi-treated patients affected by psoriatic arthritis.

The efficacy and safety of certolizumab pegol over 52 weeks was compared in two groups of patients: Group 1 comprised patients naïve to biologic treatments; Group 2 comprised patients previously treated with one or more antitumor necrosis factor (TNF)-α and/or anti-interleukin (IL) agents. We reported results in 50 patients affected by both mild psoriasis (PsO) and psoriatic arthritis (PsA). Primary endpoint was a reduction from baseline at week 52 of Disease Activity Score (DAS44-ESR) in both groups of patients. Secondary endpoints were a reduction from baseline at week 52 of Psoriasis Area Severity Index (PASI), Visual Analog Scale for Pain (PAIN VAS), ESR, CRP, and Dermatology Life Quality Index (DLQI). We observed a statistically significant improvement of both cutaneous and rheumatic disease in all patients, with a consistent reduction of DAS44-ESR, PASI, and PAIN VAS from baseline to week 52. DAS44-ESR decreased from 3.9 at BL to 1.5 at W52 (Group 1), and from 3.8 to 1.7 at W52 (Group 2). Mean PASI Score decreased from 3.2 at baseline (BL) to 0.4 at W52 (Group 1), and from 5.4 to 0.7 at W52 (Group 2). Mean PAIN-VAS decreased from a value of 73.5 at BL to 2.5 at W52 (Group 1), and from a value of 62.4 at BL to 9.2 at W52 (Group 2). We also found a reduction in ESR, CRP and DLQI values for each time point. Our results confirm that CZP can be administered safely and effectively to treat both psoriasis and psoriatic arthritis irrespective of previous treatments with biologic agents.

Clinical and economic burden of psoriasis: a retrospective study of the cost implications among cohorts in Abuja, Nigeria

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Psoriasis is a common chronic cutaneous inflammatory disorder of the skin which presents as sharply demarcated scaly erythematous papules or plaques. The level of its clinical severity at presentation largely determines the cost implications and economic burden on the patient. The study aimed to determine the direct cost of treating various clinical severity of psoriasis and its economic consequences to our healthcare system.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This is a retrospective study that was conducted between May 2016 and October 2019 at the Dermatology Unit of University of Abuja Teaching Hospital. Data was retrieved from patient’s folder into a designed proforma, noting their biodata, clinical level of severity using psoriasis area severity index (PASI) score, amount of money spent on drugs, laboratory test, nursing time and consultation fees. &lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Out of 82 psoriasis patients seen during the study period, 66 fulfilled the inclusion criteria. About 51.5% of them had severe psoriasis with a mean PASI score 33.2. The annual cost of treating mild, moderate and severe psoriasis was N198,900.00, N261,633.00 and N323,708.00 respectively. This accounted for 1.77% of the national annual healthcare spending within the years under review.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The cost of treating psoriasis and its economic burden is largely determined by the level of its clinical severity.&lt;/p&gt;

A Randomized, Double-blind, Placebo-controlled Clinical Study to Investigate the efficacy of Herring Roe Oil for treatment of Psoriasis.

The effect of omega-3 polyunsaturated fatty acid supplements in patients with psoriasis vulgaris has previously been investigated, but interventions varied in source, composition, dose, administration route and duration of treatment. The observed beneficial effects in patients with psoriasis vulgaris using herring roe oil as a dietary supplement prompted this investigation. This randomised, double-blind and placebo-controlled study was designed and performed to explore the efficacy and safety of herring roe oil supplementation in 64 patients with plaque psoriasis (ClinicalTrials.gov: NCT03359577). The primary end-point was comparing the change in mean Psoriasis Area Severity Index (PASI) scores in the herring roe oil treatment group and the placebo group from baseline to week 26. In the intention-to-treat population, a statistically significant improvement in the mean PASI score was observed with herring roe oil compared to placebo at 26 weeks. In the recruited patient group, the measured improvement was greatest in patients with a PASI score from 5.5–9.9 at baseline.

Effect of sofosbuvir plus daclatasvir for treatment of chronic hepatitis C on patients with psoriasis.

Until recently, clinicians caring for patients with psoriasis who were infected with hepatitis C virus (HCV) were concerned that treating one condition could exacerbate the other. We evaluated the outcome of treatment with direct-acting antiviral agents (DAAs) on patients with psoriasis having chronic hepatitis C (CHC) infection. This was an observational prospective cross-sectional study. It included CHC-naive patients with plaque psoriasis. All patients received sofosbuvir plus daclatasvir once daily for 12 weeks for treatment of CHC. Psoriasis area severity index (PASI) scores and the dermatology quality-of-life index were evaluated at the start of treatment with DAAs and then at 12 and 24 weeks after the end of HCV treatment. The primary end point was sustained virological response 12 weeks after treatment (SVR12). A total of 34 CHC-naive patients were enrolled in this study. Most of them were of male sex (76.5%), and most of them had severe psoriasis, as the mean PASI score was 32. The primary and secondary end points (SVR12 and SVR24) for our patients were 100%. Regarding PASI and dermatology quality-of-life index scores, there was a highly significant difference before start of treatment and after treatment at 12 and 24 weeks. The most common adverse events are fatigue and headache. Sofosbuvir plus daclatasvir is effective in the eradication of HCV and improvement of symptoms in patients with psoriasis having CHC infection. Future large series studies are needed to evaluate this promising effect of DAAs.

Evaluation of the role of whey with dodder oxymel on mild to moderate psoriasis: A double-blind, randomized controlled trial

Introduction: Psoriasis is a common chronic inflammatory disease that affects the physical, mental and sexual well-being of patients. Numerous side effects of different treatments and inadequate response to medications have resulted in pursuit of ideal treatment with low toxicity in low burden psoriasis hence complementary medicine. This study aims to evaluate the effects of whey with dodder oxymel on mild to moderate psoriatic skin lesions.&#x0D; Methods: A 12-week double-blind, randomized, controlled, clinical trial was designed. Ninety psoriatic patients participated in the intervention. Drug and placebo were randomly assigned to two groups identically (whey with dodder oxymel and lactose). Patients were visited twice by a dermatologist. Their clinical responses were evaluated using the Psoriasis Area Severity Index (PASI), the Dermatology Life Quality Index (DLQI), the Visual Analogue Scale (VAS) and the Body Surface Area (BSA).&#x0D; Results: After 12 weeks, in the intragroup analysis, the mean PASI score (P-value &lt; 0.001) and BSA (P-value = 0.004) decreased in the intervention group. The mean VAS score (P-value &lt; 0.001) and DLQI (Pvalue &lt; 0.001) in both groups decreased. However, this decrease was much higher in the intervention group. In the intergroup analysis, 70% of patients reported improvement in PASI score (P-value &lt; 0.001), the 88% improvement in quality of life (P-value &lt; 0.001) and pruritus intensity (VAS) (P-value &lt; 0.001), and the 54% reduction was detected in the area of lesions (BSA) (P-value = 0.001) as compared to the placebo group. &#x0D; Conclusion: It appears that whey with dodder oxymel would improve psoriasis conditions and it can increase patients’ quality of life.

Health-related quality of life among patients with moderate-to-severe plaque psoriasis in Taiwan

Abstract Background/Objectives Plaque psoriasis is a debilitating condition that significantly affects patient well-being. Limited data are available regarding the effect of psoriasis and treatment on health-related quality of life (HRQoL) and work ability among Taiwanese patients. To document and compare HRQoL, treatment satisfaction, and work disability among Taiwanese patients with current and past moderate-to-severe plaque psoriasis. Methods This was a multicenter, non-interventional, cross-sectional study of adult patients with moderate-to-severe plaque psoriasis. During a single clinic visit, each patient was assessed for body surface area (BSA) involvement, Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index (DLQI), Euro Quality of Life-5 Dimensions (EQ-5D), 10-level satisfaction scale for psoriasis treatment, and Working Productivity and Activity Impairment (WPAI). Multivariate regression was used to identify factors associated with HRQoL and work disability. Results A total of 305 patients were included within the analysis. The mean PASI score was 11.83, and the mean BSA involvement was 20.90%. The mean EQ-5D score was 65.68 and the mean DLQI score was 12.55. Fewer than half of patients (45.68%) indicated they were satisfied with the standard therapy they were currently receiving. Among employed patients, the mean reduction in on-the-job effectiveness was 32.09% and the mean reduction in overall productivity was 33.48%. The regression analysis indicated that patients with more severe psoriasis defined by PASI scores show a greater impact in quality of life and impairment in work disability; and that patients who were satisfied with current standard treatment had a better quality of life. Conclusion The effect of psoriasis on HRQoL among patients with psoriasis in Taiwan is substantial, with fewer than half of patients reporting satisfaction with therapeutic options.

Topical Betamethasone Valerate and Calcipotriol Ointments for the Therapyof Mild and Moderate Psoriasisvulgaris: A Randomized, Comparative Study

To determine the effectiveness of both topically applied Betamethasone valerate and Calcipotriol ointments for the therapy of mild and moderate types of psoriasis. This comparative study was conducted in Jinnah Postgraduate Medical Centre, Karachi in the Pharmacology and Therapeutics department of BasicMedical Science Institute (BMSI). In 90 days study, 80 patients of mild and moderate psoriasis vulgaris were placed into A and B groups. The Betamethasone valerate treated patients were placed in group A while Calcipotriol treated patients were placed in group B; 40 patients in each group. The Psoriasis AreaSeverity Index (PASI criterion) was used to observe improvement in psoriatic patients taking these drugs. In this randomized and comparative study, psoriasis severity was checked by Psoriasis Area Severity Index (PASI). At day 90 Calcipotriol treated group B patients showed more improvement in mean PASI score ascompared to Betamethasone valerate treated group A patients. In PASI score, Calcipotriol shows 71.61% betterment whereas Betamethasone vale rate shows 63.2% betterment in mild psoriatic patients. In PASI score, Calcipotriol shows 69.21% betterment whereas Betamethasone valerate shows 60.44% betterment inmoderate psoriatic patients. In Pakistani population topically applied Calcipotriol ointment was more efficacious in the treatment of mild and moderate types of psoriasisvulgaris when compared to topically applied Betamethasone valerate ointment.

Comparison of efficacy, safety, and cost-effectiveness of topical salicylic acid 6% versus clobetasol propionate 0.05% in the treatment of limited chronic plaque psoriasis

Aims: The aims of this study were to: (1) Comparison of Psoriasis Area Severity Index (PASI), Physician Global Assessment (PGA) Scores, and adverse effect profile on the use of topical salicylic acid 6% versus clobetasol propionate 0.05% in the chronic-limited plaque psoriasis.(2) Selection of the cost-effectiveness option using average cost-effective ratios of the two individual regimens. Materials and Methods: This was a randomized, open-labeled, parallel group design which was conducted at dermatology department of a tertiary care hospital located in resource-limited settings of South India. A total of 75 patients were recruited and randomized into two groups: Group A received 6% of topical salicylic acid and Group B received 0.05% of clobetasol propionate for 3 months with a three follow-up visits. Efficacy was assessed based on the reduction of PASI and PGA scores at each visit. The safety profile of two drugs was assessed by a screening of adverse drug reactions. Cost-effectiveness of treatment groups was calculated by considering inputs of direct medical costs required to reduce one unit on PGA scale. Results: Demographic and clinical profiles of participants were matched between two groups. The mean PASI score of Group A and Group B were reduced from baseline (4.36, 4.67) to final follow-up (1.97, 2.03). There was a statistically significant difference exist in mean PASI score difference of Group A and Group B from baseline to 1st follow-up and baseline to 2nd follow-up (P

Propylthiouracil in treating psoriasis, a promise that failed: A hospital-based prospective study of propylthiouracil in the treatment of psoriasis

Introduction: Psoriasis is a common skin disorder with no cure and definite treatment options. Propylthiouracil (PTU), an antithyroid drug, has been found to be effective in treating psoriasis in certain studies. This prompted us to conduct a study to assess the effectiveness of PTU in treating patients with psoriasis. Aims: The primary objective of our study was to assess the efficacy of PTU as a safe and effective agent in the management of psoriasis. Settings and Design: This study was a clinical prospective study conducted over a period of 3 months. Materials and Methods: Thirty one patients with psoriasis and those fulfilling the inclusion criteria were treated with PTU (100 mg thrice a day) and topical emollient, and were followed up for 12 weeks. Psoriasis Area Severity Index (PASI) at the baseline and at the end of the study were compared. Patients who attained PASI score 50 were considered to respond to the treatment. Statistical Analysis Used: Mean values of variables. Results: The mean PASI score at the beginning of the treatment with PTU was 17.6. The mean PASI score at the end of the study was 16.06. Conclusions: We found PTU to be ineffective in reducing both the symptoms and severity of psoriasis. It is also intriguing to note that PTU, which was found to be effective in treating psoriasis almost two decades ago, has never been used widely in practice. Probably, this bears testimony to the fact that PTU is not as effective as it was promised to be.

Study of the impact of viral load of hepatitis C on patients with concomitant psoriasis vulgaris

Background and study aimConcomitant hepatitis C virus (HCV) infection and psoriasis vulgaris (PV) are not uncommon coexisting diseases, especially in areas with high viral hepatitis endemicity. To date, data about the interaction between both diseases are scarce. Therefore, we aimed to describe the possible interplay between the HCV viral load and psoriatic activity in concomitant Egyptian diseased patients. Patients and methodsBetween December 2011 and August 2013, all psoriatic patients attending Assiut University Hospital outpatient clinics were tested for HCV serologic assay. Patients with positively coexisting diseases were further reevaluated for psoriasis area severity index (PASI) score assessment, liver function tests, HCV-RNA-polymerase chain reaction (PCR) assays, and sonographic examination of the liver. For comparative purposes, another matched group (n=26) with psoriasis only (HCV-negative group) was enrolled as a control. ResultsDuring the period of the study, 20 patients with concomitant PV and HCV infection (HCV-positive group; 50% males, mean age of 44.15±10.66years) were recruited. The mean PASI score was 44.75±10.38 and clinical signs of liver dysfunction were observed in 40% (n=8), 100% had abnormal liver function tests (n=20), and 75% had sonographic findings of cirrhosis (n=15). The PASI score was significantly higher in the HCV-positive psoriatic group compared to the HCV-negative control (p<0.001). Significant correlations were detected between the PASI score and the viral loads, and also with alanine aminotransferase (ALT). ConclusionWhen HCV was found concomitantly with PV, a high possibility of severe disease pattern will be expected that entails special precautions in the treatment process.

Efficacy and safety of adalimumab when added to inadequate therapy for the treatment of psoriasis: results of PRIDE, an open‐label, multicentre, phase IIIb study

Adalimumab is an effective treatment for chronic plaque psoriasis. To evaluate the safety and efficacy of adalimumab for psoriasis patients who did not adequately respond to prior psoriasis therapy. PRIDE (an Open-Label Access PRogram to Evaluate the Safety and Effectiveness of Adalimumab When Added to InaDEquate Therapy for the Treatment of Psoriasis) was a multicentre, Phase IIIb study in Canada. Patients with active moderate-to-severe plaque psoriasis who failed to respond to, or were intolerant of, prior therapies received adalimumab 80 mg at Week 0 followed by adalimumab 40 mg every other week Weeks 1 through 23. The primary efficacy measure was PASI (Psoriasis Area Severity Index) 75 response at Week 16. Secondary efficacy measures included PASI 90/100 and percentage change from baseline PASI score. Adverse events (AEs) and serious AEs were recorded. A total of 203 patients were enrolled at 26 sites. Baseline characteristics were: male, 61.1%; mean age, 45.5 years; mean PASI score, 20.0; previous exposure to biologics, 38.4%. At Week 16, PASI 75/90/100 responses were achieved by 70.9%/49.3%/24.1% of patients, respectively. Mean percentage PASI score decrease from baseline to Week 16 was 79.5%. Mean percentage PASI improvement and response rates were maintained through Week 24. Nasopharyngitis and upper respiratory tract infection were the only AEs to occur in ≥5% of patients. Nine patients experienced serious AEs; four were considered possibly or probably related to adalimumab. Adalimumab was safe, well-tolerated and effective for treatment of active plaque psoriasis in patients who had not adequately responded to prior therapy.