Psoriasis In Europe Research Articles

Management of moderate to severe psoriasis with brodalumab-Real-world evidence from the LIBERO study.

Brodalumab, a fully human monoclonal immunoglobulin IgG2 antibody that binds the human interleukin 17 receptor subunit A, is available for the treatment of moderate-to-severe plaque psoriasis in Europe since September 2017, but so far there are only a few studies on its use in real-world conditions. To assess the management of moderate-to-severe psoriasis with brodalumab 210 mg in daily practice after 12 and 52 weeks (W). In addition, patient profiles and treatment pathways are described. LIBERO is a prospective, multicenter, non-interventional study including adult patients with plaque psoriasis treated with brodalumab 210 mg. In total, 638 patients (65% male, mean age: 49.3 ± 14.4 years) from 148 sites in Germany were enrolled. The majority suffered from severe (51.1%) or very severe (13.1%) psoriasis according to physician global assessment (PGA0-5). When starting with brodalumab, 58.5% were biologic naïve and 41.5% were previously treated with another biologic, mainly adalimumab (18.5%) and secukinumab (17.9%). About 74.0% of patients met the primary endpoint of an absolute PASI ≤3 at ~W12 (n = 618, LOCF). The mean PASI was reduced significantly as of ~W2 from 17.2 (±11.7) to 9.7 (±8.8) and improved further to 3.3 (±6.3) at ~W12 (p < 0.001). At ~W52 85.5% of patients reached a PGA0/1-response (primary endpoint) and 54.1% patients were assessed as completely clear (PGA0) (both n = 399, as observed). Effectiveness of brodalumab was confirmed in relevant subgroup analysis by previous treatment regimen. Most frequently reported adverse events were nasopharyngitis (4.6%), psoriasis (4.6%) and arthralgia (4.1%), new safety signals were not detected. This representative, non-interventional study confirms the short- and long-term effectiveness and safety profile of brodalumab in the management of psoriasis in daily practice as well as in relevant treatment pathways.

PCR261 Uncovering Patient-Reported Outcome Differences Between Undiagnosed and Diagnosed Individuals With Moderate to Severe Psoriasis in Europe

PCR261 Uncovering Patient-Reported Outcome Differences Between Undiagnosed and Diagnosed Individuals With Moderate to Severe Psoriasis in Europe

42268 Real-World Utilization of Adalimumab Biosimilar (ABP 501) in Patients with Psoriasis in Europe

42268 Real-World Utilization of Adalimumab Biosimilar (ABP 501) in Patients with Psoriasis in Europe

Brodalumab for the Treatment of Moderate-to-Severe Psoriasis: An Expert Delphi Consensus Statement.

Brodalumab is a recombinant, fully human immunoglobulin IgG2 monoclonal antibody specifically targeted against interleukin-17RA that has been approved for the treatment of moderate-to-severe psoriasis in Europe. We developed a Delphi consensus document focused on brodalumab for the treatment of moderate-to-severe psoriasis. Based on published literature and their clinical experience a steering committee drafted 17 statements covering 7 domains specific to the treatment of moderate-to-severe psoriasis with brodalumab. A panel of 32 Italian dermatologists indicated their level of agreement using a 5-point Likert scale (from 1 = "strongly disagree" to 5 = "strongly agree") using an online modified Delphi method. After the first round of voting (32 participants), positive consensus was reached for 15/17 (88.2%) of the proposed statements. Following a face-to-face virtual meeting, the steering committee decided that 5 statements would form "main principles" and 10 statements formed the final list. After a second round of voting, consensus was reached in 4/5 (80%) of the main principles and 8/10 (80%) for consensus statements. The final list of 5 main principles and 10 consensus statements identify key indications specific to the use of brodalumab in the treatment of moderate-to-severe psoriasis in Italy. These statements aid dermatologists in the management of patients with moderate-to-severe psoriasis.

Bimekizumab for psoriasis.

Psoriasis is a chronic, immune-mediated, inflammatory skin disease, affecting 1% to 3% of the population in Western countries. Due to advances in the understanding of psoriasis pathogenesis, in particular, the role of the interleukin-23 (IL-23)/T-helper 17 (Th17) immune axis, highly effective, targeted biologic therapies have been developed, shifting the psoriasis treatment paradigm. However, some patients do not respond or lose response to these novel therapies. Bimekizumab is a first-in-class humanized monoclonal immunoglobulin G1 (IgG1) antibody that potently and selectively inhibits both IL-17A and IL-17F, functioning as a dual inhibitor. All bimekizumab studies have shown high efficacy in psoriasis patients. Its onset of response was rapid and sustained for periods up to 60 weeks. In active-comparator trials to date, bimekizumab was superior to adalimumab (BE SURE), ustekinumab (BE VIVID) and secukinumab (BE RADIANT). It has demonstrated a consistent safety profile and high tolerability. The most common adverse events were largely restricted to mucosal candidiasis. Dual inhibition of IL-17A and IL-17F with bimekizumab showed to be a highly effective treatment for psoriasis, and the product is already approved for treatment of moderate to severe plaque psoriasis in Europe, Canada and Japan.

A New Risk Polymorphism rs10403848 of CARD8 Significantly Associated with Psoriasis Vulgaris in Northeastern China.

Caspase recruitment domain family member 8 (CARD8) is an adaptor molecule that negatively regulates nuclear factor-κB (NF-κB) activation, interleukin (IL)-1β secretion, and apoptosis. These play important roles in the pathogenesis of psoriasis. Genetic variants of CARD8 have been associated with an increased risk of several inflammatory diseases and psoriasis in Europe. However, nothing is known about the association of the polymorphisms of CARD8 and psoriasis vulgaris (PsV) in the Han population of northeastern China. To investigate the potential association between them, we designed a case-control study to genotype four selected single nucleotide polymorphisms (SNPs) using the improved multiplex ligation reaction (iMLDR) method. Model-based single SNP frequentist-test and haplotype association studies were performed to assess the association between SNPs and PsV. The results showed that the intron SNP rs10403848 was significantly associated with PsV (additive model p=0.0418, p′=0.0411, and statistical power 0.1902; heterozygous model p=0.0418, p′=0.0164, and statistical power 0.9406). A potential risk locus of nonsynonymous SNP rs2043211 found in the European population did not show a significant association in our study. We found that the polymorphism rs10403848 in CARD8 is significantly associated with PsV risk in the Han population of northeastern China. CARD8 may be involved in PsV in this population, as in the European population, but a different genetic process should be considered for the heterogeneity of risk loci.

Assessing the impact of patient support programs in adalimumab-treated adults with psoriasis in Europe

Assessing the impact of patient support programs in adalimumab-treated adults with psoriasis in Europe

Assessing the impact of patient support programs on patient outcomes in adalimumab-treated patients with psoriasis in Europe

Assessing the impact of patient support programs on patient outcomes in adalimumab-treated patients with psoriasis in Europe

Health-related quality of life in patients with psoriasis: a systematic review of the European literature.

To summarize the data published over the last 5years in the European Union related to the health-related quality of life (HRQoL) of patients with psoriasis and its conditioning factors. International electronic databases and gray literature were searched to identify studies conducted on patient-reported outcomes in patients with psoriasis, published in Europe between January 1, 2009 and December 31, 2013. Bibliographic references were hand-searched. Editorials, letters, commentaries, opinion papers, and studies related to specific treatments were excluded. A total of 46 studies met the inclusion criteria, 27 of them reporting data related to HRQoL or its conditioning factors. The publications reviewed highlighted the substantial negative impact of psoriasis on patients' HRQoL. Most of the studies that analyzed the relationship between HRQoL and sociodemographic characteristics described a relation between gender (female) and age (young patients) and poorer HRQoL. An association between HRQoL impairment and visibility of skin lesions and disease activity and severity was also established. Skin discomfort and pruritus were identified as elements that negatively influenced HRQoL. Use of biological agents had a positive impact on HRQoL and on treatment satisfaction, a better HRQoL being seen in patients treated with systemic therapies and biologics. HRQoL has been broadly addressed in patients with psoriasis in Europe. Several disease- and patient-related factors contributed to its deterioration. Therapeutic measures with proven effectiveness in controlling disease symptoms and reducing PASI should be considered in patients with a severe disease who have a poorer HRQoL.

PSS14 - Costs of Psoriasis in Europe. A Systematic Review of the Literature

PSS14 - Costs of Psoriasis in Europe. A Systematic Review of the Literature

PSS51 - Factors Conditioning Health Related Quality Of Life In Patients With Psoriasis In Europe: A Systematic Review Of The Literature

PSS51 - Factors Conditioning Health Related Quality Of Life In Patients With Psoriasis In Europe: A Systematic Review Of The Literature

Biologic therapies of psoriasis

With the progress in the understanding of immunological mechanisms and susceptibility genes of psoriasis,an increasing number of targeted biological agents have been developed over the past decade.According to the mechanism of action,these agents are mainly divided into two groups,including costimulatory signal-blocking agents and inflammatory mediator-inhibiting agents.Inflammatory mediators targeted by these agents mainly include tumor necrosis factor α,interleukin-12 and interleukin-23.This review introduces the mechanism,clinical efficacy and safety of many biological agents which have been approved or unapproved but have shown vast potential for treating psoriasis in Europe and America. Key words: Psoriasis ; Biologics ; Immunity ;

A framework for improving the quality of care for people with psoriasis

SummaryA lack of national guidelines in some countries and lack ofconsensus amongst those that do exist in others is problematic.Specifically, poor and inconsistent advice on initiating and opti-mising therapeutic interventions is a barrier to improving out-comes. While European guidelines can help to fill the gap incountries without national guidelines, their role should primar-ily be to strengthen and harmonise existing guidelines, and toprovide a framework for the development of new nationalguidelines. They therefore need to lead the provision of advicethat is not given in existing guidelines. Limited awareness ofguidelines and increasing pressures on patient consultation can Figure 5 The concept of cumulative life course impairment(CLCI) in psoriasis. 22 CLCI results from an interaction betweenthe burden of stigmatisation, physical and psychological co-mor-bidities; and coping strategies and external factors. Significantimpairment may occur in patients with ineffective coping strate-gies and limited social support, even if they have a small burden.This impairment may be less in patients with effective copingstrategies and strong social support networks, even if the bur-den is large. (Figure adapted from Kimball 2010.)

Considerazioni sui farmaci biologici nel trattamento della psoriasi a placche e loro impatto economico. Focus su etanercept

Plaque psoriasis is a common inflammatory skin condition with a significant impact on quality of life and social costs. The prevalence of psoriasis is about 2–3%. Recent developments in systemic targeted therapies, like biological agents (anti-T-cell agents and inhibitors of tumour-necrosis-factor-α), have offered an alternative treatment approach which may translate into disease control and improvement of quality of life. The British Association of Dermatologists Guidelines (2005) stated that etanercept should be considered the first choice for patients with significant and stable psoriasis. A Consensus Paper of Italian Dermatologists has recently stated (2008) that, according to the ‘physiologic’ paradigm of selection among TNF-antagonists linked to more or less physiologic mechanisms of action, etanercept appears to be the anti-TNF of choice for treating most patients with moderate to severe plaque psoriasis and psoriatic arthritis, possibly even at an early stage. Etanercept, unlike other biological agents, is approved for the intermittent treatment (up to 24 weeks) of the psoriasis in Europe. Overall, the biological agents showed high efficacy in the treatment of patients who have not responded to other systemic therapies. No head-to-head studies comparing those agents are available in the peer-reviewed literature, but the economic impact showed higher cost of other biological agents compared to intermittent etanercept in the treatment of psoriasis. It would seem reasonable to state that intermittent therapy with etanercept results in a more contained budget impact in comparison to the other suitable biological agents for the treatment of psoriasis. Taking for granted the general recognition of innovation of the new biological therapies, the debate is now focused on the sustainability of the expense for these therapies by National Health Services. Considering this need, the saving opportunity offered by an intermittent biological therapy seems to be remarkable.

Prevalence of Antigliadin Antibodies in Patients with Psoriasis is Not Elevated Compared with Controls

Antigliadin antibodies (AGAs) are markers of celiac sprue but may have autoimmune implications in the absence of gastrointestinal disease. There is anecdotal evidence to suggest that gluten sensitivity may play a role in psoriasis, and patients with psoriasis in Europe have been reported to improve on a gluten-free diet. To assess whether patients with psoriasis in the US have an increased prevalence of elevated AGAs. A US sample of patients with psoriasis (n=100), patients with psoriasis and psoriatic arthritis (n=100), and age-matched control individuals without any personal or family history of autoimmune disorders (n=100) were tested for IgG and IgA AGAs. No difference in the prevalence of abnormal AGAs among patients with psoriasis (14%), combined psoriasis and psoriatic arthritis (18%), and control individuals (19%) was observed. No significant correlations between AGA positivity and psoriasis severity, joint involvement, or age of onset of psoriasis or arthritis were observed. We found no support for the results of prior studies showing that elevated AGAs occur with increased frequency in patients with psoriasis. Furthermore, the relatively high prevalence of abnormal AGAs in our control population suggests these antibodies may not be associated with autoimmune disease.

Recommendations for the use of etanercept in psoriasis: a European dermatology expert group consensus

Psoriasis is a chronic, inflammatory skin disorder that has a significant impact on quality of life and, particularly in moderate to severe cases, adversely affects the patient's overall health and well-being. Biological treatments, such as etanercept, are being widely adopted across Europe for treatment of moderate to severe psoriasis due to favourable safety and efficacy profiles. The increase in usage, combined with a growing body of clinical evidence, has identified a need to clarify the best use of etanercept within its current treatment label. To prepare a series of recommendations agreed by an expert group of dermatologists, relating to the most effective use of etanercept for psoriasis in Europe, within the product license. An expert panel of dermatologists from across Europe completed a Delphi survey to address the current use of etanercept in psoriasis in Europe. In June 2005 the results were presented to the expert panel at their nominal group meeting, and a consensus was agreed. It was recommended that, where possible, patients are initiated on the 50 mg twice-weekly (BIW) dose. Etanercept should be given until remission is achieved (maximum 24 weeks) and retreatment should be initiated according to the physician's judgement. Before commencing treatment, contraindications, such as infection or previous malignancy (within 5 years), should be ruled out. The consensus presented herein provides valuable clarification of use of etanercept according to the label, which may have wider implications relating to the use of all biological therapies in psoriasis.

Infliximab in the treatment of psoriasis

Psoriasis is one of the most common chronic inflammatory diseases with a prevalence of 2–3%. Traditional treatment options in patients with moderate-to-severe disease include ultraviolet light irradiation and systemic agents such as methotrexate and cyclosporine. In a substantial subgroup of patients, these treatments are not effective, associated with intolerable side effects or contraindicated due to comorbidities. Increased production of tumor necrosis factor-α has been identified as an important disease pathomechanism in psoriasis. Infliximab (Remicade®) is a chimeric monoclonal antibody directed against tumor necrosis factor-α that has recently been approved for the treatment of moderate-to-severe plaque psoriasis in Europe. This article reviews the relevant clinical and safety data of infliximab in psoriasis with emphasis on its practical use in this indication.

European patient perspectives on the impact of psoriasis: the EUROPSO patient membership survey

EUROPSO (European Federation of Psoriasis Patient Associations) undertook a Europe-wide survey examining quality of life and patients' perspectives on treatment and their disease. To explore patients' perspectives of psoriasis on their lifestyle and well-being and to gain insight into the effectiveness of and satisfaction with currently available therapies for psoriasis. Self-administered questionnaires (n = 50,500) were mailed to members of psoriasis patient associations in Belgium, the Czech Republic, Finland, France, Germany, Italy and the Netherlands. Responses were received from 18,386 patients (36%), of whom 17,990 had psoriasis. Mean age at onset of psoriasis was 30.5 years, 59% of respondents had self-reported moderate to severe psoriasis (3% or greater body surface area involvement) and 30% had been diagnosed with psoriatic arthritis. The mean Psoriasis Disability Index score was 12.2 (25% of the maximum score), increasing to 21 (44%) in patients with more than 10% body surface area involvement. The greatest impact was on activities of daily living, especially affecting clothing choice, bathing routine and sporting activities. Overall, 77% replied that psoriasis was a problem or a significant problem. While patients were satisfied with the information and care from their dermatologist (40% highly satisfied), available treatment options were less satisfactory, with over 70% reporting only low to moderate satisfaction. This is the largest survey of people with psoriasis in Europe and shows that psoriasis has a profound impact on quality of life.

Methotrexate for psoriasis: current European practice. A postal survey

The aim of this survey was to determine current practice throughout Europe regarding use and monitoring of methotrexate therapy for psoriasis. A structured questionnaire with questions on methotrexate prescribing and monitoring was mailed to 150 dermatologists in 32 European countries in June 2002. Dermatologists' names were chosen at random from the 2001 European Academy of Dermatology and Venereology membership directory. A reply was received from 69 dermatologists of whom 59 prescribed methotrexate regularly. In those patients receiving systemic treatment for psoriasis, methotrexate was the most widely used drug (4.4 patients of every 10) followed by acitretin (3.2) and cyclosporin (1.6). Myelosuppression was the commonest reported fatal side-effect of methotrexate (eight of a total of 10 cases). None of the respondents routinely requested a baseline liver biopsy before starting methotrexate treatment and of every 10 of their patients on long-term methotrexate it was estimated that less than two had had a liver biopsy some time during treatment. Serum measurement of the amino-terminal peptide of type III procollagen (PIIINP) was used routinely to detect liver fibrosis by 12 (20%) of the 59 respondents who regularly prescribed methotrexate. This survey demonstrates that, despite the advent of new therapies, methotrexate retains a central role in the treatment of severe psoriasis in Europe. The responses demonstrated variation in, among others, the methotrexate dose regimen utilized and the use of folate supplementation, confirming the need for randomized controlled studies to address these issues.