Updates on Psoriasis and Cutaneous Oncology: Proceedings from the 2016 MauiDerm Meeting
Updates on Psoriasis and Cutaneous Oncology Proceedings from the 2016 MauiDerm Meeting based on presentations by George Martin, MD; Bruce E. Strober, MD, PhD; Craig L. Leonardi, MD; Joel M. Gelfand, MD, MSCE; Andrew Blauvelt, MD, MBA; Arthur Kavanaugh, MD; Linda Stein Gold, MD; Brian Berman, MD, PhD; Ted Rosen, MD; Eggert Stockfleth, MD
PSORIASIS UPDATE
Patient-reported Outcomes: Association with Clinical Response to Psoriasis Therapies Patient-reported outcomes (PROs) of psoriasis control do not always align with objective clinical observations of the disease. PROs are inherently subjective, but these self-reported assessments can complement objective observations, provide important insights into how patients perceive their own disease and its treatment, and may help advance care by incorporating this point of view into how clinicians treat psoriasis. In a retrospective study of patients with moderate-tosevere psoriasis treated with biologics (adalimumab and etanercept), methotrexate, or placebo drawn from several recent clinical trials (n=11,015 patient-visits), a total of 534 had a Physician’s Global Assessment (PGA) score of “clear” and 1,725 of “minimal.”1 A subset of these 2,259 patient-visits had a Patient’s Global Assessment (PtGA) of “uncontrolled” (n=60) or “limited disease control” (n=450). In those patients with a PGA of “clear” or “minimal,” the factors most associated with increased odds of patient-assessed limited disease control or uncontrolled disease were: pain, pruritus, and current joint inflammation. Pain (defined as 10mm on a visual analog scale [VAS]) was associated with a 12-percent increase (odds ratio [OR] 1.12, 95% confidence interval [CI], 1.01–1.23, p=0.027), pruritus with a 49-percent increase (1.49, 95% CI, 1.38-1.60, p0.90) and were considered moderate-to-strong in magnitude (0.41–0.73) by Week 12 of the study. This suggests that the PSD is a valid tool that can help in reaching appropriate treatment choices in these patients.11 Sex-specific differences in quality of life of patients with moderate-to-severe plaque psoriasis were evaluated using data from the Phase 3 REVEAL study12 of adalimumab.13 Women had significantly worse mean scores than men for DLQI, mental component score (MCS), and physical component score (PCS) than men (MCS and PCS are part of the SF-36 metric). Women had significantly higher scores in presenteeism (20.5% vs. 16.6%, p=0.0229), in total work productivity impairment (21.8% vs. 17.0%, p=0.0079, and total activity impairment (32.3% vs. 24.0%, p
Updates on Psoriasis and Cutaneous Oncology Proceedings from the 2016 MauiDerm Meeting based on presentations by George Martin, MD; Bruce E. Strober, MD, PhD; Craig L. Leonardi, MD; Joel M. Gelfand, MD, MSCE; Andrew Blauvelt, MD, MBA; Arthur Kavanaugh, MD; Linda Stein Gold, MD; Brian Berman, MD, PhD; Ted Rosen, MD; Eggert Stockfleth, MD
PSORIASIS UPDATE
Patient-reported Outcomes: Association with Clinical Response to Psoriasis Therapies Patient-reported outcomes (PROs) of psoriasis control do not always align with objective clinical observations of the disease. PROs are inherently subjective, but these self-reported assessments can complement objective observations, provide important insights into how patients perceive their own disease and its treatment, and may help advance care by incorporating this point of view into how clinicians treat psoriasis. In a retrospective study of patients with moderate-tosevere psoriasis treated with biologics (adalimumab and etanercept), methotrexate, or placebo drawn from several recent clinical trials (n=11,015 patient-visits), a total of 534 had a Physician’s Global Assessment (PGA) score of “clear” and 1,725 of “minimal.”1 A subset of these 2,259 patient-visits had a Patient’s Global Assessment (PtGA) of “uncontrolled” (n=60) or “limited disease control” (n=450). In those patients with a PGA of “clear” or “minimal,” the factors most associated with increased odds of patient-assessed limited disease control or uncontrolled disease were: pain, pruritus, and current joint inflammation. Pain (defined as 10mm on a visual analog scale [VAS]) was associated with a 12-percent increase (odds ratio [OR] 1.12, 95% confidence interval [CI], 1.01–1.23, p=0.027), pruritus with a 49-percent increase (1.49, 95% CI, 1.38-1.60, p0.90) and were considered moderate-to-strong in magnitude (0.41–0.73) by Week 12 of the study. This suggests that the PSD is a valid tool that can help in reaching appropriate treatment choices in these patients.11 Sex-specific differences in quality of life of patients with moderate-to-severe plaque psoriasis were evaluated using data from the Phase 3 REVEAL study12 of adalimumab.13 Women had significantly worse mean scores than men for DLQI, mental component score (MCS), and physical component score (PCS) than men (MCS and PCS are part of the SF-36 metric). Women had significantly higher scores in presenteeism (20.5% vs. 16.6%, p=0.0229), in total work productivity impairment (21.8% vs. 17.0%, p=0.0079, and total activity impairment (32.3% vs. 24.0%, p
