Anxiety and depression in patients with moderate‐to‐severe psoriasis and comparison of change from baseline after treatment with guselkumab vs. adalimumab: results from the Phase 3 VOYAGE 2 study

Gordon, Kenneth B.; Armstrong, April W.; Han, Chenglong; Foley, Peter; Song, Michael; Wasfi, Y.; Yin, You; Shen, Yaung‐Kaung; Reich, Kristian

doi:10.1111/jdv.15012

Cited by 72 publications

(74 citation statements)

References 43 publications

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“…The HADS‐A and HADS‐D scores were also higher than previously reported in other chronic skin disorders, e.g. patients enrolled in clinical trials of biologics for moderate‐to‐severe psoriasis (6·8–7·2 and 5·3–5·7, respectively), and other medical disorders such as diabetes (5·7 and 5·0, respectively) and HIV (6·5 and 5·5, respectively) . A cross‐sectional study that used HADS scores of 1519 adults with AD from six U.S. medical centres found that approximately one‐quarter of patients with mild AD and one‐half of patients with moderate‐to‐severe AD had symptoms of anxiety or depression, with even more severe HADS scores among those with uncontrolled AD .…”

Section: Discussionmentioning

confidence: 90%

Symptoms and diagnosis of anxiety and depression in atopic dermatitis in U.S. adults

et al. 2019

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SummaryBackgroundThe relationship between atopic dermatitis (AD), anxiety and depression in the U.S. adult population is not well established.ObjectivesTo determine the relationship of AD and its severity with symptoms and diagnosis of anxiety and depression in U.S. adults.MethodsA cross‐sectional, population‐based study of 2893 adults was performed. AD was determined using modified U.K. Diagnostic Criteria.ResultsAdults with AD vs. those without AD had higher mean Hospital Anxiety and Depression Scale anxiety (HADS‐A) (7·7 vs. 5·6) and depression (HADS‐D) (6·0 vs. 4·3) scores and higher prevalences of abnormal (≥ 11) HADS‐A (28·6% vs. 15·5%) and HADS‐D (13·5% vs. 9·0%) scores. In multivariable linear and logistic regression models controlling for sociodemographics, AD was associated with significantly higher mean HADS‐A and HADS‐D scores (7·7 and 6·0) and higher odds of abnormal HADS‐A [odds ratio (OR) 2·19, 95% confidence interval (CI) 1·65–2·91] and HADS‐D scores (OR 1·50, 95% CI 1·04–2·17) (P ≤ 0·03 for all). Mean and abnormal HADS‐A and HADS‐D scores were increased in moderate and severe/very severe self‐reported global AD severity, Patient‐Oriented Eczema Measure (POEM), Patient‐Oriented Scoring AD (PO‐SCORAD), PO‐SCORAD itch and sleep (P < 0·0001 for all). All respondents with severe PO‐SCORAD, POEM and PO‐SCORAD itch had borderline or abnormal HADS‐A and HADS‐D scores. Adults with AD vs. those without AD had higher prevalence of self‐reported healthcare‐diagnosed anxiety or depression in the past year (40·0% vs. 17·5%). Many adults with AD who had borderline and/or abnormal HADS‐A or HADS‐D scores reported no diagnosis of anxiety or depression.Conclusions AD is associated with significantly increased anxiety and depression, which may go undiagnosed. What's already known about this topic? Previous studies found higher rates of anxiety and depression in clinical cohorts of patients with atopic dermatitis. What does this study add? This study found dramatically higher rates of anxiety and depression among adults with atopic dermatitis in the U.S. population, which was primarily driven by atopic dermatitis severity.Anxiety and depression often go undiagnosed in adults with atopic dermatitis.

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Section: Discussionmentioning

confidence: 90%

Symptoms and diagnosis of anxiety and depression in atopic dermatitis in U.S. adults

et al. 2019

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“…For example, Breuer et al [21] found that psoriasis patients with more symptoms of depression at baseline showed less PASI reduction at discharge after a 3-week multidisciplinary inpatient rehabilitation program. In addition, Gordon et al [20] demonstrated that reductions in depression and anxiety scores were correlated with PASI score improvement in psoriasis patients receiving 24-week guselkumab or adalimumab treatment; however, the predictive values of depression and anxiety before treatment for clinical response to TNF-α inhibitors were not investigated in their study. In our study, we found that PASI 75/90 response rates in depressed patients were lower compared with those in non-depressed patients at M6, and depression symptoms at baseline was an independent predictive factor for the lower possibility of PASI 75/90 response achievement after etanercept treatment in psoriasis patients.…”

Section: Discussionmentioning

confidence: 99%

“…Psychosocial problems are not only associated with poor skin conditions but also have negative impacts on prognosis in psoriasis patients with various treatments [11, 20-22]. For example, Breuer et al [21] found that psoriasis patients with more symptoms of depression at baseline showed less PASI reduction at discharge after a 3-week multidisciplinary inpatient rehabilitation program.…”

Section: Discussionmentioning

confidence: 99%

Depression Symptoms Predict Worse Clinical Response to Etanercept Treatment in Psoriasis Patients

2018

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Background/Aims: This study aimed to investigate the predicting values of depression and anxiety symptoms for clinical response to etanercept treatment in psoriasis patients. Methods: A total of 85 psoriasis patients who received 6 months of etanercept treatment were consecutively enrolled in this prospective cohort study. The Psoriasis Area and Severity Index (PASI) score was evaluated at month 0 (M0), M1, M3, and M6, and the corresponding PASI 75/90 response at each visit was assessed. Also, anxiety and depression symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS) at M0, M1, M3, and M6. Results: Depression symptoms were observed to correlate with female gender (p = 0.004), longer disease duration (p = 0.018), and higher PASI score (p < 0.001), and anxiety symptoms were seen to be associated with female gender (p = 0.017), larger psoriasis-affected body surface area (p = 0.049), and higher PASI score (p = 0.017) in psoriasis patients. After etanercept treatment, HADS-Depression (HADS-D) and HADS-Anxiety (HADS-A) scores were both decreased at M1, M3, and M6 (all p < 0.001) compared with M0. Most importantly, baseline depressed patients presented with a lower PASI 75 response rate at M3 (p = 0.014) and M6 (p = 0.005), and a reduced PASI 90 response rate at M6 (p = 0.045) compared with baseline non-depressed patients. Furthermore, multivariate logistic regression analyses revealed that depression symptoms at baseline were an independent predictive factor for the lower possibility of both PASI 75 response (p = 0.048) and PASI 90 response (p = 0.048) achievements at M6 in psoriasis patients. However, no correlation of baseline anxiety symptoms with PASI 75/90 responses was observed. Conclusion: Depression symptoms at baseline independently predict a worse clinical response to etanercept treatment in psoriasis patients.

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“…A single suicide attempt was reported in a patient taking adalimumab in VOYAGE 1 . In VOYAGE 2, greater improvements in anxiety and depression scores were seen in patients treated with guselkumab than in those who received adalimumab or placebo …”

Section: Safety Data From Clinical Trialsmentioning

confidence: 99%

“…41 In VOYAGE 2, greater improvements in anxiety and depression scores were seen in patients treated with guselkumab than in those who received adalimumab or placebo. 46 The NAVIGATE trial assessed guselkumab in adult patients with an inadequate response to ustekinumab. 43 All patients (n = 871) initially received open-label ustekinumab (45 or 90 mg at Weeks 0 and 4).…”

Section: Guselkumabmentioning

confidence: 99%

Safety of selective IL‐23p19 inhibitors for the treatment of psoriasis

Crowley

Warren

Cather³

2019

Acad Dermatol Venereol

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Psoriasis is a chronic disease that requires long‐term treatment. Consequently, understanding the safety and tolerability of any potential treatment over time is critical to effective prescribing. The biologic agents currently available for the treatment of psoriasis target a number of different inflammatory cytokines involved in psoriasis disease pathogenesis. The monoclonal antibodies tildrakizumab, guselkumab and risankizumab target the p19 subunit that is specific to interleukin (IL)‐23. This article reviews published data on the safety of these IL‐23p19 inhibitors in patients with psoriasis compared with other currently available biologic therapies. Data from randomized, placebo‐ and active‐controlled phase 3 clinical trials show tildrakizumab, guselkumab and risankizumab to have a favourable risk–benefit profile in patients with moderate to severe psoriasis. No significant safety concerns have been observed for any of these IL‐23p19 inhibitors in the data published to date. The most commonly reported adverse events (AEs) associated with these agents in phase 3 studies were upper respiratory tract infections. No increase was seen in rates of serious infections, malignancies or major adverse cardiovascular events, with no signals suggestive of an elevated risk of opportunistic infections, active tuberculosis or reactivation of latent tuberculosis infection, mucocutaneous Candida infections, triggering or worsening of inflammatory bowel disease, demyelinating disorders or suicidal ideation. Selectively targeting IL‐23p19 may help avoid AEs that have been associated with biologic agents with other mechanisms of action. Data from long‐term extension studies and patient registries will further establish the safety profile of IL‐23p19 inhibitors for the treatment of moderate to severe psoriasis in routine practice.

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Anxiety and depression in patients with moderate‐to‐severe psoriasis and comparison of change from baseline after treatment with guselkumab vs. adalimumab: results from the Phase 3 VOYAGE 2 study

Abstract: Guselkumab treatment was associated with greater improvements in symptoms of anxiety and depression scores in patients with psoriasis compared with placebo and adalimumab.

Cited by 72 publications

References 43 publications

Symptoms and diagnosis of anxiety and depression in atopic dermatitis in U.S. adults

Symptoms and diagnosis of anxiety and depression in atopic dermatitis in U.S. adults

Depression Symptoms Predict Worse Clinical Response to Etanercept Treatment in Psoriasis Patients

Safety of selective IL‐23p19 inhibitors for the treatment of psoriasis

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