Diagnostic and therapeutic guidelines for plaque psoriasis - Brazilian Society of Dermatology

Arnone, Marcelo; Takahashi, Marcelo Straus; Carvalho, André Vicente Esteves de; Bernardo, Wanderley Marques; Bressan, Aline Lopes; Ramos, Andréa Machado Coelho; Terena, Aripuanã Cobério; Souza, Cacilda da Silva; Nunes, Daniel Holthausen; Bortoletto, Maria Cecília de Carvalho; Oliveira, Maria de Fátima Santos Paim de; Neffá, Jane; Fieri, Luciana Cristina; Azulay‐Abulafia, Luna; Felix, Paulo Antônio Oldani; Magalhães, Renata Ferreira; Romiti, Ricardo; Jaime, Tatiana Jerez

doi:10.1590/abd1806-4841.2019940211

Cited by 34 publications

(29 citation statements)

References 266 publications

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“…29 This behavior should alert to the influence of gender when describing the impact of HRQoL on dermatological diseases, especially when HRQoL scores subside therapeutic decisions, as occurs in some psoriasis treatment flowcharts. 30 …”

Section: Discussionmentioning

confidence: 99%

Validation of the Skindex-17 quality of life assessment instrument for a Brazilian population

Jorge

Mourão

Pollo

et al. 2021

Anais Brasileiros de Dermatologia

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Background Health-related quality of life assesses how diseases affect the daily life of people; there are several generic instruments for this assessment in dermatology. Skindex was created in 1996; it is a multidimensional instrument, aiming to encompass some psychological and social aspects not yet addressed by other questionnaires. Among its versions (Skindex-29, 16, and 17), Skindex-17 had not been validated in Brazil. Objectives To validate Skindex-17 for use in Brazilians with dermatological diseases. Methods This was a methodological, cross-sectional, and prospective study of 217 patients attended at the Dermatology Service Outpatient Clinic, Faculdade de Medicina de Botucatu - Universidade Estadual Paulista (Botucatu, SP, Brazil), from December 2017 to September 2019. The following were evaluated: content validity, filling time, internal consistency, dimensional structure, concurrent validity (DLQI), temporal stability, and responsiveness. Results The sample consisted of 71% women, mean age (SD) of 45 (16) years; phototypes II−IV accounted for 95% of the cases. Cronbach's alpha coefficients were 0.82 and 0.93 for the symptoms and psychosocial conditions, respectively. A high correlation was observed with the DLQI score: symptoms (rho = 0.69) and psychosocial conditions (rho = 0.75). The instrument's two-dimensional structure was confirmed through confirmatory factor analysis. Temporal stability (ICC > 0.9) and score responsiveness (p ≤ 0.02) were verified. The instrument was shown to be feasible in clinical practice due to the content validation performed by professionals and patients, as well as the low time spent completing it (< 5 min). Study limitations Single-center study, with patients exclusively from the public healthcare system. Conclusions Skindex-17 was shown to be a valid and consistent instrument for assessing quality of life among patients with dermatological diseases, in Brazil. Its two-dimensional structure was confirmed.

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Section: Discussionmentioning

confidence: 99%

Validation of the Skindex-17 quality of life assessment instrument for a Brazilian population

Jorge

Mourão

Pollo

et al. 2021

Anais Brasileiros de Dermatologia

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“…Psoriasis is a chronic inflammatory skin disease with an autoimmune component and a strong genetic basis. Plaque psoriasis is characterized by well-defined, raised, chronic erythematous plaques with silver patches observed commonly in the elbows, knees, scalp, umbilicus, and lumbar area (11)(12)(13). The worldwide reported prevalence of psoriasis ranges from 0.09% to 11.43% and results in a severe economic burden to patients and a significant challenge to public health (14,15).…”

Section: Introductionmentioning

confidence: 99%

Gamma Delta T Cells and Their Pathogenic Role in Psoriasis

Qian

Wang

et al. 2021

Front. Immunol.

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γδT cells are an unconventional population of T lymphocytes that play an indispensable role in host defense, immune surveillance, and homeostasis of the immune system. They display unique developmental, distributional, and functional patterns and rapidly respond to various insults and contribute to diverse diseases. Although γδT cells make up only a small portion of the total T cell pool, emerging evidence suggest that aberrantly activated γδT cells may play a role in the pathogenesis of psoriasis. Dermal γδT cells are the major IL-17-producing cells in the skin that respond to IL-23 stimulation. Furthermore, γδT cells exhibit memory-cell-like characteristics that mediate repeated episodes of psoriatic inflammation. This review discusses the differentiation, development, distribution, and biological function of γδT cells and the mechanisms by which they contribute to psoriasis. Potential therapeutic approaches targeting these cells in psoriasis have also been detailed.

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“…Regardless of PASI 75 historically substantial presence as a primary endpoint in PsO randomized controlled trials (RCT), updates to clinical guidelines have reinforced that PASI 90 response may represent a better efficacy outcome for moderate-to-severe disease. Its achievement is related to higher clinically significant improvements in quality of life, providing patients with greater satisfaction with treatment (Arnone et al, 2019;Puig, 2015). For example, in a posthoc analysis of a phase 2 PsO trial, only 33% of patients achieving a PASI 75 response reached a DLQI score of 0 or 1 (meaning the lower impact on QoL).…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of moderate-to-severe psoriasis biologic treatments in Brazilian private healthcare system: cost-per-responder results derived from a network metanalysis

Carvalho¹,

Duarte²,

Ianhez³

et al. 2020

JBES

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Objective: To assess the cost-per-responder (CpR) of biologic therapies available in Brazil to treat moderate-to-severe plaque psoriasis (PsO) from the private healthcare system’s perspective. Methods: Number needed to treat (NNT) and (CpR) analyses were performed to evaluate biologic therapies’ cost-effectiveness for moderate-to-severe PsO available in Brazil. The effectiveness of biologic treatments for moderate-to-severe PsO was assessed based on a previously published metanalysis, which included studies considering PsO patients and outcomes of interest (PASI 75, 90, and 100). The clinical efficacy data in terms of estimated NNT based on the network metanalysis (NMA) results were combined with drug treatment costs to determine the CpR for each treatment arm in 3-time horizons: the primary response period, 1-year, and 2-years. Results: Risankizumab was the most cost-effective option when NMA base case scenario data was used to calculate NNT in all PASI response for both the primary response period and 1- and 2-years follow-up durations. Differences in CpR between risankizumab and other biologic drugs increased with more significant PASI improvements. CpR sensitivity analysis also confirmed these findings, indicating that risankizumab has a better performance for PASI 100, and both risankizumab and guselkumab are very similar in terms of cost per additional PASI 75 and PASI 90 responder. Conclusions: Risankizumab was estimated to have a lower cost per PASI 75, 90, and 100 responders in most simulated scenarios (primary response period [12-16 weeks], 1-year and 2-years), among the evaluated biologic therapies.

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Diagnostic and therapeutic guidelines for plaque psoriasis - Brazilian Society of Dermatology

Cited by 34 publications

References 266 publications

Validation of the Skindex-17 quality of life assessment instrument for a Brazilian population

Validation of the Skindex-17 quality of life assessment instrument for a Brazilian population

Gamma Delta T Cells and Their Pathogenic Role in Psoriasis

Cost-effectiveness of moderate-to-severe psoriasis biologic treatments in Brazilian private healthcare system: cost-per-responder results derived from a network metanalysis

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