Efficacy of Systemic Treatments for Moderate to Severe Plaque Psoriasis: Systematic Review and Meta-Analysis

Bansback, Nick; Sizto, Sonia; Sun, Huiying; Feldman, Steven R.; Willian, Mary Kaye; Anis, Aslam H.

doi:10.1159/000233234

Cited by 85 publications

(63 citation statements)

References 79 publications

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“…Efficacy and outcomes were not analyzed, but they have been shown previously to be similar between TNF blockers. [24][25][26][27][28][29][30][31] The model included an adjustment for the cost of copayment and dispensing fees and did not consider the cost to a plan that uses coinsurance. This approach, combined with the fact that all patients in the analysis were continuously enrolled in a managed care plan, may limit the generalizability of these results in patients who are not enrolled in managed care plans.…”

Section: Limitationsmentioning

confidence: 99%

Costs of Tumor Necrosis Factor Blockers Per Treated Patient Using Real-World Drug Data in a Managed Care Population

Schabert¹,

Watson²,

Joseph³

et al. 2013

JMCP

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BACKGROUND: Several anti-inflammatory biologic medications are available in the United States for the treatment of moderate-to-severe rheumatoid arthritis, moderate-to-severe psoriasis, psoriatic arthritis, or ankylosing spondylitis. The tumor necrosis factor (TNF) blockers etanercept, adalimumab, and infliximab are approved for use in adults with any of these conditions, but predicting the annual costs of TNF-blocker treatment is complex due to differences in dosing schedules, treatment gaps, switching between TNF blockers, and dose escalation over time.

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Section: Limitationsmentioning

confidence: 99%

Costs of Tumor Necrosis Factor Blockers Per Treated Patient Using Real-World Drug Data in a Managed Care Population

Schabert¹,

Watson²,

Joseph³

et al. 2013

JMCP

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“…Since biological agents were introduced for patients with moderate to severe psoriasis, randomized controlled trials (RCTs) have shown substantial benefits of these treatments; both in terms of clinical skin involvement [1,2] and in terms of health-related quality of life (HRQOL) [3,4,5]. RCTs are the gold standard for testing efficacy and safety in evidence-based medicine.…”

Section: Introductionmentioning

confidence: 99%

Switch to Biological Agent in Psoriasis Significantly Improved Clinical and Patient-Reported Outcomes in Real-World Practice

et al. 2012

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Background: Although clinical studies have shown efficacy of biological agents in moderate to severe psoriasis, observational studies of real-world effectiveness are rare. Objective: To analyse the psoriasis area and severity index (PASI) and quality of life by the EQ-5D questionnaire and dermatology quality of life index (DLQI) in psoriasis patients who switched from conventional systemic treatment to biological agents in clinical practice. Furthermore, to analyse patient groups with the highest benefit of biological agents. Methods: Longitudinal, observational study based on the Swedish National Registry for Systemic Treatment of Pso-riasis, PsoReg. Outcomes of biological-naïve patients who switched to a biological agent (n = 267) were analysed before switch and at the first follow-up. Results: Patients significantly improved in EQ-5D, DLQI and PASI (p < 0.001). Patients with DLQI ≥10 and/or PASI ≥10 had the greatest benefits from biological agents in terms of EQ-5D. Conclusions: Patients with moderate to severe psoriasis benefit from biological agents in clinical practice; the patients with the highest benefits were those with high pretreatment PASI and DLQI scores.

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“…Further, expression of CD26 on the surface of keratinocytes and T cells in psoriatic skin is upregulated [4]. Methotrexate, cyclosporine and retinoids have been used as conventional systemic treatments in psoriasis, but are not fully effective [5]. Recently, biologics such as TNF-α inhibitors and ustekinumab, have been introduced for the treatment of psoriasis as they inhibit T cell activation [6].…”

Section: Introductionmentioning

confidence: 99%

Sitagliptin, a Dipeptidyl Peptidase-IV Inhibitor, Improves Psoriasis

Nishioka¹,

Shinohara²,

Tanimoto³

et al. 2011

Dermatology

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A patient with a 17-year history of plaque psoriasis accompanied by type 2 diabetes mellitus discontinued cyclosporine and steroid ointment given for treatment of psoriasis because she was dissatisfied with the effects of the drugs. After sitagliptin, a dipeptidyl peptidase-IV (DPP-IV) inhibitor, was administered for control of blood glucose, psoriatic skin lesions were gradually diminished, although HbA1c did not improve. Three months after the administration of sitagliptin, infiltration, scales and erythema on all psoriatic plaques disappeared, leaving pigmentation on flat skin. DPP-IV in serum degrades the incretin hormones which stimulate β-cell insulin secretion. DPP-IV inhibitors, as incretin enhancers, cause an increase in glucose-dependent insulin secretion, and are applied for the treatment of diabetes mellitus. DPP-IV is also expressed on T cells as CD26, a surface antigen which plays an important role in activating T cells. As helper T cells are involved in the pathogenesis of psoriasis, it is possible that DPP-IV inhibitors improve psoriatic skin lesions by inhibiting T cell activation, independently of glycemic control. DPP-IV inhibitors could be an alternative for the treatment of psoriasis.

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Efficacy of Systemic Treatments for Moderate to Severe Plaque Psoriasis: Systematic Review and Meta-Analysis

Cited by 85 publications

References 79 publications

Costs of Tumor Necrosis Factor Blockers Per Treated Patient Using Real-World Drug Data in a Managed Care Population

Costs of Tumor Necrosis Factor Blockers Per Treated Patient Using Real-World Drug Data in a Managed Care Population

Switch to Biological Agent in Psoriasis Significantly Improved Clinical and Patient-Reported Outcomes in Real-World Practice

Sitagliptin, a Dipeptidyl Peptidase-IV Inhibitor, Improves Psoriasis

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