Management of psoriatic arthritis in rheumatology and dermatology settings: sub-analysis of the Italian population from the international LOOP study

Lubrano, Ennio; Sedie, Andrea Delle; Romanelli, Marco; Chimenti, Maria Sole; Bianchi, Luca; Piaserico, Stefano; Felice, Catia De; Graceffa, Dario; Andres, Maria Ilenia De; Curatolo, Salvatore; Grembiale, Rosa Daniela; Dastoli, Stefano; Arcuri, Chiara; Angileri, Rosa Giuseppa; Prignano, Francesca; Bandinelli, Francesca; Baldissera, Elena; Mercuri, Santo Raffaele; Franchi, C.; Longhi, Matteo; Patrì, Angela; Caso, Francesco; Passiu, Giuseppe; Montesu, Maria Antonia; Parisi, Simone; Stroppiana, Elena; Luzio, Genoveffa Scotto Di; Italiano, Giovanni; Nuzzo, Sergio Di; Santilli, Daniele; Bigi, Laura; Lumetti, Federica; Agnusdei, Concetto Paolo; Ferrucci, M; Gualberti, Giuliana; Marando, Francesca; Ramonda, Roberta; Cusano, Francesco

doi:10.1007/s10067-020-05482-w

Cited by 12 publications

(17 citation statements)

References 43 publications

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“…Indeed, it has been shown that PsA patients benefitting from multidisciplinary care (i.e., visited by rheumatologists and dermatologists) in a US clinic were more likely to receive systemic medication (25% vs. 15%) and be treated with a biologic agent (37% vs. 16%) than in prior care with only a dermatologist or a rheumatologist [ 45 ]. Another study recently performed in Italy also highlighted a diagnostic delay emerging from both settings with significantly different therapeutic approaches [ 46 ]. While a multidisciplinary approach may indeed be the best option for these patients [ 47 ], further surveys that address the QoL specific to patients with underlying joint disease are warranted.…”

Section: Discussionmentioning

confidence: 99%

Sharing Patient and Clinician Experiences of Moderate-to-Severe Psoriasis: A Nationwide Italian Survey and Expert Opinion to Explore Barriers Impacting upon Patient Wellbeing

Prignano

Brunasso

Fabbrocini

et al. 2022

JCM

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A nationwide survey was conducted in adult patients with psoriasis (PsO) across Italy to obtain their real-world perspective of the impact of PsO on their wellbeing. Patients completed a 26-question survey (based on the patient benefit index; PBI, The Dermatology Life Quality Index; DLQI and the World Health Organization-five; WHO-5 wellbeing index) and workshop discussion sessions were undertaken by dermatologists to interpret results from the survey. 392 patients with PsO completed the survey. Analysis of results was restricted to patients who had moderate-to-severe plaque psoriasis (assessed by patients; n = 252; 64.3%). Dermatologists (n = 32) completed one question from the survey related to wellbeing and rated social, physical and mental domains as contributing to a similar extent, with comparable scores also observed by patients. For treatment, biologics yielded higher scores on average, whereas little difference was observed between topical and conventional systemic treatments. Only 23.8% of patients felt that their dermatologist was taking into consideration their wellbeing and 32.6% of the patients considered their therapy as inadequate in improving signs and symptoms of the disease. This survey identified key factors contributing to barriers impacting on patient wellbeing. Simple, but comprehensive questionnaires can provide important insight to patients’ needs that may significantly increase clinician awareness during visits leading to tailored treatment.

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Section: Discussionmentioning

confidence: 99%

Sharing Patient and Clinician Experiences of Moderate-to-Severe Psoriasis: A Nationwide Italian Survey and Expert Opinion to Explore Barriers Impacting upon Patient Wellbeing

Prignano

Brunasso

Fabbrocini

et al. 2022

JCM

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“…Data were previously described for the entire sample and also in subsamples from United States, Japan, and Italy. In summary, significant differences were observed for the time elapsed from diagnosis and DMARD use 21–24 . These findings suggest that PsA patients should be evaluated by a rheumatologist.…”

Section: Discussionmentioning

confidence: 83%

“…This analysis presents the Brazilian data set of LOOP, a crosssectional, observational study evaluating the clinical specialty setting as determinant of management of patients with PsA conducted in 17 countries across different geographic regions. The results of the LOOP study have been previously published, [21][22][23][24] with a focus on patient data both within 21,23 and outside of the United States. 22,24 The study population consisted of patients 18 years or older with suspected or confirmed PsA who attended a routine visit with a rheumatologist or dermatologist at a participating clinical site.…”

Section: Methodsmentioning

confidence: 99%

Clinical Specialty Setting as Determinant of Management of Psoriatic Arthritis

Souza

Goldenstein-Schainberg

Lima

et al. 2021

J Clin Rheumatol

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ObjectiveThe aim of this study was to examine the effect of clinical specialty setting on the management of psoriatic arthritis (PsA) as well as disease activity/burden in Brazil.MethodsThis study is a post hoc analysis of the Brazilian population in a cross-sectional, observational study conducted in 17 countries. Patients were 18 years or older with suspected or confirmed PsA attending routine visits at participating sites. Primary end points were time from symptom onset to PsA diagnosis, from diagnosis to first conventional systemic disease-modifying antirheumatic drug (DMARD) or first biologic DMARD, and from first conventional systemic DMARD to first biologic DMARD. Potential associations were assessed using the Student t test or the Mann-Whitney U nonparametric test. Normality was tested using the Shapiro-Wilk and Kolmogorov-Smirnov tests. For qualitative variables, the χ2 test was adopted.ResultsPatients (n = 130) visited dermatology (n = 75) or rheumatology (n = 55) sites. All primary end points were similar between the 2 settings; however, dermatology patients had significantly greater enthesitis counts (2.1 vs 0.6; p = 0.002), absenteeism at work (Work Productivity and Activity Impairment, 19.7% vs 5.2%; p = 0.03), and pain (Health Assessment Questionnaire–Disability Index pain scale, 1.39 vs 1.01; p = 0.032), as well as worse quality of life related to psoriasis (Dermatology Life Quality Index total score, 8.5 vs 5.0; p = 0.019) and mental health (12-item Short-Form Health Survey, version 2.0 subscale, 42.4 vs 47.4; p = 0.029).ConclusionsIn Brazil, PsA disease burden and disease activity were influenced by clinical specialty. Irrespective of setting, patients experienced a delay in being diagnosed with PsA, reinforcing the need for collaborative management of PsA by rheumatologists and dermatologists for better outcomes in these patients.

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“…Joint involvement in PsA is a potentially debilitating disease: patients may present arthritis to both small and large peripheral joints, enthesitis, and the axial Maria Sole Chimenti and Paola Conigliaro are equally contributed to this work. disease, leading to progressive erosive arthritis and severe functional impairment in more than half of the patients [3]. PsA pathogenesis is only partially understood and still remains to be completely clarified.…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of PsO ranges from 2 to 3% in the general population, and PsA may affect 10–30% of PsO patients [ 2 ]. Joint involvement in PsA is a potentially debilitating disease: patients may present arthritis to both small and large peripheral joints, enthesitis, and the axial disease, leading to progressive erosive arthritis and severe functional impairment in more than half of the patients [ 3 ]. PsA pathogenesis is only partially understood and still remains to be completely clarified.…”

Section: Introductionmentioning

confidence: 99%

Long-term effectiveness and drug survival of golimumab in patients affected by psoriatic arthritis with cutaneous involvement

et al. 2021

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Objectives To determine the effectiveness of golimumab (GLM) in improving joint, periarticular structures and cutaneous manifestations in patients with moderate to severe psoriatic arthritis (PsA) with cutaneous psoriasis in different real-life clinical settings and 48-month drug survival. Methods Clinical and laboratory records were collected from PsA patients treated with GLM at baseline (T0) and after 6, 12, 24, 36, and 48 months of treatment. Comparisons were performed using a paired t-test or Wilcoxon test. Drug survival rates were analyzed using Kaplan–Meier estimates. p value < 0.05 was considered statistically significant. Results Data from 105 patients were collected. PsO occurred in 80% of patients and enthesitis in 78%, peripheral and axial arthritis in 63.8% and 35.3%, respectively, while erosions in 36.2%. The main comorbidities were cardiovascular diseases (31.4%) and metabolic syndrome (MetS) (19%). A statistically significant improvement in articular and cutaneous psoriasis was registered at T48 of GLM-therapy in clinical (DAPSA p < 0.0001; PASI p < 0.01; BASDAI p < 0.0001) and laboratory (CRP < 0.05) indexes. Gender (p = 0.652), BMI (p = 0.655), smoking habit (p = 0.466), and line of treatment (p = 0.208) did not affect treatment efficacy nor persistence. At T48, 42% of patients discontinued GLM: the most frequent reason was an insufficient response or loss of efficacy (28.6%). Conclusion A 48-month GLM high drug persistence of PsA patients was observed in real-life, in patients presenting high disease activity, elevated prevalence of comorbidities, and more than one line of treatment at baseline. Patients’ characteristics as gender, smoke, BMI, different lines of treatment, and concomitant methotrexate treatment affected treatment persistence, making GLM effective and safe in moderate-severe PsA in a long-term real-life setting. Key Points• Golimumab was effective in psoriatic arthritis, including both musculoskeletal and cutaneous manifestations. • Golimumab effectiveness and drug survival were not affected by comorbidities and patient-related characteristics. • The 4-year drug survival curves confirm the efficacy and safety of golimumab in psoriatic arthritis patients in a real-life setting.

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Management of psoriatic arthritis in rheumatology and dermatology settings: sub-analysis of the Italian population from the international LOOP study

Cited by 12 publications

References 43 publications

Sharing Patient and Clinician Experiences of Moderate-to-Severe Psoriasis: A Nationwide Italian Survey and Expert Opinion to Explore Barriers Impacting upon Patient Wellbeing

Sharing Patient and Clinician Experiences of Moderate-to-Severe Psoriasis: A Nationwide Italian Survey and Expert Opinion to Explore Barriers Impacting upon Patient Wellbeing

Clinical Specialty Setting as Determinant of Management of Psoriatic Arthritis

Long-term effectiveness and drug survival of golimumab in patients affected by psoriatic arthritis with cutaneous involvement

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