Patient-reported outcomes for psoriasis patients with clear versus almost clear skin in the clinical setting

Takeshita, Junko; Duffin, Kristina Callis; Shin, Daniel B.; Krueger, Gerald G.; Robertson, Andrew D.; Troxel, Andrea B.; Voorhees, Abby S. Van; Gelfand, Joel M.

doi:10.1016/j.jaad.2014.05.001

Cited by 71 publications

(79 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…L'indice PASI tuttavia, analogamente a quanto avviene per l'indice BSA (Body Surface Area) e il giudizio globale del medico (Physician Global Assessment, PGA), non prende in considerazione l'impatto psico-sociale della malattia [13]. I disturbi delle forme più severe di psoriasi (per estensione o per localizzazione) vanno oltre il puro ambito cutaneo, tanto che l'impatto negativo della malattia sul benessere e sulla qualità di vita (Quality of Life, QoL) del paziente è comparabile con quello associato a patologie croniche invalidanti quali artrosi, cancro, cardiopatie e diabete [15].…”

Section: Valutare La Severità Della Malattiaunclassified

“…Alla luce di queste considerazioni, varie linee guida per il trattamento della psoriasi raccomandano di inserire tra gli obiettivi terapeutici sia gli outcomes riportati dal medico sia quelli riferiti dal paziente attraverso questionari autosomministrati, i cosiddetti Patient Reported Outcomes (PRO) [13,19]. In particolare, i PRO identificano qualsiasi rilevazione sullo stato di salute proveniente direttamente dal paziente piuttosto che dalla tradizionale prospettiva clinica.…”

Section: Il Contributo Del Pazienteunclassified

“…Anche se negli ultimi anni si sono rese disponibili nuove opzioni terapeutiche per le forme moderate-severe di psoriasi, non sempre è possibile raggiungere e/o mantenere una condizione di skin clearance; per tale motivo i pazienti possono rimanere insoddisfatti dei trattamenti. Comprendere le necessità e le aspettative dei pazienti allineandole con gli obiettivi del medico è parte fondamentale della strategia terapeutica di una condizione cronica come la psoriasi, il cui scopo dovrebbe essere proprio quello di raggiungere un'efficacia ottimale patient-centered [13,14].…”

Section: Introduzioneunclassified

See 2 more Smart Citations

Patients engagemnet in clinical trial input

Malagoli

2016

ABTPN

View full text Add to dashboard Cite

IntroduzioneLa psoriasi, della quale soffrono circa 1.500.000 persone nel nostro Paese (corrispondenti a una prevalenza del 2,8%), è tradizionalmente considerata una malattia infiammatoria della cute, nonostante il dimostrato coinvolgimento sistemico possa determinare un ampio ventaglio di comorbilità a carico di altri organi/apparati [1,2]. La forma più frequente è la psoriasi a placche (80-90% dei casi), caratterizzata dalla comparsa di placche eritemato-squamose localizzate su cuoio capelluto, tronco e arti, spesso associate a prurito, dolore e secchezza della cute, che può arrivare a lacerarsi e a sanguinare [1,3]. La psoriasi guttata, la psoriasi eritrodermica e la psoriasi pustolosa costituiscono delle varianti della malattia distinte per morfologia e andamento. Nel 33% circa dei pazienti psoriasici si osservano alterazioni distrofiche delle unghie [1]. Inoltre, nel 20-30% circa dei casi, generalmente alcuni anni dopo l'insorgenza delle lesioni cutanee, si hanno manifestazioni articolari diagnosticabili come artrite psoriasica, una malattia spesso trascurata e/o sottodiagnosticata [4][5][6]. La psoriasi può insorgere a ogni età, ma ci sono due picchi di presentazione, il primo tra i 15 e i 20 anni e il secondo tra i 55 e i 60 [7]. Il suo andamento è cronico-recidivante: i pazienti -che non raggiungono mai la guarigione -sperimentano periodi nei quali la malattia è meno evidente alternati a periodi di riacutizzazione [7]. Nella patogenesi della psoriasi, non ancora completamente chiarita, si riconosce una complessa base genetica sulla quale intervengono vari fattori ambientali tra cui l'impiego di farmaci, i traumi cutanei, le infezioni e lo stress. Inoltre, crescenti evidenze indicano il coinvolgimento di meccanismi immunologici, con la risoluzione della psoriasi associata a Patient engagement in clinical trial input. La valutazione del trattamento della psoriasi dal punto di vista del paziente

show abstract

Section: Valutare La Severità Della Malattiaunclassified

Section: Il Contributo Del Pazienteunclassified

Section: Introduzioneunclassified

See 1 more Smart Citation

Patients engagemnet in clinical trial input

Malagoli

2016

ABTPN

View full text Add to dashboard Cite

show abstract

“…An increased number of IFN-γ-producing T-cells and activation of IFN-γ-induced immune response genes in psoriatic plaques enhance the pro-inflammatory phenotype of T-cells and contribute to keratinocyte hyperproliferation [13]. Although the number of treatments for patients with different psoriasis severity has rapidly increased, most of them fail to achieve skin clearance, and many patients are uncomfortable during these treatments [14]. …”

Section: Introductionmentioning

confidence: 99%

“…Recently, attention has been paid to microRNAs (miRNAs), since they are involved in various human diseases, including cancers, immunological disorders and metabolic disorders [14]. Let-7 is a type of miRNA shows high sequence and functional conservation; there are ten mature let-7 isoforms with the same seed sequence [15].…”

Section: Introductionmentioning

confidence: 99%

Let-7a Inhibits T-Cell Proliferation and IFN-γ Secretion by Down-Regulating STAT3 Expression in Patients with Psoriasis

Xie

Chen

et al. 2017

Cell Physiol Biochem

View full text Add to dashboard Cite

Objective: This study aimed to explore the effects of STAT3 targeting by let-7a on T-cell proliferation and IFN-γ secretion in psoriasis. Methods: From January 2013 to January 2015, 40 patients with psoriasis (psoriasis group) and 38 volunteers undergoing plastic surgery (control group) were enrolled in this study. Pearson correlation analysis was performed to evaluate the correlation between let-7a and STAT3 expression. T-cells were isolated and subjected to different transfection methods. A dual luciferase reporter assay was carried out to confirm STAT3 as a target gene of let-7a. Let-7a, STAT3 and IFN-γ mRNA expression was detected by quantitative real-time fluorescent polymerase chain reaction (qRT-PCR), and pSTAT3 protein levels were determined by Western blot. T-cell proliferation was evaluated with a cell counting kit-8 (CCK-8) assay. Results: The level of STAT3 mRNA and pSTAT3 was higher, but let-7a expression was lower in the psoriasis group than the control group. Pearson correlation analysis indicated that STAT3 expression was negatively correlated with let-7a expression. T-cells transfected with inhibitors exhibited greater IFN-γ mRNA expression and T-cell proliferation than transfected T-cells and T-cells transfected with a non-sense sequence, while T-cells transfected with let-7a mimics exhibited lower IFN-γ mRNA expression and T-cell proliferation than transfected T-cells and T-cells transfected with a non-sense sequence. This suggested that siRNA-STAT3 could reverse the increase in IFN-y mRNA expression and T-cell proliferation induced by let-7a inhibitors. Conclusion: Our results demonstrated that let-7a inhibits T-cell proliferation and IFN-γ secretion by down-regulating STAT3 in psoriasis.

show abstract

Home- vs Office-Based Narrowband UV-B Phototherapy for Patients With Psoriasis

Gelfand,

Armstrong,

Lim

et al. 2024

JAMA Dermatol

View full text Add to dashboard Cite

ImportanceOffice-based phototherapy is cost-effective for psoriasis but difficult to access. Home-based phototherapy is patient preferred but has limited clinical data, particularly in patients with darker skin.ObjectiveTo compare the effectiveness of home- vs office-based narrowband UV-B phototherapy for psoriasis.Design, Setting, and ParticipantsThe Light Treatment Effectiveness study was an investigator-initiated, pragmatic, open-label, parallel-group, multicenter, noninferiority randomized clinical trial embedded in routine care at 42 academic and private clinical dermatology practices in the US. Enrollment occurred from March 1, 2019, to December 4, 2023, with follow-up through June 2024. Participants were 12 years and older with plaque or guttate psoriasis who were candidates for home- and office-based phototherapy.InterventionsParticipants were randomized to receive a home narrowband UV-B machine with guided mode dosimetry or routine care with office-based narrowband UV-B for 12 weeks, followed by an additional 12-week observation period.Main Outcomes and MeasuresThe coprimary effectiveness outcomes were Physician Global Assessment (PGA) dichotomized as clear/almost clear skin (score of ≤1) at the end of the intervention period and Dermatology Life Quality Index (DLQI) score of 5 or lower (no to small effect on quality of life) at week 12.ResultsOf 783 patients enrolled (mean [SD] age, 48.0 [15.5] years; 376 [48.0%] female), 393 received home-based phototherapy and 390 received office-based phototherapy, with 350 (44.7%) having skin phototype (SPT) I/II, 350 (44.7%) having SPT III/IV, and 83 (10.6%) having SPT V/VI. A total of 93 patients (11.9%) were receiving systemic treatment. At baseline, mean (SD) PGA was 2.7 (0.8) and DLQI was 12.2 (7.2). At week 12, 129 patients (32.8%) receiving home-based phototherapy and 100 patients (25.6%) receiving office-based phototherapy achieved clear/almost clear skin, and 206 (52.4%) and 131 (33.6%) achieved DLQI of 5 or lower, respectively. Home-based phototherapy was noninferior to office-based phototherapy for PGA and DLQI in the overall population and across all SPTs. Home-based phototherapy, compared to office-based phototherapy, was associated with better treatment adherence (202 patients [51.4%] vs 62 patients [15.9%]; P &lt; .001), lower burden of indirect costs to patients, and more episodes of persistent erythema (466 of 7957 treatments [5.9%] vs 46 of 3934 treatments [1.2%]; P &lt; .001). Both treatments were well tolerated with no discontinuations due to adverse events.Conclusions and RelevanceIn this randomized clinical trial, home-based phototherapy was as effective as office-based phototherapy for plaque or guttate psoriasis in everyday clinical practice and had less burden to patients.Trial RegistrationClinicalTrials.gov Identifier: NCT03726489

show abstract

Patient-reported outcomes for psoriasis patients with clear versus almost clear skin in the clinical setting

Cited by 71 publications

References 30 publications

Patients engagemnet in clinical trial input

Patients engagemnet in clinical trial input

Let-7a Inhibits T-Cell Proliferation and IFN-γ Secretion by Down-Regulating STAT3 Expression in Patients with Psoriasis

Home- vs Office-Based Narrowband UV-B Phototherapy for Patients With Psoriasis

Contact Info

Product

Resources

About