Systemic Management of Psoriasis Patients in Indian Scenario

Rajagopalan, Murlidhar; Chatterjee, Manas; De, Abhishek; Dogra, Sunil; Ganguly, Satyaki; Kar, Bikash Ranjan; Madnani, Nina; Neema, Shekhar; Parasramani, ShrichandG; Patel, Kartik; Tahiliani, Sushil

doi:10.4103/idoj.idoj_113_21

Cited by 8 publications

(6 citation statements)

References 40 publications

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“…It is only recently that the Indian guidelines have been proposed for the early use of oral therapy and biologics in PsO. 19 It will be interesting to see the effect of these guidelines on further practice patterns.…”

Section: Discussionmentioning

confidence: 99%

Nature and Treatment Received for Psoriasis and Co-morbidities in Patients with Psoriatic Arthritis. A Multi-centre Observational Study from Western India

Kadam,

Jadhav,

Shaikh

et al. 2024

Indian Journal of Rheumatology

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Background: Many recent studies have suggested a changing paradigm of management of psoriatic disease. One of the main concerns is the lost opportunity of controlling ‘psoriatic disease’ during the early phase, especially when the disease is limited to the skin. Objective: The study’s main aim was to determine psoriasis (PsO) treatment before the patient’s presentation to the rheumatologist. We also studied the associated comorbidities in these patients. Methods: This was a cross-sectional study done at eight centres. Data was collected from 375 patients with psoriatic arthritis (PsA) about their demography, details of psoriatic lesions, treatment taken for them, additional co-morbidities and pattern of PsA. Results: Only 22.4% of patients had received oral methotrexate for PsO: the majority for less than a year. Plaque and scalp PsO were the most common, and 75% of patients had body surface area involvement greater than 5%. There was a significantly higher prevalence of type II diabetes mellitus (T2DM) (24% vs. 9.1%) and obesity as compared to the general population. Conclusion: Few patients received sustained systemic treatment for PsO prior to the development of arthritis. There was a significant association of co-morbidities such as T2DM and obesity with PsA.

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Section: Discussionmentioning

confidence: 99%

Nature and Treatment Received for Psoriasis and Co-morbidities in Patients with Psoriatic Arthritis. A Multi-centre Observational Study from Western India

Kadam,

Jadhav,

Shaikh

et al. 2024

Indian Journal of Rheumatology

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“…There was guidance based on the expert consensus that defined an inadequate response as <PASI 50 41 . Other guidelines and consensus have proposed similar criteria to define treatment failure of biologics 15 34 35 42 43 44 . The advent of new biologics and their expanded use have dramatically improved the outcome of psoriasis treatment 45 .…”

Section: Discussionmentioning

confidence: 99%

Basic Therapeutic Approach for Patients with Plaque Psoriasis: Korean Expert Consensus Using the Modified Delphi Method

Baek

Kim

et al. 2023

Ann Dermatol

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Background Currently, there is no consensus on the treatment of psoriasis in Korean patients. Objective This study aimed to establish a consensus on the basic therapeutic principles for Korean patients with plaque psoriasis. Methods Using the modified Delphi method, a steering committee proposed 53 statements for the first Delphi round, which covered five subjects: (1) the goal of treatment and evaluation of disease severity, (2) topical therapy, (3) phototherapy, (4) conventional systemic therapy, and (5) biologic therapy. The panel of dermatologists scored the level of agreement for each statement on a ten-point scale with scores ranging from 1 (strongly disagree) to 10 (strongly agree). After discussing the results of the first round, the committee reformulated 41 statements. Finally, consensus was defined as more than 70% of the second round scores being ≥7. Results The panel participants strongly agreed that the ideal treatment goals for Korean patients with plaque psoriasis should include complete skin clearance and high dermatological quality of life. A strong consensus was also reached on the use of topical agents for psoriasis of any severity, the consideration of phototherapy before biologics therapy, the conventional systemic agents for moderate-to-severe psoriasis, and the recommendation of biologic for retractable psoriasis to conventional systemic therapy and phototherapy. Conclusion This modified Delphi panel established an expert consensus on the therapeutic approach for Korean patients with plaque psoriasis. This consensus may improve the treatment outcomes for psoriasis in Korea.

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“…23,[25][26][27] However, in the Indian context, the applicability is still restricted with the proposed ranking of biologics (available in India) in terms of efficacy being secukinumab, adalimumab/ infliximab, and etanercept. 28 In the real-world study by Armstrong et al, patients affirmed highest effectiveness with the use of biologics (73%), with up to a 55% adherence. However, median treatment duration and high side effects were the major causes for discontinuation of biologics.…”

Section: Introductionmentioning

confidence: 97%

“… 23 , 25–27 However, in the Indian context, the applicability is still restricted with the proposed ranking of biologics (available in India) in terms of efficacy being secukinumab, adalimumab/infliximab, and etanercept. 28 …”

Section: Introductionmentioning

confidence: 99%

Therapeutic Inertia in the Management of Psoriasis: A Quantitative Survey Among Indian Dermatologists and Patients

Rajagopalan¹,

Dogra²,

Godse³

et al. 2022

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The primary objective of the study was to understand the therapeutic inertia in treatment and management of plaque psoriasis among dermatologists, along with determining the preferred treatment choices for management of plaque psoriasis; it also included the resulting treatment satisfaction among patients. The secondary objective was to identify the gaps in terms of knowledge and attitude among dermatologists and the expectations of patients. Patients and Methods: A multicentre, cross-sectional quantitative survey was conducted among dermatologists and patients with moderate to severe plaque psoriasis across India. The interviews were conducted either face to face or via telephone between September and November 2020, using structured and validated questionnaires based on specific themes. The data obtained were statistically analysed, wherever applicable. Results: Overall, 207 adult patients with moderate-to-severe plaque psoriasis and 303 dermatologists were interviewed. Post experiencing symptoms, 44% of the patients visited general physicians for treatment and there was an average 7.8-month delay by the patients to consult a dermatologist. Approximately one-fourth of patients used home remedies before seeking medical help. Onethird of dermatologists used the Psoriasis Area and Severity Index (PASI) for assessing the disease severity. Majority of dermatologists preferred combination therapy for their patients. The lack of quick resolution and side effects were the major reasons for changing the treatment. Overall, only 35% of the patients complied to current treatment. Satisfaction with existing forms of therapies was highest for mild plaque psoriasis (62%) as confirmed by dermatologists, while 52% of the overall patients were satisfied with their therapy. Majority of the patients (64%) affirmed living with plaque psoriasis impacted their lives. Conclusion: This first-of-its-kind survey in India highlighted the gaps in terms of the disease journey between dermatologists and patients. The survey emphasises the need for shared decision-making and may benefit dermatologists in suggestive modifications of the treatment algorithm and disease management in clinical settings.

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Systemic Management of Psoriasis Patients in Indian Scenario

Cited by 8 publications

References 40 publications

Nature and Treatment Received for Psoriasis and Co-morbidities in Patients with Psoriatic Arthritis. A Multi-centre Observational Study from Western India

Nature and Treatment Received for Psoriasis and Co-morbidities in Patients with Psoriatic Arthritis. A Multi-centre Observational Study from Western India

Basic Therapeutic Approach for Patients with Plaque Psoriasis: Korean Expert Consensus Using the Modified Delphi Method

Therapeutic Inertia in the Management of Psoriasis: A Quantitative Survey Among Indian Dermatologists and Patients

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