Treatment Goals in Psoriasis: Which Outcomes Matter Most?

Svoboda, Steven A; Ghamrawi, Rima I.; Owusu, Dorellie A; Feldman, Steven R.

doi:10.1007/s40257-020-00521-3

Cited by 21 publications

(17 citation statements)

References 46 publications

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“…The evaluation of efficacy in the original RCTs revealed that the total effective rate was usually defined as PASI 60, whereas PASI 75 was internationally considered treatment success. To better reflect the efficacy of the interventions and to enhance the international recognition of the evidence of CHM in the treatment of psoriasis, future studies should choose the evaluation indices of efficacy that are recommended by international guidelines or by expert consensuses, such as PASI 75, PASI 90, physician’s global assessment, and body surface area ( van der Kraaij et al, 2019 ; Svoboda et al, 2020 ). When evaluating the effects of treatment, we should not only consider the abovementioned evaluation indices reported by the physicians to quantify the removal of skin lesions but also take into account the assessment of other conditions (such as quality of life) that affect the efficacy and prognosis of patients with psoriasis.…”

Section: Discussionmentioning

confidence: 99%

“…When evaluating the effects of treatment, we should not only consider the abovementioned evaluation indices reported by the physicians to quantify the removal of skin lesions but also take into account the assessment of other conditions (such as quality of life) that affect the efficacy and prognosis of patients with psoriasis. Thus, the use of evaluation indices that can be reported by the patients, such as the Dermatology Life Quality Index, Psoriasis Disability Index, Psoriasis Symptom Inventory, and 36-item short-form health survey, can comprehensively evaluate the efficacy of interventions ( Lizán et al, 2019 ; Svoboda et al, 2020 ). Additionally, most of the original RCTs either did not mention follow-up or just had a short follow-up.…”

Section: Discussionmentioning

confidence: 99%

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Benefits and Safety of Chinese Herbal Medicine in Treating Psoriasis: An Overview of Systematic Reviews

Zhang

Peng

et al. 2021

Front. Pharmacol.

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Background: In recent years, systematic reviews/meta-analyses (SRs/MAs) of Chinese herbal medicine (CHM) for psoriasis have continuously emerged. Their methods and evidence quality, however, are yet to be evaluated, and whether their conclusions can provide clinicians with reliable evidence is still debatable.Objectives: This overview aims to evaluate the methodological quality, risk of bias, and reporting quality of relevant SRs/MAs, as well as the current evidence of CHM for treating psoriasis.Methods: We searched nine electronic databases from their respective time of establishment to January 20, 2021, as well as the reference lists of the included SRs/MAs, protocol registries, and gray literature. Two reviewers independently used the following: A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2, Risk of Bias in Systematic Reviews (ROBIS), the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), and Grades of Recommendations, Assessment, Development and Evaluation (GRADE) to evaluate the methodological quality, risk of bias, reporting quality, and evidence quality of the included SRs/MAs.Results: This review included 14 SRs/MAs involving 45 outcomes, of which 12 (85.71%) SRs/MAs had a very low quality evaluated by AMSTAR 2 and 7 (50.00%) SRs/MAs had a high risk of bias assessed by ROBIS. The protocol and registration and funding statements were the major reporting flaws according to the PRISMA checklist. The evaluation with the GRADE system demonstrated no outcome of high-quality evidence, and inconsistent efficacy evaluations were found in this overview. Only 15 (33.33%) outcomes were moderate-quality evidence, supporting the claim that CHM plus Western medicine (WM) was superior to WM. Generally low quality of evidence showed no difference in the incidence of adverse events between the combined therapy and WM. However, the conclusion that CHM was superior to WM cannot be drawn due to the inconsistent results.Conclusion: Despite that CHM has the potential benefit and safety in the adjuvant treatment of psoriasis, the conclusion should be treated with caution because of the generally low quality of methodology and evidence. In the future, high-quality randomized controlled trials (RCTs) should be carried out, and the quality of relevant SRs should also be improved to promote their clinical application.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Benefits and Safety of Chinese Herbal Medicine in Treating Psoriasis: An Overview of Systematic Reviews

Zhang

Peng

et al. 2021

Front. Pharmacol.

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“…Неудовлетворенность терапией ГИБП у пациентов с псориазом была выше -30,4%. По мнению экспертов, при обследовании таких больных в клинической практике, помимо оценки тяжести кожных проявлений, необходимо учитывать нарушение функции, боль в суставах, коморбидность, переносимость назначенных препаратов и бремя расходов на их приобретение [12].…”

Section: применение Prosunclassified

Patient's reported outcomes – a new philosophy for analyzing the effectiveness of therapy in immunoinflammatory diseases

Редакционная¹

2021

Sovremennaâ revmatologiâ

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A fundamentally important task of modern pharmacotherapy of immunoinflammatory diseases (IID) is a significant improvement in the quality of life (QOL) of patients, the fastest and most complete elimination of the most unpleasant manifestations of the disease, restoration of function and working capacity. Specialists in the therapy of various IID took part in panel dedicated to the discussion of this problem: Professor E.L. Nasonov, PhD., member of the Academy of Science; Professor A.M. Lila, PhD; V.N. Amirjanova, PhD; A.E. Karateev, PhD; T.V. Korotaeva, PhD; O.V. Knyazev, PhD; T.A. Lisitsyna, PhD; M.M Hobeish, PhD; E.S. Filatova. PhD.One of the central issues was the discussion of the need to use the patient's reported outcomes (PROs) indicator in analyzing the results of IID therapy (rheumatoid arthritis, psoriatic arthritis, psoriasis and inflammatory bowel disease). The need for its use is due to the fact that the principal goal of treatment with modern disease modifying antirheumatic drugs (DMARDs) is not only to achieve low activity or remission of IID, but also to maximize the general condition and QOL of patients. Therefore, such manifestations of IID as pain, fatigue, dysfunction, depression and anxiety, etc., must be analyzed in the course of treatment. The development of these symptoms is determined by the main immunopathological process and is associated, among others, with systemic overproduction of a number of pro-inflammatory cytokines. Modern DMARDs: Janus kinase (JAK) inhibitors, in particular tofacitinib, are capable of directly blocking the effect of cytokines on cells (suppressing the intracellular JAK / STAT signaling pathway), quickly and effectively eliminating pain, fatigue and dysfunction. The use of JAK inhibitors seems to be especially appropriate in patients with IID with high inflammatory activity and severe clinical manifestations.

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“…Although there is no cure for psoriasis, treatments are available to assist in providing sustained clearance of lesions, particularly among patients with moderate-to-severe plaque psoriasis [ 10 ]. Several clinician-reported outcome measures are used to evaluate the magnitude of the disease burden and the effectiveness of therapies in clinical studies and real-world practice [ 11 ]. The Psoriasis Area and Severity Index (PASI) is a commonly used instrument for measuring psoriasis severity and evaluating treatment response.…”

Section: Introductionmentioning

confidence: 99%

Deterioration of Health-Related Quality of Life After Withdrawal of Risankizumab Treatment in Patients with Moderate-to-Severe Plaque Psoriasis: A Machine Learning Predictive Model

Papp

Soliman

Done

et al. 2021

Dermatol Ther (Heidelb)

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Introduction: Risankizumab has demonstrated efficacy in treating moderate-to-severe psoriasis. The phase-3 IMMhance trial (NCT02672852) examined the effect of continuing versus withdrawing from risankizumab treatment on psoriasis severity, including the Psoriasis Area and Severity Index (PASI) and static Physician Global Assessment (sPGA). However, the effect of withdrawal on health-related quality of life (HRQL) was not assessed. Therefore, this study was conducted to evaluate the impact of risankizumab withdrawal on HRQL measured by the Dermatology Life Quality Index (DLQI).

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Treatment Goals in Psoriasis: Which Outcomes Matter Most?

Cited by 21 publications

References 46 publications

Benefits and Safety of Chinese Herbal Medicine in Treating Psoriasis: An Overview of Systematic Reviews

Benefits and Safety of Chinese Herbal Medicine in Treating Psoriasis: An Overview of Systematic Reviews

Patient's reported outcomes – a new philosophy for analyzing the effectiveness of therapy in immunoinflammatory diseases

Deterioration of Health-Related Quality of Life After Withdrawal of Risankizumab Treatment in Patients with Moderate-to-Severe Plaque Psoriasis: A Machine Learning Predictive Model

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