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Association of patient-reported disease burden and treatment switching among patients with plaque psoriasis on nonbiologic systemic therapy 斑块型银屑病非生物系统治疗患者报告的疾病负担与治疗转换的相关性
Pub Date : 2023-03-13 DOI: 10.25251/skin.7.supp.113
Sang Hee Park, Y. Zhong, A. Sima, V. Patel, J. Zhuo, C. Roberts-Toler, B. Becker, S. Hovland, B. Strober
Introduction: Better understanding of the relationship between quality of life and treatment patterns in psoriasis may help guide therapeutic algorithms. This study evaluated the association between patient-reported disease burden and treatment switching from nonbiologic to biologic therapy in patients with plaque psoriasis enrolled in the CorEvitas Psoriasis Registry. Methods: This cross-sectional study included biologic-naive patients aged ≥18 years who had used nonbiologic systemic therapy 28–365 days prior to their registry enrollment between April 2015 and August 2022. A switch to biologic therapy was defined as the introduction of biologic treatment up to 45 days post-enrollment, in addition to or in place of the initial nonbiologic systemic  therapy. Measures of patient-reported disease burden collected at enrollment were: the Dermatology Life Quality Index (DLQI); Work Productivity and Activity Impairment Index (WPAI); itch, skin pain, fatigue, and Patient Global Assessment (PGA), measured on visual analog scales (VAS); and the EuroQoL 5-Dimension, 3-Level (EQ-5D-3L) questionnaire. The association between each patient-reported disease burden measure and switching to biologic therapy was evaluated using multivariable logistic regression models, adjusting for age, sex, race, ethnicity, work status, body mass index, psoriasis duration, psoriatic arthritis status, disease severity, number of prior nonbiologic therapies used, and history of difficult-to-treat areas. A secondary analysis stratified each model by patients with PASI scores ≤2 or >2. Results: Of 848 patients included in the analysis, 323 (38.1%) switched to biologic treatment at enrollment. Significantly higher odds of switching were observed for patients reporting greater vs lesser burden on the DLQI (adjusted odds ratio [aOR] = 1.55; 95% CI, 1.08–2.23); VAS measures of itch (aOR = 2.14; 95% CI, 1.49–3.08), skin pain (aOR = 2.18; 95% CI, 1.45–3.29), fatigue (aOR = 1.66; 95% CI, 1.15–2.40), or PGA (aOR = 3.09; 95% CI, 1.94–4.91); or WPAI activities impairment (aOR = 2.51; 95% CI, 1.72–3.65). Numerically higher odds of switching were observed for greater vs lesser burden measured by EQ-5D-3L. In the secondary analysis, 52 of 330 patients with PASI scores ≤2 (15.8%) switched to biologic treatment. Among patients with PASI scores ≤2, those with greater vs lesser burden for VAS itch, skin pain, or PGA, or with impairment of their usual activities as measured by EQ-5D-3L had significantly higher odds of switching to biologic treatments. Conclusion: Data collected from real-world patients with plaque psoriasis suggest that, in addition to disease severity, patient-reported disease burden, such as itch and skin pain, may be an important driver of switching from a nonbiologic to biologic therapy, even among patients with a low degree of skin involvement. Sponsored by: CorEvitas.
引言:更好地了解银屑病的生活质量和治疗模式之间的关系可能有助于指导治疗算法。本研究评估了CorEvitas银屑病登记处登记的斑块型银屑病患者报告的疾病负担与从非生物治疗转向生物治疗之间的关系。方法:这项横断面研究包括年龄≥18岁的生物学幼稚患者,他们在2015年4月至2022年8月期间注册登记前28–365天使用了非生物系统治疗。向生物治疗的转变被定义为在入组后45天内引入生物治疗,以补充或取代最初的非生物系统治疗。在登记时收集的患者报告的疾病负担指标为:皮肤科生活质量指数(DLQI);工作生产率和活动损害指数;在视觉模拟量表(VAS)上测量的瘙痒、皮肤疼痛、疲劳和患者整体评估(PGA);以及EuroQoL 5-维度,3-水平(EQ-5D-3L)问卷。使用多变量逻辑回归模型评估每位患者报告的疾病负担测量与转向生物治疗之间的相关性,并对年龄、性别、种族、民族、工作状态、体重指数、银屑病持续时间、银屑病关节炎状态、疾病严重程度、既往使用的非生物治疗次数和难治地区病史进行了调整。二次分析按PASI评分≤2或>2的患者对每个模型进行分层。结果:在纳入分析的848名患者中,323名(38.1%)在入组时转为生物治疗。对于DLQI负担较大或较小的患者,观察到明显较高的转换几率(调整后的比值比[aOR]=1.55;95%置信区间,1.08-2.23);瘙痒(aOR=2.14;95%置信区间,1.49–3.08)、皮肤疼痛(aOR=2.18;95%可信区间,1.45–3.29)、疲劳(aOR=1.66;95%置信度,1.15–2.40)或PGA(aOR=3.09;95%置信指数,1.94–4.91)的VAS测量;或WPAI活动损伤(aOR=2.51;95%CI,1.72–3.65)。通过EQ-5D-3L测量,负荷越大,转换的几率越高。在二次分析中,330名PASI评分≤2的患者中有52名(15.8%)转为生物治疗。在PASI评分≤2的患者中,那些VAS瘙痒、皮肤疼痛或PGA负担较大或较小的患者,或通过EQ-5D-3L测量的其日常活动受损的患者,转换为生物治疗的几率显著较高。结论:从真实世界的斑块型银屑病患者中收集的数据表明,除了疾病严重程度外,患者报告的疾病负担,如瘙痒和皮肤疼痛,可能是从非生物治疗转向生物治疗的重要驱动因素,即使在皮肤受累程度较低的患者中也是如此。主办单位:CorEvitas。
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引用次数: 0
Tapinarof Cream 1% Once Daily: Disease Control Off Treatment and Minimal Disease Activity Through End of Remittive Period in a 1-year Trial Tapinarof乳膏1%每日一次:在一项为期1年的试验中,疾病控制治疗和最小疾病活动到缓解期结束
Pub Date : 2023-03-13 DOI: 10.25251/skin.7.supp.125
B. Strober, J. Zeichner, S. Desai, Michael C Cameron, J. Cather, Matthew J. Bruno, D. Rubenstein, A. Tallman, P. Brown
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引用次数: 0
Patient Perspectives on use of a water-based Calcipotriene and Betamethasone Dipropionate Cream for the treatment of Plaque Psoriasis 使用水性钙三烯和倍他米松双丙酸乳膏治疗斑块型银屑病的患者展望
Pub Date : 2023-03-13 DOI: 10.25251/skin.7.supp.127
Michael Vecchiolla, N. Bhatia
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引用次数: 0
Rapid Improvements in Itch with Tapinarof Cream 1% Once Daily in Two Phase 3 Trials in Adults with Mild to Severe Plaque Psoriasis 在成人轻度至重度斑块状银屑病的两项3期试验中,每天一次使用1%Tapinarof乳膏快速改善瘙痒
Pub Date : 2023-03-13 DOI: 10.25251/skin.7.supp.126
L. Kircik, Mathew Zirwas, S. Kwatra, M. Lewitt, H. Glover, Tomas Chao, P. Brown, D. Rubenstein, A. Tallman
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引用次数: 1
Safety of tralokinumab in pediatric patients aged 12-17 years with moderate to severe atopic dermatitis: results from the phase 3 ECZTRA 6 trial tralokinumab用于12-17岁中度至重度特应性皮炎患儿的安全性:来自3期ECZTRA 6试验的结果
Pub Date : 2023-03-13 DOI: 10.25251/skin.7.supp.140
A. Wollenberg, M. Cork, C. Flohr, A. Bewley, A. Blauvelt, C. Hong, S. Imafuku, M. Schuttelaar, E. Simpson, W. Soong, P. Amoudruz, Katja Wendicke Lophaven, A. Kurbasic, L. Soldbro, Natacha Strange Vest, A. Paller
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引用次数: 0
Linear Depigmented Macules and Patches in an Elderly Man 老年男性线状脱色斑和斑块
Pub Date : 2023-03-13 DOI: 10.25251/skin.7.2.11
Maansi Kulkarni, Sean Igelman, J. Trevino, C. Conner
The development of immune checkpoint inhibitors such as programmed cell-death receptor 1 (PD-1) antagonists has rapidly advanced chemotherapy within the last several decades. PD-1 targeted immunotherapy drugs like pembrolizumab, ipilimumab, nivolumab, and durvalumab have known associations with several immune-mediated dermatological reactions. We report a case in which an elderly male experienced segmental vitiligo after use of durvalumab therapy for small cell lung cancer. Distinct from non-segmental vitiligo, segmental vitiligo presents in a unilateral blaschkoid distribution and typically does not cross the midline. To our knowledge, checkpoint inhibitor-induced segmental vitiligo has yet to be documented.
免疫检查点抑制剂如程序性细胞死亡受体1(PD-1)拮抗剂的开发在过去几十年中迅速推进了化疗。PD-1靶向免疫治疗药物,如pembrolizumab、ipilimumab、nivolumab和durvalumab,已知与几种免疫介导的皮肤病反应有关。我们报告了一例老年男性在使用杜伐单抗治疗小细胞肺癌癌症后出现节段性白癜风的病例。与非节段性白癜风不同的是,节段性白斑呈单侧裂孔样分布,通常不越过中线。据我们所知,检查点抑制剂诱导的节段性白癜风尚待证实。
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引用次数: 0
Impact of Actinic Keratosis (AK), as measured by patient-reported AK symptoms, and impact on emotions and functioning (using Skindex-16) among patients with AK administered tirbanibulin in real-world community practices across the U.S. (PROAK Study) 光化性角化病(AK)的影响,通过患者报告的AK症状来衡量,以及在美国现实世界社区实践中使用tibanibulin的AK患者中对情绪和功能的影响(使用skinindex -16) (PROAK研究)
Pub Date : 2023-03-13 DOI: 10.25251/skin.7.supp.161
L. Kircik, T. Schlesinger, A. Armstrong, B. Berman, N. Bhatia, J. D. Del Rosso, M. Lebwohl, Vishal Patel, D. Rigel, Siva Narayanan, V. Koscielny, I. Kasujee
Introduction: Actinic Keratosis (AK) has been shown to negatively affect emotional functioning and skin-related quality of life of patients. Impact of tirbanibulin treatment on patients with AKs is not adequately understood. The primary objective of the study was to evaluate patient-reported outcomes in terms of AK symptoms, and impact of AKs on emotions and functioning, among AK patients treated with tirbanibulin in community practices across the U.S. Methods: A single-arm, prospective cohort study (PROAK) was conducted among adult patients with AK of the face or scalp who were newly initiated with tirbanibulin treatment in real-world community practices in the U.S, as part of usual care. Patients and clinicians completed surveys and clinical assessments at baseline, Week-8 (timeframe for main endpoints) and Week-24. Skindex-16, completed at baseline and Week-8, is a 16-item survey with 3 domains: symptoms (4 items), emotions (7 items) and functioning (5 items), with each domain score computed on a scale of 0 to 100 with higher score indicating severe impairment due to AKs. Changes from baseline in Skindex-16 scores were analyzed. Results: A total of 290 AK patients completed the study assessments at Week-8 (female: 31.38%; history of skin cancer: 61.72%; Fitzpatrick skin type: I: 7.59%, II: 71.38%, III: 18.62%, IV: 1.38%, V: 1.03%). Patient self-reported skin-texture was – dry: 39.66%, smooth: 47.59%, rough: 19.66%, bumpy: 18.62%, scaly: 35.17%, blistering/peeling: 6.55%. Baseline Skindex-16 domain scores were: symptoms: 22.30, emotions: 38.17, functioning: 14.41. At Week-8, a statistically significant (p<0.0001) decrease in scores from baseline was observed for all Skindex-16 domains, with Week-8 domain scores being: symptoms: 8.15, emotions: 13.49, functioning: 4.63. Conclusion: Patients with AKs who used once-daily tirbanibulin treatment for 5-days reported a significant reduction in AK burden, as indicated by the improvement in AK symptoms and emotional/functional impact, at Week-8.
引言:光化性角膜炎(AK)已被证明会对患者的情绪功能和皮肤相关的生活质量产生负面影响。替巴尼布林治疗对AKs患者的影响尚不清楚。该研究的主要目的是评估在美国各地的社区实践中接受替巴尼布林治疗的AK患者中,患者报告的AK症状的结果,以及AK对情绪和功能的影响。方法:单臂,前瞻性队列研究(PROAK)是在美国现实世界社区实践中新开始接受替巴尼布林治疗的面部或头皮AK成年患者中进行的,作为常规护理的一部分。患者和临床医生在基线、第8周(主要终点的时间框架)和第24周完成了调查和临床评估。Skindex-16在基线和第8周完成,是一项16项调查,共有3个领域:症状(4项)、情绪(7项)和功能(5项),每个领域的得分按0-100分计算,得分越高表示AKs导致的严重损伤。分析Skindex-16评分与基线相比的变化。结果:共有290名AK患者在第8周完成了研究评估(女性:31.38%;皮肤癌症病史:61.72%;Fitzpatrick皮肤类型:I型:7.59%,II型:71.38%,III型:18.62%,IV型:1.38%,V型:1.03%),起泡/剥落:6.55%。基线Skindex-16领域评分为:症状:22.30,情绪:38.17,功能:14.41。在第8周,观察到所有Skindex-16领域的得分比基线有统计学显著下降(p<0.0001),第8周领域的得分为:症状:8.15,情绪:13.49,功能:4.63。结论:在第8周,每天使用一次替巴尼布林治疗5天的AK患者报告AK负荷显著减轻,AK症状和情绪/功能影响有所改善。
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引用次数: 1
Investigator Global assessment (IGA) of Actinic Keratosis (AK) among patients administered tirbanibulin in real-world community practices across the U.S., and clinician likelihood to consider tirbanibulin again for future AK treatments (PROAK Study) 在美国各地的真实社区实践中,研究者对服用替巴尼布林的患者的光化性角化病(AK)的全球评估(IGA),以及临床医生在未来AK治疗中再次考虑替巴尼布林的可能性(PROAK研究)
Pub Date : 2023-03-13 DOI: 10.25251/skin.7.supp.162
T. Schlesinger, L. Kircik, A. Armstrong, B. Berman, N. Bhatia, J. D. Del Rosso, M. Lebwohl, Vishal Patel, D. Rigel, Siva Narayanan, V. Koscielny, I. Kasujee
Introduction: Actinic Keratosis (AK) are epidermal lesions with potential to progress to squamous cell carcinomas if left untreated. AKs have also been shown to negatively affect emotional functioning and skin-related quality of life of patients. The primary objective of the analysis was to evaluate IGA success at Week-8, and clinician-reported likelihood to consider tirbanibulin again for future treatments, among patients with AKs administered tirbanibulin in community practices across the U.S. Methods: A single-arm, prospective cohort study (PROAK) was conducted among adult patients with AKs on the face or scalp who were newly initiated with tirbanibulin treatment in real-world community practices in the U.S, as part of usual care. Patients and clinicians completed surveys and clinical assessments at baseline, Week-8 (timeframe for main endpoints) and Week-24. Clinicians assessed AK responses using an IGA on a five-point adjectival response scale of 0 (completely cleared), 1 (partially cleared), 2 (moderately cleared), 3 (minimally cleared) and 4 (not cleared). IGA success was defined as achieving an IGA score of 0 or 1 at Week-8. Clinicians also reported their likelihood to reuse tirbanibulin treatment for their patients, as a surrogate measure of satisfaction with the treatment. Results: A total of 290 AK patients completed the study assessments at Week-8 (female: 31.38%; history of skin cancer: 61.72%; Fitzpatrick skin type: I: 7.59%, II: 71.38%, III: 18.62%, IV: 1.38%, V: 1.03%). At Week-8, proportion of patients with completely/partially cleared AK (Approximately 75-100% clearance of AK lesions in the treated area, IGA 1/0) was 73.79%; moderately cleared (IGA 2) was 17.24%, and minimally cleared/not cleared (IGA 3/4) was 8.97%. Correspondingly, IGA success in this cohort of patients treated with tirbanibulin was 73.79%. Proportion of patients for whom clinicians noted that they would ‘somewhat or very likely’ consider tirbanibulin treatment again, if need arises, was 85.17%, with 7.59% reporting a neutral response, and 7.24% reporting ‘somewhat or very unlikely’ to consider treatment with tirbanibulin again. Conclusion: Overwhelming majority of patients with AK using tirbanibulin experienced IGA success at Week-8, and an overwhelming majority of clinicians reported their desire to consider tirbanibulin again to treat AK lesions for their patients.
简介:光化性角化病(AK)是一种表皮病变,如果不及时治疗,有可能发展为鳞状细胞癌。AKs也被证明会对患者的情绪功能和皮肤相关的生活质量产生负面影响。分析的主要目的是评估IGA在第8周的成功,以及临床医生报告的在美国社区实践中给予替巴布林的AKs患者在未来治疗中再次考虑使用替巴布林的可能性。方法:在美国现实世界社区实践中,作为常规护理的一部分,新开始接受替巴布林治疗的面部或头皮成年AKs患者中进行了单组前瞻性队列研究(PROAK)。患者和临床医生在基线、第8周(主要终点的时间框架)和第24周完成了调查和临床评估。临床医生使用IGA量表对AK反应进行评估,该量表分为5个形容词反应量表,0(完全清除)、1(部分清除)、2(中度清除)、3(最低清除)和4(未清除)。IGA成功定义为在第8周达到IGA评分0或1。临床医生还报告了他们对患者再次使用替巴布林治疗的可能性,作为对治疗满意度的替代衡量标准。结果:共有290例AK患者在第8周完成了研究评估(女性:31.38%;皮肤癌病史:61.72%;Fitzpatrick皮肤类型:I: 7.59%, II: 71.38%, III: 18.62%, IV: 1.38%, V: 1.03%)。在第8周,完全/部分清除AK的患者比例为73.79%(治疗区域AK病灶清除约75-100%,IGA 1/0);中度清除(IGA 2)为17.24%,轻度清除/未清除(IGA 3/4)为8.97%。相应地,在接受替巴布林治疗的患者中,IGA的成功率为73.79%。临床医生指出,如果有需要,他们“有点或很可能”再次考虑使用替巴布林治疗的患者比例为85.17%,7.59%的患者报告无反应,7.24%的患者报告“有点或很不可能”再次考虑使用替巴布林治疗。结论:绝大多数使用蒂巴尼布林的AK患者在第8周IGA治疗成功,绝大多数临床医生报告他们希望再次考虑使用蒂巴尼布林治疗AK病变。
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引用次数: 1
Quality of Information on Molluscum Contagiosum Consumer Websites 传染性软疣消费者网站的信息质量
Pub Date : 2023-03-13 DOI: 10.25251/skin.7.supp.200
Elaine S. Siegfried, Samantha Ong, J. Andres, C. Crosby, Melissa Olivadoti
{"title":"Quality of Information on Molluscum Contagiosum Consumer Websites","authors":"Elaine S. Siegfried, Samantha Ong, J. Andres, C. Crosby, Melissa Olivadoti","doi":"10.25251/skin.7.supp.200","DOIUrl":"https://doi.org/10.25251/skin.7.supp.200","url":null,"abstract":"","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42267521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Halobetasol Propionate 0.01% Lotion for Plaque Psoriasis: Epidermal Permeation, Efficacy, and Safety 0.01%丙酸盐倍他索洗剂治疗斑块型银屑病:表皮渗透性、有效性和安全性
Pub Date : 2023-03-13 DOI: 10.25251/skin.7.supp.130
L. Green, J. Bagel, G. Han, A. Jacobson, Martha Sikes
{"title":"Halobetasol Propionate 0.01% Lotion for Plaque Psoriasis: Epidermal Permeation, Efficacy, and Safety","authors":"L. Green, J. Bagel, G. Han, A. Jacobson, Martha Sikes","doi":"10.25251/skin.7.supp.130","DOIUrl":"https://doi.org/10.25251/skin.7.supp.130","url":null,"abstract":"","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48793328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Skin (Milwood, N.Y.)
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