Can artificial intelligence be used for accurate remote scoring of the Psoriasis Area and Severity Index (PASI) in adult patients with plaque psoriasis? A Critically Appraised Topic

2021 ◽  
Author(s):  
M. Brito ◽  
B.R. Stevens ◽  
Z.Z.N. Yiu
Keyword(s):  
Artificial Intelligence ◽  
Plaque Psoriasis ◽  
Severity Index ◽  
Adult Patients

Pilot Study to Evaluate the Efficacy and Safety of Oral Tacrolimus in Adult Patients With Refractory Severe Plaque Psoriasis

2015 ◽  
Vol 20 (3) ◽  
pp. 228-232 ◽  
Author(s):  
Ankit Mittal ◽  
Sunil Dogra ◽  
Tarun Narang ◽  
Aman Sharma
Keyword(s):  
Pilot Study ◽  
Plaque Psoriasis ◽  
Severity Index ◽  
Term Treatment ◽  
Adult Patients ◽  
Efficacy And Safety ◽  
Open Label ◽  
Short Term Treatment ◽  
Psoriasis Area Severity Index ◽  
Severe Plaque Psoriasis

Background: Tacrolimus, a congener of cyclosporine, has replaced cyclosporine as a first-line treatment for most transplant patients due to its superior efficacy and safety. Tacrolimus has not been extensively studied for the treatment of psoriasis. Objectives: To study the efficacy and safety of oral tacrolimus in adult patients with severe refractory plaque psoriasis. Methods: This was an open-label pilot study. Patients with severe plaque type psoriasis who were unresponsive to at least 1 systemic treatment were treated with oral tacrolimus. Results: Thirty patients were treated. After 12 weeks, improvement in mean Psoriasis Area Severity Index (PASI) score was 80.37% ( P < .001), PASI 75 was observed in 19 of 26 (73.1%) patients, and PASI 90 was observed in 11 of 26 (42.3%) patients. No severe side effects were noted. Conclusion: Oral tacrolimus is an effective and safe option for the short-term treatment of severe plaque psoriasis.

Pharmacoeconomic analysis of using genetically engineered biologic drugs for treating adult patients with moderate to severe plaque psoriasis in the Russian Federation

2020 ◽  
pp. 57-65
Author(s):  
Maksim Frolov ◽  
Vladimir Rogov ◽  
Alla Salasyuk
Keyword(s):  
Plaque Psoriasis ◽  
Impact Analysis ◽  
Pharmacoeconomic Analysis ◽  
Certolizumab Pegol ◽  
Genetically Engineered ◽  
Adult Patients ◽  
Comparable Efficacy ◽  
Biologic Drugs ◽  
Severe Plaque Psoriasis ◽  
Cost Minimisation Analysis

The aim of the study was to assess clinical and economic effectiveness of netakimab compared to other genetically engineered biologic drugs (infliximab, adalimumab, etanercept, ustekinumab, secukinumab, ixekizumab, certolizumab pegol) for the treatment of adult patients with moderate to severe plaque psoriasis. We have conducted cost-benefit analysis, cost-minimisation analysis, and budget impact analysis. We have considered only direct medical costs. The results of the study show that netakimab has higher or comparable efficacy and significantly lower costs compared to other biologic drugs, that makes it the most preferable treatment option for patients with moderate to severe plaque psoriasis. Use of netakimab in clinical practice will significantly reduce budget expenditures and increase patient access to biologic therapy.

VALIDATION OF QUICK COVID SEVERITY INDEX IN COVID PATIENTS ADMITTED THROUGH EMERGENCY DEPARTMENT OF A PRIVATE TERTIARY CARE HOSPITAL IN WEST BENGAL, INDIA

2021 ◽  
pp. 53-55
Author(s):  
Harsimran Singh Das
Keyword(s):  
Emergency Department ◽  
Respiratory Failure ◽  
Tertiary Care Hospital ◽  
Clinical Status ◽  
Tertiary Care ◽  
Severity Index ◽  
Adult Patients ◽  
Care Hospital ◽  
Oxygen Requirement ◽  
Clinical Tool

Introduction:qCSI (Quick COVID severity index) is a clinical tool established recently post pandemic to predict respiratory failure within 24 hours of admission in COVID-19 patients; respiratory failure being explain as increased oxygen requirement greater than 6L/min by low ow device, high ow device, noninvasive or invasive ventilation to maintain spO2 of greater than or equal to 94%, or death. Aim:To verify and validate the application of the qCSI in Emergency Department in Indian demographic for evidence-based guidance to aid physician decision making in safely dispositioning adult patients with COVID-19 with oxygen requirement less than or equal to 6L/min via low ow devices including nasal cannula and oxygen mask Materials and methods:This is an observational, retrospective study from Emergency Department in a private tertiary care hospital of admitted adult patients with COVID-19 disease. Clinical parameters in qCSI and disposition of 210 patients admitted through Emergency Department included in this study selected randomly was sought on admission and clinical status with level of care 24 hours following admission was recorded and compared with prediction based on qCSI from a period of 1 May 2020 to 31 October 2020. Result:We found that19(9.0%) patients Initial qCSI Score was Low, 80(38.1%) patients Initial qCSI Score was Low-intermediate, 84(40.0%) patients Initial qCSI Score was High-intermediate and 27(12.9%)patients Initial qCSI Score was High.qCSI Score after 24 hours 16(11.4%) patients were Low, 43(30.7%) patients were Low-intermediate, 63(45.0%) patients was High-intermediate and 18(12.9%) patients was High.Out of 210(100.0%) patients, 70 (33.3%) patients were critically ill. Conclusion:In conclusion these data show that the quick COVID-19 Severity Index provides easily accessed risk stratication relevant to Emergency Department provider.

PS-026 Relative safety of biological drugs in the maintenance phase in adult patients with moderate to severe plaque psoriasis

2014 ◽  
Vol 21 (Suppl 1) ◽  
pp. A154.1-A154
Author(s):  
M Galván-Banqueri ◽  
A Castillo-Muñoz ◽  
R Ubago-Pérez ◽  
L Abdel-Kader Martín ◽  
C Beltrán-Calvo ◽  
...  
Keyword(s):  
Plaque Psoriasis ◽  
Maintenance Phase ◽  
Adult Patients ◽  
Biological Drugs ◽  
Severe Plaque Psoriasis ◽  
Relative Safety

Efficacy of Brodalumab for Moderate to Severe Plaque Psoriasis: A Canadian Network Meta-Analysis

2020 ◽  
Vol 24 (6) ◽  
pp. 561-572
Author(s):  
Weiguang Xue ◽  
Paranjoy Saharia ◽  
Emma Gray ◽  
Shoghag Khoudigian-Sinani ◽  
Véronique Gaudet ◽  
...  
Keyword(s):  
Relative Risk ◽  
Plaque Psoriasis ◽  
Meta Analysis ◽  
Credible Interval ◽  
Severity Index ◽  
Biologic Agents ◽  
Sensitivity Analyses ◽  
Induction Phase ◽  
Significant Heterogeneity ◽  
Severe Plaque Psoriasis

Background Several treatments for plaque psoriasis are available, but it remains challenging for physicians to make informed treatment decisions due to a lack of head-to-head trials. Objectives This network meta-analysis (NMA) compares the efficacy of brodalumab to other biologic agents in Canada for moderate-to-severe plaque psoriasis. Methods A systematic literature review of randomized controlled trials (RCTs) published before October 2017 was conducted to populate the NMA. Comparators included etanercept, infliximab, adalimumab, ustekinumab, secukinumab, ixekizumab, guselkumab, and placebo. The primary outcome was the psoriasis area and severity index (PASI) response at the end of induction phase. A random effects Bayesian multinomial likelihood and probit link model analyzed PASI 75, 90, and 100 responses. Inconsistency and heterogeneity were assessed. Sensitivity analyses were conducted to explore potential effect modifiers like baseline PASI score, age, and weight. Results A total of 43 RCTs were included. Brodalumab 210 mg had significantly better PASI response than etanercept, ustekinumab, adalimumab, secukinumab, and guselkumab and comparable responses to infliximab and ixekizumab. Relative risk of PASI 90 response for brodalumab varied from 2.84 (95% credible interval [CrI]: 2.35-3.52, P < .05) to 0.99 (95% CrI: 0.88-1.11, ns) compared to etanercept and ixekizumab. This was similar across PASI 75 responses, but a larger relative risk between brodalumab and all comparators except ixekizumab was observed for PASI 100. No significant heterogeneity or inconsistencies were identified. The results were consistent across sensitivity analyses, indicating robustness of the results. Conclusion Brodalumab 210 mg has efficacy superior to most biologic agents for moderate-to-severe plaque psoriasis in Canada.

Risankizumab for the Treatment of Moderate to Severe Plaque Psoriasis

2019 ◽  
Vol 54 (4) ◽  
pp. 380-387 ◽  
Author(s):  
Wendy Li ◽  
Rima Ghamrawi ◽  
Wasim Haidari ◽  
Steven R. Feldman
Keyword(s):  
Clinical Trials ◽  
Phase Ii ◽  
Plaque Psoriasis ◽  
Data Extraction ◽  
Severity Index ◽  
Phase Iii ◽  
Cochrane Library ◽  
Severe Plaque Psoriasis ◽  
Phase Iii Clinical Trials ◽  
Interleukin 23

Objective: Risankizumab (Skyrizi), an interleukin-23 (IL-23) antagonist, was approved by the Food and Drug Administration (FDA) for the treatment of moderate to severe plaque psoriasis in April 2019. This article will review phase II and III clinical trials to assess the efficacy, safety, and clinical application of this drug. Data Sources: A systematic literature review was performed using the terms “psoriasis AND risankizumab” in the OVID MEDLINE, PubMed, Cochrane Library, EMBASE, and Web of Science databases. ClinicalTrials.gov was searched to identify ongoing or nonpublished studies. Study Selection and Data Extraction: Articles written in English between January 2000 and October 2019 discussing phase II and phase III clinical trials were evaluated. Data Synthesis: By the primary end point at week 16 in phase III trials, more patients achieved Psoriasis Area and Severity Index 90 receiving 150 mg risankizumab (72%-75%) compared with placebo (2.0%-4.9%, P < 0.001), 45 or 90 mg ustekinumab (42.0%-48%, P < 0.0001), and 40 mg adalimumab (47%, P < 0.0001). More patients achieved a static Physician’s Global Assessment score of 0 or 1 receiving 150 mg risankizumab (84%-88%) compared with placebo (5.1%-7.8%, P < 0.001), 45 or 90 mg ustekinumab (62%-63%, P < 0.0001), and 40 mg adalimumab (60%, P < 0.0001). Risankizumab was well tolerated across all studies. Conclusion: Risankizumab is a newly FDA-approved IL-23 inhibitor that shows particular promise in the treatment of plaque psoriasis. Based on this review, it is an effective and safe addition to the armamentarium of biologics that are currently available.

scholarly journals Superiority of a vitamin B12-containing emollient compared to a standard emollient in the maintenance treatment of mild-to-moderate plaque psoriasis

2017 ◽  
Vol 30 (4) ◽  
pp. 439-444 ◽  
Author(s):  
Ester Del Duca ◽  
Francesca Farnetani ◽  
Nathalie De Carvalho ◽  
Ugo Bottoni ◽  
Giovanni Pellacani ◽  
...  
Keyword(s):  
Plaque Psoriasis ◽  
Severity Index ◽  
Vitamin B ◽  
Psoriasis Area Severity Index ◽  
Wide Range ◽  
Significant Difference ◽  
Therapy Option ◽  
The Difference ◽  
Time Point ◽  
Emollient Cream

Psoriasis is a chronic inflammatory skin disease affecting 2%–3% of the population. The wide range of drugs currently available for its treatment could be associated, in the long term, with organ toxicity and adverse events, thus, clinical monitoring throughout treatment is required. This investigator-initiated trial (IIT) evaluated the efficacy and the safety of a vitamin B12-containing ointment in comparison with glycerol-petrolatum-based emollient cream used twice a day to treat mild-to-moderate plaque psoriasis for a period over 12 weeks followed by a wash-out observation period of 4 weeks. This study was conducted as a randomized, controlled, single-blind, intra-patient left- to right-side trial comparing the efficacy and safety of vitamin B12-containing ointment (M-treatment) with a glycerol-petrolatum-based emollient cream (C-treatment). The Psoriasis Area Severity Index (PASI) was determined at baseline (T0), at time points T2 (14 days), T4 (4 weeks), T8 (8 weeks), T12 (12 weeks) and 4 weeks after the end of the wash-out period (F1). In total, 24 patients with plaque psoriasis were randomized to receive left- or right-side treatment with B12 ointment. From time point T2 to time point F1, there was a statistically significant difference in PASI reduction between M-treatment side and C-treatment side. At time point T 12, the difference between the mean reductions from baseline PASI scores by 5.92 ± 2.49 (87, 6%) in the M-treatment side versus 1.08 ± 1.02 (23, 1%) C-treatment side was statistically highly significant ( PWex < 0.001). On the contemporary panorama in the treatment of psoriasis, we conclude that vitamin B12 ointment will represent a new concrete therapy option and should be considered in the update of therapeutic algorithm for the treatment of psoriasis

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