18 research outputs found
Budget impact analysis of ustekinumab in the management of moderate to severe psoriasis in Greece
BACKGROUND: The purpose of this study was to estimate the annual and per-patient budget impact of the treatment of moderate to severe psoriasis in Greece before and after the introduction of ustekinumab. METHODS: A budget impact model was constructed from a national health system perspective to depict the clinical and economic aspects of psoriasis treatment over 5 years. The model included drug acquisition, monitoring, and administration costs for both the induction and maintenance years for patients in a treatment mix with etanercept, adalimumab, infliximab, with or without ustekinumab. It also considered the resource utilization for non-responders. Greek treatment patterns and resource utilization data were derived from 110 interviews with dermatologists conducted in February 2009 and evaluated by an expert panel of 18 key opinion leaders. Officially published sources were used to derive the unit costs. Costs of adverse events and indirect costs were excluded from the analysis. Treatment response was defined as the probability of achieving a PASI 50, PASI 75, or PASI 90 response, based on published clinical trial data. RESULTS: The inclusion of ustekinumab in the biological treatment mix for moderate to severe psoriasis is predicted to lead to total per-patient savings of €443 and €900 in years 1 and 5 of its introduction, respectively. The cost savings were attributed to reduced administration costs, reduced hospitalizations for non-responders, and improved efficacy. These results were mainly driven by the low number of administrations required with ustekinumab over a 5 year treatment period (22 for ustekinumab, compared with 272 for etanercept, 131 for adalimumab, and 36 for infliximab). CONCLUSIONS: The inclusion of ustekinumab in the treatment of moderate to severe psoriasis in Greece is anticipated to have short- and long-term health and economic benefits, both on an annual and per-patient basis.Georgia Avgerinou, Ioannis Bassukas, Georgios Chaidemenos, Andreas Katsampas, Marita Kosmadaki, Hara Kousoulakou, Athanasios Petridis, Brad Schenkel, Dimitrios Sotiriadis, Theofanis Spiliopoulos, Panagiotis Stavropoulos, Evgenia Toumpi, and Loukas Xaplanteri
Regressionsphase als therapeutisches Ziel der kryochirurgischen Behandlung wachsender kapillärer Säuglingshämangiome. Behandlungsentscheidung, Behandlungsstrategie und Ergebnisse einer offenen klinischen Stude
Regressionsphase als therapeutisches Ziel der kryochirurgischen Behandlung wachsender kapillärer Säuglingshämangiome. Behandlungsentscheidung, Behandlungsstrategie und Ergebnisse einer offenen klinischen Stude
Budget impact analysis of ustekinumab in the management of moderate to severe psoriasis in Greece
Background: The purpose of this study was to estimate the annual and per-patient budget impact of the treatment of moderate to severe psoriasis in Greece before and after the introduction of ustekinumab.Methods: A budget impact model was constructed from a national health system perspective to depict the clinical and economic aspects of psoriasis treatment over 5 years. The model included drug acquisition, monitoring, and administration costs for both the induction and maintenance years for patients in a treatment mix with etanercept, adalimumab, infliximab, with or without ustekinumab. It also considered the resource utilization for non-responders. Greek treatment patterns and resource utilization data were derived from 110 interviews with dermatologists conducted in February 2009 and evaluated by an expert panel of 18 key opinion leaders. Officially published sources were used to derive the unit costs. Costs of adverse events and indirect costs were excluded from the analysis. Treatment response was defined as the probability of achieving a PASI 50, PASI 75, or PASI 90 response, based on published clinical trial data.Results: The inclusion of ustekinumab in the biological treatment mix for moderate to severe psoriasis is predicted to lead to total per-patient savings of €443 and €900 in years 1 and 5 of its introduction, respectively. The cost savings were attributed to reduced administration costs, reduced hospitalizations for non-responders, and improved efficacy. These results were mainly driven by the low number of administrations required with ustekinumab over a 5 year treatment period (22 for ustekinumab, compared with 272 for etanercept, 131 for adalimumab, and 36 for infliximab).Conclusions: The inclusion of ustekinumab in the treatment of moderate to severe psoriasis in Greece is anticipated to have short- and long-term health and economic benefits, both on an annual and per-patient basis. © 2012 Avgerinou et al.; licensee BioMed Central Ltd
Eruptive Pseudoangiomatosis: Report of an Adult Case and Unifying Hypothesis of the Pathogenesis of Paediatric and Adult Cases
Effectiveness and safety of apremilast in biologic-naive patients with moderate psoriasis treated in routine clinical practice in Greece: the APRAISAL study
Background Apremilast is an oral phosphodiesterase-4 inhibitor indicated
for patients with moderate-to-severe chronic plaque psoriasis and active
psoriatic arthritis. Objectives To examine the effectiveness of
apremilast on Dermatology Life Quality Index (DLQI), Psoriasis Area and
Severity Index (PASI) and nail, scalp and palmoplantar involvement, when
administered prior to biologics. Methods This 52-week real-world study
included biologic-naive adults with moderate psoriasis
(psoriasis-involved body surface area 10% to <20%, or PASI 10 to <20
and DLQI 10 to <20). Apremilast was initiated <= 7 days before
enrolment. Data from the first 100 eligible patients who completed 24
weeks (W24) of observation (or were prematurely withdrawn) are presented
in this interim analysis using the last-observation-carried-forward
imputation method. Results Eligible patients (mean age: 49.9 years;
71.0% males; median disease duration: 8.0 years) were consecutively
enrolled between April and October 2017, by 18 dermatology specialists
practising in hospital outpatient settings in Greece. Baseline DLQI
(median: 12.0) and PASI (median: 11.7) scores improved (P < 0.001) at
all postbaseline timepoints (Weeks 6, 16 and 24; W24 median decreases:
9.0 and 9.4 points respectively). At W24, DLQI <= 5, DLQI 0 or 1, and
PASI-75 response rates were 63.0%, 25.0% and 48.0% respectively. The
Nail Psoriasis Severity Index score in patients with baseline nail
involvement (n = 57) decreased at all postbaseline timepoints (P <
0.001; W24 median decrease: 20.0 points). At W24, 50.0% and 51.7% of
patients with baseline scalp (n = 76) and palmoplantar (n = 29)
involvement respectively achieved postbaseline Physician’s Global
Assessment (PGA) score of 0 or 1 if baseline score was >= 3, or 0 if
baseline score was 1 or 2. The adverse drug reaction rate was 21.0%
(serious: 2.0%). Conclusions These interim results indicate that
through 24 weeks, apremilast improved quality of life and reduced
disease severity in biologic-naive patients with moderate plaque
psoriasis, while demonstrating safety consistent with the known safety
profile
Proof of concept for the clinical effects of oral rilzabrutinib, the first Bruton tyrosine kinase inhibitor for pemphigus vulgaris: the phase II BELIEVE study
Background Bruton tyrosine kinase (BTK) inhibition targets B-cell and
other non-T-cell immune cells implicated in the pathophysiology of
pemphigus, an autoimmune disease driven by anti-desmoglein
autoantibodies. Rilzabrutinib is a new reversible, covalent BTK
inhibitor demonstrating preclinical efficacy as monotherapy in canine
pemphigus foliaceus.
Objectives To evaluate the efficacy and safety of oral rilzabrutinib in
patients with pemphigus vulgaris in a multicentre, proof-of-concept,
phase II trial.
Methods Patients with Pemphigus Disease Area Index severity scores 8-45
received 12 weeks of oral rilzabrutinib 400-600 mg twice daily and 12
weeks of follow-up. Patients initially received between 0 and <= 0
center dot 5 mg kg(-1) prednisone-equivalent corticosteroid (CS; i.e.
‘low dose’), tapered after control of disease activity (CDA; no new
lesions, existing lesions healing). The primary endpoints were CDA
within 4 weeks on zero-to-low-dose CS and safety.
Results In total, 27 patients with pemphigus vulgaris were included:
nine newly diagnosed (33%) and 18 relapsing (67%); 11 had moderate
disease (41%) and 16 moderate to severe (59%). The primary endpoint,
CDA, was achieved in 14 patients (52%, 95% confidence interval 32-71):
11 using low-dose CS and three using no CS. Over 12 weeks of treatment,
mean CS doses reduced from 20 center dot 0 to 11 center dot 8 mg per day
for newly diagnosed patients and from 10 center dot 3 to 7 center dot 8
mg per day for relapsing patients. Six patients (22%) achieved complete
response by week 24, including four (15%) by week 12. Treatment-related
adverse events were mostly mild (grade 1 or 2); one patient experienced
grade 3 cellulitis.
Conclusions Rilzabrutinib alone, or with much lower CS doses than usual,
was safe, with rapid clinical activity in pemphigus vulgaris. These data
suggest that BTK inhibition may be a promising treatment strategy and
support further investigation of rilzabrutinib for the treatment of
pemphigus
A real-world, non-interventional, prospective study of the effectiveness and safety of apremilast in bio-naïve adults with moderate plaque psoriasis treated in the routine care in Greece – the ‘APRAISAL’ study
Background: Real-world data in patients with moderate psoriasis treated with apremilast is limited. Objectives: To evaluate the effectiveness and safety of apremilast in bio-naïve patients with moderate psoriasis in real-world clinical settings. Methods: This was a 52-week multicenter, observational, prospective study of adult outpatients with moderate psoriasis {[10% < body surface area < 20% or 10 < psoriasis area severity index (PASI) < 20] and 10 < dermatology quality of life index (DLQI) < 20} initiated on apremilast ≤7 days before enrollment. Missing data were imputed using the last observation carried forward method. Results: A total of 287 eligible patients (median age: 54.2 years; median psoriasis duration: 9.8 years) were consecutively enrolled. At baseline, the median DLQI and PASI scores were 12.0 and 11.8, respectively. The 52-week DLQI ≤ 5 and PASI75 response rates were 68.3% and 61.0%. At 52 weeks, 70.8% and 72.7% of the patients shifted from moderate/severe/very severe to clear/minimal scalp and palmoplantar psoriasis involvement, respectively; the pruritus severity state improved in 67.2%. The 52-week Kaplan–Meier estimated drug continuation rate was 85.3%. The adverse drug reaction rate was 19.9%. Conclusions: Apremilast is a safe and effective treatment for bio-naïve patients with moderate psoriasis and specific psoriasis manifestations. © 2022 European Academy of Dermatology and Venereology