Long-term topical management of psoriasis: the road ahead

AbstractTopical therapies have been available for the treatment of psoriasis for several decades. Despite this and the availability of several types of topicals, with varying potency, and numerous ..

Impact of Baricitinib on Patients’ Quality of Life after One Year of Treatment for Atopic Dermatitis in Real-World Practice: Results of the Observatory of Chronic Inflammatory Skin Diseases Registry

The efficacy and safety of baricitinib for treatment of atopic dermatitis have been demonstrated in clinical trials; however, very few real-life studies have been published to date. The Observatory of Chronic Inflammatory Skin Diseases (OMCCI) registry was initiated to prospectively determine the long-term impairment caused by chronic inflammatory dermatoses on patients’ lives. The study included 88 patients starting baricitinib for treatment of atopic dermatitis. Clinical evaluation and patient-reported outcomes were recorded at baseline and after 6 and 12 months. After 6 months and 1 year of follow-up, 65 and 47 patients, respectively, were still being treated with baricitinib. Treatment failure was the main reason for discontinuation. Only 1 patient stopped baricitinib because of a side-effect. After 1 year of follow-up, the mean Eczema Area and Severity Index score decreased significantly from 20.7 to 6.4; the percentage of patients with severe atopic dermatitis decreased from 42.9% to 6.5% and a significant improvement in most patient-reported outcomes was noted. There was no difference in terms of efficacy whether or not patients were previously treated with dupilumab. The results remained stable after 6 and 12 months of treatment, which suggests a sustained efficacy of the treatment in patients who initially responded well

26607 Proactive management using Cal/BD foam in patients with plaque psoriasis prolongs time with a health-related quality of life improvement, compared with reactive management

Introduction: The Phase III PSO-LONG study (NCT02899962) showed that proactive (PM) vs reactive management (RM) using calcipotriene 0.005%/betamethasone dipropionate 0.064% (Cal/BD) foam for up to 52 weeks in adults with psoriasis, resulted in superior efficacy. The patient-reported outcome measure Dermatology Life Quality Index (DLQI) evaluates patient-perception of psoriasis on health-related quality of life (HRQoL). In this post hoc analysis of PSO-LONG we evaluate whether initial DLQI responses, obtained following open-label Cal/BD foam treatment, were better sustained using subsequent PM or RM. Methods: PSO-LONG included an initial 4-week open-label phase (OLP) (once-daily Cal/BD foam) and a 52-week, double-blind, maintenance phase (MP) where patients were randomized to twice-weekly Cal/BD or vehicle foam (PM or RM, respectively), with 4-weeks once-daily Cal/BD foam rescue treatment for relapse (Physician’s Global Assessment [PGA] ≥2). The proportion of patients achieving DLQI = 0/1 following OLP was assessed during MP to evaluate how long patients sustained initially gained responses. Survival analysis curves and hazard ratios (HR) for time with response in each group, were evaluated. Results: The analysis included 521 patients with predominantly PGA-moderate psoriasis (85.2%). During OLP, 49% of patients achieved DLQI = 0/1. During MP, RM vs PM was associated with almost double the risk (hazard) of losing DLQI = 0/1 (HR: 1.92; P ˂.001) and median time to lost response was almost 3.5 times shorter (57 vs 197 days, respectively). Conclusion: In a subset of patients achieving a DLQI = 0/1 HRQoL response following initial open-label Cal/BD foam, subsequent PM with Cal/BD foam significantly prolonged time with DLQI response vs RM