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

BMC Public Health

BACKGROUND: In 2009, the World Health Organization's Commission on Social Determinants of Health set out its recommendations for action, which included establishing equity from early childhood onwards by enabling all children and their mothers to benefit from a comprehensive package of quality programmes. In order to address social inequalities in health, it is recommended that action be taken from early childhood, and actions providing support for parenting are an effective lever in this respect. The aim of this review of systematic reviews is to analyse, on the one hand, the components and characteristics of effective interventions in parenting support and, on the other, the extent to which the reviews took into account social inequalities in health. METHODS: A total of 796 reviews were selected from peer-reviewed journals published between 2009 and 2016 in French or English. Of these, 21 reviews responding to the AMSTAR and selected ROBIS criteria were retained. These were analysed in relation to the consideration they gave to social inequalities in health according to PRISMA-equity. RESULTS: The reviews confirmed that parenting support programmes improved infants' sleep, increased mothers' self-esteem and reduced mothers' anger, anxiety and stress levels. The mainly authors noted that the contexts in which the interventions had taken place were described either scantly or not at all, making it difficult to evaluate them. Only half of the reviews had addressed the question of social inequalities in health. In particular, there had been little research conducted on the relational aspect and the social link. CONCLUSION: In terms of addressing social inequalities in perinatal health, the approach remains both modest and reductive. Understanding how, for whom and in what conditions interventions operate is one way of optimising their results. Further research is needed to study the interactions between the interventions and their contexts

Automatic Code generation for Interconnected distributed RAM in the AAA Methodology: H264 Motion Estimation Case Study

New video compression standard achieves high compression rates at the cost of a high encoder complexity. High definition context magnifies the difficulty of a real-time embedded implementation. Programmable multicomponent architectures can provide suitable target solutions combining flexibility and computation power. New architectures are designed to use up to 70 processors in a single equipment to address such an application. The result is that a fast and automatic prototyping methodology cannot be ignored for an optimized application development. This paper presents the methodology to automatically generate a distributed implementation of an application over such a multiprocessor platform from a high level application description. The methodology is adapted to handle interconnected distributed RAM media and illustrated in the context of a H264 coding application. The encoder performances are greatly linked to the motion estimation which can reach 60% of the computation load. A multiprocessor implantation of a motion estimation operation is presented

Building a scale for measuring burden of hand eczema: BoHEM

International audienc

<p>Individual Burden of Psoriasis (I-BOP): Building and Validation of a New Scoring Tool for Patients with Psoriasis</p>

International audienceBackground: Psoriasis impacts independently of its severity on patients' lifestyle and quality of life (QoL).Aim: To build a tool for assessing the patient-reported psoriasis burden.Methods: An expert group created a questionnaire using a standardized methodology building questionnaires assessing quality of life issues. The questionnaire was translated from French into a cultural and linguistically validated US English version.Results: A conceptual questionnaire of 54 questions was created. The confirmatory analyses resulted in a 10-feature questionnaire divided into 4 internally consistent domains with a Cronbach's alpha coefficient of 0.9. It was reproducible and highly reliable. It correlated well with the Dermatology Life Quality Index (DLQI), Perceived Stress Scale (PSS), and SF-12 mental and SF12 physical scores.Conclusion: This tool allows for the first time to assess the burden of psoriasis patients. Its use may allow improving medical and nonmedical patient care, thus improving their daily life

Effectiveness and short-term (16-week) tolerance of guselkumab for psoriasis under real-life conditions: a retrospective multicenter study.

Guselkumab (Tremfya , Janssen Biotech, Inc., Horsham, PA, USA) is an anti-IL-23 p19 antibody, recently marketed for the management of moderate to severe psoriasis in adults. To date, there are only limited post-marketing data available on its effectiveness and tolerance. A retrospective, real-life multicenter study conducted in France and Belgium evaluated guselkumab tolerance and effectiveness at Month 4 (M4) in the treatment of cutaneous psoriasis, and to describe patient characteristics at baseline and after 4 months of treatment. Collected data included socio-demographic characteristics, psoriasis history (age at beginning, clinical type, associated psoriatic arthritis, previous treatments), comorbidities, psoriasis severity at beginning of treatment (PASI, PGA, DLQI) as well as about tolerance. A total of 194 patients were included; data was analyzed for 180 (14 were excluded due to missing PASI at inclusion or at M4)

Prescriptions hors AMM (autorisation de mise sur le marché) dans le psoriasis de l'enfant

International audienceIntroduction: Psoriasis affects 0.5% of children in Europe, with moderate to severe clinical forms in 15–35% of cases warranting the use of systemic treatments. Few treatments are licensed for childhood psoriasis. In this study, we analyzed the frequency of such prescriptions. Materials and methods: Our study was based on 3 retrospective cohort trials conducted in France between 2012 and 2018: χ-Psocar (313 children with psoriasis seen in hospitals), PsoLib (207 children seen in a private practice), and BiPe (134 children on biotherapies). Our evaluation was centered on off-label use. To avoid duplicates between cohorts, analysis focused on each cohort independently. Results: In the χ-Psocar study, in 34.8% of cases, use of at least one off-label treatment, mainly topical vitamin D (36.0%), and systemic treatments (methotrexate and cyclosporine) was noted, on account of either the clinical type of psoriasis (13.7%) or patient age (24.6%). In the PsoLib study, in 41.5% of cases, at least one off-label treatment was noted, mainly combined calcipotriol-betamethasone (24.2%), ciclopirox shampoo (7.2%) and systemic treatments (n = 20). The main reason was patient age (41.5%). In the BiPe study, in 97.0% of cases, at least one off-label treatment was noted. These prescriptions mainly concerned a combination of calcipotriol-betamethasone (68.7%) and tacrolimus (11.2%) along with systemic treatment comprising methotrexate, cyclosporin, methoxsalen or apremilast (n = 125), but also biotherapies (n = 85). The biotherapies were used off-label since at that time they had not yet been granted marketing authorisation. Discussion: This study focused on 3 cohorts of children with psoriasis seen either in private practice or in a hospital setting, and it involved all types of treatment. Off-label prescriptions ranged from one-third to almost 100% of the children, depending on the individual cohorts. The prescribed drugs were topical treatments, conventional systemic drugs and biotherapies. Off-label prescription is not strictly prohibited in France provided it is within a well-defined regulatory framework. Where there is a rich bibliography, confident recommendations may be made. Unfortunately, in childhood psoriasis, the literature and recommendations are very limited, leaving prescribers with considerable individual responsibilities. Review of the license concerning children with psoriasis, a push to conduct therapeutic studies and the drafting of recommendations all appear necessary

Development of monoclonal gammopathy under biotherapy in psoriasis: a French multicenter retrospective study.

International audienceBACKGROUND:Biotherapies or targeted therapies are fairly new treatments indicated for moderate to severe psoriasis. The side effects appear to be mainly infectious or cancerous. The role of biotherapies in the development of a pre-cancerous condition, monoclonal gammopathy of undetermined significance (MGUS), has recently been debated in the literature.OBJECTIVES:To evaluate the incidence of MGUS in psoriasis patients treated with biotherapy.MATERIALS AND METHODS:This study was a French multicenter retrospective study carried out through the French multicenter study group RESOPSO. Data on the results of serum protein electrophoreses performed before and within at least six months after the start of the biotherapy were collected. Demographic data, medical history, and psoriasis treatment history were specified.RESULTS:Four hundred and forty three patients were eligible for inclusion. Of these, three presented with monoclonal gammopathy for which the assessment was in favor of MGUS. The average treatment period was 19.7 months. Six patients presented with MGUS prior to the treatment. These patients' immunoglobulin levels remained stable, with an average remission of 24 months. Only psoriatic rheumatism appeared to be statistically linked to MGUS.CONCLUSION:The incidence and frequency of MGUS in psoriasis patients treated with biotherapy do not appear to increase relative to the general population

Impact on disease mortality of clinical, biological, and virological characteristics at hospital admission and overtime in COVID‐19 patients

International audienc