The long-term efficacy and safety of new biological therapies for psoriasis

Long-term therapy is often required for psoriasis. This article reviews the most recent long-term clinical data for biological agents that have been approved or for which late-stage development data have been released for the treatment of patients with moderate to severe plaque psoriasis. Efficacy data are available for up to five 12-week courses of alefacept (approximately 60 weeks of therapy), 36 months (144 weeks) of continuous efalizumab, 48 weeks of continuous etanercept, and 50 weeks of bimonthly infliximab. Data sources include publications, product labeling, and posters presented at recent international scientific meetings. Alefacept appears to continue to be efficacious over multiple treatment courses for some responsive patients. The efficacy of efalizumab achieved during the first 12–24 weeks of therapy appears to be maintained or improved through at least 60 weeks of continuous treatment. The efficacy of etanercept appears to be maintained through at least 48 weeks of continuous treatment. Infliximab demonstrates a high response rate soon after initiation, which appears to be maintained through 24 weeks but declines modestly with therapy out to 50 weeks. After 48 weeks, approximately 60% of efalizumab-treated and 45% of etanercept-treated patients remaining on therapy achieved ≥75% improvement from baseline in Psoriasis Area and Severity Index, as did 70.5% of infliximab patients who did not miss more than two infusions. Safety data suggest that these agents may be used for long-term administration. Long-term data from psoriasis trials continue to accumulate. Recent data suggest that biological therapies have efficacy and safety profiles suitable for the long-term treatment of patients with moderate to severe psoriasis

Gene Expression Profiles Characterize Inflammation Stages in the Acute Lung Injury in Mice

Acute Lung Injury (ALI) carries about 50 percent mortality and is frequently associated with an infection (sepsis). Life-support treatment with mechanical ventilation rescues many patients, although superimposed infection or multiple organ failure can result in death. The outcome of a patient developing sepsis depends on two factors: the infection and the pre-existing inflammation. In this study, we described each stage of the inflammation process using a transcriptional approach and an animal model. Female C57BL6/J mice received an intravenous oleic acid injection to induce an acute lung injury (ALI). Lung expression patterns were analyzed using a 9900 cDNA mouse microarray (MUSV29K). Our gene-expression analysis revealed marked changes in the immune and inflammatory response metabolic pathways, notably lipid metabolism and transcription. The early stage (1 hour–1.5 hours) is characterized by a pro-inflammatory immune response. Later (3 hours–4 hours), the immune cells migrate into inflamed tissues through interaction with vascular endothelial cells. Finally, at late stages of lung inflammation (18 hours–24 hours), metabolism is deeply disturbed. Highly expressed pro-inflammatory cytokines activate transcription of many genes and lipid metabolism. In this study, we described a global overview of critical events occurring during lung inflammation which is essential to understand infectious pathologies such as sepsis where inflammation and infection are intertwined. Based on these data, it becomes possible to isolate the impact of a pathogen at the transcriptional level from the global gene expression modifications resulting from the infection associated with the inflammation

Validity and Reliability of the Dutch Adaptation of the Psoriatic Arthritis Quality of Life (PsAQoL) Questionnaire

<p>Objective: The Psoriatic Arthritis Quality of Life (PsAQoL) questionnaire is a disease-specific instrument developed to measure quality of life (QoL) in patients with psoriatic arthritis (PsA). The aim of this study was to translate the measure into Dutch and to determine its psychometric properties.</p><p>Method: Translation of the original English PsAQoL into Dutch was performed by bilingual and lay panel. Ten field-test interviews with PsA patients were performed to assess face and content validity. In total, 211 PsA patients were included in a test-retest postal survey to investigate the reliability and construct validity of the Dutch adaptation of the PsAQoL. The PsAQoL, Health Assessment Questionnaire (HAQ) and Skindex-17 were administered on two different occasions approximately two weeks apart.</p><p>Results: The Dutch version of the PsAQoL was found to be relevant, understandable and easy to complete in only a few minutes. It correlated as expected with the HAQ (Spearman's rho = 0.72) and the 2 subscales of the Skindex-17 (rho = 0.40 for the psychosocial and rho = 0.46 for the symptom scale). Furthermore, the measure had good internal consistency (Cronbach's alpha = 0.92) and test-retest reliability (rho = 0.89). The PsAQoL was able to define groups of patients based on self-reported general health status, self-reported severity of PsA and flare of arthritis. Duration of PsA did not influence PsAQoL scores.</p><p>Conclusions: The Dutch version of the PsAQoL is a valid and reliable questionnaire suitable for use in clinical or research settings to asses PsA-specific QoL.</p>

Peer To Peer lending in Sweden : A comparative study between bank lending and Peer To Peer lending in the Swedish consumer credit market

Background: Peer to peer lending has in recent years emerged and become a popular way to borrow money, mostly in the US and the UK. Since the first company was established in 2005, several competitors have emerged, and P2P lending has grown on average by 84 % quarterly between the second quarter year 2007 and the second quarter year 2014 in the US. Lending Club, which is the largest player within P2P-lending, has since its start in 2008 carried loans of a total value of six billions USD. Aim: The purpose of the study is to identify and analyze P2P lending and its preconditions to operate on the Swedish consumer credit market. Completion: A qualitative approach was selected where the empirical data partly consist of primary data collected through interviews and partly of secondary data in the form of a literature study on P2P lending. The empirical data lays ground for a comparative institutional analysis in which the transaction costs of P2P lending is compared to traditional bank lending. Conclusion: The study shows that P2P lending in Sweden have higher transaction costs than traditional bank lending. The main reason for this is the uncertainty associated with P2P lending in the current situation. However, the study shows that P2P lending through technological innovation can maintain lower transaction costs in the assessment of a specific borrower's repayment capacity. For the concept to grow, society’s knowledge about P2P lending needs to increase and the legal framework needs to be more clearly defined.Bakgrund: Peer to peer-utlåning har under de senaste åren vuxit fram och blivit ett populärt sätt att låna på, främst i USA och Storbritannien. Sedan den första aktören grundades år 2005 har flera aktörer vuxit fram och i USA har P2P-utlåningen vuxit med 84 % per kvartal i snitt mellan andra kvartalet år 2007 och andra kvartalet år 2014. Lending Club, som är den största aktören inom P2P-utlåning, har sedan starten år 2008 förmedlat lån till ett värde av totalt 6 miljarder USD. Syfte: Studiens syfte är att kartlägga och analysera P2P-utlåning och dess förutsättningar att bedriva verksamhet på den svenska konsumentkreditmarknaden. Genomförande: Ett kvalitativt tillvägagångssätt har valts där empirin dels består av primärdata som insamlats genom intervjuer och dels av sekundärdata i form av en litteraturstudie på P2P-utlåning. Empirin ligger till grund för en komparativ institutionell analys där transaktionskostnaderna för utlåning genom P2P jämförs med traditionell bankutlåning. Slutsats: Studien visar på att P2P-utlåning håller högre transaktionskostnader än traditionell bankutlåning. Den största anledningen till detta är den osäkerhet som är förknippad med P2P-utlåning i dagsläget. Dock visar studien på att P2P-utlåning, genom teknologisk innovation, kan hålla lägre transaktionskostnader i bedömningen av en specifik låntagares återbetalningsförmåga. För att konceptet ska växa krävs det att den allmänna kunskapen om P2P-utlåning ökar, samt att regelverket under vilket P2P-aktörerna verkar blir tydligare definierat