Abstract not available. Disclosures: Study sponsored by LEO Pharma. Copyright 2018 SKIN

Purpose: To evaluate the relative efficacy of brodalumab compared with approved biologic therapies and apremilast for moderate-to-severe psoriasis.Methods: We searched MEDLINE, Embase, and Cochrane for randomized controlled trials reporting induction phase responses. The primary analysis examined the proportion of patients achieving Psoriasis Area Severity Index (PASI) 50, 75, 90, or 100 responses using a random-effects Bayesian multinomial likelihood model with probit link, with and without adjustment for variation in study-level placebo responses.Results: A total of 54 studies were included. Based on PASI 100 response, the most efficacious therapies were brodalumab 210 mg every two weeks (Q2W) and ixekizumab. Brodalumab 210 mg Q2W was significantly more efficacious than adalimumab, apremilast, brodalumab 140 mg Q2W, etanercept, infliximab, secukinumab, and ustekinumab. Results were consistent for PASI 50, 75, and 90 outcomes and all sensitivity analyses.Conclusions: Our findings are consistent with pivotal trials which indicate that high levels of complete clearance can be achieved with brodalumab. Based on existing evidence, induction-phase efficacy of brodalumab is similar to ixekizumab and superior to other approved therapies, including anti-TNFs, apremilast, secukinumab, and ustekinumab.

Health-related quality of life (HRQoL) measures provide patient-centred evaluations of response to treatment. In the 12-week, Phase III PSO-ABLE study, fixed-combination calcipotriol 50 μg/g as hydrate (Cal) plus betamethasone 0.5 mg/g as dipropionate (BD) aerosol foam was significantly more effective for the treatment of psoriasis than Cal/BD gel.

Fixed-combination calcipotriol 50 μg/g plus betamethasone 0.5 mg/g (Cal/BD) aerosol foam is a new topical treatment for psoriasis. Although moderate-to-severe psoriasis is typically treated with systemic/biologic therapies, a topical treatment that is efficacious in these patients may be a significant cost-saving alternative to systemic therapy.

INTRODUCTION:Psoriasis has a major impact on patient quality of life, similar to that seen in other chronic diseases, eg, diabetes. Health-related quality of life (HRQoL) measures are commonly included in clinical trial designs, capturing the disease burden and therapeutic success of a treatment. In the randomized, double-blind, phase III PSO-FAST (Psoriasis vulgaris, a Four-week, vehicle-controlled, efficacy And Safety Trial) study (nCT01866163), fixed combination calcipotriene (Cal) 0.005% plus betamethasone dipropionate (BD) 0.064% aerosol foam was compared with vehicle. By treatment end, 53% of patients using Cal/BD foam achieved treatment success.OBJECTIVE:To compare the impact on HRQoL of Cal/BD foam vs vehicle in patients with mild-to-severe psoriasis.METHOD:HRQoL was assessed by dermatology life-quality index (DLQI; baseline, weeks 1, 2, 4) and EQ-5D-5L (EQ-5D; baseline, week 4) questionnaires. A DLQI score of 0 (range, 0-30) indicates no effect on the patient's life; an EQ-5D utility score of 1 (range, 0-1) and an EQ-5D visual analog scale (VAS) score of 100 (range, 1-100) indicate perfect health.RESULTS:426 patients were randomized (Cal/BD foam, n=323; vehicle, n=103). Baseline mean DLQI scores were 9.9 (Cal/BD foam) and 10.3 (vehicle). The impact of psoriasis on HRQoL (EQ-5D utility score) at baseline was primarily driven by pain/discomfort (Cal/BD foam: 69.9%; vehicle: 65.0%) and anxiety/depression (Cal/BD foam: 45.3%; vehicle 44.7%). There was a greater improvement from baseline in DLQI score for Cal/BD foam vs vehicle at week 4 (-7.0 vs -4.4; P<.001); increased improvement was also seen in EQ-5D scores. At week 4, 48.1% of patients using Cal/BD foam reported no effect of psoriasis on their lives (DLQI = 0/1), and of patients using Cal/BD foam with baseline DLQI scores ≥5, 81.2% achieved a ≥5-point improvement.CONCLUSION:Cal/BD aerosol foam improved HRQoL after 4 weeks, with most patients experiencing a clinically meaningful improvement and almost 50% reporting no impairment.J Drugs Dermatol. 2016;15(8):981-987.

BACKGROUND:Psoriasis is a chronic, immune-mediated dermatological disease associated with substantial economic, clinical, and humanistic burden.OBJECTIVE:The aim of this study was to understand the disutility of patients with psoriasis vulgaris, using mean baseline EuroQoL five dimensions (EQ-5D) index scores reported in the published literature, and to compare this to patients with other chronic diseases.METHODS:Two systematic literature searches were conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Searches were conducted in ten databases including Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials (CENTRAL). The first search (December 2013) used search terms psoria* AND (EQ5D OR EQ OR EUROQoL). Only publications of original research, which reported baseline EQ-5D scores for mild/moderate/severe psoriasis, were included. The second search (March 2014) used the terms (systematic review) AND (EQ5D OR EQ 5D OR EuroQoL). Titles were screened by two independent reviewers. Four independent reviewers reviewed titles and full-length papers. EQ-5D scores for psoriasis patients were qualitatively compared with scores from patients with other chronic diseases identified through the literature search.RESULTS:Of 133 publications on psoriasis, 12 met the inclusion criteria. The mean EQ-5D index scores for psoriasis (all severities) ranged from 0.52 (standard deviation: 0.39) to 0.9 (standard deviation: 0.1). Of the 48 results from the second search, six met the inclusion criteria. The reported EQ-5D lower limit for other diseases ranged from 0.20 (Type 2 diabetes mellitus) to 0.66 (liver diseases). The highest EQ-5D estimates for other diseases ranged from 0.79 (liver diseases) to 0.93 (cancer patients). Both lower and upper EQ-5D estimates in psoriasis patients were within the range of those reported for other chronic diseases.CONCLUSION:Comparative studies of morbidity are relevant in health care studies and patient advocacy. This systematic review demonstrates that the ranges of disutility among psoriasis patients are within the ranges of other chronic diseases (cardiovascular diseases, diabetes, end-stage renal diseases, liver diseases, cancer, and visual disorders).