ABSTRACT
Antecedentes y objetivos Es conveniente ampliar el conocimiento del manejo de apremilast en práctica clínica. El estudio APPRECIATE (NCT02740218) pretende describir las características de pacientes con psoriasis tratados con apremilast, evaluar sus perspectivas y las de sus dermatólogos, y los resultados obtenidos en la práctica clínica española. Métodos Estudio observacional, retrospectivo, transversal y multicéntrico en pacientes con psoriasis crónica en placas, a los que se visitó seis (± 1) meses después de iniciar apremilast. Los datos se obtuvieron de las historias clínicas y cuestionarios realizados por pacientes y dermatólogos. Resultados Se evaluaron 80 pacientes, al iniciar apremilast presentaban Psoriasis Area and Severity Index (PASI) medio (desviación estándar, DE) = 8,3 (5,3) y Dermatology Life Quality Index (DLQI) medio (DE) = 8,9 (6,6). A los seis meses, el 58,8% (n = 47) continuaba con apremilast (discontinuaciones: falta de eficacia [16,3%], seguridad/tolerabilidad [20,0%]). En pacientes que continuaban en tratamiento, el PASI75 fue alcanzado por el 36,7%; la puntuación DLQI media (IC 95%) fue 2,2 (0,7-3,6) y Patient Benefit Index medio (DE) 2,8 (0,8). El cumplimiento de las expectativas de los dermatólogos se correlacionó con los beneficios descritos por los pacientes (r = 0,636). El 56,3% reportó acontecimientos adversos (diarrea y náuseas los más frecuentes). Conclusiones Los pacientes que recibieron apremilast durante seis meses en la práctica clínica en España reportaron una mejoría en su calidad de vida (DLQI medio se redujo más de seis puntos) y en la gravedad de la enfermedad (PASI75 alcanzado por más de un tercio de los pacientes), a pesar de presentar una afectación cutánea menor que aquellos pacientes incluidos en ensayos clínicos (AU)
Background and objectives It is necessary to expand the knowledge in the use of apremilast in clinical practice. The APPRECIATE study (NCT02740218) aims to describe the characteristics of patients with psoriasis treated with apremilast, to evaluate their perspectives and those of dermatologists, as well as the outcomes obtained in clinical practice in Spain. Methods Observational, retrospective, cross-sectional, multicenter study of patients with chronic plaque psoriasis who could be contacted 6 (±1) months after apremilast initiation. The data were obtained from medical records and questionnaires from patients and physicians. Results A total of 80 patients were evaluated; at apremilast onset, they showed mean (standard deviation, SD) Psoriasis Area and Severity Index (PASI) = 8.3 (5.3), mean (SD) Dermatology Life Quality Index (DLQI) = 8.9 (6.6). At six months, 58.8% (n=47) of patients continued apremilast treatment (discontinuations due to lack of efficacy [16.3%], safety/tolerability [20.0%]). In patients continuing treatment, PASI75 was achieved by 36.7% of patients; mean (95% CI) DLQI score was 2.2 (0.7-3.6) and mean (SD) Patient Benefit Index score was 2.8 (0.8). Compliance with physicians expectations was correlated with benefits reported by patients (r=0.636). Adverse events were reported by 56.3% of patients (the most common were diarrhoea and nausea). Conclusions Patients receiving apremilast for 6 months in Spanish clinical practice, reported substantial improvements in their quality of life (mean DLQI reduced by more than 6 points) and disease severity (PASI75 achieved by over one-third of patients), despite less skin involvement than patients who enrolled in clinical trials (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Thalidomide/analogs & derivatives , Practice Patterns, Physicians' , Psoriasis/drug therapy , Severity of Illness Index , Treatment Outcome , Retrospective Studies , Cross-Sectional StudiesABSTRACT
BACKGROUND AND OBJECTIVES: It is necessary to expand the knowledge in the use of apremilast in clinical practice. The APPRECIATE study (NCT02740218) aims to describe the characteristics of patients with psoriasis treated with apremilast, to evaluate their perspectives and those of dermatologists, as well as the outcomes obtained in clinical practice in Spain. METHODS: Observational, retrospective, cross-sectional, multicenter study of patients with chronic plaque psoriasis who could be contacted 6 (±1) months after apremilast initiation. The data were obtained from medical records and questionnaires from patients and physicians. RESULTS: A total of 80 patients were evaluated; at apremilast onset, they showed mean (standard deviation, SD) Psoriasis Area and Severity Index (PASI) = 8.3 (5.3), mean (SD) Dermatology Life Quality Index (DLQI) = 8.9 (6.6). At six months, 58.8% (n=47) of patients continued apremilast treatment (discontinuations due to lack of efficacy [16.3%], safety/tolerability [20.0%]). In patients continuing treatment, PASI75 was achieved by 36.7% of patients; mean (95% CI) DLQI score was 2.2 (0.7-3.6) and mean (SD) Patient Benefit Index score was 2.8 (0.8). Compliance with physicians' expectations was correlated with benefits reported by patients (r=0.636). Adverse events were reported by 56.3% of patients (the most common were diarrhoea and nausea). CONCLUSIONS: Patients receiving apremilast for 6 months in Spanish clinical practice, reported substantial improvements in their quality of life (mean DLQI reduced by more than 6 points) and disease severity (PASI75 achieved by over one-third of patients), despite less skin involvement than patients who enrolled in clinical trials.
ABSTRACT
Presentamos un caso de esta entidad en una paciente caucásica, con lesiones maculosas purpúricas en zona tibial posterior de pierna derecha, sin afectación sistémica, de curso crónico y persistente en la actualidad, tras dieciocho meses de seguimiento con mejoría parcial, después de recibir tratamiento con esteroides e inmunosupresores tópicos. Los anticonceptivos orales y la hipercolesterolemia leve, podrían ser datos asociados en nuestro caso a dicha entidad, aunque se necesitarían más estudios para confirmar esta hipótesis.
We present a case of this entity in a Caucasian, patient with purpuric macular lesion area with her right posterior tibial, without affecting systemic, chronic and persistent course now, after eighteen months of follow-up with partial improvement after treatment with topical steroids and immunosuppressors. Oral contraceptives and mild hypercholesterolemia may be associated data in our case to the entity, althought further studies are needed to confirm this hypothesis.
ABSTRACT
Presentamos un caso de micosis fungoide liquenoide. La paciente presentó prurito intenso, pero con una buena evolución hasta el momento. Tanto clínica como histológicamente se correspondía con un patrón liquenoide, hecho de excepcional frecuencia. Respondió al tratamiento esteroideo tópico de alta potencia.
A 53-years-old woman with a lichenoid mycoses fungoides is reported. Both clinical and histological lichenoid pattern was finding, which is unusual. The treatment with high potency corticoids was successfully and the outcome is favorable up to now.
ABSTRACT
Las neurofibromatosis son un grupo de enfermedades autosómico dominantes caracterizadas por manchas café con leche, neurofibromas dérmicos y tumores del sistema nervioso central y periférico. Estudiamos la neurofibromatosis tipo 1 y 2, las manifestaciones comunes de ambas y sugerencias de cuidado, así como el tratamiento que es sintomático con seguimiento multidisciplinario (AU)
