scholarly journals Clinical and economic burden of psoriasis: a retrospective study of the cost implications among cohorts in Abuja, Nigeria

2020 ◽  
Vol 6 (4) ◽  
pp. 443
Author(s):  
Bob A. Ukonu ◽  
Perpetua U. Ibekwe
Keyword(s):  
Retrospective Study ◽  
Economic Burden ◽  
Severe Psoriasis ◽  
Clinical Severity ◽  
Inflammatory Disorder ◽  
Hospital Data ◽  
Psoriasis Area Severity Index ◽  
Pasi Score ◽  
Cost Implications ◽  
The Cost

<p class="abstract"><strong>Background:</strong> Psoriasis is a common chronic cutaneous inflammatory disorder of the skin which presents as sharply demarcated scaly erythematous papules or plaques. The level of its clinical severity at presentation largely determines the cost implications and economic burden on the patient. The study aimed to determine the direct cost of treating various clinical severity of psoriasis and its economic consequences to our healthcare system.</p><p class="abstract"><strong>Methods:</strong> This is a retrospective study that was conducted between May 2016 and October 2019 at the Dermatology Unit of University of Abuja Teaching Hospital. Data was retrieved from patient’s folder into a designed proforma, noting their biodata, clinical level of severity using psoriasis area severity index (PASI) score, amount of money spent on drugs, laboratory test, nursing time and consultation fees. <strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 82 psoriasis patients seen during the study period, 66 fulfilled the inclusion criteria. About 51.5% of them had severe psoriasis with a mean PASI score 33.2. The annual cost of treating mild, moderate and severe psoriasis was N198,900.00, N261,633.00 and N323,708.00 respectively. This accounted for 1.77% of the national annual healthcare spending within the years under review.</p><p class="abstract"><strong>Conclusions:</strong> The cost of treating psoriasis and its economic burden is largely determined by the level of its clinical severity.</p>

scholarly journals Treatment of moderate to severe psoriasis with apremilast over 2 years in the context of long-term treated HIV infection: A case report

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984519 ◽  
Author(s):  
Misha Zarbafian ◽  
Benoit Cote ◽  
Vincent Richer
Keyword(s):  
Hiv Infection ◽  
Opportunistic Infections ◽  
Total Body Surface Area ◽  
Undetectable Viral Load ◽  
Severity Index ◽  
Severe Psoriasis ◽  
Psoriasis Area Severity Index ◽  
Quality Of Life Index ◽  
Pasi Score ◽  
Total Body

Treatment of moderate-to-severe psoriasis in patients with HIV infection is a clinical challenge. We present the case of a patient with a longstanding history of well-controlled HIV. He had failed topical management, and his hypertriglyceridemia made use of acitretin potentially unsafe. He was unable to regularly attend a phototherapy unit. Physical examination revealed 12% total body surface area involvement with a Psoriasis Area Severity Index (PASI) of 10.2. His Dermatology Quality of Life Index (DLQI) was 20. After 3 months of apremilast treatment, his PASI decreased to 4.1. After 7 months, his PASI decreased to 2.7 and his DLQI to 1. Two years later, his PASI score was 2.4, with a stable CD4 count of 1200 cells/mm3 and an undetectable viral load. There were no serious opportunistic infections or laboratory abnormalities. To our knowledge, this represents the second reported case of psoriasis treatment with apremilast in a patient with HIV.

scholarly journals Evaluation of Clinical and Ultrasonographic Parameters in Psoriatic Arthritis Patients Treated with Adalimumab: A Retrospective Study

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
M. Teoli ◽  
A. Zangrilli ◽  
M. S. Chimenti ◽  
M. Talamonti ◽  
M. Bavetta ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Laboratory ◽  
Health Assessment ◽  
Severity Index ◽  
Joint Disease ◽  
Joint Effusion ◽  
Psoriasis Area Severity Index ◽  
Laboratory Findings ◽  
Adalimumab Treatment ◽  
Pasi Score

Objectives. The aim of this study was to evaluate clinical and US-PD parameters in PsA during adalimumab treatment.Methods. A retrospective study has been conducted in forty patients affected by moderate-to-severe peripheral PsA. Clinical, laboratory, and US-PD evaluations were performed at baseline, after 4, 12, and 24 weeks of treatment. They included erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), visual analogue scale (VAS), Health Assessment Questionnaire (HAQ) modified for Spondyloarthritis, Psoriasis Area Severity Index (PASI) score, the 28-joint Disease Activity Score (DAS 28), and US-PD assessment. US-PD findings were scored according to a semiquantitative scale (ranging 0–3) for synovial proliferation (SP), joint effusion (SE), bone erosions (BE), and PD.Results. Data obtained for clinical, laboratory findings and US-PD evaluation showed statistical significant improvement in all the measures performed except for BE. A significant parallel decrease in SE, SP, and PD values were demonstrated.Conclusion. This study demonstrated that US-PD is a valid technique in monitoring the response to adalimumab in moderate-to-severe PsA.

scholarly journals Economic Burden and Cost-Effectiveness of Moderate to Severe Psoriasis Treatment in Asian Region: A Systematic Review

2021 ◽  
Vol 7 (1) ◽  
pp. 196
Author(s):  
Nurul Fatiha Risma Rismayuddin ◽  
Nor Azmaniza Azizam ◽  
Aniza Ismail
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Economic Burden ◽  
English Language ◽  
Cost Effective ◽  
The United States ◽  
Severe Psoriasis ◽  
Economic Effects ◽  
Asian Region ◽  
The Cost

Psoriasis poses a significant economic burden. A systematic review of psoriasis treatments cost and effectiveness has been performed extensively in the United States (US) and Europe, but such review is limited in Asia. This review aims to analyze all previous literature on the cost and effectiveness of systemic and biological treatment for moderate to severe psoriasis. Cost of illness and cost-effectiveness studies that examined the economic burden, cost, and effectiveness of psoriasis treatments (systemic and biological) in Asian region from 2010 to 2020 were published in English language. All costs were converted into 2020 US Dollar. All COIs included found that direct medical costs were greater than indirect costs. Adalimumab, ustekinumab, risankizumab, secukinumab 150 mg were cost-effective treatments and of the lowest cost per PASI-75/PASI1 and/or QALY. When comparing the different treatments, topical and systemic psoriasis treatments were observed to be the most cost-effective compared with other modalities. Given the tremendous economic effects of psoriasis on patients and hospitals, economic analysis, clinicians, and policymakers should consider cost and effectiveness evidence, as this systematic literature review was conducted to analyze previous documentation regarding the cost and effectiveness of systemics and biologics in Asian countries.

scholarly journals Cost-Effectiveness Analysis of Psoriasis Treatment Modalities in Malaysia

2019 ◽  
Vol 8 (7) ◽  
pp. 394-402
Author(s):  
Nor Azmaniza Azizam ◽  
Aniza Ismail ◽  
Saperi Sulong ◽  
Norazirah Md Nor
Keyword(s):  
Cost Effectiveness ◽  
Treatment Options ◽  
Life Quality ◽  
Severity Index ◽  
Severe Psoriasis ◽  
Public Hospitals ◽  
Treatment Modalities ◽  
Psoriasis Area Severity Index ◽  
Cost Effective Treatment ◽  
The Cost

Background: There is limited evidence detailing the cost-effectiveness of psoriasis treatments in the Asian region. Therefore, this study is aimed to evaluate the cost-effectiveness of 3 psoriasis treatments tailored for moderate to severe psoriasis, namely topical and phototherapy (TP), topical and systemic (TS), and topical and biologic (TB) regimens, respectively. Methods: This has been achieved by the participation of a prospective cohort involving a total of 90 moderate to severe psoriasis patients, which has been conducted at 5 public hospitals in Malaysia. The main outcome measures have been evaluated via cost and effectiveness psoriasis area severity index (PASI)-75 and/or body surface area (BSA) <5 and/or dermatology life quality index (DLQI) ≤5), estimated from the societal perspective over a 6-months duration. All costs are based on 2015’s recorded Malaysian Ringgit (RM) currency. Results: Consequently, TS has been found to be the most cost-effective treatment with the lowest cost/PASI-75/and/or BSA <5 and/or DLQI ≤5, valued at RM9034.56 (US$2582.55). This is followed by TP, which is valued at RM28 080.71 (US$8026.93) and TB, valued at RM54 287.02 (US$15 518.06). Furthermore, one-way sensitivity analysis has highlighted the cost of medication as the most sensitive parameter. Conclusion: Thus, the input from this study is helpful for policy-makers in determining the first line treatment for moderate to severe psoriasis with consideration of the costs and its effectiveness in Malaysia. This will consequently allow hospitals to justify and provide the essential resources for further research and development, as well as the adoption of better treatment options.

scholarly journals A comparison of efficacy and safety with add on therapy of pioglitazone in adult patients of psoriasis with and without metabolic syndrome

2020 ◽  
Vol 9 (6) ◽  
pp. 943
Author(s):  
Mahesh Chander Gupta ◽  
Kartik Nayak ◽  
Kamal Aggarwal
Keyword(s):  
Metabolic Syndrome ◽  
Dose Range ◽  
Life Quality ◽  
Severity Index ◽  
Clinical Severity ◽  
Open Label ◽  
Psoriasis Area Severity Index ◽  
Comparative Clinical Study ◽  
Pasi Score

Background: Psoriasis is a chronic disease involving skin with systemic manifestations whose etiology remains unknown. In recent times, an increased occurrence of metabolic syndrome has been seen in psoriatic patients and potential role of antihyperglycemic in such conditions is being evaluated.Methods: This was a prospective, controlled, randomized, open label comparative clinical study conducted on 51 psoriatic patients. The patients were divided into two groups with and without MS and both these groups were further randomised to receive either standard therapy alone (topical 0.05% betamethasone dipropionate applied twice daily) or therapy with pioglitazone 15 mg orally once daily as add on to standard treatment. The study was conducted over a period of 12 weeks and the primary efficacy outcome was assessed by a change in psoriasis area severity index (PASI). The secondary outcomes were achievement PASI 50/75 and change in parameters of metabolic syndrome (MS). Change in quality of life assessed using dermatological life quality index (DLQI). Results: Both the treatments significantly reduced the PASI score in psoriatic patients with and without MS, maximum being at 12 weeks. In patients with and without MS, pioglitazone caused a greater reduction in PASI score and DLQI score though it was found comparable to ST alone. Significant improvement in parameters of metabolic syndrome was observed in pioglitazone treated group.Conclusions: Pioglitazone given as add on therapy caused an additional improvement in clinical severity and QOL in both the group of psoriatic patients with and without metabolic syndrome. Role of pioglitazone needs to be further explored with higher recommended dose range (30 mg and 45 mg) to demonstrate the usefulness of this drug in psoriatic patients.

Primary varicose veins

Phlebologie ◽  
2010 ◽  
Vol 39 (03) ◽  
pp. 133-137
Author(s):  
H. Partsch
Keyword(s):  
Varicose Veins ◽  
Compression Therapy ◽  
Daily Practice ◽  
Clinical Severity ◽  
Compression Stockings ◽  
Primary Varicose Veins ◽  
The Cost ◽  
Convincing Data ◽  
Long Term Studies

SummaryBackground: Compression stockings are widely used in patients with varicose veins. Methods: Based on published literature three main points are discussed: 1. the rationale of compression therapy in primary varicose veins, 2. the prescription of compression stockings in daily practice, 3. studies required in the future. Results: The main objective of prescribing compression stockings for patients with varicose veins is to improve subjective leg complaints and to prevent swelling after sitting and standing. No convincing data are available concerning prevention of progression or of complications. In daily practice varicose veins are the most common indication to prescribe compression stockings. The compliance depends on the severity of the disorder and is rather poor in less severe stages. Long-term studies are needed to proof the cost-effectiveness of compression stockings concerning subjective symptoms and objective signs of varicose veins adjusted to their clinical severity. Conclusion: Compression stockings in primary varicose veins are able to improve leg complaints and to prevent swelling.

scholarly journals Healthcare Expenditures Associated with Heart Failure in Saudi Arabia: A Cost of Illness Study

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 988
Author(s):  
Ahmed Alghamdi ◽  
Eman Algarni ◽  
Bander Balkhi ◽  
Abdulaziz Altowaijri ◽  
Abdulaziz Alhossan
Keyword(s):  
Heart Failure ◽  
Saudi Arabia ◽  
Cost Of Illness ◽  
Economic Burden ◽  
Indirect Costs ◽  
Health Care Expenditures ◽  
Decision Makers ◽  
Hospitalization Costs ◽  
Illness Study ◽  
The Cost

Heart failure (HF) is considered to be a global health problem that generates a significant economic burden. Despite the growing prevalence in Saudi Arabia, the economic burden of HF is not well studied. The aim of this study was to estimate the health care expenditures associated with HF in Saudi Arabia from a social perspective. We conducted a multicenter cost of illness (COI) study in two large governmental centers in Riyadh, Saudi Arabia using 369 HF patients. A COI model was developed in order to estimate the direct medical costs associated with HF. The indirect costs of HF were estimated based on a human capital approach. Descriptive and inferential statistics were analyzed. The direct medical cost per HF patient was $9563. Hospitalization costs were the major driver in total spending, followed by medication and diagnostics costs. The cost significantly increased in line with the disease progression, ranging from $3671 in class I to $16,447 in class IV. The indirect costs per working HF patient were $4628 due to absenteeism, and $6388 due to presenteeism. The economic burden of HF is significantly high in Saudi Arabia. Decision makers need to focus on allocating resources towards strategies that prevent frequent hospitalizations and improve HF management and patient outcomes in order to lower the growing economic burden.

Strain specific response of mice to IMQ-induced psoriasis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Murali Badanthadka ◽  
Lidwin D’Souza ◽  
Fathima Salwa
Keyword(s):  
Body Weight ◽  
Disease Severity ◽  
Histopathological Examination ◽  
Redox System ◽  
Mechanistic Study ◽  
Strain Effect ◽  
Skin Thickness ◽  
Specific Response ◽  
Psoriasis Area Severity Index ◽  
Pasi Score

Abstract Objectives Psoriasis is an autoimmune, inflammatory disease that needs a reliable animal model. Imiquimod (IMQ)-induced psoriasis is a widely used preclinical tool for psoriasis research. However, this model is sensitive to the genetic variation of mice. The present study explores mice’s genetic background on disease stability and severity induced by IMQ. Methods Three distinct strains of mice (Balb/c, C57BL/6, and Swiss albino) were divided into four groups (Vaseline, IMQ, IMQ+Clobetasol, and IMQ+Curcumin). Psoriasis area severity index (PASI) score, ear/back skin thickness, body weight alterations, and histopathological examination were employed to analyze disease severity. The spleen index studied the systemic effect. Strain effect on oxidative stress induced by IMQ was evaluated by estimating antioxidant factors, superoxide dismutase (SOD), catalase, and glutathione (GSH). Results IMQ application resulted in increased PASI score, thickness, and alterations in body weight, confirming disease development in all the mice. However, the disease stability/severity between these strains was not identical. Although IMQ application caused splenomegaly, IMQ+curcumin treated C57BL/6 mice demonstrated a synergistic effect of IMQ and curcumin on the spleen resulting in increased splenomegaly. Decreased cellular enzyme activity in SOD, Catalase, and levels of GSH was observed in IMQ challenged mice, indicating the participation of the redox system in the genesis of the disease that was comparable among the strains. Conclusions These results indicate the existence of strain-dependent development of the disease. The Swiss model was found to be better in terms of disease severity and stability than other models. Further, a detailed mechanistic study might help to explain the pathological difference between these strains.

scholarly journals Role of Multiple Comorbidities and Therapies in Conditioning the Clinical Severity of DRESS: A Mono-Center Retrospective Study of 25 Cases

2021 ◽  
Vol 22 (13) ◽  
pp. 7072
Author(s):  
Andrea Toniato ◽  
Chiara Gamba ◽  
Jan Walter Schroeder ◽  
Valeria Fabbri ◽  
Scarlett Valeria Bernal Ortiz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Drug Reaction ◽  
Retrospective Study ◽  
Clinical Severity ◽  
Severe Reaction ◽  
Skin Involvement ◽  
Inflammatory State ◽  
Reaction Severity ◽  
Clinical Conditions

DRESS/DiHS is a complex and potentially fatal drug reaction. Little is known about risk factors and elements that can help to identify patients with a severe reaction early. The aim of the study was to investigate those factors favoring the disease and its severity by analyzing the clinical conditions and therapies preceding the reaction. We conducted a retrospective analysis on patients admitted to our center between 2010 and 2020 who were discharged with a diagnosis of DRESS. We used the RegiSCAR diagnostic criteria. We defined the severity of DRESS using the criteria of Mizukawa et al. We included 25 patients (15 females) with a median age of 66 years. Skin involvement, eosinophilia, and liver injury were the most important aspects. Allopurinol was found to be the most involved drug. Reaction severity was significantly associated with the number of daily medications (p=0.0067) and an age of at least 68 years (p=0.013). In addition, 75% of severe cases had at least three comorbidities in history, and most of the severe cases were female. In our study the advanced age, the high number of comorbidities and home therapies, and the inflammatory state were found to be predisposing elements to the development of the disease and its severity.

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