scholarly journals Efficacy of Dupilumab on Different Phenotypes of Atopic Dermatitis: One-Year Experience of 221 Patients

2020 ◽  
Vol 9 (9) ◽  
pp. 2684
Author(s):  
Simona Tavecchio ◽  
Luisa Angileri ◽  
Francesco Pozzo Giuffrida ◽  
Francesca Germiniasi ◽  
Angelo Valerio Marzano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atopic Dermatitis ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Clinical Manifestations ◽  
Life Quality ◽  
Daily Practice ◽  
Severity Index ◽  
Efficacy And Safety

Background: The clinical features of adult-onset atopic dermatitis (AD) are heterogeneous and the diagnosis can be a challenge. A new biologic drug (dupilumab) has been approved for moderate to severe AD in adult patients. The efficacy and safety have been demonstrated in clinical trials, but these studies do not reflect conditions in daily practice and do not consider the different clinical manifestations of AD. Objectives: Analyzing the dupilumab activity in a real-world setting and comparing its efficacy on different AD phenotypes. Methods: We retrospectively evaluated 221 AD patients treated with dupilumab, stratified into six clinical phenotypes: classic, generalized eczema inflammatory and lichenoid patterns, prurigo, nummular eczema, and erythroderma. At baseline and at weeks 4, 16, and 52, the disease severity was assessed through the Eczema Area and Severity Index (EASI) and the quality of life was assessed through the Dermatology Life Quality Index (DLQI) questionnaire, Peak Pruritus Numerical Rating Scale (itch NRS), and Peak Sleep NRS. Results: We found a significant improvement after 16 weeks of treatment (p < 0.0001) in all six phenotypes for all the assessed scores mentioned above, persisting up to week 52. The best improvement was seen in the more severe phenotypes, particularly the erythrodermic one. Conclusions: The present study confirmed the efficacy and safety of dupilumab in the treatment of severe AD. Its strength was in the stratification of AD patients in six different phenotypes based on their clinical presentation, all of whom markedly improved in terms of both clinically evident and reported symptoms, as well as their quality of life.

scholarly journals Clinical Response and Quality of Life in Patients with Severe Atopic Dermatitis Treated with Dupilumab: A Single-Center Real-Life Experience

2020 ◽  
Vol 9 (3) ◽  
pp. 791 ◽  
Author(s):  
Silvia Ferrucci ◽  
Giovanni Casazza ◽  
Luisa Angileri ◽  
Simona Tavecchio ◽  
Francesca Germiniasi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atopic Dermatitis ◽  
Rating Scale ◽  
Real Life ◽  
Life Quality ◽  
Depression Scale ◽  
Interleukin 4 ◽  
Severe Atopic Dermatitis ◽  
Single Center

Dupilumab is an anti-interleukin-4 receptor monoclonal antibody that was recently approved for the treatment of atopic dermatitis (AD). In this single-center retrospective study, clinical baseline data of 117 severe AD patients treated with dupilumab were collected. At baseline and at weeks 4 and 16, disease severity was assessed through the Eczema Area and Severity Index (EASI) and quality of life through the Dermatology Life Quality Index (DLQI) questionnaire, Patient-Oriented Eczema Measure (POEM), Hospital Anxiety and Depression Scale (HADS), Peak Pruritus Numerical Rating Scale (NRS-itch), and VAS-sleep. Response to dupilumab was defined as an improvement of ≥75% in EASI from baseline (EASI75). At multivariate analysis, AD onset before 18 years [OR, 2.9; 95% CI, 1.2–7.2; p = 0.0207] and absence of hypereosinophilia [OR, 2.24; 95% CI, 1.03–4.86; p = 0.0412] were identified as significant predictive parameters for response to dupilumab in terms of EASI75 at week 4 but not at week 16. Significant reductions in EASI, DLQI, POEM, HADS, NRS-itch, and VAS-sleep were found between week 4 versus baseline (p < 0.0001 for all) and week 16 versus baseline (p < 0.0001 for all). Early AD onset and absence of hypereosinophilia may be suggested as predictive markers of early response to dupilumab. We confirmed the efficacy and safety of this agent along with the improvement of life quality in severe AD patients.

Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document. Section II: Tools for Assessing the Severity of Atopic Dermatitis

2018 ◽  
Vol 22 (1_suppl) ◽  
pp. 10S-16S ◽  
Author(s):  
Melinda J. Gooderham ◽  
Robert Bissonnette ◽  
Parbeer Grewal ◽  
Perla Lansang ◽  
Kim A. Papp ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Disease Severity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Life Quality ◽  
Severity Index ◽  
Adult Patients ◽  
Physician Global Assessment ◽  
Atopic Dermatitis Severity ◽  
Patient Reported

Clinicians rely on clinical measures to define the severity of atopic dermatitis and assess outcomes of therapy. These measures can be objective (ie, physician assessments of disease severity) or subjective (ie, patient-reported symptoms and quality of life outcomes). In this review, the most commonly used tools for assessing atopic dermatitis severity in adult patients are presented and compared. These include Eczema Area and Severity Index (EASI); SCORing Atopic Dermatitis (SCORAD); Physician Global Assessment (PGA); body surface area (BSA); Atopic Dermatitis Severity Index (ADSI); Six Area, Six Sign Atopic Dermatitis (SASSAD); Patient Oriented Eczema Measure (POEM); Dermatology Life Quality Index (DLQI); and pruritus Numerical Rating Scale (NRS). Available severity strata for the tools are summarized, although the use of severity strata in clinical practice is not recommended. Since both objective and subjective assessments of disease severity are important to assess, consideration of clinical characteristics such as disease recurrence or persistence, as well as location of the affected areas, should be considered in the overall judgement of disease severity and consideration of therapy choice.

scholarly journals Antipruritic Effect of Acupuncture in Patients with Atopic Dermatitis: Feasibility Study Protocol for a Randomised, Sham-Controlled Trial

2017 ◽  
Vol 2017 ◽  
pp. 1-14
Author(s):  
Yu-Kang Kim ◽  
Mijung Yeom ◽  
SeHyun Kang ◽  
Hi-Joon Park ◽  
Kyuseok Kim ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atopic Dermatitis ◽  
Controlled Trial ◽  
Life Quality ◽  
Severity Index ◽  
Randomised Clinical Trial ◽  
Sham Acupuncture ◽  
Blood Collection ◽  
Assess Quality

This study aims to test the feasibility of a randomised clinical trial to evaluate how acupuncture affects atopic dermatitis (AD) symptoms and quality of life and to explore potential biomarkers that may be associated with AD. It is a sham-controlled trial in which 30 eligible patients will be randomly allocated in a 1 : 1 : 1 ratio to one of three groups: verum acupuncture (VA) group 1 (3 times weekly for 4 weeks); VA group 2 (twice weekly for 4 weeks); or sham acupuncture group (SA; twice weekly for 4 weeks). SA will consist of nonpenetrating acupuncture. Outcome measures will include the Visual Analogue Scale for itch, SCORing Atopic Dermatitis, and Eczema Area and Severity Index to evaluate AD symptoms improvement along with the Patient Oriented Eczema Measure and Dermatology Life Quality Index to assess quality of life. Measures will be collected at baseline, once weekly during the treatment period, and after a 4-week follow-up period. Blood collection will be at baseline and 4 and 8 weeks after treatment and compared with healthy controls. Illumina sequencing will be used to profile microRNA expression in each group to explore candidate microRNA biomarkers for specific effects of acupuncture in patients with AD. This trial is registered via US National Institutes of Health Clinical Trials registry (ClinicalTrials.gov) on 15 July 2016, identifier: NCT02844452.

scholarly journals The Contributions of Extracorporeal Shockwave Therapy to the Improvement of the Quality of Life in Patients with Scapulohumeral Periarthritis

GYMNASIUM ◽  
2020 ◽  
Vol XXI (1) ◽  
pp. 87
Author(s):  
Daniel-Lucian Dobreci ◽  
Adina Camelia Șlicaru
Keyword(s):  
Quality Of Life ◽  
Shock Wave ◽  
Rating Scale ◽  
Life Quality ◽  
Good Effect ◽  
Shock Wave Therapy ◽  
Extracorporeal Shockwave Therapy ◽  
Shockwave Therapy ◽  
Quality Scale

The main purpose of this study was to evaluate to what extent shock wave therapy (ESWT) can influence the quality of life of patients with scapular-humeral periarthritis (PSH). The study included 30 male and female PSH sufferers who had previously undergone various therapies without any success in disease progression. The VAS scale, the Roles-Maudsley score, and the Flanagan Life Quality Scale with seven points on the rating scale recommended by Andrews and Crandall were used to evaluate patient evolution. ESWT sessions were held on a seven-day session for 12 weeks. Between ESWT meetings each patient followed a home medical gymnastics program. Following the study, ESWT treatment had a good effect on the progression of PSH patients in terms of pain reduction and disappearance, as well as regaining mobility of the affected shoulder. The conclusion of this studio is that shock wave therapy can help improve the quality of life of PSH patients.

Subjective quality of life in schizophrenic patients living in the community. Relationship to clinical and social characteristics

1999 ◽  
Vol 14 (5) ◽  
pp. 256-263 ◽  
Author(s):  
A. Bengtsson-Tops ◽  
L. Hansson
Keyword(s):  
Quality Of Life ◽  
Rating Scale ◽  
Life Quality ◽  
Subjective Quality ◽  
Social Characteristics ◽  
Clinical Factors ◽  
Subjective Quality Of Life ◽  
Social Interventions ◽  
Schizophrenic Patients

SummaryThe aims of this study were to assess the quality of life among 120 schizophrenic patients who were attending a psychiatric outpatient department and to investigate which socio-demographic and clinical factors influenced their subjective quality of life. Quality of life was assessed by the Lanchashire quality of life profile, social functioning was judged according to the Global Assessment of Functioning (GAF) scale, and psychopathology was rated by means of the Brief Psychiatric Rating Scale (BPRS). Both objective and subjective life conditions indicated an impaired quality of life for the patients. The areas of finance and work had the largest proportion of dissatisfied patients. Socio-demographic indicators showed to have a weak influence on the patient's self-assessed quality of life while clinical factors, such as psychopathology, strongly influenced the patient's life satisfaction. It is concluded that there is a need for further emphasise on the clinical, financial, and social interventions for this group of patients.

The Development of the Mymop Pictorial Version

2004 ◽  
Vol 22 (2) ◽  
pp. 68-71 ◽  
Author(s):  
Anthony Day
Keyword(s):  
Quality Of Life ◽  
Complementary Therapies ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Life Instrument ◽  
Numerical Rating

The MYMOP is a well accepted quality of life instrument that is particularly suitable for assessing the effect of complementary therapies; however, some groups of patients find it difficult to use. A pictorial version was developed using faces instead of the numerical rating scale – it is called MYMOP pictorial. This version appears to be more acceptable to patients but has not been formally validated.

scholarly journals Correlation of Disease Activity and Quality of Life of Patients with Psoriasis after Narrow-band Ultraviolet B Therapy

Folia Medica ◽  
2020 ◽  
Vol 62 (1) ◽  
pp. 89-93
Author(s):  
Lyubomir A. Dourmishev ◽  
Karolina Lyubomirova
Keyword(s):  
Quality Of Life ◽  
Narrow Band ◽  
Life Quality ◽  
Clinical Effectiveness ◽  
Symptom Assessment ◽  
Severity Index ◽  
Ultraviolet B ◽  
Effective Treatment Option ◽  
Pasi Score

Introduction: Treatment with ultraviolet light is a well-established and effective treatment option for mild to moderate psoriasis. The aims of the study were to measure the psoriasis area and severity index (PASI) reduction after narrow-band ultraviolet B (NB UVB) therapy, to evaluate the quality of life before and after treatment using the dermatology life quality index (DLQI), and to compare the clinical effectiveness with quality of life improvement. &nbsp; Material and methods: Twenty two patients (13 male and 9 female patients), aged between 21 to 70 years (mean age 40&plusmn;14.65 years) were enrolled in the study. NB UVB treatment was performed with 10 to 25 (mean 18.5; SD 3.39) procedures with cumulative doses of 5 to 19.4 J/cm2. The baseline median PASI score was 20.027 which decreased after therapy to 11.11. More than PASI 50% reduction was achieved in 40.91% of the patients after at least 6 weeks of treatment and the results are highly statistically significant. Quality of life (QoL) assessed using DLQI was found moderately affected by disease pretreatment. NB UVB therapy significantly increased DLQI score in spectrum of &lsquo;symptoms and feelings&rsquo; and &lsquo;treatment&rsquo;. &nbsp; Discussion: The PASI score reduction that we observed after NB-UVB therapy is consistent with the results reported by other authors. Baseline DLQI scores were indicative of moderate QoL impairments associated with disease. At the same time, the reduction of the DLQI index corresponding to improved QoL correlated with the objective clinical symptom assessment.&nbsp; &nbsp; Conclusion: Our data suggest that DLQI and PASI indexes are important complementary methods for comprehensive health assessment of patients with psoriasis.&nbsp;

scholarly journals Erectile dysfunction in men with diabetes (literature review) Part 1

2021 ◽  
Vol 17 (5) ◽  
pp. 426-434
Author(s):  
E.V. Luchytskyy ◽  
V.Ye. Luchytskiy
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Risk Factor ◽  
Erectile Dysfunction ◽  
Rating Scale ◽  
Sexual Experience ◽  
Clinical Manifestations ◽  
Phosphodiesterase Type 5 Inhibitors ◽  
Patients With Diabetes

The first part of the review article highlights modern views on the prevalence, etiology and features of the pathogenesis of erectile dysfunction (ED) in men with diabetes mellitus. Google Scholar and PubMed databases were used to search for literature sources. The role of comorbid diseases in the development of ED in men with diabetes mellitus has been shown. The generalized data on the main clinical manifestations of erectile dysfunction, methods of its diagnosis and treatment are given. A number of epidemiological studies over the past 20 years have found that erectile dysfunction in men with diabetes may be an early marker of cardiovascular complications. Thus, in the algorithm for ED diagnosis in patients with diabetes it is necessary to conduct a thorough examination of the cardiovascular system. Numerous literature sources indicate an important role in the correction of androgen deficiency in men with type 2 diabetes, in order to enhance the effectiveness of phosphodiesterase type 5 inhibitors. Erectile dysfunction involves a change in any of the components of an erectile response. ED can negatively affect a man’s quality of life because most patients experience symptoms of depression and anxiety related to their sexual capabilities. These symptoms also affect a partner’s sexual experience and the couple’s quality of life. Clinical features of ED have many key features in the anamnesis, including some physical signs during examination depending on a type of diabetes. With age, comorbid conditions play an increasing role in the development of ED. Diabetes mellitus, cardiovascular diseases, obesity can lead to the development of ED before accelerated deterioration of erectile function and disorders at the molecular level of the mechanisms underlying erection. Patients with diabetes and ED have higher scores on the depression rating scale, and poorer overall health and quality of life. Early detection of ED in individuals with diabetes can improve the overall health and quality of life of patients. Patients with diabetes with poor glycemic control and older age are more likely to develop severe ED, which further exacerbates an already compromised health and quality of life. According to the National Health and Nutrition Examination Survey (2001–2002), diabetes mellitus is a modified risk factor independently associated with the development of ED (odds ratio (OR) 2.69), obesity (OR 1.60), smoking (OR 1.74) and hypertension (OR 1.56). Erectile dysfunction is a common complication of diabetes, and diabetes is a risk factor for ED; men with diabetes are three times more likely to have ED.

scholarly journals 1% ivermectin in combination therapy regimens for rosacea

2020 ◽  
pp. 17-23
Author(s):  
E. A. Khlystova ◽  
A. L. Savastenko
Keyword(s):  
Quality Of Life ◽  
Comparative Analysis ◽  
Combination Therapy ◽  
Combination Treatment ◽  
Clinical Manifestations ◽  
Life Quality ◽  
Clinical Results ◽  
Control Group ◽  
Before And After

Introduction. The article provides latest data on modern methods of treating rosacea. The results of own clinical observations of patients with moderate to severe papulopustular rosacea receiving combination treatment and a comparative analysis of the efficacy of various therapy regimens are presented.Objective of the study. The aim of the study was to conduct a comparative analysis of the therapeutic efficacy of combination therapy using the ivermectin 1% topical drug combined with systemic therapy drugs (doxycycline, minocycline, isotretinoin).Materials and methods. We observed 37 patients with moderate to severe papulo-pustular rosacea subtype. The patients were divided into 4 groups (A, B, C, D). Patients in the control group received monotherapy with 1% ivemectin topical drug, patients in the other groups received combination therapy (1% ivermectin combined with low-dose doxycycline, minocycline and isotretinoin). The efficacy of the therapy was evaluated by measuring rosacea severity on the Scale for Diagnostic Assessment of Rosacea (SDAR), clinical manifestations according to the IGA (Investigator Global Assessment) criteria, and by assessing the patients' quality of life using the DLQI (Dermatology Life Quality Index) questionnaire before and after 3-month treatment.Results. The comparative analysis of changes in severity indicators of the skin process and quality of life in patients with moderate to severe papulopustular rosacea after topical and combination therapy showed that the results of the treatment in patients receiving combination therapy were more significant than those in the group receiving monotherapy.Conclusion. The concomitant use of 1% ivermectin and systemic drugs is most effective in patients with severe papulopustular rosacea subtype. The combination treatment tailored to the clinical forms and severity of rosacea allows to optimize the clinical results of the therapy, which significantly affects the patients' quality of life and opens up potential for an individual approach in the algorithms for the treatment of rosacea.

scholarly journals Atopic Dermatitis Severity, Patient Perception of the Disease, and Personality Characteristics: How Are They Related to Quality of Life?

Life ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 1434
Author(s):  
Liborija Lugović-Mihić ◽  
Jelena Meštrović-Štefekov ◽  
Iva Ferček ◽  
Nives Pondeljak ◽  
Elvira Lazić-Mosler ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atopic Dermatitis ◽  
Anxiety Disorder ◽  
Personality Traits ◽  
Clinical Manifestations ◽  
Personality Characteristics ◽  
World Health ◽  
Patient Specific ◽  
World Health Organization Quality

Introduction: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin condition that greatly affects patients’ quality of life, psychological condition, and social relationships. Materials And Methods: To analyze different aspects of AD patients’ quality of life, we used the SCORing Atopic Dermatitis (SCORAD) index (for AD severity), the Dermatology Life Quality Index (DLQI), the World Health Organization Quality of Life Brief Version (WHOQOL-BREF), the Brief Illness Perception Questionnaire (Brief IPQ), and the Crown–Crisp Experiential Index (CCEI) to analyze personality traits. The study included 84 AD patients, 42 with clinical manifestations and 42 in remission. Results: SCORAD values correlated positively and linearly with DLQI (r = 0.551; p < 0.001) and with disease impact on life, disease control, and disease symptoms (r = 0.350–0.398; p ≤ 0.023). DLQI was also related to certain personality characteristics (free-floating anxiety disorder, obsession, somatization, and depression (p ≤ 0.032)). Symptomatic AD patients had a significantly more impaired DLQI than asymptomatic patients (p < 0.001) and the two groups differed in some IPQ dimensions, but they did not differ significantly concerning the WHOQOL-BREF dimensions and personality traits (CCEI). Conclusion: Since AD patient quality of life was dependent not only on disease severity but was also influenced by patient personality characteristics (anxiety disorder, obsession, somatization, depression), many factors need to be taken into account to create effective, patient-specific therapy regimens.

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