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  • Title: [Treatment of psoriasis with biologics: a survey of dermatological and rheumatological practice at Reims University Hospital].
    Author: Adnot-Desanlis L, Brochot P, Eschard JP, Bernard P, Reguiaï Z.
    Journal: Ann Dermatol Venereol; 2012 May; 139(5):355-62. PubMed ID: 22578339.
    Abstract:
    BACKGROUND: Biological drugs have become a major treatment for moderate-to-severe forms of psoriasis. We sought to evaluate the characteristics of patients treated with biotherapies for psoriasis in daily practice in the dermatology and rheumatology departments of the University Hospital of Reims. PATIENTS AND METHODS: This retrospective study included all psoriasis patients treated with biological agents in the dermatology or rheumatology departments between March 2005 and June 2009. Data concerning the characteristics of psoriasis patients and treatments were collected using a standardized form. In June 2010, we evaluated therapeutic efficacy after at least 1 year of treatment with the first prescribed biotherapy. RESULTS: We note that 109 patients were included in the study (70 in dermatology and 39 in rheumatology). In dermatology, the mean age at diagnosis of psoriasis was 27 years. The sex ratio was 2.5. Of these patients, 26% were smokers, 19% were obese and 29% had dyslipidaemia. In most patients, psoriasis affected between 10% and 50% of body surface area. Thirty percent had associated psoriatic arthritis (confirmed by a rheumatologist in 17% of cases). The mean time from diagnosis to initial systemic treatment was 7 years, and 21 years to use of the first biotherapy. On average, patients received three systemic treatments before the introduction of biological drugs. In rheumatology, the mean age at diagnosis was 37 years. In 95% of patients, psoriasis affected less than 10% of the body surface area. The mean time from diagnosis to initial systemic treatment was 5 years, and 9 years to use of the first biotherapy; 41% of patients were referred to a dermatologist. There was no significant difference between the groups in terms of comorbidities except for dyslipidaemia, which was noted more frequently by dermatologists. DISCUSSION: This study shows little difference between patients treated in the dermatology and in the rheumatology departments in terms of psoriasis characteristics or comorbidities. However, patients in both groups exhibit more cardiovascular risk factors than the general population and 30% had psoriatic arthritis. These two points highlight the importance of the interaction between dermatologists and rheumatologists and the sentinel role of dermatologists in the management of comorbidities. In terms of efficacy, more than 70% of patients were satisfactorily controlled by biotherapy after 1 year of treatment. Therapeutic failures were more common in dermatology than in rheumatology.
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