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Psoriasis: HELP
Articles by Kristina Callis Duffin
Based on 32 articles published since 2008
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Between 2008 and 2019, K. C. Duffin wrote the following 32 articles about Psoriasis.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Guideline Consensus guidelines for the management of plaque psoriasis. 2012

Hsu, Sylvia / Papp, Kim Alexander / Lebwohl, Mark G / Bagel, Jerry / Blauvelt, Andrew / Duffin, Kristina Callis / Crowley, Jeffrey / Eichenfield, Lawrence F / Feldman, Steven R / Fiorentino, David F / Gelfand, Joel M / Gottlieb, Alice B / Jacobsen, Carmen / Kalb, Robert E / Kavanaugh, Arthur / Korman, Neil J / Krueger, Gerald G / Michelon, Melissa A / Morison, Warwick / Ritchlin, Christopher T / Stein Gold, Linda / Stone, Stephen P / Strober, Bruce E / Van Voorhees, Abby S / Weiss, Stefan C / Wanat, Karolyn / Bebo, Bruce F / Anonymous4210715. ·Department of Dermatology, Baylor College of Medicine, Houston, TX 77030, USA. shsu@bcm.edu ·Arch Dermatol · Pubmed #22250239.

ABSTRACT: The Canadian Guidelines for the Management of Plaque Psoriasis were reviewed by the entire National Psoriasis Foundation Medical Board and updated to include newly approved agents such as ustekinumab and to reflect practice patterns in the United States, where the excimer laser is approved for psoriasis treatment. Management of psoriasis in special populations is discussed. In the updated guidelines, we include sections on children, pregnant patients or pregnant partners of patients, nursing mothers, the elderly, patients with hepatitis B or C virus infections, human immunodeficiency virus-infected patients, and patients with malignant neoplasms, as well as sections on tumor necrosis factor blockers, elective surgery, and vaccinations.

2 Review The International Dermatology Outcome Measures (IDEOM) Initiative: A Review and Update. 2017

Elman, Scott A / Merola, Joseph F / Armstrong, April W / Duffin, Kristina Callis / Latella, John / Garg, Amit / Gottlieb, Alice B. · ·J Drugs Dermatol · Pubmed #28300853.

ABSTRACT:

The International Dermatology Outcome Measures (IDEOM) group, comprising patients, physicians, health economists, industry partners, payers, and regulatory agencies, was established to develop unified and validated patient-centered outcome measures in dermatology in response to increasing demand to quantify effectiveness of treatments and performance outcomes among providers. IDEOM has chosen to start with psoriasis outcome measures, and then apply its methodology to other dermatologic diseases. In this paper, we review the background and progress to date of IDEOM, including an update of IDEOM activities as of our 2016 meeting in Washington DC, USA. Briefly, the progress-to-date of a Delphi process to create outcome measures for psoriasis was reviewed, including preliminary data from the first round of Delphi voting. Updates were also heard from industry partners including the National Psoriasis Foundation (NPF) and the US Food and Drug Administration (FDA). Furthermore, plans to establish outcome measures for hidradenitis suppurativa (HS) were discussed.

J Drugs Dermatol. 2017;16(2):119-124.

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3 Review Genetic variations in cytokines and cytokine receptors associated with psoriasis found by genome-wide association. 2009

Duffin, Kristina Callis / Krueger, Gerald G. ·Department of Dermatology, School of Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah 84132-2409, USA. kcallis@derm.med.utah.edu ·J Invest Dermatol · Pubmed #18830267.

ABSTRACT: Genetic variants have long been suspected to be important in psoriasis. Recent work has suggested that HLA-Cw6 on chromosome 6 is the risk variant in the PSORS1 [MIM 177900] susceptibility locus that confers the greatest risk for early onset of psoriasis. Although numerous minor susceptibility loci have been identified by linkage analysis, few biologically relevant candidates have been discovered within these intervals. Recent large-scale genome-wide association studies have yielded new candidates in genes encoding cytokines with functional relevance to psoriasis. Polymorphisms within the genes encoding the IL-12 p40 subunit, IL12B, and one of the IL-23 receptor subunits, IL23R, have been replicated in US and European populations and overlap with risk of Crohn's disease. Polymorphisms within the gene encoding IL-13, a Th2 cytokine, also confer risk for psoriasis. Variants of the gene IL15 encoding IL-15 have been identified that associate with psoriasis in a Chinese population. These discoveries pose the challenge of elucidating the role of common genetic variants in susceptibility to and manifestations of psoriasis.

4 Review Genetics of psoriasis and psoriatic arthritis: update and future direction. 2008

Duffin, Kristina Callis / Chandran, Vinod / Gladman, Dafna D / Krueger, Gerald G / Elder, James T / Rahman, Proton. ·Department of Dermatology, University of Utah, Salt Lake City, Utah, USA. ·J Rheumatol · Pubmed #18609743.

ABSTRACT: Psoriasis and psoriatic arthritis (PsA) both have substantive genetic determinants. Numerous candidate regions and genes have now been replicated in disease susceptibility, and to a lesser extent in disease expression, in both disease entities. Intensive efforts are now under way or are being planned to perform genome-wide association scans (GWAS) in psoriasis and PsA. A major determinant of success for GWAS is likely to be accumulation of multiple large well-phenotyped cohorts, sophisticated data management, and verification of the findings. At the 2007 Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), members of the GRAPPA genetics committee presented a discussion of the genetics of psoriasis and PsA, including future trends. This article is a summary of that presentation and a review of the literature.

5 Clinical Trial Longitudinal Study of the Psoriasis-Associated Skin Microbiome during Therapy with Ustekinumab in a Randomized Phase 3b Clinical Trial. 2018

Loesche, Michael A / Farahi, Kamyar / Capone, Kimberly / Fakharzadeh, Steven / Blauvelt, Andrew / Duffin, Kristina Callis / DePrimo, Samuel E / Muñoz-Elías, Ernesto J / Brodmerkel, Carrie / Dasgupta, Bidisha / Chevrier, Marc / Smith, Kevin / Horwinski, Joseph / Tyldsley, Amanda / Grice, Elizabeth A. ·Departments of Dermatology and Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. · Dermatology Medical Group, Janssen Research & Development, Horsham, Pennsylvania, USA; Dermatology Medical Group, Janssen Research & Development, Spring House, Pennsylvania, USA; Dermatology Medical Group, Janssen Research & Development, Titusville, New Jersey, USA. · Emerging Science & Innovation, Johnson & Johnson Consumer, Skillman, New Jersey, USA. · Oregon Medical Research Center, Portland, Oregon, USA. · Department of Dermatology, University of Utah, Salt Lake City, Utah, USA. · Immunology Biomarkers, Janssen Research & Development, San Diego, California, USA; Immunology Biomarkers, Janssen Research & Development, Spring House, Pennsylvania, USA. · Lupus Strategy, Janssen Research & Development, Spring House, Pennsylvania, USA. · Departments of Dermatology and Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Electronic address: egrice@pennmedicine.upenn.edu. ·J Invest Dermatol · Pubmed #29559344.

ABSTRACT: Plaque psoriasis, a chronic inflammatory disease primarily affecting the skin, is thought to have a multifactorial etiology, including innate immune system dysregulation, environmental triggers, and genetic susceptibility. We sought to further understand the role of skin microbiota in psoriasis pathogenesis, as well as their response to therapy. We systematically analyzed dynamic microbiota colonizing psoriasis lesions and adjacent nonlesional skin in 114 patients prior to and during ustekinumab treatment in a phase 3b clinical trial. By sequencing the bacterial 16S ribosomal RNA gene from skin swab samples obtained at six anatomical sites, we identified minor, site-specific differences in microbial diversity and composition between pretreatment lesional and nonlesional skin. During therapy, microbial communities within lesional and nonlesional skin diverged, and body-site dispersion increased, reflecting microbial skin site-specificity. Microbiota demonstrated greater pretreatment heterogeneity in psoriatic lesions than in nonlesional skin, and variance increased as treatment progressed. Microbiota colonizing recurrent lesions did not overlap with pretreatment lesional microbiota, suggesting colonization patterns varied between initial and recurrent psoriatic lesions. While plaque psoriasis does not appear to be associated with specific microbes and/or microbial diversity, this large dataset provides insight into microbial variation associated with (i) disease in different body locations, (ii) initial versus recurrent lesions, and (iii) anti-IL12/23 therapy.

6 Clinical Trial Efficacy and Safety of Apremilast in Systemic- and Biologic-Naive Patients With Moderate Plaque Psoriasis: 52-Week Results of UNVEIL. 2018

Stein Gold, Linda / Bagel, Jerry / Lebwohl, Mark / Jackson, J Mark / Chen, Rongdean / Goncalves, Joana / Levi, Eugenia / Duffin, Kristina Callis. · ·J Drugs Dermatol · Pubmed #29462231.

ABSTRACT:

BACKGROUND: Many patients with moderate plaque psoriasis are undertreated despite broadening treatment options. In the phase IV UNVEIL study, oral apremilast demonstrated efficacy and safety in systemic-naive patients with chronic moderate plaque psoriasis with lower psoriasis-involved body surface area (BSA; 5%-10%) during the 16-week, double-blind, placebo-controlled phase. We describe efficacy and safety of apremilast in this population through week 52 in UNVEIL.

METHODS: Patients with moderate plaque psoriasis (BSA 5%-10%; static Physician's Global Assessment [sPGA] score of 3 [moderate]) and naive to systemic therapies for psoriasis were randomized (2:1) to receive apremilast 30 mg twice daily or placebo for 16 weeks. At week 16, patients continued on apremilast (apremilast/apremilast) or were switched from placebo to apremilast (placebo/apremilast) through week 52 (open-label apremilast treatment phase). Efficacy assessments included the product of sPGA and BSA (PGAxBSA) (mean percentage change from baseline; ≥75% reduction from baseline [PGAxBSA-75]), sPGA response (achievement of score of 0 [clear] or 1 [almost clear]), and the Dermatology Life Quality Index (DLQI; mean change from baseline).

RESULTS: A total of 136 patients completed the 52-week analysis period (placebo/apremilast, n=50/64; apremilast/apremilast, n=86/121). At week 52, improvements in all efficacy end points observed at week 16 were maintained in the apremilast/apremilast group (mean percentage change from baseline in PGAxBSA: -55.5%; PGAxBSA-75: 42.1%; sPGA response: 33.1%; mean change from baseline in DLQI score: -4.4); similar improvements emerged in the placebo/apremilast group after switching to apremilast. The most common adverse events (≥5% of patients) through week 52 were diarrhea (28.0%), nausea (19.0%), headache (15.2%), nasopharyngitis (10.4%), upper respiratory tract infection (7.1%), vomiting (5.7%), and decreased appetite (5.2%).

CONCLUSIONS: Apremilast was effective in systemic-naive patients with moderate plaque psoriasis with BSA 5%-10%; efficacy was sustained through week 52. No new safety signals emerged with continued apremilast exposure.

ClinicalTrials.gov: NCT02425826

J Drugs Dermatol. 2018;17(2):221-228.

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7 Clinical Trial Assessing clinical response and defining minimal disease activity in plaque psoriasis with the Physician Global Assessment and body surface area (PGA × BSA) composite tool: An analysis of apremilast phase 3 ESTEEM data. 2017

Gottlieb, Alice B / Merola, Joseph F / Chen, Rongdean / Levi, Eugenia / Duffin, Kristina Callis. ·New York Medical College, Valhalla, New York. Electronic address: alicegottliebderm@gmail.com. · Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. · Celgene Corporation, Summit, New Jersey. · University of Utah, Salt Lake City, Utah. ·J Am Acad Dermatol · Pubmed #29132853.

ABSTRACT: -- No abstract --

8 Clinical Trial The effect of secukinumab on moderate-to-severe scalp psoriasis: Results of a 24-week, randomized, double-blind, placebo-controlled phase 3b study. 2017

Bagel, Jerry / Duffin, Kristina Callis / Moore, Angela / Ferris, Laura K / Siu, Kimberly / Steadman, Jennifer / Kianifard, Farid / Nyirady, Judit / Lebwohl, Mark. ·Psoriasis Treatment Center of Central New Jersey, East Windsor, New Jersey. Electronic address: dreamacres1@aol.com. · Department of Dermatology, University of Utah, Salt Lake City, Utah. · Arlington Research Center, Arlington, Texas; Baylor Medical Center, Dallas, Texas. · Department of Dermatology, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania. · Novartis Pharmaceuticals Corporation, East Hanover, New Jersey. · Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York. ·J Am Acad Dermatol · Pubmed #28780364.

ABSTRACT: BACKGROUND: Moderate-to-severe scalp psoriasis has not been evaluated in prospective trials of patients without moderate-to-severe body psoriasis. OBJECTIVE: Evaluate the efficacy and safety of secukinumab in moderate-to-severe scalp psoriasis. METHODS: In this 24-week, double-blind, phase 3b study, 102 patients were randomized 1:1 to subcutaneous secukinumab 300 mg or placebo at baseline, weeks 1, 2, and 3, and then every 4 weeks from week 4 to 20. The primary efficacy variable was 90% improvement of Psoriasis Scalp Severity Index (PSSI 90) score from baseline to week 12. RESULTS: At week 12, PSSI 90 (secukinumab 300 mg vs placebo, 52.9% vs 2.0%) and Investigator's Global Assessment modified 2011 scalp responses of 0 or 1 (secukinumab 300 mg vs placebo, 56.9% vs 5.9%) were significantly greater with secukinumab 300 mg than placebo (P < .001 for both). In addition, significantly more patients achieved complete clearance of scalp psoriasis at week 12 with secukinumab 300 mg than placebo (35.3% vs 0%; P < .001). The median time to 50% reduction in PSSI score was 3.29 weeks with secukinumab 300 mg. The safety profile of secukinumab was consistent with previous phase 3 studies. LIMITATIONS: There was no active comparator arm. CONCLUSION: Secukinumab is efficacious and well-tolerated for patients with extensive moderate-to-severe scalp psoriasis.

9 Clinical Trial Evaluation of the Physician Global Assessment and Body Surface Area Composite Tool for Assessing Psoriasis Response to Apremilast Therapy: Results from ESTEEM 1 and ESTEEM 2. 2017

Duffin, Kristina C / Papp, Kim A / Bagel, Jerry / Levi, Eugenia / Chen, Rongdean / Gottlieb, Alice B. · ·J Drugs Dermatol · Pubmed #28300857.

ABSTRACT: BACKGROUND: The Physician Global Assessment and Body Surface Area (PGAxBSA) composite tool is a simple, effective alternative for measuring psoriasis severity. OBJECTIVE: To evaluate the product of PGAxBSA as a sensitive alternative to the Psoriasis Area and Severity Index (PASI) for assessing disease severity and therapeutic response with data collected from the phase 3 ESTEEM 1 and 2 trials. METHODS: This post hoc analysis included 836 patients randomized to apremilast 30 mg BID at baseline (ESTEEM 1, n=562; ESTEEM 2, n=274). Spearman correlation coefficients were used to compare PGAxBSA, PASI, and the Dermatology Life Quality Index (DLQI). Concordance between PGAxBSA and PASI was evaluated for 50%/75%/90% improvement from baseline at week 16. RESULTS: In ESTEEM 1 and 2, PGAxBSA and PASI exhibited significant positive correlations for measuring disease severity at baseline (r≥0.757) and week 16 (r≥0.807). At week 16, ≥79% concordance was observed between PGAxBSA and PASI for 75% and 90% improvement from baseline; greater concordance (>88.0%) was observed using 50% improvement from baseline. At week 16, PGAxBSA and PASI were moderately correlated with DLQI. LIMITATIONS: Analysis was limited to patients with baseline BSA ≥10% and static PGA ≥3. CONCLUSIONS: In patients with moderate to severe psoriasis, PGAxBSA is correlated with PASI and sensitive to therapeutic response.

J Drugs Dermatol. 2017;16(2):147-153.

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10 Clinical Trial A Phase 2 Trial of Guselkumab versus Adalimumab for Plaque Psoriasis. 2015

Gordon, Kenneth B / Duffin, Kristina Callis / Bissonnette, Robert / Prinz, Jörg C / Wasfi, Yasmine / Li, Shu / Shen, Yaung-Kaung / Szapary, Philippe / Randazzo, Bruce / Reich, Kristian. ·From the Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago (K.B.G.) · the Department of Dermatology, University of Utah School of Medicine, Salt Lake City (K.C.D.) · Innovaderm Research, Montreal (R.B.) · the Department of Dermatology, Ludwig-Maximilians-Universität München, Munich (J.C.P.), and the Dermatologikum Hamburg, Hamburg (K.R.) - both in Germany · and Janssen Research and Development, Spring House (Y.W., S.L., Y.-K.S., P.S., B.R.), and the Department of Dermatology, University of Pennsylvania, Philadelphia (B.R.) - both in Pennsylvania. ·N Engl J Med · Pubmed #26154787.

ABSTRACT: BACKGROUND: Little is known about the effect of specific anti-interleukin-23 therapy, as compared with established anti-tumor necrosis factor therapies, for the treatment of moderate-to-severe plaque psoriasis. METHODS: In a 52-week, phase 2, dose-ranging, randomized, double-blind, placebo-controlled, active-comparator trial, we compared guselkumab (CNTO 1959), an anti-interleukin-23 monoclonal antibody, with adalimumab in patients with moderate-to-severe plaque psoriasis. A total of 293 patients were randomly assigned to receive guselkumab (5 mg at weeks 0 and 4 and every 12 weeks thereafter, 15 mg every 8 weeks, 50 mg at weeks 0 and 4 and every 12 weeks thereafter, 100 mg every 8 weeks, or 200 mg at weeks 0 and 4 and every 12 weeks thereafter) through week 40, placebo, or adalimumab (standard dosage for psoriasis). At week 16, patients in the placebo group crossed over to receive guselkumab at a dose of 100 mg every 8 weeks. The primary end point was the proportion of patients with a Physician's Global Assessment (PGA) score of 0 (indicating cleared psoriasis) or 1 (indicating minimal psoriasis) at week 16. RESULTS: At week 16, the proportion of patients with a PGA score of 0 or 1 was significantly higher in each guselkumab group than in the placebo group: 34% in the 5-mg group, 61% in the 15-mg group, 79% in the 50-mg group, 86% in the 100-mg group, and 83% in the 200-mg group, as compared with 7% in the placebo group (P≤0.002 for all comparisons). Moreover, the proportion was significantly higher in the 50-mg, 100-mg, and 200-mg guselkumab groups than in the adalimumab group (58%) (P<0.05 for all comparisons). At week 16, the proportion of patients with at least a 75% improvement in Psoriasis Area and Severity Index scores was significantly higher in each guselkumab group than in the placebo group (P<0.001 for all comparisons). At week 40, the proportion of patients with a PGA score of 0 or 1 remained significantly higher in the 50-mg, 100-mg, and 200-mg guselkumab groups than in the adalimumab group (71%, 77%, and 81%, respectively, vs. 49%) (P<0.05 for all comparisons). Between week 0 and week 16, infections were observed in 20% of the patients in the guselkumab groups, 12% in the adalimumab group, and 14% in the placebo group. CONCLUSIONS: The results of this phase 2 trial suggest that guselkumab may be an effective therapy for plaque psoriasis and that control of psoriasis can be achieved with specific anti-interleukin-23 therapy. (Funded by Janssen Research and Development; X-PLORE ClinicalTrials.gov number, NCT01483599.).

11 Clinical Trial Sleep quality and other patient-reported outcomes improve after patients with psoriasis with suboptimal response to other systemic therapies are switched to adalimumab: results from PROGRESS, an open-label Phase IIIB trial. 2012

Strober, B E / Sobell, J M / Duffin, K C / Bao, Y / Guérin, A / Yang, H / Goldblum, O / Okun, M M / Mulani, P M. ·Dermatology Associates, University of Connecticut Health Center, Farmington, CT 06030, USA. brucestrober30@me.com ·Br J Dermatol · Pubmed #22897348.

ABSTRACT: BACKGROUND: Psoriasis is associated with poor health-related quality of life, including sleep impairment. OBJECTIVE: To assess the extent of sleep impairment, the effect of adalimumab on sleep and other patient-reported outcomes, and correlations between changes in these outcomes and sleep quality in patients with psoriasis. METHODS: Patients in the 16-week, open-label, Phase IIIb PROGRESS trial had chronic plaque psoriasis and suboptimal response to prior therapy (etanercept, methotrexate or narrowband ultraviolet B phototherapy). Adalimumab was self-injected subcutaneously (80 mg at week 0, then 40 mg every other week from week 1). The focus for this analysis was the Medical Outcomes Study Sleep Scale. Other patient-reported outcomes included the Dermatology Life Quality Index (DLQI), Psoriasis Area and Severity Index (PASI), Physician's Global Assessment, a visual analogue scale for psoriasis/psoriatic arthritis (PsA) pain, and the Work Productivity and Activity Index Questionnaire-Specific Health Problems. RESULTS: Patients with psoriasis had impaired sleep at baseline. The degree of sleep impairment was significantly associated with the extent of work productivity for all sleep measures and, for some sleep measures, was associated with DLQI impairment, clinical severity measured by PASI, the presence of PsA, and depression. Adalimumab treatment significantly improved sleep quality by 15% from baseline, as well as DLQI score, pain and work productivity. The improvement in sleep was partially explained (R(2 ) = 0·16, P < 0·001) by improvements in the objectively measured psoriasis signs in PASI. CONCLUSIONS: Adalimumab treatment improved sleep outcomes and other patient-reported outcomes including health-related quality of life, work productivity, daily activity and disease-related pain.

12 Article Achieving international consensus on the assessment of psoriatic arthritis in psoriasis clinical trials: an International Dermatology Outcome Measures (IDEOM) initiative. 2018

Perez-Chada, Lourdes Maria / Cohen, Jeffrey M / Gottlieb, Alice Bendix / Duffin, Kristina Callis / Garg, Amit / Latella, John / Armstrong, April Wang / Ogdie, Alexis / Merola, Joseph Frank. ·Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. · The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, USA. · Department of Dermatology, New York Medical College at Metropolitan Hospital, New York, NY, USA. · Department of Dermatology, University of Utah, Salt Lake City, UT, USA. · Department of Dermatology, Hofstra Northwell School of Medicine, New Hyde Park, NY, USA. · International Dermatology Outcome Measures (IDEOM), Windsor, CT, USA. · Department of Dermatology, University of Southern California Keck School of Medicine, Los Angeles, CA, USA. · Division of Rheumatology and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. · Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. jfmerola@bwh.harvard.edu. · Division of Rheumatology, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA. jfmerola@bwh.harvard.edu. ·Arch Dermatol Res · Pubmed #30167814.

ABSTRACT: Psoriatic arthritis (PsA) is rarely assessed in psoriasis randomized controlled trials (RCT); thus, the effect of psoriasis therapy on PsA is unknown. The International Dermatology Outcome Measures (IDEOM) has included "PsA Symptoms" as part of the core domains to be measured in psoriasis RCT. This study aimed to achieve consensus about screening for PsA and how to measure for "PsA Symptoms" in psoriasis RCT. At the IDEOM 2017 Annual Meeting, stakeholders voted on the role of PsA screening in psoriasis RCT. To select measures for "PsA Symptoms", we adapted the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. Three potential measures were selected. At the meeting, stakeholders voted on the validity, feasibility, and responsiveness of these measures. Of the 47 stakeholders, 93% voted that all psoriasis trial participants should be screened for PsA. "PsA Symptoms" measures included Patient Global (PG)-arthritis, Routine Assessment Patient Index Data (RAPID)-3, and Psoriatic Arthritis Impact of Disease (PsAID)-9. During the voting, more than 50% of the voters agreed that RAPID3 and PsAID9 were good measures for PsA Symptoms, able to capture all its essential elements. PsAID9 was considered the most feasible instrument, followed by RAPID3 and PG-arthritis, respectively. Finally, most participants agreed that RAPID3 and PsAID9 were responsive measures. Most study participants voted that all subjects in a psoriasis clinical trial should be screened for PsA. RAPID3 and PsAID9 outperformed PG-arthritis in measuring PsA Symptoms. This will be followed by a Delphi survey involving a larger stakeholder group.

13 Article The Static Physician's Global Assessment of Genitalia: A Clinical Outcome Measure for the Severity of Genital Psoriasis. 2017

Merola, Joseph F / Bleakman, Alison Potts / Gottlieb, Alice B / Menter, Alan / Naegeli, April N / Bissonnette, Robert / Guenther, Lyn / Sullivan, John / Meeuwis, Kim / See, Kyoungah / Duffin, Kristina Callis. · ·J Drugs Dermatol · Pubmed #28809994.

ABSTRACT:

Introduction: Genital psoriasis is a common but frequently overlooked manifestation of psoriasis with a considerable impact on patients' quality of life. Currently no validated clinical trial outcome measures exist to assess genital psoriasis severity that meet regulatory agency requirements.

Methods: This study describes the development of the static Physician's Global Assessment of Genitalia (sPGA-G) scale, a clinical outcome measure for the assessment of genital psoriasis severity that accounts for the erythematous clinical presentation of genital psoriasis. The reliability of the sPGA-G was evaluated using scores collected from clinician assessments of photographs of genital psoriasis cases. Scores were collected from 10 academic and clinical experts in genital psoriasis and 95 clinician assessors who participated in either in-person (n=28) or online (n=67) sPGA-G training modules.

Results: The sPGA-G had a high inter-rater reliability (IRR, measured by Kendall's W) for expert raters (W=0.856, P less than 0.0001), in-person assessors (W=0.822, P less than 0.0001), and online assessors (W=0.678, P less than 0.0001). IRR was also high for all clinical assessors combined, (W=0.714, P less than 0.0001).

Discussion: This study demonstrates that the sPGA-G is an intuitive and reliable clinical outcome measure that specifically measures the severity of genital psoriasis.

J Drugs Dermatol. 2017;16(8):793-799.

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14 Article Large scale meta-analysis characterizes genetic architecture for common psoriasis associated variants. 2017

Tsoi, Lam C / Stuart, Philip E / Tian, Chao / Gudjonsson, Johann E / Das, Sayantan / Zawistowski, Matthew / Ellinghaus, Eva / Barker, Jonathan N / Chandran, Vinod / Dand, Nick / Duffin, Kristina Callis / Enerbäck, Charlotta / Esko, Tõnu / Franke, Andre / Gladman, Dafna D / Hoffmann, Per / Kingo, Külli / Kõks, Sulev / Krueger, Gerald G / Lim, Henry W / Metspalu, Andres / Mrowietz, Ulrich / Mucha, Sören / Rahman, Proton / Reis, Andre / Tejasvi, Trilokraj / Trembath, Richard / Voorhees, John J / Weidinger, Stephan / Weichenthal, Michael / Wen, Xiaoquan / Eriksson, Nicholas / Kang, Hyun M / Hinds, David A / Nair, Rajan P / Abecasis, Gonçalo R / Elder, James T. ·Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA. · Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan 48109, USA. · Department of Computational Medicine &Bioinformatics, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA. · 23andMe, Inc., Mountain View, California 94041, USA. · Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel 24105, Germany. · St John's Institute of Dermatology, Division of Genetics and Molecular Medicine, Faculty of Life Sciences and Medicine, King's College London, London SE1 9RT, UK. · Department of Medicine, Division of Rheumatology, University of Toronto, Toronto, Ontario, Canada M5S 1A8. · Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Research Institute, University of Toronto, Toronto, Ontario, Canada M5T 2S8. · Department of Dermatology, University of Utah, Salt Lake City, Utah 84132, USA. · Department of Dermatology, Linköping University, Linköping SE-581 83, Sweden. · Estonian Genome Center, University of Tartu, Tartu 51010, Estonia. · Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA. · Institute of Human Genetics, University of Bonn, Bonn 53127, Germany. · Division of Medical Genetics, Department of Biomedicine, University of Basel, Basel 4031, Switzerland. · Dermatology Clinic, Tartu University Hospital, Department of Dermatology and Venereology, University of Tartu, Tartu 50417, Estonia. · Department of Pathophysiology, Centre of Translational Medicine and Centre for Translational Genomics, University of Tartu, Tartu 50411, Estonia. · Department of Reproductive Biology, Estonian University of Life Sciences, Tartu 51006, Estonia. · Department of Dermatology, Henry Ford Hospital, Detroit, Michigan 48202, USA. · Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel 24105, Germany. · Memorial University, St. John's, Newfoundland, Newfoundland and Labrador, Canada A1B 3X9. · Institute of Human Genetics, FAU Erlangen-Nürnberg, Erlangen 91054, Germany. · Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan 48105, USA. · Department of Medical and Molecular Genetics, King's College London, London WC2R 2LS, UK. ·Nat Commun · Pubmed #28537254.

ABSTRACT: Psoriasis is a complex disease of skin with a prevalence of about 2%. We conducted the largest meta-analysis of genome-wide association studies (GWAS) for psoriasis to date, including data from eight different Caucasian cohorts, with a combined effective sample size >39,000 individuals. We identified 16 additional psoriasis susceptibility loci achieving genome-wide significance, increasing the number of identified loci to 63 for European-origin individuals. Functional analysis highlighted the roles of interferon signalling and the NFκB cascade, and we showed that the psoriasis signals are enriched in regulatory elements from different T cells (CD8

15 Article Genome-wide meta-analysis identifies multiple novel associations and ethnic heterogeneity of psoriasis susceptibility. 2015

Yin, Xianyong / Low, Hui Qi / Wang, Ling / Li, Yonghong / Ellinghaus, Eva / Han, Jiali / Estivill, Xavier / Sun, Liangdan / Zuo, Xianbo / Shen, Changbing / Zhu, Caihong / Zhang, Anping / Sanchez, Fabio / Padyukov, Leonid / Catanese, Joseph J / Krueger, Gerald G / Duffin, Kristina Callis / Mucha, Sören / Weichenthal, Michael / Weidinger, Stephan / Lieb, Wolfgang / Foo, Jia Nee / Li, Yi / Sim, Karseng / Liany, Herty / Irwan, Ishak / Teo, Yikying / Theng, Colin T S / Gupta, Rashmi / Bowcock, Anne / De Jager, Philip L / Qureshi, Abrar A / de Bakker, Paul I W / Seielstad, Mark / Liao, Wilson / Ståhle, Mona / Franke, Andre / Zhang, Xuejun / Liu, Jianjun. ·1] Institute of Dermatology and Department of Dermatology at No.1 Hospital, Anhui Medical University, Hefei, Anhui 230032, China [2] State Key Laboratory Incubation Base of Dermatology, Ministry of National Science and Technology, Anhui Medical University, Hefei, Anhui 230032, China [3] Key Lab of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui 230032, China [4] Collaborative Innovation Center for Complex and Severe Skin Diseases, Anhui Medical University, Hefei, Anhui 230032, China. · Department of Human Genetics, Genome Institute of Singapore, A*STAR, Singapore 138672, Singapore. · Celera, Alameda, California 94502, USA. · Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Schittenhelm Street 12, Kiel 24105, Germany. · 1] Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana 46202, USA [2] Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, Indiana 46202, USA [3] Department of Dermatology, School of Medicine, Indiana University, Indianapolis, Indiana 46202, USA. · 1] Genetic Causes of Disease Group, Centre for Genomic Regulation (CRG), Barcelona, Catalonia, E-08003, Spain [2] Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Catalonia, E-08003, Spain [3] Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, E-08003, Spain [4] CIBER in Epidemiology and Public Health (CIBERESP), Barcelona, Catalonia, E-08003, Spain. · Unit of Dermatology and Venereology, Department of Medicine, Karolinska Institutet, Stockholm 17176, Sweden. · Rheumatology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm 17177, Sweden. · Department of Dermatology, University of Utah, Salt Lake, Utah 84132, USA. · Department of Dermatology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany. · Institute of Epidemiology and Biobank PopGen, Christian Albrechts University, Kiel, Germany. · 1] Departments of Statistics and Applied Probability, National University of Singapore, Singapore 138672, Singapore [2] Department of Epidemiology and Public Health, National University of Singapore, Singapore 138672, Singapore. · National Skin Centre, Singapore 308205, Singapore. · Department of Dermatology, University of California San Francisco, San Francisco, California 94115, USA. · National Heart and Lung Institute, Imperial College, London SW3 6LY, UK. · 1] Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts 02138, USA [2] Program in Translational NeuroPsychiatric Genomics, Department of Neurology, Brigham &Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. · 1] Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana 46202, USA [2] Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, Indiana 46202, USA [3] Program in Translational NeuroPsychiatric Genomics, Department of Neurology, Brigham &Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. · 1] Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, 3584 CG, The Netherlands [2] Department of Medical Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht, 3584 CG, The Netherlands. · 1] Department of Human Genetics, Genome Institute of Singapore, A*STAR, Singapore 138672, Singapore [2] Institute for Human Genetics, University of California San Francisco, San Francisco, California 94143, USA. · 1] State Key Laboratory Incubation Base of Dermatology, Ministry of National Science and Technology, Anhui Medical University, Hefei, Anhui 230032, China [2] Key Lab of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui 230032, China [3] Collaborative Innovation Center for Complex and Severe Skin Diseases, Anhui Medical University, Hefei, Anhui 230032, China [4] Department of Human Genetics, Genome Institute of Singapore, A*STAR, Singapore 138672, Singapore [5] Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore, 138672, Singapore [6] School of Life Sciences, Anhui Medical University, Hefei, Anhui 230032, China. ·Nat Commun · Pubmed #25903422.

ABSTRACT: Psoriasis is a common inflammatory skin disease with complex genetics and different degrees of prevalence across ethnic populations. Here we present the largest trans-ethnic genome-wide meta-analysis (GWMA) of psoriasis in 15,369 cases and 19,517 controls of Caucasian and Chinese ancestries. We identify four novel associations at LOC144817, COG6, RUNX1 and TP63, as well as three novel secondary associations within IFIH1 and IL12B. Fine-mapping analysis of MHC region demonstrates an important role for all three HLA class I genes and a complex and heterogeneous pattern of HLA associations between Caucasian and Chinese populations. Further, trans-ethnic comparison suggests population-specific effect or allelic heterogeneity for 11 loci. These population-specific effects contribute significantly to the ethnic diversity of psoriasis prevalence. This study not only provides novel biological insights into the involvement of immune and keratinocyte development mechanism, but also demonstrates a complex and heterogeneous genetic architecture of psoriasis susceptibility across ethnic populations.

16 Article The International Dermatology Outcome Measures Group: formation of patient-centered outcome measures in dermatology. 2015

Gottlieb, Alice B / Levin, Adriane A / Armstrong, April W / Abernethy, April / Duffin, Kristina Callis / Bhushan, Reva / Garg, Amit / Merola, Joseph F / Maccarone, Mara / Christensen, Robin. ·Department of Dermatology, Tufts Medical Center, Boston, Massachusetts; Tufts University School of Medicine, Boston, Massachusetts. · Department of Dermatology, Tufts Medical Center, Boston, Massachusetts; Boston University School of Medicine, Boston, Massachusetts. · University of Colorado School of Medicine, Denver, Colorado. · National Psoriasis Foundation, Portland, Oregon. · Department of Dermatology, University of Utah, Salt Lake City, Utah. · American Academy of Dermatology, Schaumburg, Illinois. Electronic address: rbhushan@aad.org. · Department of Dermatology, Hofstra North Shore Long Island Jewish School of Medicine, Manhasset, New York. · Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. · Associazione per la Difesa delgi Proriasici, Rome, Italy. · Department of Rheumatology, Michigan State University, Parker Institute, Copenhagen, Denmark. ·J Am Acad Dermatol · Pubmed #25486914.

ABSTRACT: As quality standards are increasingly in demand throughout medicine, dermatology needs to establish outcome measures to quantify the effectiveness of treatments and providers. The International Dermatology Outcome Measures Group was established to address this need. Beginning with psoriasis, the group aims to create a tool considerate of patients and providers using the input of all relevant stakeholders in assessment of disease severity and response to treatment. Herein, we delineate the procedures through which consensus is being reached and the future directions of the project.

17 Article Fine mapping of eight psoriasis susceptibility loci. 2015

Das, Sayantan / Stuart, Philip E / Ding, Jun / Tejasvi, Trilokraj / Li, Yanming / Tsoi, Lam C / Chandran, Vinod / Fischer, Judith / Helms, Cynthia / Duffin, Kristina Callis / Voorhees, John J / Bowcock, Anne M / Krueger, Gerald G / Lathrop, G Mark / Nair, Rajan P / Rahman, Proton / Abecasis, Goncalo R / Gladman, Dafna / Elder, James T. ·Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, USA. · Department of Dermatology, University of Michigan, Ann Arbor, MI, USA. · 1] Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, USA [2] Laboratory of Genetics, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA. · Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, ON, Canada. · Centre National de Génotypage, Institut Génomique, Commissariat à l'Énergie Atomique, Evry, France. · National Heart and Lung Institute, Imperial College London, London, UK. · Department of Dermatology, University of Utah, Salt Lake City, UT, USA. · Department of Medicine, Memorial University, St John's, NL, Canada. · 1] Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, ON, Canada [2] Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Research Institute, Toronto, ON, Canada. · 1] Department of Dermatology, University of Michigan, Ann Arbor, MI, USA [2] Ann-Arbor Veteran Affairs Hospital, Ann Arbor, MI, USA. ·Eur J Hum Genet · Pubmed #25182136.

ABSTRACT: Previous studies have identified 41 independent genome-wide significant psoriasis susceptibility loci. After our first psoriasis genome-wide association study, we designed a custom genotyping array to fine-map eight genome-wide significant susceptibility loci known at that time (IL23R, IL13, IL12B, TNIP1, MHC, TNFAIP3, IL23A and RNF114) enabling genotyping of 2269 single-nucleotide polymorphisms (SNPs) in the eight loci for 2699 psoriasis cases and 2107 unaffected controls of European ancestry. We imputed these data using the latest 1000 Genome reference haplotypes, which included both indels and SNPs, to increase the marker density of the eight loci to 49 239 genetic variants. Using stepwise conditional association analysis, we identified nine independent signals distributed across six of the eight loci. In the major histocompatibility complex (MHC) region, we detected three independent signals at rs114255771 (P = 2.94 × 10(-74)), rs6924962 (P = 3.21 × 10(-19)) and rs892666 (P = 1.11 × 10(-10)). Near IL12B we detected two independent signals at rs62377586 (P = 7.42 × 10(-16)) and rs918518 (P = 3.22 × 10(-11)). Only one signal was observed in each of the TNIP1 (rs17728338; P = 4.15 × 10(-13)), IL13 (rs1295685; P = 1.65 × 10(-7)), IL23A (rs61937678; P = 1.82 × 10(-7)) and TNFAIP3 (rs642627; P = 5.90 × 10(-7)) regions. We also imputed variants for eight HLA genes and found that SNP rs114255771 yielded a more significant association than any HLA allele or amino-acid residue. Further analysis revealed that the HLA-C*06-B*57 haplotype tagged by this SNP had a significantly higher odds ratio than other HLA-C*06-bearing haplotypes. The results demonstrate allelic heterogeneity at IL12B and identify a high-risk MHC class I haplotype, consistent with the existence of multiple psoriasis effectors in the MHC.

18 Article Work productivity loss and fatigue in psoriatic arthritis. 2014

Walsh, Jessica A / McFadden, Molly L / Morgan, Michael D / Sawitzke, Allen D / Duffin, Kristina Callis / Krueger, Gerald G / Clegg, Daniel O. ·From the Division of Rheumatology, Division of Epidemiology, Department of Dermatology, University of Utah; Division of Rheumatology, George E. Wahlen Veteran Affairs Medical Center, Salt Lake City, Utah, USA.J.A. Walsh, MD, Assistant Professor of Rheumatology, Division of Rheumatology, University of Utah, and Division of Rheumatology, George E. Wahlen Veteran Affairs Medical Center; M.L. McFadden, MS, Biostatistician III, Division of Epidemiology, University of Utah; M.D. Morgan, MD, Fellow of Rheumatology, Division of Rheumatology, University of Utah, and Division of Rheumatology, George E. Wahlen Veteran Affairs Medical Center; A.D. Sawitzke, MD, Professor of Rheumatology, Division of Rheumatology; K. Callis Duffin, MD, Assistant Professor of Dermatology; G.G. Krueger, MD, Professor of Dermatology, Department of Dermatology, University of Utah; D.O. Clegg, MD, Professor of Rheumatology, Division of Rheumatology, University of Utah, and Division of Rheumatology, George E. Wahlen Veteran Affairs Medical Center. ·J Rheumatol · Pubmed #25028377.

ABSTRACT: OBJECTIVE: To explore the relationship between fatigue and work productivity loss (WPL) in people with psoriatic arthritis (PsA). METHODS: Data were collected from participants in the Utah Psoriasis Initiative Arthritis registry between January 2010 and May 2013. WPL was measured with the 8-item Work Limitations Questionnaire. Fatigue was assessed with question 1 from the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI#1), "How would you describe the overall level of fatigue/tiredness you have experienced?" and with question 1 from the Psoriatic Arthritis Quality of Life Questionnaire (PsAQOL#1) "I feel tired whatever I do." Psoriatic activity was evaluated with tender joint count (TJC), swollen joint count (SJC), dactylitis count, enthesitis count, inflammatory back pain (IBP), physician global assessment, body surface area, and psoriasis pain and itch. RESULTS: Among 107 participants, work productivity was reduced by 6.7%, compared to benchmark employees without limitations. Fatigue was reported by 54 patients (50.5%) on PsAQOL#1, and 64 (60.0%) were classified as high fatigue by BASDAI#1. TJC, SJC, enthesitis count, IBP, and depressed mood were highest or most frequent in participants reporting fatigue. After adjustments for psoriatic activity and depressed mood, WPL was associated with fatigue, as measured by PsAQOL#1 (p = 0.01) and BASDAI#1 (p = 0.002). CONCLUSION: WPL was associated with fatigue, and the association was not entirely explained by the evaluated musculoskeletal, cutaneous, or psychiatric manifestations of PsA.

19 Article Psoriasis and psoriatic arthritis educational initiatives: an update from the 2013 GRAPPA Annual Meeting. 2014

Duffin, Kristina Callis / Garg, Amit / Armstrong, April W / Helliwell, Philip / Mease, Philip J. ·From the University of Utah, Salt Lake City, Utah; Department of Dermatology, Hofstra North Shore LIJ School of Medicine, Hempstead, New York; Department of Dermatology, University of Colorado, Denver, Colorado, USA; Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital, Leeds, UK; Rheumatology Research, Swedish Medical Center; University of Washington School of Medicine, Seattle, Washington, USA.K. Callis Duffin, MD, University of Utah; A. Garg, MD, Associate Professor, Department of Dermatology, Hofstra North Shore LIJ School of Medicine; A.W. Armstrong, MD, MPH, Department of Dermatology, University of Colorado; P.S. Helliwell, DM, PhD, Academic Unit of Musculoskeletal Disease, Chapel Allerton Hospital; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center; Clinical Professor, University of Washington School of Medicine. ·J Rheumatol · Pubmed #24882862.

ABSTRACT: At the 2013 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), members were updated on educational areas in psoriasis and psoriatic arthritis (PsA). Discussions included (1) the psoriasis and PsA GRAPPA video project, comprising a set of educational online videos that provide standardized psoriatic disease endpoint training to clinicians and researchers; (2) the GRAPPA Educational Outreach Project, focused on cross-disciplinary education for rheumatologists and dermatologists and including several collaborations to expand educational sessions globally; (3) the Dermatology and Rheumatology Trainee Educational Initiative, that provides psoriatic disease education to medical students, residents, and fellows training in dermatology and/or rheumatology; and (4) the GRAPPA Educational Slide Library, developed as a resource for GRAPPA members for their own educational presentations.

20 Article The International Dermatology Outcome Measures initiative as applied to psoriatic disease outcomes: a report from the GRAPPA 2013 meeting. 2014

Gottlieb, Alice B / Armstrong, April W / Christensen, Robin / Garg, Amit / Duffin, Kristina Callis / Boehncke, Wolf-Henning / Merola, Joseph F / Gladman, Dafna D / Mease, Philip J / Swerlick, Robert A / Rosen, Cheryl F / Abernethy, April. ·From the Tufts Medical Center, Boston, Massachusetts; Department of Dermatology, University of Colorado, Denver, Colorado, USA; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark; Department of Dermatology, Hofstra North Shore LIJ School of Medicine, Hempstead, New York; Department of Dermatology, University of Utah, Salt Lake City, Utah, USA; Department of Dermatology, Geneva University Hospital, Geneva, Switzerland; Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA; University of Toronto, Toronto Western Research Institute; Psoriatic Arthritis Program, University Health Network, Toronto, Ontario, Canada; Seattle Rheumatology Associates, Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine, Seattle, Washington; Department of Dermatology, Emory University, Atlanta, Georgia, USA; Division of Dermatology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada; National Psoriasis Foundation, Portland, Oregon, USA.A.B. Gottlieb, MD, PhD, Tufts Medical Center; A.W. Armstrong, MD, MPH, Department of Dermatology, University of Colorado; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital; A. Garg, MD, Department of Dermatology, Hofstra North Shore LIJ School of Medicine; K. Callis Duffin, MD, MS, Department of Dermatology, University of Utah; W-H. Boehncke, MD, Department of Dermatology, Geneva University Hospital; J.F. Merola, MD, Harvard Medical School, Brigham and Women's Hospital; D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto; Senior Scientist, Toronto Western Research Institute; Director, Psoriatic Arthritis Program, University Health Network; P.J. Mease, MD, Seattle Rheumatology Associates, Director, Rheumatology Research, Swedish Medical Center, Clinical Professor, Univ ·J Rheumatol · Pubmed #24882858.

ABSTRACT: In the United States, access to care is the number one issue facing our patients with dermatological conditions. In part, this is because we do not have outcome measures that are useful in clinical practice and available in databases where payers and governmental agencies can compare the performance of physicians and treatments. There is a growing recognition that insufficient attention has been paid to the outcomes measured in clinical trials and subsequently in clinical practice. The International Dermatology Outcome Measures group includes all willing stakeholders: patients, physicians, payers, and pharmaceutical scientists. As reported herein, the group's goal is to develop outcome measures in dermatology that address the needs of all involved.

21 Article Patient satisfaction with treatments for moderate-to-severe plaque psoriasis in clinical practice. 2014

Duffin, K Callis / Yeung, H / Takeshita, J / Krueger, G G / Robertson, A D / Troxel, A B / Shin, D B / Van Voorhees, A S / Gelfand, J M. ·Department of Dermatology, University of Utah School of Medicine, Salt Lake City, UT, USA. · Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA. · Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. · Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. · National Psoriasis Foundation, Portland, OR, USA. · Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. ·Br J Dermatol · Pubmed #24266717.

ABSTRACT: BACKGROUND: Treatment satisfaction among patients with moderate-to-severe psoriasis has not been studied and compared across treatments using a validated instrument. OBJECTIVES: To assess patient-reported satisfaction with systemic and phototherapy treatments for moderate-to-severe psoriasis in clinical practice and to correlate satisfaction with disease severity and quality-of-life measures. METHODS: This was a cross-sectional study of 1182 patients with moderate-to-severe psoriasis in the Dermatology Clinical Effectiveness Research Network in the U.S.A. Patients receiving either topical therapies only; monotherapy with oral systemic therapies, biologics or narrowband ultraviolet B phototherapy; or combination therapy with biologics and methotrexate completed the Treatment Satisfaction Questionnaire for Medication version II. RESULTS: Median unadjusted overall satisfaction scores were highest for patients receiving biologic monotherapies, biologic-methotrexate combinations, or phototherapy (83.3); scores were lowest for those receiving topical therapies only or acitretin (66.7). In fully adjusted models, compared with patients receiving methotrexate monotherapy, those receiving adalimumab, etanercept, ustekinumab, phototherapy or adalimumab with methotrexate had significantly higher median overall satisfaction scores by 7.2-8.3 points, while those receiving topical therapies only had significantly lower overall satisfaction by 8.9 points. Adjusted convenience scores were lowest for patients receiving topical therapies only or infliximab. Modest but significant correlations were found between the overall satisfaction subscale and both the Psoriasis Area and Severity Index (ρ = -0.36, P < 0.001) and the Dermatology Life Quality Index (ρ = -0.47, P < 0.001). CONCLUSIONS: Discernible differences were found in treatment satisfaction among therapies, particularly regarding treatment effectiveness and convenience. Further application of treatment satisfaction measures may inform treatment decisions and guideline development.

22 Article Product of the Physician Global Assessment and body surface area: a simple static measure of psoriasis severity in a longitudinal cohort. 2013

Walsh, Jessica A / McFadden, Molly / Woodcock, Jamie / Clegg, Daniel O / Helliwell, Philip / Dommasch, Erica / Gelfand, Joel M / Krueger, Gerald G / Duffin, Kristina Callis. ·Division of Rheumatology, University of Utah, Salt Lake City, Utah. Electronic address: jessica.walsh@hsc.utah.edu. ·J Am Acad Dermatol · Pubmed #24054760.

ABSTRACT: BACKGROUND: The Psoriasis Area and Severity Index (PASI) is considered the gold standard assessment tool for psoriasis severity, but PASI is limited by its complexity and insensitivity in people with mild psoriasis. OBJECTIVE: We sought to evaluate the product of a Physician Global Assessment (PGA) and Body Surface Area (BSA) (PGAxBSA) as an alternative to PASI. METHODS: Psoriasis severity was evaluated at 6-month intervals in participants of the Utah Psoriasis Initiative registry. Correlation coefficients were used to compare PGAxBSA with PASI and the Simplified PASI (SPASI). RESULTS: Between August 2008 and November 2010, 435 assessments were completed in 226 participants. The median PASI score was 3.2 (interquartile range 1.8-5.4) and the median BSA was 3.0% (interquartile range 1.0%-5.0%). PGAxBSA had higher correlations with PASI than SPASI (0.87 vs 0.76, P < .001). PGAxBSA also had higher correlations with a Global Patient Assessment of psoriasis severity (0.65) than both PASI (0.59, P < .001) and SPASI (0.51, P < .001). LIMITATIONS: The use of PGAxBSA for measuring severe psoriasis and response to therapy is unclear, because most participants had mild to moderate psoriasis and data were not collected at predefined intervals in relation to therapy initiation. Interrater reliability was not assessed. CONCLUSIONS: PGAxBSA is a simple and sensitive instrument for measuring psoriasis severity.

23 Article Standardizing training for psoriasis measures: effectiveness of an online training video on Psoriasis Area and Severity Index assessment by physician and patient raters. 2013

Armstrong, April W / Parsi, Kory / Schupp, Clayton W / Mease, Philip J / Duffin, Kristina C. ·Department of Dermatology, University of California, Davis, 3301 C St, Ste 1400, Sacramento, CA 95816, USA. aprilarmstrong@post.harvard.edu ·JAMA Dermatol · Pubmed #23426158.

ABSTRACT: IMPORTANCE: Because the Psoriasis Area and Severity Index (PASI) is the most commonly used and validated disease severity measure for clinical trials, it is imperative to standardize training to ensure reliability in PASI scoring for accurate assessment of disease severity. OBJECTIVE: To evaluate whether an online PASI training video improves scoring accuracy among patients with psoriasis and physicians on first exposure to PASI. DESIGN: This equivalency study compared PASI assessment performed by patients and PASI-naive physicians with that of PASI-experienced physicians at baseline and after standardized video training. The study was conducted from March 15, 2011, to September 1, 2011. SETTING: Outpatient psoriasis clinic at University of California, Davis. PARTICIPANTS: Forty-two psoriasis patients and 14 PASI-naive physicians participated in the study. The scores from 12 dermatologists experienced in PASI evaluation were used as the criterion standard against which other scores were compared. MAIN OUTCOME MEASURES: Aggregate and component PASI scores from image sets corresponding to mild, moderate, and severe psoriasis. RESULTS: After viewing the training video, PASI-naive physicians produced equivalent scores for all components of PASI; patients provided equivalent scores for most PASI components, with the exception of area scores for moderate-to-severe psoriasis images. After the online video training, the PASI-naive physicians and patients exhibited improved accuracy in assigning total PASI scores for mild (Mean(experienced physician) - Mean(PASI-naive physician): 1.2; Mean(experienced physician) - Mean(patient): -2.1), moderate (Mean(experienced physician) - Mean(PASI-naive physician): 0; Mean(experienced physician) - Mean(patient): -5.7), and severe (Mean(experienced physician) - Mean(PASI-naive physician): -5.1; Mean(experienced physician) - Mean(patient): -10.4) psoriasis, respectively. CONCLUSIONS AND RELEVANCE: Use of an online PASI training video represents an effective tool in improving accuracy in PASI scoring by both health care professionals and patients. The video-based online platform for disseminating standardized training on the use of validated instruments in dermatology represents a novel form of standardized education.

24 Article Rare and common variants in CARD14, encoding an epidermal regulator of NF-kappaB, in psoriasis. 2012

Jordan, Catherine T / Cao, Li / Roberson, Elisha D O / Duan, Shenghui / Helms, Cynthia A / Nair, Rajan P / Duffin, Kristina Callis / Stuart, Philip E / Goldgar, David / Hayashi, Genki / Olfson, Emily H / Feng, Bing-Jian / Pullinger, Clive R / Kane, John P / Wise, Carol A / Goldbach-Mansky, Raphaela / Lowes, Michelle A / Peddle, Lynette / Chandran, Vinod / Liao, Wilson / Rahman, Proton / Krueger, Gerald G / Gladman, Dafna / Elder, James T / Menter, Alan / Bowcock, Anne M. ·Division of Human Genetics, Department of Genetics, Washington University School of Medicine, St. Louis, MO 63110, USA. ·Am J Hum Genet · Pubmed #22521419.

ABSTRACT: Psoriasis is a common inflammatory disorder of the skin and other organs. We have determined that mutations in CARD14, encoding a nuclear factor of kappa light chain enhancer in B cells (NF-kB) activator within skin epidermis, account for PSORS2. Here, we describe fifteen additional rare missense variants in CARD14, their distribution in seven psoriasis cohorts (>6,000 cases and >4,000 controls), and their effects on NF-kB activation and the transcriptome of keratinocytes. There were more CARD14 rare variants in cases than in controls (burden test p value = 0.0015). Some variants were only seen in a single case, and these included putative pathogenic mutations (c.424G>A [p.Glu142Lys] and c.425A>G [p.Glu142Gly]) and the generalized-pustular-psoriasis mutation, c.413A>C (p.Glu138Ala); these three mutations lie within the coiled-coil domain of CARD14. The c.349G>A (p.Gly117Ser) familial-psoriasis mutation was present at a frequency of 0.0005 in cases of European ancestry. CARD14 variants led to a range of NF-kB activities; in particular, putative pathogenic variants led to levels >2.5× higher than did wild-type CARD14. Two variants (c.511C>A [p.His171Asn] and c.536G>A [p.Arg179His]) required stimulation with tumor necrosis factor alpha (TNF-α) to achieve significant increases in NF-kB levels. Transcriptome profiling of wild-type and variant CARD14 transfectants in keratinocytes differentiated probably pathogenic mutations from neutral variants such as polymorphisms. Over 20 CARD14 polymorphisms were also genotyped, and meta-analysis revealed an association between psoriasis and rs11652075 (c.2458C>T [p.Arg820Trp]; p value = 2.1 × 10(-6)). In the two largest psoriasis cohorts, evidence for association increased when rs11652075 was conditioned on HLA-Cw*0602 (PSORS1). These studies contribute to our understanding of the genetic basis of psoriasis and illustrate the challenges faced in identifying pathogenic variants in common disease.

25 Article Response to ustekinumab in a patient with both severe psoriasis and hypertrophic cutaneous lupus. 2012

Winchester, D / Duffin, K Callis / Hansen, C. ·University of Utah, Department of Dermatology, 30 North 1900 East 4A330, School of Medicine, SLC UT 84132, USA. daniel.winchester@hsc.utah.edu ·Lupus · Pubmed #22438028.

ABSTRACT: Psoriasis is an autoimmune inflammatory disease that has recently been treated with a novel treatment, ustekinumab, a human monoclonal antibody that targets the Th17 pathway. Discoid lupus is a subset of chronic cutaneous lupus erythematosus. Recent studies have suggested the Th17 pathway may be involved in cutaneous lupus. We present a case of a 41-year-old man with both severe psoriasis and hypertrophic discoid lupus treated with ustekinumab. After three doses of 45 mg subcutaneous injections at day 1, week 4, and week 16, his psoriasis plaques cleared and his hypertrophic discoid lupus plaques showed moderate improvement. Following a fourth dose of 90 mg his lupus plaques showed marked improvement. Ustekinumab may be a promising therapy for this and other forms of cutaneous lupus.

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