The Resource Biologic and nonbiologic systemic agents and phototherapy for treatment of chronic plaque psoriasis, prepared for Agency for Healthcare Research and Quality ; prepared by the University of Connecticut/Hartford Hospital Evidence-based Practice Center ; investigators, Soyon Lee [and others], (electronic resource)

Biologic and nonbiologic systemic agents and phototherapy for treatment of chronic plaque psoriasis, prepared for Agency for Healthcare Research and Quality ; prepared by the University of Connecticut/Hartford Hospital Evidence-based Practice Center ; investigators, Soyon Lee [and others], (electronic resource)

Label
Biologic and nonbiologic systemic agents and phototherapy for treatment of chronic plaque psoriasis
Title
Biologic and nonbiologic systemic agents and phototherapy for treatment of chronic plaque psoriasis
Statement of responsibility
prepared for Agency for Healthcare Research and Quality ; prepared by the University of Connecticut/Hartford Hospital Evidence-based Practice Center ; investigators, Soyon Lee [and others]
Contributor
Subject
Genre
Language
eng
Summary
OBJECTIVES: To examine the comparative effectiveness of biologic systemic agents versus nonbiologic systemic agents or phototherapy, on an individual drug level, for treatment of chronic plaque psoriasis (CPP) and to determine patient and disease characteristics that modify outcomes of interest. DATA SOURCES: Medline, the Cochrane Central Register of Controlled Trials, and Web of Science from inception to June 2012, with no language restrictions. REVIEW METHODS: Randomized controlled trials (RCTs) and observational studies were included in our review if they compared treatment with Food and Drug Administration-approved biologic systemic agents with either an approved nonbiologic systemic agent or phototherapy in adult patients with CPP and provided data on at least one prespecified outcome. Using predefined criteria, data on study design and population, interventions, quality, and outcomes were extracted. No quantitative analyses were performed and all data were qualitatively synthesized. The strength of evidence (SOE) for individual outcome was rated, when possible, as insufficient (I), low (L), moderate (M), or high (H). The applicability of the body of evidence was described. RESULTS: Five RCTs and four observational studies directly compared therapies from the specified classes. An additional five studies provided data on the transition of patients from one therapy to another. Studies generally reported short-term outcomes (median of 24 weeks) in small (<200 subjects) international patient populations. Compared with methotrexate, adalimumab improved health-related quality of life (HRQoL) [SOE: L], Psoriasis Area and Severity Index (PASI) [SOE: L], Physician's Global Assessment (PGA) score [SOE: L], and patient's assessment of disease severity score [SOE: L], while reducing pain [SOE: L] and pruritus [SOE: L] with no effect on infection rates [SOE: L]. Compared with acitretin, etanercept improved PASI [SOE: M] and compared with methotrexate, infliximab improved HRQoL [SOE: L], PASI [SOE: L], and PGA [SOE: L]. Compared with methotrexate, ustekinumab improved PGA [SOE:L]. Data were insufficient for any other comparisons and outcomes. Data from the post-hoc subgroup analysis of one RCT that compared treatment with adalimumab with treatment with methotrexate suggested that as disease severity improved, so did a patient's HRQoL. Data were insufficient to evaluate the impact of any other patient or disease characteristics on outcomes. CONCLUSIONS: In patients with CPP, there were limited data directly comparing systemic biologic agents with either systemic nonbiolgic agents or with phototherapy on an individual drug level. Overall there is insufficient evidence to determine the comparative effectiveness of individual therapies, as compared with each other between the specified classes, with few exceptions. For the comparisons of adalimumab versus methotrexate, infliximab versus methotrexate, ustekinumab versus methotrexate, and etanercept versus acitretin, there is predominantly low strength of evidence favoring the individual biologic agent versus the nonbiologic agent. Additional trials directly comparing biologic systemic agents, systemic nonbiologic agents, and phototherapy are needed
Member of
Cataloging source
NLM
Funding information
Conducted by the University of Connecticut/Hartford Hospital Evidence-based Practice Center under contract to the Agency for Healthcare Research and Quality
Government publication
federal national government publication
Illustrations
illustrations
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • bibliography
NLM call number
WR 205
http://library.link/vocab/relatedWorkOrContributorName
  • Lee, Soyon
  • United States
  • University of Connecticut-Hartford Hospital Evidence-based Practice Center
  • Effective Health Care Program (U.S.)
Series statement
  • Comparative effectiveness reviews
  • AHRQ publication
Series volume
  • no. 85
  • no. 12(13)-EHC144-EF
http://library.link/vocab/subjectName
  • Psoriasis
  • Comparative Effectiveness Research
  • Treatment Outcome
http://bibfra.me/vocab/relation/supportingbody
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Label
Biologic and nonbiologic systemic agents and phototherapy for treatment of chronic plaque psoriasis, prepared for Agency for Healthcare Research and Quality ; prepared by the University of Connecticut/Hartford Hospital Evidence-based Practice Center ; investigators, Soyon Lee [and others], (electronic resource)
Instantiates
Publication
Note
"November 2012."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier
Content category
text
Content type code
txt
Content type MARC source
rdacontent
Control code
827951063
Extent
1 online resource (167 pages)
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
c
Other physical details
illustrations
Specific material designation
remote
System control number
(OCoLC)827951063
Label
Biologic and nonbiologic systemic agents and phototherapy for treatment of chronic plaque psoriasis, prepared for Agency for Healthcare Research and Quality ; prepared by the University of Connecticut/Hartford Hospital Evidence-based Practice Center ; investigators, Soyon Lee [and others], (electronic resource)
Publication
Note
"November 2012."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier
Content category
text
Content type code
txt
Content type MARC source
rdacontent
Control code
827951063
Extent
1 online resource (167 pages)
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
c
Other physical details
illustrations
Specific material designation
remote
System control number
(OCoLC)827951063

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