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        "resumen" => "<span class="elsevierStyleSectionTitle">Background and objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">&#58;</span> Various treatment options are available for use in moderate-to-severe psoriasis and election is dependent upon the clinical criteria applied by the attending physician&#46; We undertook a survey among dermatologists to assess the treatment of moderate-to-severe psoriasis currently used in clinical practice in Spain&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A cross-sectional study was performed by sending a questionnaire to dermatologists in Spain who treat patients with moderate-to-severe psoriasis&#46; The questionnaire comprised 33 items distributed in 6 sections&#58; profile of the dermatologist&#44; case load&#44; patient profile&#44; follow-up and management of the disease&#44; treatment regimens&#44; and assessment of pharmacological treatments&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">According to the responses of the 164 dermatologists surveyed&#44; 6&#46;8&#37; of patients seen in their clinics have moderate-to-severe psoriasis&#59; of those&#44; 45&#46;8&#37; receive systemic treatment and 22&#46;9&#37; are treated with biologic drugs&#46; In many of those patients &#40;50&#46;2&#37;&#41;&#44; the dermatologist felt that a change in treatment was necessary&#59; in 51&#46;1&#37; of cases&#44; this change would be from systemic therapy to a biologic drug&#46; The principal reason for the change &#40;50&#46;8&#37;&#41; would be lack of efficacy or the appearance of adverse effects&#46; Efficacy and safety were considered essential criteria in the choice of an appropriate treatment &#40;82&#46;9&#37; and 28&#46;0&#37; of dermatologists&#44; respectively&#41;&#46; Patient quality of life was also considered an essential consideration in choice of treatment by 28&#46;0&#37; of dermatologists&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Optimal treatment for moderate-to-severe psoriasis should be effective and safe&#44; and improve patient quality of life&#46; This makes it essential to use drugs with an excellent efficacy and safety profile&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n y objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Las estrategias terap&#233;uticas existentes para la psoriasis moderada-grave son m&#250;ltiples&#44; siendo el criterio cl&#237;nico fundamental para su elecci&#243;n&#46; Para conocer la realidad terap&#233;utica de la psoriasis moderada-grave&#44; se realiz&#243; una encuesta de opini&#243;n basada en pr&#225;ctica cl&#237;nica habitual en Espa&#241;a&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio transversal mediante encuesta a dermat&#243;logos que tratan a pacientes con psoriasis moderada-grave en Espa&#241;a&#46; La encuesta constaba de 33 &#237;tems distribuidos en 6 secciones&#58; perfil del dermat&#243;logo&#44; carga asistencial&#44; perfil de paciente&#44; seguimiento y manejo terap&#233;utico de la enfermedad&#44; pautas de tratamiento y valoraci&#243;n de f&#225;rmacos&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Seg&#250;n los datos de opini&#243;n y experiencia de los 164 dermat&#243;logos encuestados&#44; el 6&#44;8&#37; de los pacientes atendidos en consulta presentar&#237;an psoriasis moderada-grave&#44; de los que el 45&#44;8&#37; estar&#237;an tratados con un f&#225;rmaco sist&#233;mico y el 22&#44;9&#37; con uno biol&#243;gico&#46; En muchos de estos pacientes &#40;50&#44;2&#37;&#41; se har&#237;a un cambio de tratamiento&#44; de sist&#233;mico a biol&#243;gico en el 51&#44;1&#37; de los casos&#46; El principal motivo de cambio &#40;50&#44;8&#37;&#41; ser&#237;a una falta de eficacia o aparici&#243;n de efectos adversos&#46; La eficacia y seguridad ser&#237;an criterios imprescindibles a considerar para la elecci&#243;n de un tratamiento &#243;ptimo &#40;82&#44;9 y 28&#44;0&#37; de los dermat&#243;logos&#44; respectivamente&#41;&#46; Un 28&#44;0&#37; de los dermat&#243;logos consider&#243; tambi&#233;n imprescindible la valoraci&#243;n de la calidad de vida de los pacientes para instaurar un tratamiento&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El tratamiento &#243;ptimo para la psoriasis moderada-grave deber&#237;a ser eficaz&#44; seguro y capaz de mejorar la calidad de vida del paciente&#46; Para ello&#44; es imprescindible el uso de f&#225;rmacos de elevada eficacia y seguridad&#46;</p>"
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Vol. 101. Issue 10.
Pages 858-865 (December 2010)
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Vol. 101. Issue 10.
Pages 858-865 (December 2010)
Original article
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Treatment of Moderate-to-Severe Psoriasis in Clinical Practice: A Survey of Spanish Dermatologists
Realidad terapéutica de la psoriasis moderada-grave en España. Encuesta de opinión
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D. Moreno-Ramíreza,
Corresponding author
dmoreno@e-derma.org

Corresponding author.
, E. Fonsecab, P. Herranzc, M. Arad
a Servicio de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, Spain
b Servicio de Dermatología, Complejo Hospitalario de A Coruña, A Coruña, Spain
c Servicio de Dermatología, Hospital Universitario La Paz, Madrid, Spain
d Servicio de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
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Abstract
Background and objectives

: Various treatment options are available for use in moderate-to-severe psoriasis and election is dependent upon the clinical criteria applied by the attending physician. We undertook a survey among dermatologists to assess the treatment of moderate-to-severe psoriasis currently used in clinical practice in Spain.

Methods

A cross-sectional study was performed by sending a questionnaire to dermatologists in Spain who treat patients with moderate-to-severe psoriasis. The questionnaire comprised 33 items distributed in 6 sections: profile of the dermatologist, case load, patient profile, follow-up and management of the disease, treatment regimens, and assessment of pharmacological treatments.

Results

According to the responses of the 164 dermatologists surveyed, 6.8% of patients seen in their clinics have moderate-to-severe psoriasis; of those, 45.8% receive systemic treatment and 22.9% are treated with biologic drugs. In many of those patients (50.2%), the dermatologist felt that a change in treatment was necessary; in 51.1% of cases, this change would be from systemic therapy to a biologic drug. The principal reason for the change (50.8%) would be lack of efficacy or the appearance of adverse effects. Efficacy and safety were considered essential criteria in the choice of an appropriate treatment (82.9% and 28.0% of dermatologists, respectively). Patient quality of life was also considered an essential consideration in choice of treatment by 28.0% of dermatologists.

Conclusions

Optimal treatment for moderate-to-severe psoriasis should be effective and safe, and improve patient quality of life. This makes it essential to use drugs with an excellent efficacy and safety profile.

Keywords:
Psoriasis
Disease management
Survey
Dermatology
Spain
Resumen
Introducción y objetivos

Las estrategias terapéuticas existentes para la psoriasis moderada-grave son múltiples, siendo el criterio clínico fundamental para su elección. Para conocer la realidad terapéutica de la psoriasis moderada-grave, se realizó una encuesta de opinión basada en práctica clínica habitual en España.

Método

Estudio transversal mediante encuesta a dermatólogos que tratan a pacientes con psoriasis moderada-grave en España. La encuesta constaba de 33 ítems distribuidos en 6 secciones: perfil del dermatólogo, carga asistencial, perfil de paciente, seguimiento y manejo terapéutico de la enfermedad, pautas de tratamiento y valoración de fármacos.

Resultados

Según los datos de opinión y experiencia de los 164 dermatólogos encuestados, el 6,8% de los pacientes atendidos en consulta presentarían psoriasis moderada-grave, de los que el 45,8% estarían tratados con un fármaco sistémico y el 22,9% con uno biológico. En muchos de estos pacientes (50,2%) se haría un cambio de tratamiento, de sistémico a biológico en el 51,1% de los casos. El principal motivo de cambio (50,8%) sería una falta de eficacia o aparición de efectos adversos. La eficacia y seguridad serían criterios imprescindibles a considerar para la elección de un tratamiento óptimo (82,9 y 28,0% de los dermatólogos, respectivamente). Un 28,0% de los dermatólogos consideró también imprescindible la valoración de la calidad de vida de los pacientes para instaurar un tratamiento.

Conclusiones

El tratamiento óptimo para la psoriasis moderada-grave debería ser eficaz, seguro y capaz de mejorar la calidad de vida del paciente. Para ello, es imprescindible el uso de fármacos de elevada eficacia y seguridad.

Palabras clave:
Psoriasis
Manejo de la enfermedad
Encuesta de opinión
Dermatología
España
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