Original article
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
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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Galimberti, A. Pontón Montaño, D. Ferrario, A. Kowalczuk, R. Galimberti" "autores" => array:5 [ 0 => array:2 [ "nombre" => "G." "apellidos" => "Galimberti" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Pontón Montaño" ] 2 => array:2 [ "nombre" => "D." "apellidos" => "Ferrario" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Kowalczuk" ] 4 => array:2 [ "nombre" => "R." "apellidos" => "Galimberti" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219010707320?idApp=UINPBA000044" "url" => "/15782190/0000010100000010/v1_201304241533/S1578219010707320/v1_201304241533/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Treatment of Moderate-to-Severe Psoriasis in Clinical Practice: A Survey of Spanish Dermatologists" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "858" "paginaFinal" => "865" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "D. Moreno-Ramírez, E. Fonseca, P. Herranz, M. Ara" "autores" => array:4 [ 0 => array:4 [ "nombre" => "D." "apellidos" => "Moreno-Ramírez" "email" => array:1 [ 0 => "dmoreno@e-derma.org" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "E." "apellidos" => "Fonseca" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "P." "apellidos" => "Herranz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "M." "apellidos" => "Ara" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Dermatología, Complejo Hospitalario de A Coruña, A Coruña, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Universitario La Paz, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Realidad terapéutica de la psoriasis moderada-grave en España. Encuesta de opinión" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2009-12-23" "fechaAceptado" => "2010-06-10" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec84831" "palabras" => array:5 [ 0 => "Psoriasis" 1 => "Disease management" 2 => "Survey" 3 => "Dermatology" 4 => "Spain" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec84830" "palabras" => array:5 [ 0 => "Psoriasis" 1 => "Manejo de la enfermedad" 2 => "Encuesta de opinión" 3 => "Dermatología" 4 => "España" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Background and objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">:</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. We undertook a survey among dermatologists to assess the treatment of moderate-to-severe psoriasis currently used in clinical practice in Spain.</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. 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.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">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.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">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.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción y objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">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.</p> <span class="elsevierStyleSectionTitle">Método</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">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.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">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.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">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.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:24 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of psoriasis in Spain (Epiderma Project: phase I)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Ferrándiz" 1 => "X. Bordas" 2 => "V. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 10 | 4 | 14 |
| 2024 Octubre | 56 | 43 | 99 |
| 2024 Septiembre | 52 | 23 | 75 |
| 2024 Agosto | 87 | 57 | 144 |
| 2024 Julio | 64 | 40 | 104 |
| 2024 Junio | 58 | 29 | 87 |
| 2024 Mayo | 41 | 31 | 72 |
| 2024 Abril | 58 | 27 | 85 |
| 2024 Marzo | 69 | 36 | 105 |
| 2024 Febrero | 41 | 34 | 75 |
| 2024 Enero | 39 | 35 | 74 |
| 2023 Diciembre | 42 | 41 | 83 |
| 2023 Noviembre | 51 | 37 | 88 |
| 2023 Octubre | 39 | 44 | 83 |
| 2023 Septiembre | 33 | 24 | 57 |
| 2023 Agosto | 26 | 12 | 38 |
| 2023 Julio | 31 | 40 | 71 |
| 2023 Junio | 48 | 24 | 72 |
| 2023 Mayo | 37 | 32 | 69 |
| 2023 Abril | 33 | 21 | 54 |
| 2023 Marzo | 25 | 25 | 50 |
| 2023 Febrero | 23 | 30 | 53 |
| 2023 Enero | 44 | 37 | 81 |
| 2022 Diciembre | 52 | 61 | 113 |
| 2022 Noviembre | 12 | 36 | 48 |
| 2022 Octubre | 15 | 33 | 48 |
| 2022 Septiembre | 18 | 47 | 65 |
| 2022 Agosto | 44 | 41 | 85 |
| 2022 Julio | 24 | 33 | 57 |
| 2022 Junio | 43 | 37 | 80 |
| 2022 Mayo | 68 | 44 | 112 |
| 2022 Abril | 69 | 49 | 118 |
| 2022 Marzo | 48 | 52 | 100 |
| 2022 Febrero | 28 | 31 | 59 |
| 2022 Enero | 29 | 40 | 69 |
| 2021 Diciembre | 19 | 46 | 65 |
| 2021 Noviembre | 28 | 52 | 80 |
| 2021 Octubre | 35 | 45 | 80 |
| 2021 Septiembre | 20 | 42 | 62 |
| 2021 Agosto | 20 | 32 | 52 |
| 2021 Julio | 29 | 37 | 66 |
| 2021 Junio | 45 | 31 | 76 |
| 2021 Mayo | 26 | 24 | 50 |
| 2021 Abril | 54 | 46 | 100 |
| 2021 Marzo | 66 | 10 | 76 |
| 2021 Febrero | 48 | 38 | 86 |
| 2021 Enero | 15 | 13 | 28 |
| 2020 Diciembre | 30 | 16 | 46 |
| 2020 Noviembre | 17 | 16 | 33 |
| 2020 Octubre | 24 | 17 | 41 |
| 2020 Septiembre | 23 | 17 | 40 |
| 2020 Agosto | 20 | 16 | 36 |
| 2020 Julio | 22 | 14 | 36 |
| 2020 Junio | 27 | 24 | 51 |
| 2020 Mayo | 14 | 13 | 27 |
| 2020 Abril | 24 | 15 | 39 |
| 2020 Marzo | 22 | 25 | 47 |
| 2020 Febrero | 1 | 4 | 5 |
| 2020 Enero | 0 | 2 | 2 |
| 2019 Diciembre | 0 | 11 | 11 |
| 2019 Noviembre | 0 | 4 | 4 |
| 2019 Octubre | 0 | 4 | 4 |
| 2019 Septiembre | 0 | 1 | 1 |
| 2019 Agosto | 0 | 1 | 1 |
| 2019 Julio | 0 | 1 | 1 |
| 2019 Junio | 0 | 1 | 1 |
| 2019 Mayo | 1 | 43 | 44 |
| 2019 Abril | 0 | 1 | 1 |
| 2019 Marzo | 0 | 10 | 10 |
| 2018 Mayo | 0 | 1 | 1 |
| 2018 Abril | 0 | 1 | 1 |
| 2018 Marzo | 1 | 1 | 2 |
| 2018 Febrero | 14 | 4 | 18 |
| 2018 Enero | 21 | 6 | 27 |
| 2017 Diciembre | 22 | 6 | 28 |
| 2017 Noviembre | 18 | 3 | 21 |
| 2017 Octubre | 12 | 4 | 16 |
| 2017 Septiembre | 22 | 8 | 30 |
| 2017 Agosto | 30 | 8 | 38 |
| 2017 Julio | 25 | 4 | 29 |
| 2017 Junio | 17 | 15 | 32 |
| 2017 Mayo | 18 | 8 | 26 |
| 2017 Abril | 19 | 44 | 63 |
| 2017 Marzo | 27 | 8 | 35 |
| 2017 Febrero | 25 | 6 | 31 |
| 2017 Enero | 19 | 4 | 23 |
| 2016 Diciembre | 40 | 4 | 44 |
| 2016 Noviembre | 20 | 3 | 23 |
| 2016 Octubre | 15 | 10 | 25 |
| 2016 Septiembre | 20 | 2 | 22 |
| 2016 Agosto | 34 | 9 | 43 |
| 2016 Julio | 23 | 8 | 31 |
| 2016 Junio | 13 | 6 | 19 |
| 2016 Mayo | 8 | 0 | 8 |
| 2016 Abril | 3 | 2 | 5 |
| 2016 Marzo | 2 | 1 | 3 |
| 2016 Febrero | 14 | 1 | 15 |
| 2016 Enero | 8 | 3 | 11 |
| 2015 Diciembre | 9 | 0 | 9 |
| 2015 Noviembre | 13 | 2 | 15 |
| 2015 Octubre | 5 | 1 | 6 |
| 2015 Septiembre | 6 | 2 | 8 |
| 2015 Agosto | 12 | 6 | 18 |
| 2015 Julio | 33 | 4 | 37 |
| 2015 Junio | 41 | 3 | 44 |
| 2015 Mayo | 64 | 16 | 80 |
| 2015 Abril | 25 | 13 | 38 |
| 2015 Marzo | 24 | 21 | 45 |
| 2015 Febrero | 19 | 3 | 22 |
| 2015 Enero | 23 | 8 | 31 |
| 2014 Diciembre | 28 | 5 | 33 |
| 2014 Noviembre | 21 | 7 | 28 |
| 2014 Octubre | 20 | 11 | 31 |
| 2014 Septiembre | 26 | 16 | 42 |
| 2014 Agosto | 27 | 19 | 46 |
| 2014 Julio | 26 | 17 | 43 |
| 2014 Junio | 40 | 11 | 51 |
| 2014 Mayo | 45 | 17 | 62 |
| 2014 Abril | 34 | 14 | 48 |
| 2014 Marzo | 34 | 17 | 51 |
| 2014 Febrero | 18 | 15 | 33 |
| 2014 Enero | 25 | 16 | 41 |
| 2013 Diciembre | 31 | 14 | 45 |
| 2013 Noviembre | 31 | 13 | 44 |
| 2013 Octubre | 30 | 16 | 46 |
| 2013 Septiembre | 20 | 21 | 41 |
| 2013 Agosto | 25 | 29 | 54 |
| 2013 Julio | 18 | 35 | 53 |
| 2013 Junio | 19 | 34 | 53 |
| 2013 Mayo | 15 | 17 | 32 |
| 2013 Abril | 20 | 22 | 42 |
| 2013 Marzo | 23 | 21 | 44 |
| 2013 Febrero | 9 | 13 | 22 |
| 2013 Enero | 3 | 1 | 4 |
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