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Mark Lebwohl, MD Chairman, Department of Dermatology Mount Sinai School of Medicine New York, NY PowerPoint Presentation
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Raptiva ™ (efalizumab) Plaque Psoriasis: The Unmet Need. Mark Lebwohl, MD Chairman, Department of Dermatology Mount Sinai School of Medicine New York, NY. Psoriasis. Psoriasis. Psoriasis. Psoriasis: Unmet Medical Need.

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Raptiva™ (efalizumab)Plaque Psoriasis: The Unmet Need

Mark Lebwohl, MD

Chairman, Department of DermatologyMount Sinai School of Medicine

New York, NY

psoriasis unmet medical need
Psoriasis: Unmet Medical Need
  • 4½ million Americans have psoriasis with at least 10% of those patients having moderate-to-severe disease
  • About 500-600,000 of these patients are candidates for systemic therapy
  • People with moderate-to-severe disease reported a larger, negative impact on QOL
  • Majority of patients with moderate-to-severe psoriasis are not using the most aggressive treatments for their disease

Koo JY. Dermatol Clinics 1996;14:485-96., NPF Survey

short form 36 sf 36 health survey
Short Form 36 (SF-36) Health Survey
  • Health status measurement tool that can compare different disease states
  • 8 domains
  • Assesses impact of disease and treatment on functional status and well-being
  • Physical Component Summary
  • Mental Component Summary

Ware JE, et al. SF-36® Health Survey Manual and Interpretation Guide. The Health Institute;1993.

impact of psoriasis vs other diseases on patient reported physical outcomes
Impact of Psoriasis vs. Other Diseases on Patient-reported Physical Outcomes

35

Congestive Heart Failure

41

Psoriasis

42

Diabetes

43

Myocardial Infarction

SF-36 Score

43

Arthritis

44

Hypertension

45

Depression

45

Cancer

0

5

10

15

20

25

30

35

40

45

50

Physical Component Summary Score

(n = 317)

Lower scores reflect worse patient-reported outcomes

Rapp SR, et al. J Am Acad Dermatol. 1999;41:401-407.

impact of psoriasis vs other diseases on patient reported mental outcomes
Impact of Psoriasis vs. Other Diseases on Patient-reported Mental Outcomes

35

Depression

46

Psoriasis

49

Arthritis

Cancer

49

SF-36 Score

50

Congestive Heart Failure

52

Diabetes

52

Hypertension

52

Myocardial Infarction

0

10

20

30

40

50

60

Mental Component Summary Score

(n = 317)

Lower scores reflect worse patient-reported outcomes

Rapp SR, et al. J Am Acad Dermatol. 1999;41:401-407.

patients dissatisfied with current psoriasis therapy

0

10

20

30

40

50

60

70

80

90

100

Patients Dissatisfied with Current Psoriasis Therapy

Frustrated withtreatment

78%

Treatment notaggressive enough

32%

Percentage of respondents

Krueger G, et al. Arch Dermatol. 2001;137:280-284.

rotational therapy
Rotational Therapy
  • All widely used therapies have shortcomings
  • Major concerns with toxicities have resulted in “rotational therapy” as a management approach
concerns from a practitioner
Concerns from a Practitioner
  • Concerns
    • Safety of the current treatments for moderate-to-severe plaque psoriasis
  • Needs
    • Need for safe, convenient and effective treatment option that reduces psoriasis
    • Need for a therapy safe enough to give over the long term
    • Need for rapid acting therapy
efficacy of methotrexate treatment 15 30 mg wk pasi response at week 24
Efficacy of Methotrexate Treatment (15–30 mg/wk): PASI Response at Week 24

n = 23

Proportion

responding (%)

 50% Reduction in PASI

 90% Reduction in PASI

 75% Reductionin PASI

Callis et al. Presented at: 63rd Annual Meeting of the Society for Investigative Dermatology; May 15-18, 2002, Los Angeles, CA

example pasi 50 after 12 weeks of treatment
Example: PASI-50 After 12 Weeks of Treatment

Day 0: PASI 18.0

Day 84: PASI 6.8(62% improvement)

Study 2390, #35006

summary
Summary
  • Psoriasis is a chronic life-long disease that causes significant disability
  • Current treatments have limitations
  • Need a safe and effective therapy for long-term use