![]() Similar treatment guidelines have been published for Latin American countries. Consequently, the dermatologist’s toolkit for the treatment of moderate to severe plaque psoriasis is broad, and the current Canadian psoriasis guidelines recommend the following therapeutic options: topical calcipotriol–betamethasone dipropionate combination ointment, phototherapy (UVA with psoralen and UVB), oral systemic agents (cyclosporine, methotrexate, and acitretin) and biologic therapy. As awareness of the association of chronic inflammatory diseases and metabolic and vascular diseases increases, it has been suggested that the anti-inflammatory properties of psoriasis treatment modalities may provide therapeutic or preventive benefit related to reduction of cardiovascular- and metabolic-related risk in psoriasis patients.Īccording to the most recent Canadian Guidelines for the management of plaque psoriasis, moderate to severe psoriasis is distinguished from milder disease in that it is, or would be expected to be, refractory to topical monotherapy. The combined presence of these conditions, together with obesity, known as the metabolic syndrome, is more prevalent in psoriasis patients than the general population. In recent years, the attention paid to psoriasis-related comorbidities has amplified, and a distinct pattern of chronic disorders was found to be significantly associated with psoriasis, including psoriatic arthritis, diabetes mellitus type II, arterial hypertension, hyperlipidemia, and coronary heart disease. Consequently, although generally non-fatal, this disease incurs a significant impact on quality of life both physically and psychosocially, with reports of reduction in physical and mental functioning comparable to that seen in other chronic diseases. Up to 15.5% impairment in work productivity and 23.7% impairment in total activity have been reported to be associated with psoriasis. Along with physical discomfort, psoriasis is associated with depression, sexual impairment, social stigmatization and reduced work productivity. Chronic plaque psoriasis is the most frequent clinical presentation, and accounts for 90% of all cases. In Latin America, prevalence rates have been estimated to range between 1 and 3% though the actual prevalence is unknown. Psoriasis is a chronic, immunologically-mediated dermatosis that is estimated to affect 2–3% of the Canadian population. Secondary outcome measures relate to effectiveness (Investigator’s Global Assessment -IGA mod 2011-, Psoriasis Areas and Severity Index, Body Surface Area), patient reported outcomes (Dermatology Life Quality Index, Work Productivity and Activity Impairment Questionnaire, Hospital Anxiety and Depression Scale, Psoriasis Epidemiology Screening Tool, Psoriasis Symptom Diary, and Treatment Satisfaction Questionnaire), and healthcare resource utilization. The primary objective of the study is safety. ![]() The study includes a 5-year follow-up with recommended assessments at Baseline, 3 and 6 months post-Baseline, and every 6 months thereafter. ![]() Decision regarding treatment must have been reached prior to and independent of patient enrollment in the study. ![]() A total of 2500 patients (1250 per cohort) will be recruited in the practices of hospital and community dermatologists. This is a multinational (Canadian and Latin American), prospective, observational study of adult patients with moderate to severe psoriasis that initiate treatment with secukinumab or other approved therapies as per local standard of care. ![]()
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