12 results on '"Warren, R. B."'
Search Results
2. Time for a 'joint' approach?
- Author
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Warren RB, Helliwell PS, and Chinoy H
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- Ambulatory Care organization & administration, Arthritis, Psoriatic therapy, Humans, Interprofessional Relations, Practice Guidelines as Topic, Dermatology organization & administration, Psoriasis therapy, Rheumatology organization & administration
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- 2013
- Full Text
- View/download PDF
3. Psoriatic arthritis--what the dermatologist needs to know.
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Laws P, Barton A, and Warren RB
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- Arthritis, Psoriatic diagnosis, Arthritis, Psoriatic therapy, Diagnosis, Differential, Humans, Arthritis, Psoriatic epidemiology, Dermatology methods
- Abstract
Psoriasis is commonly associated with a co-existent arthritis known as psoriatic arthritis (PsA). Although there is some treatment overlap for psoriasis and psoriatic arthritis, it is possible that dermatologists may not diagnose or treat appropriately patients who are developing psoriatic arthritis at an early stage of the disease process when joint damage may be preventable. In this article we review the criteria for diagnosis of this sero-negative arthritis, look at the clinical indications for referral to a rheumatologist and discuss evolving treatment options relevant to both conditions., (© 2010 The Authors. Journal of the European Academy of Dermatology and Venereology © 2010 European Academy of Dermatology and Venereology.)
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- 2010
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4. Complete clearance and psoriasis area and severity index response for brodalumab and ustekinumab in AMAGINE‐2 and ‐3
- Author
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Warren, R. B., Hansen, Jes Birger, Reich, K., Paul, C., Puig Sanz, Lluís, and Universitat Autònoma de Barcelona
- Subjects
medicine.medical_specialty ,Brodalumab ,Dermatology ,Antibodies, Monoclonal, Humanized ,Severity of Illness Index ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Psoriasis Area and Severity Index ,Psoriasis ,Internal medicine ,Severity of illness ,Ustekinumab ,medicine ,Humans ,Cumulative incidence ,business.industry ,Odds ratio ,Dermatology Life Quality Index ,medicine.disease ,Treatment Outcome ,Infectious Diseases ,030220 oncology & carcinogenesis ,Quality of Life ,Dermatologic Agents ,business ,medicine.drug - Abstract
Altres ajuts: The AMAGINE-1, AMAGINE-2 and AMAGINE- 3 trials were sponsored by Amgen and AstraZeneca; this analysis was performed by LEO Pharma. Medical writing support was provided by Ian Eustace from Adelphi Communications Ltd, Bollington, UK, funded by LEO Pharma. Background: Modern biologics achieve complete skin clearance [100% improvement in psoriasis area and severity index (PASI 100)] in 30-45% of psoriasis patients. Cumulative benefit considering rapidity, frequency and sustainability of response has not been thoroughly investigated. Objectives: Compare the frequency, rapidity and sustainability of PASI 90 and 100 response in patients with moderate-to-severe psoriasis treated with brodalumab or ustekinumab. Methods: Integrated analyses of the brodalumab Phase III AMAGINE-2 (NCT01708603) and -3 (NCT01708629) trials were performed to determine proportion of patients achieving PASI response per visit; corresponding odds ratios (OR) were calculated. Cumulative clinical benefit of treatment was determined with area-under-the-curve (AUC) analysis. Cumulative incidence of response was analysed using a competing risk model of PASI response or rescue. Sustained response was evaluated by time to inadequate response using Kaplan-Meier methods. Proportion of time spent in different response states was descriptively analysed. Association between PASI response and health-related quality of life [Dermatology Life Quality Index (DLQI)] was assessed using data from all treatment groups from AMAGINE-1, -2 and -3. Results: A significantly higher proportion of patients treated with brodalumab achieved PASI 100 vs. ustekinumab (Week 52: 51% vs. 28%; OR [95% CI] 2.8 [2.1, 3.7]; P < 0.0001), with significant differences observed from Week 4. Cumulative benefit through 52 weeks was 69% higher with brodalumab (AUC ratio: 1.69; P < 0.001). Brodalumab patients were also significantly more likely to achieve a PASI 100 at least once over 52 weeks vs. ustekinumab (76% vs. 52%; P < 0.0001). Once response was achieved, brodalumab patients had a low likelihood of failure or need for rescue. There was significant positive association between PASI response level and DLQI0/1 achievement (P < 0.0001). Conclusion: Brodalumab treatment resulted in significantly higher levels of skin clearance, longer sustained response and greater cumulative treatment benefit vs. ustekinumab.
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- 2020
5. Complete clearance and Psoriasis Area and Severity Index response for brodalumab and ustekinumab by previous treatment history in AMAGINE-2 and AMAGINE-3
- Author
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Reich, K., Hansen, Jes Birger, Puig Sanz, Lluís, Konstantinou, M.P., Warren, R. B., and Universitat Autònoma de Barcelona
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medicine.medical_specialty ,Population ,Brodalumab ,Dermatology ,Antibodies, Monoclonal, Humanized ,Severity of Illness Index ,Psoriasis Area and Severity Index ,Psoriasis ,Internal medicine ,Ustekinumab ,Post-hoc analysis ,medicine ,Humans ,Cumulative incidence ,education ,education.field_of_study ,business.industry ,Area under the curve ,Antibodies, Monoclonal ,medicine.disease ,Infectious Diseases ,Treatment Outcome ,business ,medicine.drug - Abstract
Altres ajuts: Amgen; AstraZeneca. Background: The pathway for treatment of psoriasis is partly dependent upon disease severity, and patients may experience inadequate response at any point along the treatment pathway. Patients who repeatedly fail therapy represent a population in whom effective and well-tolerated treatment options are limited. Objectives: To investigate and describe patients achieving Psoriasis Area and Severity Index (PASI) 100 and cumulative treatment benefit over time in patients with moderate-to-severe psoriasis receiving brodalumab or ustekinumab by prior treatment. Methods: We conducted a post hoc analysis of data from two phase 3, randomized, controlled, 52-week AMAGINE trials of brodalumab to describe patients who achieved complete clearance as measured by PASI 100 by prior treatment subgroup (naïve to systemic and biologic treatment, systemic-treated but biologic-naïve, biologic-treated without failure, and biologic-treated with failure). A competing risk model was used to assess cumulative incidence over a 52-week period with outcomes of PASI 100 or inadequate response. Cumulative clinical benefit of treatment was determined with an area under the curve analysis. Results: The 52-week cumulative incidence of patients achieving PASI 100 was consistently higher for brodalumab vs. ustekinumab across treatment pathway subgroups (76% vs. 58% in systemic/biologic-naïve patients, 78% vs. 55% in systemic-treated/biologic-naïve patients, 75% vs. 41% in biologic-treated patients without failure, and 70% vs. 30% in biologic-treated patients with failure). Rates of inadequate response were lower with brodalumab compared with ustekinumab across all subgroups. Cumulative treatment benefit was also higher for all subgroups treated with brodalumab compared with those treated with ustekinumab. Conclusion: Treatment with brodalumab was associated with higher levels of complete clearance and greater cumulative benefit over time compared with ustekinumab, in patients with moderate-to-severe psoriasis, regardless of prior treatment experience.
- Published
- 2021
6. Assessment of two screening tools to identify psoriatic arthritis in patients with psoriasis.
- Author
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Coates, L. C., Savage, L. J., Chinoy, H., Laws, P. M., Lovell, C. R., Korendowych, E., Mahmood, F., Mathieson, H. R., McGonagle, D., Warren, R. B., Waxman, R., and Helliwell, P. S.
- Subjects
PSORIATIC arthritis ,MEDICAL screening ,PSORIASIS ,DERMATOLOGY ,QUALITY of life ,PATIENTS - Abstract
Abstract: Background: Many patients with psoriasis have undiagnosed psoriatic arthritis. Low specificity is found with many PsA screening tools. A new instrument, the CONTEST questionnaire, was developed utilizing the most discriminative items from existing instruments. Objective: The aim of this study was to compare the CONTEST and PEST screening tools. Methods: People attending secondary care clinics with psoriasis, but not PsA, completed the questionnaires, were assessed for function and quality of life, and had a physical examination. Patients thought to have PsA were compared to those without. The performance of CONTEST and PEST was compared using area under the receiver operating curve (AUC), and sensitivity and specificity at the previously published cut‐offs. Results: A total of 451 dermatology patients were approached, 35% were reviewed and 27 (17%, 95% CI 12.3–21.7) had unidentified psoriatic arthritis. The sensitivity and specificity (95% CI) of PEST were 0.60 (0.42–0.78)/0.76 (0.69–0.83) and for CONTEST 0.53 (0.34–0.72)/0.71 (0.63–0.79). The confidence limits for the AUC overlapped (AUC for PEST 0.72 (0.61–0.84), for CONTEST 0.66 (0.54–0.77). Conclusions: PEST and CONTEST questionnaires performed equally well, with no superiority of the new CONTEST tool. [ABSTRACT FROM AUTHOR]
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- 2018
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7. Matching‐adjusted indirect comparison of efficacy in patients with moderate‐to‐severe plaque psoriasis treated with ixekizumab vs. secukinumab.
- Author
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Warren, R. B., Brnabic, A., Saure, D., Langley, R. G., See, K., Wu, J. J., Schacht, A., Mallbris, L., and Nast, A.
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DRUG efficacy , *PSORIASIS treatment , *SKIN disease treatment , *DERMATOLOGY , *CLINICAL trials - Abstract
Summary: Background: Head‐to‐head randomized studies comparing ixekizumab and secukinumab in the treatment of psoriasis are not available. Objectives: To assess efficacy and quality of life using matching‐adjusted indirect comparisons for treatment with ixekizumab vs. secukinumab. Methods: Psoriasis Area and Severity Index (PASI) improvement of at least 75%, 90% and 100% and Dermatology Life Quality Index (DLQI) 0/1 response rates for approved dosages of ixekizumab (160 mg at Week 0, then 80 mg every two weeks for the first 12 weeks) and secukinumab (300 mg at Weeks 0, 1, 2, 3 and 4, then 300 mg every 4 weeks) treatment were compared using data from active (etanercept and ustekinumab) and placebo‐controlled studies. Comparisons were made using the Bucher (BU) method and two modified versions of the Signorovitch (SG) method (SG total and SG separate). Subsequently, results based on active treatment common comparators were combined using generic inverse‐variance meta‐analysis. Results: In the meta‐analysis of studies with active comparators, PASI 90 response rates were 12·7% [95% confidence interval (CI) 5·5–19·8, P = 0·0005], 10·0% (95% CI 2·1–18·0, P = 0·01) and 11·2% (95% CI 3·2–19·1, P = 0·006) higher and PASI 100 response rates were 11·7% (95% CI 5·9–17·5, P < 0·001), 12·7% (95% CI 6·0–19·4, P < 0·001) and 13·1% (95% CI 6·3–19·9, P < 0·001) higher for ixekizumab compared with secukinumab using BU, SG total and SG separate methods. PASI 75 results were comparable when SG methods were used and favoured ixekizumab when the BU method was used. Week 12 DLQI 0/1 response rates did not differ significantly. Conclusions: Ixekizumab had higher PASI 90 and PASI 100 responses at week 12 compared with secukinumab using adjusted indirect comparisons. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
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8. Genetic susceptibility to psoriasis and psoriatic arthritis: Implications for therapy
- Author
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Hébert, H. L., Ali, F. R., Bowes, J., Griffiths, C. E M, Barton, A., and Warren, R. B.
- Subjects
Dermatology - Abstract
The era of genome-wide association studies has revolutionized the search for genetic susceptibility loci in complex genetic conditions such as psoriasis. There are currently 16 loci with confirmed evidence for association with psoriasis susceptibility but there is the potential for more to be discovered as the genetic heritability of the disease has not yet been fully explained. Many of the associated loci overlap with those for psoriatic arthritis. In contrast to psoriasis susceptibility, few studies have been performed to identify predictors of drug response in psoriasis. As large-scale collaborations and registries for psoriasis and psoriatic arthritis are established, it is likely that a genome-wide approach may be used as a more effective method of searching for genetic predictors of treatment response. However, candidate gene studies will still have a role; for example, it is likely that some disease susceptibility genes will also be markers of treatment response, based on evidence from other diseases. This review summarizes recent advances in investigating the role genetics plays in psoriasis susceptibility and contrasts these to advances made in psoriatic arthritis. Further, it describes the genetics of treatment response in the two diseases and indicates how susceptibility loci could be used to identify drug response in the future. © 2011 The Authors. BJD © 2011 British Association of Dermatologists.
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- 2012
9. Cumulative life course impairment in psoriasis: patient perception of disease-related impairment throughout the life course.
- Author
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Warren, R. B., Kleyn, C. E., and Gulliver, W. P.
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PSORIASIS , *SKIN diseases , *DERMATOLOGY , *SOCIAL interaction , *DISABILITIES ,SOCIAL aspects - Abstract
Psoriasis is associated with significant physical, psychological, social and economic burden, the cumulative effect of which may result in failure to achieve 'full life potential' in some patients, termed 'cumulative life course impairment' (CLCI). In this concept, the burden of stigmatization, and physical and psychological comorbidities (risk factors for cumulative impairment) and coping strategies and external factors (having potential moderating effects), interact to cause lifetime impairment. Components of CLCI are supported by cross-sectional data; however, the cumulative nature of impairment in patients with psoriasis is not yet established. Nonetheless, CLCI makes intuitive sense to many dermatologists who recognize the cumulative impact of psoriasis on the lives of some patients. This supplement explores the causes and mechanisms of CLCI qualitatively by presenting cases which are representative of typical patients with moderate-to-severe psoriasis. These cases demonstrate the effect of psoriasis in influencing major life-changing decisions and altering the course of patients' lives, preventing patients from attaining their life goals, pursuing their chosen career, gaining a desired educational level, developing social relationships, gaining full pleasure from family life or having children. All these patients believe that their lives would have taken a different course had they not had psoriasis. Additional research to determine how CLCI occurs and to identify the risk factors for cumulative impairment is required. Understanding the key risk factors for CLCI may help physicians identify patients who are more vulnerable to the cumulative impact of psoriasis, resulting in more appropriate treatment decisions earlier in the disease course. [ABSTRACT FROM AUTHOR]
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- 2011
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10. What’s new in psoriasis? Analysis of the clinical significance of systematic reviews on psoriasis published in 2007 and 2008.
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Brown, B. C., Warren, R. B., Grindlay, D. J. C., and Griffiths, C. E. M.
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PSORIASIS , *SYSTEMATIC reviews , *SKIN diseases , *BEHAVIOR therapy , *META-analysis , *DERMATOLOGY , *MEDICAL research - Abstract
This review summarizes the clinical importance of six systematic reviews on psoriasis published between January 2007 and October 2008. A meta-analysis demonstrated that several traditional nonbiological systemic therapies have equal or superior efficacy to some biological therapies used in the treatment of psoriasis. Two further meta-analyses comparing biological therapies for psoriasis (excluding adalimumab) have established a hierarchy of efficacy for short-term treatment (10–16 weeks): infliximab > etanercept 50 mg twice weekly > etanercept 25 mg twice weekly > efalizumab > alefacept. Excluding adalimumab, rates of adverse events are significantly higher for biological therapies than for placebo, except for etanercept at both 25 and 50 mg twice weekly. Further, head to head trials of biological therapies for psoriasis and longer-term safety data on their use are required. Psoriasis can be induced by and/or exacerbated during antitumour necrosis factor (TNF) therapy. It is recommended to initially switch anti-TNF agent in this situation and only discontinue therapy if psoriasis is extensive and/or intolerable, allowing the primary disease to remain under control. Most screening and monitoring tests carried out during treatment of psoriasis with biological therapies are neither supported nor refuted by current evidence and the clinician must assess each case individually. Studies designed specifically to assess appropriate use of these tests are required. Further research is needed to evaluate the effectiveness of existing psychological interventions in psoriasis. The effectiveness of support groups has not been adequately proven, although there are limited data supporting the use of cognitive behavioural therapy. [ABSTRACT FROM AUTHOR]
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- 2009
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11. Polymorphisms in the PTPN22 region are associated with psoriasis of early onset.
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Smith, Rh. Ll., Warren, R. B., Eyre, S., Ke, X., Young, H. S., Allen, M., Strachan, D., McArdle, W., Gittins, M. P., Barker, J. N. W. N., Griffiths, C. E. M., and Worthington, J.
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GENETIC polymorphisms , *PSORIASIS treatment , *SKIN diseases , *ETIOLOGY of diseases , *PROTEIN-tyrosine phosphatase , *AUTOIMMUNE diseases , *DERMATOLOGY - Abstract
Background Psoriasis, a chronic inflammatory skin disease, affects approximately 2% of the population worldwide. Although the aetiology of psoriasis is poorly understood, patients with disease of early onset (Type I, age of onset ≤ 40 years) usually have a strong genetic component to the disease. Objectives The purpose of this study was to investigate the role of the protein tyrosine phosphatase nonreceptor type 22 ( PTPN22) gene region in susceptibility to Type I psoriasis. Patients and methods Thirteen single nucleotide polymorphisms (SNPs) mapping to the PTPN22 region were genotyped in 647 patients with Type I psoriasis and 566 normal controls. Results The rs2476601 (R620W) SNP, widely associated with other inflammatory autoimmune diseases, showed no evidence of association with susceptibility to Type I psoriasis. Two SNPs (rs1217414 and rs3789604) demonstrated significant association with Type I psoriasis and were subsequently genotyped in a further 253 unrelated patients and 2024 normal controls. rs1217414 and rs3789604 were also significantly associated with Type I psoriasis in the combined datasets ( P = 0·003 and P = 0·0002, respectively); furthermore carriage of both risk alleles was also significantly associated ( P = 0·002). Conclusions This study demonstrates evidence of association of two SNPs (rs1217414 and rs3789604) in the PTPN22 region with Type I psoriasis, providing evidence for a role of this gene in Type I psoriasis that is not conferred by the R620W variant previously associated with a number of inflammatory diseases. [ABSTRACT FROM AUTHOR]
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- 2008
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12. The potential of pharmacogenetics in optimizing the use of methotrexate for psoriasis.
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Warren, R. B. and Griffiths, C. E. M.
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PHARMACOLOGY , *BIOCHEMICAL genetics , *SKIN diseases , *ANTINEOPLASTIC agents , *IMMUNOSUPPRESSIVE agents , *DERMATOLOGY - Abstract
The study of pharmacogenetics will optimize the use of systemic therapies in dermatology. Directed prescription of azathioprine dependent on phenotypic expression of the thiopurine methyltransferase gene is now accepted practice. To some extent other, older drugs have been neglected. We look at the role that pharmacogenetics could play in the use of methotrexate for psoriasis, focusing on known polymorphisms in the folate metabolic pathway. [ABSTRACT FROM AUTHOR]
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- 2005
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