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Psoriasis

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15241. Validity and reliability of patient reported outcomes used in psoriasis: results from two randomized clinical trials. Full Text available with Trip Pro

Validity and reliability of patient reported outcomes used in psoriasis: results from two randomized clinical trials. Two Phase III randomized controlled clinical trials were conducted to assess the efficacy, safety, and tolerability of weekly subcutaneous administration of efalizumab for the treatment of psoriasis. Patient reported measures of psoriasis-related functionality and health-related quality of life and of psoriasis-related symptom assessments were included as part of the trials.To (...) assess the reliability, validity, and responsiveness of the patient reported outcome measures that were used in the trials - the Dermatology Life Quality Index (DLQI), the Psoriasis Symptom Assessment (PSA) Scale, and two itch measures, a Visual Analog Scale (VAS) and the National Psoriasis Foundation (NPF) itch measure.Subjects aged 18 to 70 years with moderate to severe psoriasis for at least 6 months were recruited into the two clinical trials (n = 1095). Internal consistency reliability

2003 Health and quality of life outcomes Controlled trial quality: uncertain

15242. HuMax-CD4: a fully human monoclonal anti-CD4 antibody for the treatment of psoriasis vulgaris. Full Text available with Trip Pro

HuMax-CD4: a fully human monoclonal anti-CD4 antibody for the treatment of psoriasis vulgaris. Psoriasis is characterized by infiltration with mononuclear cells. Especially activated memory CD4+ T cells are critical in the pathogenesis. Interaction between the CD4 receptor and the major histocompatibility complex class II molecule is important for T-cell activation.To test safety and efficacy of a fully human monoclonal anti-CD4 antibody (HuMax-CD4) in the treatment of psoriasis.Multicenter

2003 Archives of Dermatology Controlled trial quality: predicted high

15243. Remittive effects of intramuscular alefacept in psoriasis. (Abstract)

Remittive effects of intramuscular alefacept in psoriasis. Alefacept is the first biologic agent approved for the treatment of chronic plaque psoriasis in the United States. Alefacept, administered intravenously (i.v.) or intramuscularly (i.m.), was found to be well tolerated, safe, and efficacious in two pivotal phase 3 studies in patients with moderate to severe psoriasis. Treatment with i.v. alefacept was associated with a median duration of off-treatment response of 216 days (approximately (...) 7 months). In a follow-up extension study to the phase 3 i.m. study, duration of therapeutic response was also examined. Patients who achieved a > or = 75% reduction in baseline Psoriasis Area and Severity Index (PASI 75) with the first course of alefacept 15 mg i.m. in the phase 3 study maintained a PASI 50 for a median duration of 209 days. In addition, the extension study demonstrated that a second course of i.m. alefacept is safe and well tolerated in patients with psoriasis.

2003 Journal of drugs in dermatology : JDD Controlled trial quality: uncertain

15244. Strategies to optimize efficacy, duration of remission, and safety in the treatment of plaque psoriasis by using tazarotene in combination with a corticosteroid. (Abstract)

Strategies to optimize efficacy, duration of remission, and safety in the treatment of plaque psoriasis by using tazarotene in combination with a corticosteroid. In the treatment of plaque psoriasis with corticosteroids, long-term efficacy and safety are often compromised by tachyphylaxis, steroid rebound, and adverse effects. However, the results of recent studies demonstrate that the use of tazarotene in conjunction with a corticosteroid can help to optimize the efficacy, the duration

2000 Journal of the American Academy of Dermatology Controlled trial quality: uncertain

15245. Optimized UVB treatment of psoriasis: a controlled, left-right comparison trial. (Abstract)

Optimized UVB treatment of psoriasis: a controlled, left-right comparison trial. In a randomized, controlled, left-right comparison study, 20 patients with chronic plaque psoriasis were treated with UVB. One side of the body received UVB in a conventional regimen with fixed dose increments, the other side was given UVB doses according to measurements of skin pigmentation. Skin pigmentation was quantified by the skin reflectance technique. The relationship between skin pigmentation

2000 Journal of the European Academy of Dermatology and Venereology : JEADV Controlled trial quality: uncertain

15246. A comparison of bathwater and oral delivery of 8-methoxypsoralen in PUVA therapy for plaque psoriasis. (Abstract)

A comparison of bathwater and oral delivery of 8-methoxypsoralen in PUVA therapy for plaque psoriasis. Bath-PUVA is an alternative to oral-PUVA for the treatment of psoriasis. This study compares the effectiveness of the two methods in two groups, each consisting of 17 patients with plaque psoriasis. Three patients who failed to improve with oral-PUVA were transferred to bath-PUVA and subsequently cleared. Another seven patients who returned with a further episode of psoriasis received

2000 Clinical and experimental dermatology Controlled trial quality: uncertain

15247. Lack of efficacy of topical mycophenolic acid in psoriasis vulgaris. (Abstract)

Lack of efficacy of topical mycophenolic acid in psoriasis vulgaris. Mycophenolic acid is effective for systemic treatment of psoriasis. However, there is no report about its topical use in this cutaneous disorder so far. We undertook a randomized, placebo-controlled, within subject comparison of mycophenolic acid 1% incorporated in an ointment base and the corresponding vehicle alone (placebo) using the psoriasis plaque test in 7 patients with plaque-type psoriasis over a period of 3 weeks (...) . Scoring of erythema and induration was performed 3 times weekly. After 3 weeks of occlusive treatment there was a reduction of the sum score for erythema and induration in the mycophenolic acid-treated sites of 23% and of 5.7% in the vehicle-treated sites, which was not statistically significant. No adverse advents were noted during the time of study. We conclude that mycophenolic acid is ineffective when applied topically in psoriasis even under occlusion.

2000 Journal of the American Academy of Dermatology Controlled trial quality: uncertain

15248. Topical therapy for psoriasis with the use of augmented betamethasone and calcipotriene on alternate weeks. (Abstract)

Topical therapy for psoriasis with the use of augmented betamethasone and calcipotriene on alternate weeks. Topical corticosteroids, commonly used for psoriasis, show diminished response on continuous use.We tested efficacy of topical corticosteroid and calcipotriene used on alternate weeks versus daily corticosteroid in patients with psoriasis.In a randomized, observer-blind design, the experimental group of 25 patients with stable plaque psoriasis received augmented betamethasone dipropionate (...) 0.05% cream once daily in the first and third weeks and calcipotriene 0.005% ointment twice daily in the second and fourth weeks. The control group of 27 patients received augmented betamethasone once daily for 4 weeks.The experimental regimen was more effective than the control regimen as evidenced by (1) more patients with at least a 90% reduction in Psoriasis Area and Severity Index (PASI) score (difference 49.5%, 95% confidence interval [CI], 26.1%-72.9%, P <. 001), (2) lower PASI after 2 weeks

2000 Journal of the American Academy of Dermatology Controlled trial quality: uncertain

15249. A cost consequence study of the impact of a dermatology-trained practice nurse on the quality of life of primary care patients with eczema and psoriasis. Full Text available with Trip Pro

A cost consequence study of the impact of a dermatology-trained practice nurse on the quality of life of primary care patients with eczema and psoriasis. The practice nurse is central to the development of a primary care-led National Health Service. Skin diseases can have a major impact on patients' lives but general practitioners (GPs) lack many of the skills of practical dermatology care and support.To determine whether a primary care dermatology liaison nurse should be introduced by our (...) health authority. We identified the resources consumed and the benefits that accrued from a practice nurse who had received training in practical dermatology care.A cost consequence study in parallel with a randomised controlled trial was undertaken in a group of nine GPs and 109 patients between the ages of 18 and 65 years who had a diagnosis of psoriasis or eczema.Although there was a significant improvement in our primary outcome measure within group, when compared with the control group

2000 British Journal of General Practice Controlled trial quality: uncertain

15250. VML 295 (LY-293111), a novel LTB4 antagonist, is not effective in the prevention of relapse in psoriasis. (Abstract)

VML 295 (LY-293111), a novel LTB4 antagonist, is not effective in the prevention of relapse in psoriasis. Leukotriene B4 (LTB4) receptor antagonists have been the subject of several studies in the treatment of inflammatory diseases, including psoriasis. A novel oral LTB4 antagonist, VML 295 (LY-293111) has recently been developed and has a pronounced effect on epidermal inflammatory parameters. However, oral treatment of psoriasis for 4 weeks did not result in a decrease in disease severity (...) . The present study was performed in order to investigate whether prolonged treatment with VML 295 up to 8 weeks has a beneficial effect on the overall severity of psoriasis. Moreover, we studied to what extent VML 295 is able to prevent relapse in psoriasis. In the present study, 35 patients with stable chronic plaque psoriasis were included. A representative plaque of at least 16 cm2 was initially treated with clobetasol-17-propionate lotion under hydrocolloid occlusion in all patients. Clearance

2000 The British journal of dermatology Controlled trial quality: uncertain

15251. Combination therapy with tazarotene plus a topical corticosteroid for the treatment of plaque psoriasis. (Abstract)

Combination therapy with tazarotene plus a topical corticosteroid for the treatment of plaque psoriasis. Although tazarotene monotherapy is generally efficacious and well tolerated, studies show that both the efficacy and the tolerability of tazarotene therapy can be further improved when it is used in combination with certain topical corticosteroids. The studies reported here evaluate the usefulness of two potential combination regimens. In one regimen, a corticosteroid is added to tazarotene (...) treatment for plaque psoriasis.

1999 The British journal of dermatology Controlled trial quality: uncertain

15252. Treatment of psoriasis with topical NG-monomethyl-L-arginine, an inhibitor of nitric oxide synthesis. (Abstract)

Treatment of psoriasis with topical NG-monomethyl-L-arginine, an inhibitor of nitric oxide synthesis. A double blind left, right comparative study was carried out in 17 psoriatic subjects to examine the influence of a topically applied inhibitor of nitric oxide (NO) synthesis on the pathogenic events of psoriasis. The inhibitor NG-monomethyl-L-arginine (L-NMMA) in aqueous cream BP was applied to one plaque while aqueous cream BP alone served as control. Compared with the control, the L-NMMA

2000 The British journal of dermatology Controlled trial quality: uncertain

15253. Anti-CD4 monoclonal antibody treatment of moderate to severe psoriasis vulgaris: results of a pilot, multicenter, multiple-dose, placebo-controlled study. (Abstract)

Anti-CD4 monoclonal antibody treatment of moderate to severe psoriasis vulgaris: results of a pilot, multicenter, multiple-dose, placebo-controlled study. OKTcdr4a (IMUCLONE) is a humanized anti-CD4 IgG4 monoclonal antibody that retains the binding and in vitro immunosuppressive properties of the parent murine antibody. Psoriasis is a chronic disease for which treatment with multiple doses of monoclonal antibodies is likely to be required for adequate control.This study was performed to test (...) the efficacy and safety of OKTcdr4a, given in sequential courses over a period of several weeks, in the treatment of moderate to severe psoriasis vulgaris.Twenty-eight patients (45.6 +/- 10.1 years of age) were studied, with a mean pretreatment Psoriasis Area and Severity Index (PASI) score of 18.3. In the first double-blind phase of the study, patients were randomized to receive OKTcdr4a as a 225 mg/course (low dose), 750 mg/course (high dose), or placebo divided into 3 identical infusions over a 5-day

2000 Journal of the American Academy of Dermatology Controlled trial quality: uncertain

15254. Oral liarozole in the treatment of palmoplantar pustular psoriasis: a randomized, double-blind, placebo-controlled study. (Abstract)

Oral liarozole in the treatment of palmoplantar pustular psoriasis: a randomized, double-blind, placebo-controlled study. Palmoplantar pustular psoriasis (PPP) is a chronic, relapsing condition often recalcitrant to therapy. Synthetic retinoids have been found to be efficacious in the treatment of PPP, but their use is limited by side-effects. Liarozole is an imidazole-like compound that inhibits the retinoic acid (RA) 4-hydroxylase-mediated breakdown of all-trans RA, causing elevation (...) of plasma and cutaneous levels of RA. Thus liarozole acts as a retinoid-mimetic drug. Liarozole has already been found to be effective in the treatment of retinoid-responsive conditions such as chronic plaque psoriasis and ichthyoses.To assess the efficacy and side-effect profile of liarozole in the treatment of PPP.We performed a double-blind, randomized, placebo-controlled trial of oral liarozole 75 mg twice daily for 12 weeks in the treatment of PPP. The trial was conducted at two centres

2001 The British journal of dermatology Controlled trial quality: uncertain

15255. Quality of life and clinical outcome in psoriasis patients using intermittent cyclosporin. (Abstract)

Quality of life and clinical outcome in psoriasis patients using intermittent cyclosporin. Psoriasis causes considerable patient morbidity and can seriously affect a patient's quality of life (QoL).To investigate the relationships between changes in QoL and measures of severity and extent of disease, and itch, in patients with chronic plaque psoriasis receiving intermittent short courses of cyclosporin (Neoral).This study was performed as part of an international trial investigating the safety (...) , efficacy and total costs of intermittent short courses of cyclosporin (the PISCES study). All patients received cyclosporin until clearance and were then followed up until relapse. On relapsing, patients received another course. Patients were followed up for a minimum of 1 year during which they could receive as many courses of treatment as necessary. In a subgroup (n = 255) of patients in the trial, the Dermatology Life Quality Index (DLQI) was used to assess the impact of psoriasis and its treatment

2001 The British journal of dermatology Controlled trial quality: uncertain

15256. Effect of propylthiouracil on adenosine deaminase activity and thyroid function in patients with psoriasis. (Abstract)

Effect of propylthiouracil on adenosine deaminase activity and thyroid function in patients with psoriasis. T-cell activation has been implicated in the pathogenesis of psoriasis; adenosine deaminase (ADA) activity has been considered as a marker of T-cell activation. The antithyroid drug propylthiouracil (PTU) has recently been shown to have beneficial effects on psoriatic lesions, probably by acting on the immune system.To investigate whether ADA activity may be related to psoriasis (...) and whether oral PTU affects ADA activity and gives clinical improvement in psoriatic patients.ADA activities were measured in plasma, erythrocyte and tissue samples of patients with psoriasis before and after 2 months of treatment with either PTU 100 mg three times daily or PTU plus thyroxine 25 microg once daily (to prevent possible hypothyroidism, which may be induced by PTU) as well as in healthy controls. The severity of the disease was evaluated before and after treatment according to Psoriasis Area

2001 The British journal of dermatology Controlled trial quality: uncertain

15257. Improvement in psoriasis after intradermal administration of delipidated, deglycolipidated Mycobacterium vaccae (PVAC): results of an open-label trial. (Abstract)

Improvement in psoriasis after intradermal administration of delipidated, deglycolipidated Mycobacterium vaccae (PVAC): results of an open-label trial. The aim of new treatments for psoriasis is to induce extended remissions with fewer side-effects. Previous studies suggest that Mycobacterium vaccae, a harmless organism prepared as a heat-killed suspension, may induce periods of remission in some psoriasis patients after intradermal administration. To assess a more potent derivative of M (...) . vaccae, we conducted an open-label study in which 20 patients with moderate to severe psoriasis (Psoriasis Area and Severity Index of 12-35) received two intradermal inoculations of heat-killed, delipidated, deglycolipidated M. vaccae (DD-MVAC or 'PVAC') in lesion-free deltoid skin, separated by a period of 3 weeks. Twelve weeks after the injections, 13 out of 20 patients (65%) showed marked improvement in the PASI score (> 50% reduction), three were unchanged (< 25% reduction), three had worsened

2001 Clinical and experimental dermatology

15258. The cost effectiveness of tapered versus abrupt discontinuation of oral cyclosporin microemulsion for the treatment of psoriasis. (Abstract)

The cost effectiveness of tapered versus abrupt discontinuation of oral cyclosporin microemulsion for the treatment of psoriasis. To assess the cost effectiveness of tapered versus abrupt discontinuation of a microemulsion formulation of cyclosporin in patients with chronic plaque psoriasis.A cost-effectiveness analysis was performed in parallel with a non-blind, multicentre, international clinical trial of the safety and efficacy of intermittent short courses of cyclosporin. Direct (...) and indirect costs were considered within a 1-year period following randomisation.Patients with chronic plaque psoriasis inadequately controlled with topical treatment.The study was conducted from a societal perspective and was performed using data from Canada, Spain, Turkey and the UK.The health outcome used was the total number of systemic therapy-free days (STFDs) over the first year. The mean incremental cost-effectiveness ratio (ICER) was determined by dividing the differences in average cost per

2001 PharmacoEconomics Controlled trial quality: uncertain

15259. Efficacy and tolerance of topical calcitriol 3 microg g(-1) in psoriasis treatment: a review of our experience in Poland. (Abstract)

Efficacy and tolerance of topical calcitriol 3 microg g(-1) in psoriasis treatment: a review of our experience in Poland. Although topical vitamin D3 derivatives have been used in the treatment of patients with psoriasis for the past 15 years, questions remain about the indications and limitations of application. Extensive personal experience gained during the development of calcitriol (1alpha25-dihydroxyvitamin D3) is therefore reviewed. Three double-blind, vehicle-controlled trials have (...) calcitriol 15 microg g(-1) did not show any clinical superiority to the lower dose but was associated with a higher risk of hypercalciuria, particularly when applied to extensive skin lesions. These results suggest that calcitriol 3 microg g(-1) ointment is an effective and safe treatment for chronic plaque psoriasis.

2001 The British journal of dermatology Controlled trial quality: uncertain

15260. Clinical experience with topical calcitriol (1,25-dihydroxyvitamin D3) in psoriasis. (Abstract)

Clinical experience with topical calcitriol (1,25-dihydroxyvitamin D3) in psoriasis. The use of vitamin D analogues for the treatment of chronic plaque psoriasis is well documented. Of importance now is their comparability and compatibility with other established treatments for psoriasis. This paper reviews five studies with calcitriol 3 microg g(-1) ointment (Silkis ointment, Galderma Laboratories). Calcitriol applied twice daily was found to be as effective as short-contact dithranol in terms (...) with betamethasone valerate (each applied separately, once daily) was as efficacious as twice-daily betamethasone, thereby achieving a corticosteroid-sparing effect. Finally, two studies confirm that calcitriol 3 microg g(-1) ointment can be used safely in patients with psoriasis of the head and confirm the high level of clinical efficacy achieved with this compound.

2001 The British journal of dermatology Controlled trial quality: uncertain

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