Browsing by Author "Bettencourt, A."
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- Biosimilar Agents for Psoriasis Treatment: The Perspective of Portuguese PatientsPublication . Azevedo, A.; Bettencourt, A.; Selores, M.; Torres, T.INTRODUCTION: Biosimilars are highly similar copies of previously approved original biologic medicines. Their introduction on the market may yield cost reduction. The aim of this study was to evaluate the perspectives of psoriasis patients on biosimilar medications. MATERIALS AND METHODS: We conducted a 14 questions survey of psoriasis patients receiving biological therapy and followed-up in a dermatology department of a Portuguese tertiary care hospital. RESULTS: From a total of 108 patients included, 70.4% of patients did not know the definition of biosimilar agent and 76.6% of patients showed partial or total interest in using a biosimilar drug. Nearly 80% of patients partially or totally agreed in using a biosimilar drug in order to reduce healthcare costs with psoriasis treatment. However, the lack of studies in the European population and in psoriatic patients led most of the patients (72.2% and 75.0%, respectively) to somewhat or completely oppose to the use of biosimilars. Demographic variables, household income and type of current biologic therapy did not affect patient preferences. DISCUSSION: Despite of the unfamiliarity of the respondents with biosimilars, most patients seem receptive to their use. Nevertheless, there are two issues of concern: i) the use of biosimilars that are not tested in a European population, and ii) its approval for psoriasis without trials in this disease. Thus, an immediate need exists for patient education about biosimilars. CONCLUSION: Biosimilars may increase patient access to biologic therapies. Improved communication and the involvement of patients in decision-making regarding biosimilars may increase their acceptance in future.
- Efeito do Mês de Nascimento no Risco de Desenvolver PsoríasePublication . Martins, A.; Bettencourt, A.; Torres, T.Introdução: A psoríase é uma dermatose imunomediada caraterizada por inflamação crónica, proliferação e diferenciação anormal dos queratinócitos, hiperplasia vascular e infiltração de células inflamatórias. É uma doença multifatorial influenciada por alterações genéticas e epigenéticas despoletadas por estímulos ambientais. O clima e a exposição solar parecem afetar a prevalência da psoríase e a radiação ultravioleta é útil na abordagem terapêutica. O nosso objectivo foi avaliar a influência do mês de nascimento (como marcador da época de gestação) no risco de desenvolver psoríase. Métodos: Comparação da distribuição dos meses de nascimentos nos pacientes com psoríase (n = 755) seguidos no Centro Hospitalar e Universitário do Porto com uma população controlo constituída pelos cidadãos portugueses nascidos no mesmo período e área geográfica dos pacientes com psoríase (n = 6 560 032). Resultados: Observou-se uma diminuição do número de nascimentos de pacientes com psoríase no mês de outubro estatisticamente significativa (OR 0,74; 95% CI 0,55 – 0,99; p 0,041). Após correção de Bonferroni e após agrupar os meses por trimestres, não se observaram diferenças estatisticamente significativas. Conclusão: As diferenças estatísticas pouco significativas e não significativas apresentadas podem ser explicadas pelas características meteorológicas particulares de Portugal que podem tornar a síntese de vitamina D relativamente estável durante o ano. A perceção da influência ambiental no desenvolvimento de determinada patologia é importante porque permite o estabelecimento de medidas preventivas que conduzirão à diminuição da sua incidência.
- The Protective Role of HLA-DRB1(∗)13 in Autoimmune DiseasesPublication . Bettencourt, A.; Carvalho, C.; Leal, B.; Brás, S.; Lopes, D.; Martins da Silva, A.; Santos, E.; Torres, T.; Almeida, I.; Farinha, F.; Barbosa, P.; Marinho, A.; Selores, M.; Correia, J.; Vasconcelos, C.; Costa, P.; da Silva, B.Autoimmune diseases (AIDs) are characterized by a multifactorial aetiology and a complex genetic background, with the MHC region playing a major role. We genotyped for HLA-DRB1 locus 1228 patients with AIDs-213 with Systemic Lupus Erythematosus (SLE), 166 with Psoriasis or Psoriatic Arthritis (Ps + PsA), 153 with Rheumatoid Arthritis (RA), 67 with Systemic Sclerosis (SSc), 536 with Multiple Sclerosis (MS), and 93 with Myasthenia Gravis (MG) and 282 unrelated controls. We confirmed previously established associations of HLA-DRB1(∗)15 (OR = 2.17) and HLA-DRB1(∗)03 (OR = 1.81) alleles with MS, HLA-DRB1(∗)03 with SLE (OR = 2.49), HLA-DRB1(∗)01 (OR = 1.79) and HLA-DRB1(∗)04 (OR = 2.81) with RA, HLA-DRB1(∗)07 with Ps + PsA (OR = 1.79), HLA-DRB1(∗)01 (OR = 2.28) and HLA-DRB1(∗)08 (OR = 3.01) with SSc, and HLA-DRB1(∗)03 with MG (OR = 2.98). We further observed a consistent negative association of HLA-DRB1(∗)13 allele with SLE, Ps + PsA, RA, and SSc (18.3%, 19.3%, 16.3%, and 11.9%, resp., versus 29.8% in controls). HLA-DRB1(∗)13 frequency in the AIDs group was 20.0% (OR = 0.58). Although different alleles were associated with particular AIDs, the same allele, HLA-DRB1(∗)13, was underrepresented in all of the six diseases analysed. This observation suggests that this allele may confer protection for AIDs, particularly for systemic and rheumatic disease. The protective effect of HLA-DRB1(∗)13 could be explained by a more proficient antigen presentation by these molecules, favouring efficient clonal deletion during thymic selection.
- Ustekinumab in Real-Life Practice: Experience in 116 Patients with Moderate-To-Severe PsoriasisPublication . Raposo, I.; Bettencourt, A.; Leite, L.; Selores, M.; T, TorresUstekinumab is a monoclonal antibody directed against the p40 subunit common to both IL-12 and IL-23 cytokines. Although the evidence of ustekinumab efficacy and safety in clinical trials is extensively recognized, data on its use in clinical practice is limited. Our objective is to report on the real-life experience of two Portuguese dermatology departments with ustekinumab in patients with moderate to severe psoriasis, and to identify the clinical characteristics associated with a weaker clinical response.