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IntroductionPsoriasis is a chronic disease involving the skin, which significantly impacts the quality of life. Disease severity and treatment efficacy (i.e., response) are assessed through the Psoriasis Area and Severity Index (PASI). A PASI 75 response, i.e., an improvement of at least 75% with respect to the baseline PASI score, has traditionally been used as a therapeutic benchmark in clinical trials. Therapeutic advances have made PASI 90 or PASI 100 responses possible in most patients treated with some biologics. A greater response may generate social value beyond clinical outcomes that would benefit both patients and society.MethodsA 1-year economic model was applied to estimate the impact of having a PASI 75, PASI 90, or PASI 100 response in four areas of analysis (quality of life, activities of daily living, work productivity, and out-of-pocket expenditures) and the social value of having a PASI 90 or PASI 100 response in comparison with a PASI 75 response. A mixed-methods approach based on the scientific literature, a focus group with patient, and an advisory committee with psoriasis stakeholders was used. The model included three different scenarios: having a PASI 90 vs a PASI 75 response; a PASI 100 vs a PASI 90 response; and a PASI 100 vs a PASI 75 response. A sensitivity analysis was included.ResultsThe annual economic impact per patient with moderate-to-severe plaque psoriasis having a PASI 75 response was estimated at Ł 6,139, mainly related to labour productivity losses and quality of life reductions. Having a PASI 90 or a PASI 100 response would reduce this impact to €3,956 or €1,353, respectively. Accordingly, the social value of having a PASI 90 instead of a PASI 75 response was estimated at €2,183, and €4,786 with a PASI 100 response.DiscussionA PASI 90 or PASI 100 response would have a lower economic impact and a greater social value than a PASI 75 response for patients with moderate-to-severe plaque psoriasis.

Psoriasis is a chronic, systemic inflammatory disease that affects the skin, with a high impact on patients’ quality of life. The aim of this study was to identify and determine the relative importance of unmet needs in the management of moderate-to-severe psoriasis in Spain, from a multi-stakeholder perspective. A mixed method-approach was used to collect information, design a questionnaire and a discrete-choice exercise, and elicit the unmet needs through a multidisciplinary committee composed of 12 experts. A total of 65 unmet needs were identified and categorized into 4 areas: clinical, patient-related, decision-making process, and social. Decision-making process unmet needs were perceived as the most pressing ones, followed by social, clinical and patient-related. Individually, the need to incorporate outcomes that are important to the patients and to have treatments that achieve total clearance with a rapid onset of action and long-term persistence were the most important unmet needs.

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Se realizó un estudio de 50 pacientes con antecedentes de trauma craneal, atendidos en Consulta de Audiología del Hospital Militar “Dr. Carlos J. Finlay” en el período de enero de 2002 a diciembre de 2003. Los pacientes presentaban secuelas cocleo-vestibulares, y entre ellos predominó el sexo masculino (62,0 %), la edad de 16 a 30 años (52,0 %) y las fracturas en la base del cráneo (según la naturaleza del trauma). A todos se les realizó un estudio audiológico detallado para determinar las lesiones que afectaron considerablemente su calidad de vidaA study of 50 patients with cranial trauma history that received attention at the Audiology Department of “Dr. Carlos J. Finlay” Military Hospital from January 2002 to December 2003, was conducted. The patients presented cochlear-vestibular sequelae. It was observed a predominance of males (62.0 %), of age 16-30 (52.0 %) and of fractures in the base of cranium (according to the nature of the trauma). All of them underwent a detailed auditive test to determine the lesions considerably affecting their quality of life

Se realiza un estudio de 50 pacientes que padecieron de poliposis nasal. La mayoría de los pacientes están comprendidos en la 4ta. y 5ta. décadas de la vida, con predominio del sexo masculino. El tiempo de evolución de la enfermedad que predominó en los pacientes fue de 1 a 4 años. Los antecedentes alérgicos y la eosinofilia sanguínea estuvieron presentes en nuestros casos. Todos los pacientes recibieron tratamiento quirúrgico, que consistió en polipectomía nasal anterior, en ocasiones asociada a la técnica de maxiloetmoidectomía. En las muestras obtenidas predominó, desde el punto de vista macroscópico, el aspecto polipoide, la mucosa engrosada y la secreción mucoserosa. Asimismo, en el análisis histopatológico se observó hipertrofia epitelial, engrosamiento de la membrana basal, edema e hiperplasia glandular en la lámina propiaA study of 50 patients suffering from nasal polyposis was conducted. Most of the patients were 40 and 50 years old. It was observed a predominance of males. The time of the evolution of the disease prevailing among the patients was from 1 to 4 years. The allergy history and blood eosynophilia were present in our cases. All the patients underwent surgery, which consisted in anterior nasal polypectomy on occasions associated with the maxilloethmoidectomy technique. In the samples obtained it was observed a predominance, from the macroscopical point of view, of the polypoid aspect, the thickened mucosa and the mucoserous secretion. Likewise, epithelial hypertrophy, thickening of the nasal membrane, edema and glandular hyperplasia in the own lamina were found in the histopathological analysis