A Topical Treatment Optimization Programme (TTOP) improves clinical outcome for calcipotriol/betamethasone gel in psoriasis : results of a 64-week multinational randomized phase IV study in 1790 patients (PSO-TOP)
Reich, Kristian (SCIderm GmbH)
Zschocke, I. (SCIderm GmbH)
Bachelez, Hervé (AP-HP Hôpital Saint-Louis)
de Jong, E.M.G.J. (Radboud University Medical Centre and Radboud University)
Gisondi, Paolo (University of Verona)
Puig Sanz, Lluís (Institut d'Investigació Biomèdica Sant Pau)
Warren, R. B. (Manchester Academic Health Science Centre)
Ortland, C. (Das Forschungsdock Service for Clinical Development)
Mrowietz, Ulrich (University Medical Center Schleswig-Holstein)
Universitat Autònoma de Barcelona

Date:	2017
Abstract:	Around two-thirds of patients with psoriasis do not adhere to topical treatment. The Topical Treatment Optimization Programme (TTOP), a five-element tool, includes guidance for the conversation between dermatologists/nurses and patients, patient information material, telephone/e-mail helpdesks and treatment reminders. It has been developed by patients and dermatologists to help increase adherence to treatment in psoriasis. To compare TTOP with standard of care ('non-TTOP') within a large European investigator-initiated study, PSO-TOP (clinicaltrials. gov NCT01587755). Patients with mild-to-moderate psoriasis received calcipotriol/betamethasone dipropionate gel as standardized study medication and were randomized 1 : 1 to either TTOP or non-TTOP management. Study medication was applied once daily for 8 weeks followed by 'as needed' application for an additional 56 weeks. Response was defined as a Physician's Global Assessment (PGA) of 'clear' or 'almost clear'. In 1790 patients (full analysis set), response rates after 8 weeks (primary objective) were significantly higher for TTOP (36·3%) than for non-TTOP (31·3%, P = 0·0267). Better clinical outcome was accompanied by higher rates of patients feeling well informed about their skin condition, treatment and other factors related to adherence, but the Dermatology Life Quality Index was not statistically different. TTOP patients regarded the structured one-to-one conversations with their dermatologist/nurse as the most important element of TTOP. Patients randomized to the TTOP intervention had a better clinical response than patients receiving standard of care. Improved communication between the healthcare provider and patient might be an important element in increasing adherence to topical therapy in psoriasis.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	British journal of dermatology, Vol. 177 Núm. 1 (july 2017) , p. 197-205, ISSN 1365-2133

DOI: 10.1111/bjd.15466
PMID: 28301043

9 p, 267.2 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
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