Global Psoriasis Atlas Annual Report Year 3: April 2019 - March 2020 Contents Foreword page Foreword 3 It has been quite a year Mission 4 one way or another. Vision 4 As I write this from Manchester in late March, the full global significance of the COVID-19 pandemic is starting to sink in. The Launch of the Atlas 6 Many cities are in lockdown; health services around the world Psoriasis: Building the Global Picture 8 are struggling to cope with the influx of ill and very ill patients; universities are closed or closing; research has stopped The GPA and the World Health Organization 9 and educational and scientific meetings continue only via The GPA: A Strong Organisation Built to Collaborate 10 video-conferencing. Despite all of this, it is only right that we have something to celebrate namely the outstanding year Our Team 11 of success enjoyed by the Global Psoriasis Atlas and its team of dedicated international Structure and Governance 12 enthusiasts led by Rebekah Swan. As you will read in the report, we undertook our first GPA fieldtrip. In July 2019, a group of us went to Tanzania where we learnt a huge Governance and Leadership 13 amount about how psoriasis is both diagnosed and managed in East Africa. Dr Tatjana Global Network, Regional Approach 14 Maul reconnected with Chile and Brazil to learn more about psoriasis care in those countries and Professors Ashcroft and Augustin and their teams continued to add to our Regional Coordinator Spotlight 16 knowledge about psoriasis worldwide and presented this at conferences and in scientific Research Work Stream Progress 20 journals. Probably the standout success of the past year was the launch of the GPA Website, fittingly on World Psoriasis Day, 29 October 2019. Please take the time visit the Work Stream 1 Progress 20 site – we are interested in your thoughts. We have now finished Phase I (2017-20) of the Work Stream 2 Progress 24 GPA and the other piece of excellent news is the procurement of funding to cover most of our planned work for Phase II (2020-23) from our Lead Supporter the LEO Foundation. PhD Progress 27 At this juncture I would also like to thank two of our Board of Governors, who stepped Introducing Our Medical Coordinator 30 down in the past year, for their unswerving support of the GPA. Dr Harvey Lui, the first Global Collaboration: Tanzania 32 Chair of the Board in his role as President of the ILDS and Lars Ettarp, whose drive and vision as President of IFPA laid the foundations of what was to become the GPA. Success Factors for the GPA Programme 34 GPA: Phase II 2020-2023 35 A year of success but also one of uncertainty. May I wish all of you and your families good health and fortitude in the coming months. Highlights 2017-2020 36 Outreach 37 News 2019-2020 38 Social Growth 40 Engagement 41 Professor Chris Griffiths OBE Publications, Abstracts and Presentations 42 Director, Global Psoriasis Atlas 2 www.globalpsoriasisatlas.org 3 Professor Griffiths with a patient and local dermatology specialist who is acting as Maasai interpreter. Tanzania, July 2019 Mission The mission of the GPA is to ensure that people with psoriasis, wherever they live in the world, have access to the best available care. Vision The GPA will become the leading epidemiological resource globally on psoriasis providing the common benchmark on the burden of psoriasis in all countries and regions throughout the world. The Atlas will seek to: drive continuous improvement in understanding the natural history of psoriasis; uncover how it affects the individual and society; understand how healthcare can be improved for those living with the disease. 4 www.globalpsoriasisatlas.org 5 The Launch of the Atlas We are grateful to the people who shared We launched the Global Manchester and the University Medical their story with us. Center Hamburg-Eppendorf, will help Psoriasis Atlas website construct a global picture of psoriasis. Rebekah Swan, on the 29th October Bringing together both the latest Programme Manager 2019, to coincide with data and compelling insights, it serves as a valuable source of information World Psoriasis Day. not only for researchers, policy makers This important milestone means that, and healthcare providers across the for the first time, experts and those world but the many people who live highlight many of the impacts that living with psoriasis can gain a greater with psoriasis. are experienced when living with this understanding of the complex skin potentially life changing skin disease. As well as serving as a condition endured by so many people. transformational, educational and Our understanding of the epidemiology This landmark achievement has been open access scientific tool, the of this chronic condition is limited in accomplished by the International Global Psoriasis Atlas also presents many countries but the Global Psoriasis Federation of Psoriasis Associations the human face of psoriasis, Atlas is poised to radically transform (IFPA), the International League of sharing first-hand experiences. this in the future. It will uncover the true Dermatological Societies (ILDS) and Working with IFPA we were fortunate burden of the disease, ensuring those the International Psoriasis Council to be able to film the personal stories people living with psoriasis have access (IPC). The culmination of the research of people from around the world with to the best available care, wherever work conducted at The University of psoriasis. These powerful accounts they live in the world. 6 www.globalpsoriasisatlas.org 7 Psoriasis: Building the The GPA and the Global Picture World Health Organization 60 The resolution passed by the World These data, coupled with Health Assembly in 2014 highlighted the identification in 2012 by that psoriasis should be viewed as a the International League of serious non-communicable disease Dermatological Societies (ILDS) and the subsequent WHO report on that psoriasis was one of its psoriasis1, published in 2016, paved “Grand Challenges in Global the way for the development of the Skin Health”, catalysed the GPA. The resolution was aided by tripartite partnership between the 2012 systematic review from the the International Federation of million people University of Manchester reporting on the global epidemiology of psoriasis2. This highlighted marked variations in Psoriasis Associations (IFPA), the ILDS, and the International Psoriasis Council (IPC) to take with psoriasis the reported prevalence and incidence of psoriasis, both within and between forward a GPA. globally countries. Importantly it identified knowledge gaps in our understanding of the natural history and burden of Our systematic psoriasis globally. Specifically: 19% review identified that • Few studies focused on the The prevalence incidence (new cases) of psoriasis over time; of psoriasis appears to vary depending on genetic background and geographic location. For • Most studies contributing data on Good epidemiological data are example, our data indicates a prevalence estimate of disease prevalence were conducted essential for disease control and 0.06% in Europe and the USA, with far fewer identified from Asia, Africa and South appropriate healthcare planning…and of countries America. • No studies simultaneously compared dermatology remains one of the most neglected fields of epidemiological have epidemiological data on psoriasis in Taiwan trends in incidence, prevalence and mortality longitudinally in patients with psoriasis to determine: (i) study. There is a need for better quality data on incidence and prevalence of compared to a prevalence estimate of 1.91% whether the prevalence of psoriasis psoriasis to understand better the size is increasing over time; and (ii) if so, whether this is driven by increasing and distribution of the problem. trends in incidence and/or whether World Health Organization, 2016 in Denmark patients are nowadays living much longer with psoriasis due to reductions in early mortality. 1. World Health Organization. (2016). Global report on psoriasis. World Health Organization. https://apps.who.int/iris/handle/10665/204417 2. Parisi R, Symmons DPM, Griffiths CEM, Ashcroft DM. Global Epidemiology of Psoriasis: A Systematic Review of Incidence and Prevalence. J Invest Dermatol 2013;133:377-85. 8 www.globalpsoriasisatlas.org 9 We believe that it is possible to understand the The GPA: Our Team epidemiology of psoriasis in every country of the world. To help us achieve this, we work with a wide-ranging team of experts. We have a smart, passionate and A Strong Organisation caring team hard at work around the world. Built to Collaborate Director Professor Chris Griffiths Collaboration Team ILDS GPA Project Manager Caroline Bach Programme Manager Rebekah Swan ILDS Executive Director Joanna Groves The GPA is a collaboration Director of Research between three Work Stream 1 Lead Everything we achieve is thanks to our collaborating Professor Darren Ashcroft IFPA Executive Director leading international Patrik Vuorio organisations, partners and passionate supporters. organisations in world This global community is growing every year. Work Stream 2 Lead dermatology: International IFPA Scientific Officer Rebekah Swan, Programme Manager Professor Matthias Augustin Federation of Psoriasis Sicily Mburu Associations (IFPA); Medical Coordinator International League of IPC Chief Executive Officer Dr Julia-Tatjana Maul Dermatological Societies The collaborating organisations understanding and increased research Christy Langan (ILDS); and International are the joint project owners of to improve the lives of people who live the GPA. Project success can be with psoriasis and psoriatic arthritis. Psoriasis Council (IPC) attributed to the integrated and Research Associates and The University of synergistic interactions between the The International League of GPA Associates, Collaborators academic institution and the three Dermatological Societies has been Ireny Iskandar and Enthusiasts Manchester (UoM) as the partner international organisations. promoting skin health around the world lead academic institution. These organisations, between them, for over 80 years. The ILDS represents Dermatologist, Manchester, UK represent psoriasis associations dermatology at the highest level with 190 Member Societies from more Nirohshah Trialonis-Suthakharan Sidra Khan around the world, international dermatology societies and the than 80 countries they represent over education and empowerment of global 200,000 dermatologists. Dermatologist, Manchester, UK key opinion leaders in psoriasis. Finally, the International Psoriasis Tina Tian Council is a dermatology-led, PhD Students The International Federation of Psoriasis Associations is a non-profit voluntary, global, nonprofit organization with a network of more than 100 Alex Trafford Director, Regional Dermatology organisation comprising psoriasis associations from around the psoriasis experts, thought leaders, and Training Centre, Tanzania world. Together, they campaign for professionals, dedicated to improving Daudi Mavura improved medical care, greater public patient care around the globe. Maha Abo-Tabik Dermatologist, Chile, South America Peslie Ng’ambi Daniela Armijo Doctor and Researcher, Administrator Chile, South America Jade Kelly Cristóbal Lecaros 10 www.globalpsoriasisatlas.org 11 Structure and Governance and Governance Leadership GPA Board of Governors membership Lead Academic Institution reports Collaboration Team provides includes: the Presidents of the three directly to the Board and provides assistance to the Board of Governors Collaborating Organisations and other updates on project progress to the through oversight of the GPA Board of non-voting members. The Board Steering Committee at the time project progress. Members include of Governors is chaired by the ILDS of the annual European Academy executives and lead GPA staff from Governors President and is the project’s highest of Dermatology and Venereology the Collaborating Organisations decision making authority and has Congress in the autumn and the annual and the GPA Programme Manager. overall governance responsibility for meeting of the American Academy of Weekly teleconferences are held to Collaboration the GPA project, including reviewing Dermatology held in the spring. review the progress of the GPA and Team and agreeing the annual GPA budget. GPA Steering Committee is review partnerships, budget setting and support with marketing and The Governors ensure that the chaired by the GPA Director and is communications. GPA is kept abreast of emerging composed of a lead from each of the Lead Academic opportunities and overseeing risk Collaborating Organisations along Regional Coordinators are part of Institution mitigation protocols developed by the with the Project Executive Team the Steering Committee and provide Steering Committee. In addition to comprising the GPA Research Director updates to the committee on work biannual meetings, in Phase II quarterly and GPA Programme Manager. The ongoing in their regions. They also teleconferences will also be held for the GPA Medical Coordinator and our communicate ideas and questions to Scientific Board. The ILDS is responsible for the 18 Regional Coordinators also sit the Research Director and GPA team organisation of the Board meetings. on this group. The committee are during the meeting. In addition, they Advisory Board responsible for oversight of significant are invited to provide updates in the Scientific Advisory Board (SAB) will decisions, emerging opportunities and GPA quarterly newsletter and to work be established in Phase II to provide GPA risk mitigation. The GPA Programme with collaborators in their region to international and independent Manager monitors progress and market and promote the GPA. Team scientific oversight of the work provides written reports generated by of the GPA and its Collaborating the research team to the committee. Organisations. The SAB will consist The Steering Committee reports to of up to five individuals, including the Board of Governors. Meetings the Chair. Expertise would include take place on two occasions each epidemiology; dermatology; year: at the time of the annual health economics; global health European Academy of Dermatology and patient expertise. The GPA and Venereology Congress in the Programme Director, Research autumn and the annual meeting of the Steering Regional Director, Programme Manager and American Academy of Dermatology the Presidents of the Collaborating Committee Coordinators* Organisations will conduct an annual held in the spring. video conference with the SAB. GPA Team provides overall project progress updates to the Steering Committee including, finance, communications and marketing and achievement of milestones. The team hold a monthly teleconference with collaborators outside The University of Manchester. team as well as internal face to face monthly meetings for the GPA staff and PhD students based at The University of Manchester. * Regional Coordinators are part of the Steering Committee 12 www.globalpsoriasisatlas.org 13 Global Network, Regional Approach Regional Coordinators (2017-2020) The GPA has established a global European Region network of 18 Regional Peter van de Kerkhof Coordinators who are key Netherlands opinion leaders in psoriasis. Alexander Egeberg Denmark Arnon Cohen Israel Jacek C Szepietowski Poland Asja Prohic Bosnia and Herzegovina Region of the Americas Yves Poulin South-East Eastern Canada Asia Region Jashin Wu Mediterranean Murlidhar Western USA Region Rajagopalan Pacific Region Claudia de la Cruz Mahira India Chile Chris Baker Hamdy el Sayed Australia Ricardo Romiti Egypt Brazil Colin Theng Singapore Vermen Verallo-Rowell Philippines African Region Xuejun Zhang Ncoza Dlova China The work of GPA will contribute to South Africa Jianzhong Zhang improvement in care of psoriasis Moussa Diallo China Senegal patients in our region by raising awareness among dermatologists and patients of early diagnosis and treatment of psoriasis. Mahira el Sayed 14 www.globalpsoriasisatlas.org 15 Regional Coordinator Spotlight Mahira el Sayed Xuejun Zhang What made you want to specialise in What are the challenges of psoriasis on the incidence of co-morbidities in What made you want to specialise in patients in China. We have established For dermatologists: they will get the the field of psoriasis? management in your country/region? psoriasis will encourage governments the field of psoriasis? the Chinese Committee of the GPA latest epidemiological knowledge of to recognise psoriasis as a disabling during Chinese Psoriasis Committee psoriasis and treatment guidelines. Psoriasis is a very common disease There are a lot of challenges facing As we all know, psoriasis is a serious disease worthy of allocating more and selected 100 hospital dermatology in Egypt affecting a wide range of us in the region in terms of the global problem endangering human What inspires you the most in your resources. clinics as GPA monitoring points. The patients of different ages and genders. management of psoriasis patients, health. Currently, there are at least field of work? online questionnaire system is under It is an extremely debilitating disease due to socio-economic and political What inspires you the most in your 60 million people with psoriasis in the the debug phase. Public education is really important. and the ideal treatment is not always factors. As a result, patients with field of work? world, and more than 2 million in China. It can significantly reduce the available so I took special interest in moderate to severe psoriasis are Due to wrong diagnosis, untimely What are the challenges of psoriasis The thing that inspires me most is recurrence rate of psoriasis, improve the disease over 15 years ago. I was undertreated and have significant diagnosis, inappropriate treatment, management in your country/region? the patients and their stories. The their life quality and rebuild their lucky to join the International Psoriasis disease burden. Patients are inadequate medical care and social new era of biologic therapy has given Due to the COVID-19 pandemic, China self-confidence. Now, the short-term Council which motivated me even stigmatized which prevents them bias, many psoriasis patients suffer hope to many patients and being able is facing a number of challenges at outcome of biologics is good for more to work with my patients. from seeking early treatment for fear unnecessary pain. To promote the to clear the patients of disease and present and as a result, our education psoriasis, but the recurrence of the of judgement. Lack of awareness development of psoriasis prevention, How did you get involved in the return them back to their normal life is programme for psoriasis has been disease can be high. I plan to explore among dermatologists and limited treatment and improve the life quality Global Psoriasis Atlas? beyond inspiring. affected. However, we have plans in the mechanism of recurrence after governmental funding contributes to of psoriasis patients in China, my work place to change from a face to face using biologics. I got involved with the Global Psoriasis the problem. is focused in the field of psoriasis. educational model to an online model. Atlas through the International Psoriasis How will the work of the Global How did you get involved in the Council, which is a partner of the GPA, How will the work of the Global Psoriasis Atlas contribute to Global Psoriasis Atlas? of which I have been a councillor and Psoriasis Atlas contribute to improvements in care for people with now proudly a board member. As a Regional Coordinator, I have improvements in care for people with psoriasis in your country/region? publicised the campaign for the psoriasis in your country/region? How does your work contribute to The work of the GPA will contribute to Global Psoriasis Atlas in China. the Global Psoriasis Atlas? For psoriasis patients: this project improvement in the care of psoriasis I set up the Chinese Committee helps me to gather Chinese Working closely with psoriasis patients patients in our region by raising of the GPA. Then, I conducted the dermatologists together and learn on a daily basis and recognising the awareness among dermatologists Psoriasis Healthcare Survey among more about caring for psoriasis burden they carry due to their disease and patients of early diagnosis and dermatologists and patients. Now, patients. It will teach them about will make me able to further contribute treatment of psoriasis. Also, focusing I am organising the education psoriasis, make them to the work of the GPA. program for patients and building understand how to an online questionnaire system. relieve their patients’ uncomfortable condition, How does your work contribute to reduce the recurrence the Global Psoriasis Atlas? rate of psoriasis, lighten Until now, our group have finished the burden of medical the Psoriasis Healthcare Survey expenses, improve their questionnaire among 1345 life quality and rebuild their dermatologists and 460 psoriasis self-confidence. EGYPT ESTIMATED CHINA ESTIMATED 489 2.5 0.5 0.18 PSORIASIS PREVALENCE PSORIASIS PREVALENCE THOUSAND MILLION % PEOPLE AFFECTED % PEOPLE AFFECTED 16 www.globalpsoriasisatlas.org 17 Regional Coordinator Spotlight Dr Claudia de la Cruz and Dr Maul with staff members at Dermacross Clinica Dermatologica. Claudia de la Cruz What made you want to specialise in How does your work contribute to How will the work of the Global the field of psoriasis? the Global Psoriasis Atlas? Psoriasis Atlas contribute to improvements in care for people with My interest in psoriasis began at a There is a lot of work ongoing in Latin psoriasis in your country/region? very young age during my residency America and, as there has been a lack program when I saw a lot of children of data available to conduct research, I am confident that this work will affected by the disease. I completed most countries do not have official improve the management of psoriasis my thesis on this subject in order numbers on the epidemiology of in my country. We have always thought to get my degree in dermatology psoriasis. My work has mostly been that the incidence was between 3-5%, and took a special interest in the based on creating this information but with this work we have discovered epidemiology of psoriasis for this age in the field by recording patients’ that is near to 1.7% of the population group. Psoriasis was my very first area experiences in hospitals and also affected by this disease. This lowers of interest in dermatology and the private health facilities. The major the expected costs associated with focus of my attention at that time, as contribution to this work has been Dr systemic therapy in patients who need it is now. The treatment that patients Cristobal Lecaros, with whom we have it, and health authorities may take receive often does not satisfy their recruited analysed data from about action on this to improve access to needs and they see their whole life 9000 patients. Along with this, we have treatment. affected by the disease. The chance been supported by Dr Tatjana Maul What inspires you the most in your of relieving them of the burden caused from Switzerland and together we field of work? by this disease was my primary reason have created and applied a prospective to take interest in this area and to questionnaire which by now has been It is particularly rewarding for me to see consider the new discoveries regarding completed by over 800 patients from the happiness of my patients and their their treatment. It was very exciting for Chile and Brazil and we expect to families after they recieve appropriate publish results by the end of the year. treatment for this disease. Living with me to investigate what was affecting psoriasis should not lower a person’s their life quality using the available new What are the challenges of psoriasis chances of achieving a good quality information in medicine. management in your country/region? of life, and I am proud to contribute How did you get involved in the Definitely the most relevant challenges to ensuring that people with psoriasis Global Psoriasis Atlas? for my country and region are to receive the best possible treatment for improve the access of patients to their disease. As a board member for the International Psoriasis Council, I treatment in two ways: Firstly by was working in research on access educating general physicians, to therapy for psoriasis around the family physicians and dermatology physicians word and I had a lot of information to on psoriasis as a disease contribute, especially in my region. So, and also on its impact when I heard about the GPA project, I on life quality for the saw an opportunity to collaborate. This patients, as much as work will not only help Chile (which is the how it should be treated. country I represent) but also the whole Secondly, we need to Latin American continent, encouraging improve the access to the better health policies based on the treatments available for this information discovered. During the disease. This is very difficult process of coordinating for the region to achieve patients in Chile I have also worked with professor and the rest of South America, CHILE ESTIMATED 214.8 Ricardo Romiti from São Paulo, Brazil, especially when it comes to 1.19 PSORIASIS PREVALENCE trying to get as much information systemic therapy which is not available to develop the Atlas. usually given by their doctors or THOUSAND % PEOPLE AFFECTED financed by the health system. 18 www.globalpsoriasisatlas.org 19 Research Work Stream Progress The link between psoriasis and cancer Beyond the high societal burden that their increased prevalence in people with psoriasis may go some way to explaining an increase in risk. Finally, a number of studies have Through database searching, 2830 records were identified. This number fell to 2302 once duplicates were removed. Articles were then psoriasis creates through its relatively considered the role that certain screened through two stages: (1) title high prevalence, the condition also therapies used in psoriasis treatment, and abstract screening (2) full-text enacts a significant burden on the particularly phototherapies and screening. A total of 2206 records individuals that it affects. Pain and immunosuppressants, may play in any were excluded through initial title and discomfort may arise from plaque sites, change in cancer risk. Understanding abstract screening, with common whilst societal stigmatisation the risk of cancer in psoriasis, and reasons for exclusion including Work Stream 1 Progress can often lead to mental and emotional detriment. These issues are often especially the role that these potential mechanisms may play, remains randomised control trial study design, lack of an appropriate comparison compounded by further comorbidities complex and challenging. group and case report study design. Of that have been shown to be associated the 96 studies screened by full-text, 40 with psoriasis. An increased risk of Summary of results from were excluded, with common reasons including: drug study with selected I am pleased to report We have continued to work closely We are very grateful to all our cardiovascular disease in people with a systematic review of population; lack of direct comparison with our GPA Regional Advisors to international dermatology colleagues psoriasis has been suggested in a that we have completed identify electronic health record who completed our Delphi survey that number of studies, with a recent psoriasis and cancer risk measure; and mortality study with no cancer-specific estimates. An all our milestones for data sources, and taken forward new we launched to establish consensus on meta-analysis of 75 studies finding As the Global Psoriasis Atlas additional 2 records were identified studies examining the epidemiology of clinical examination-based diagnostic a 40% increased risk in people with progresses, one of the important aims Work Stream 1, and psoriasis. In November, we published criteria for psoriasis in adults. We psoriasis compared to those without is to understand the complex picture through hand-searching of reference lists. Following this screening process, subsequently initiated new work reporting on time trends reached consensus on 9 diagnostic the condition1. The association of comorbidities surrounding the a total of 58 studies were included in in the incidence and prevalence of criteria among the international panel, between psoriasis and metabolic condition. A key step in understanding new work to further psoriasis in Israel, in collaboration with and are looking forward to reporting syndrome, an overarching health state the place that cancer holds in this the systematic review, of which 50 considered cancer incidence and 15 extend our international Prof Arnon Cohen. We have initiated on all these new insights, and further representing diabetes, hypertension picture is consolidating the information considered cancer mortality. new studies in Chile and Taiwan too, developing the diagnostic criteria in and obesity, has similarly been explored that is already available in the literature. research programme. and will be reporting on these new validation studies with our international through a meta-analysis, with a 226% This important step was achieved Studies of cancer incidence were Two extensive systematic reviews have population-based study findings later collaborators. increased risk reported2. Additional through the completion of systematic mostly conducted in North America been completed: the first, the largest this year. evidence has also suggested an review and meta-analysis7, which not (36%) or Europe (54%), with the Professor Darren Ashcroft ever review examining the international association with psoriatic arthritis3, only identified all relevant studies on remaining studies conducted in Planning for further new research data on the incidence and prevalence depression and anxiety4 . the topic, but also pooled estimates of Taiwan (10%). Study setting was studies in other countries is well of psoriasis from population-based cancer risk from these studies together split between hospital (56%) and underway too. We have worked Cancer has similarly been explored as studies; and the second detailed in order to provide greater precision. population (44%). There was variation closely in partnership with the ILDS a potential comorbidity in psoriasis. systemic review examining the risks in the ascertainment of covariates and received additional funding However, the link remains unclear. For the initial systematic review, six of developing or dying from cancer between studies, with 70% of studies support from the UK Global Research Despite this lack of clarity, there are electronic databases (MEDLINE, among people with psoriasis. These not reporting smoking status, alcohol Challenge that allowed us to spend a number of plausible mechanisms Embase, MEDLINE in Process, are important data resources that consumption or obesity. The quality time at the Regional Dermatology for an association between psoriasis Cochrane Central Register, Web underpin the development of the of cancer incidence studies was Training Centre in Moshi, Tanzania in and cancer. Chronic inflammation of Science, and LILACS [Literatura Global Psoriasis Atlas which we also mostly fair (58%), with high quality July 2019 to better understand the plays a key role in the pathogenesis Latino-Americana e do Caribe em launched on World Psoriasis Day (29 (26%) and low quality (16%) studies healthcare systems and data collection of psoriasis and has been suggested Ciências da Saúde]) were searched October 2019). less numerous. methods throughout Sub-Saharan as potentially causing an increased from database inception to November Africa. Building on this, we are now cancer risk. Supporting evidence for 2017. In order to be considered eligible, Studies of cancer mortality were seeking additional support to take this mechanism is provided through studies were required to meet the similarly conducted across North forward new research studies in the increased cancer risk seen in following eligibility criteria: prospective America (20%), Europe (73%) and Sub-Saharan Africa. other conditions involving chronic or retrospective case-control or Taiwan (7%). Study setting was also inflammation, such as Crohn’s disease cohort study design; at least one split between hospital (67%) and and Barrett’s oesophagus5. Beyond study group of psoriasis patients; population (33%). However, the chronic inflammation, it has also been one comparison group consisting of proportion of studies not reporting posited that factors associated with non-psoriasis patients or the general smoking status, alcohol consumption psoriasis may lead to an increased population; and cancer incidence and obesity (53%), was lower than risk of cancer. Indeed, smoking, or mortality as an outcome. There was found in cancer incidence studies. alcohol consumption and obesity were no restrictions by geography Study quality was also different in are all associated with psoriasis6. or language. The risk of bias and studies of cancer mortality, with 53% Given the independent association study quality was assessed using the of studies being high quality, 33% fair between these factors and cancer, Newcastle Ottawa Scale8. and only 14% low. 20 www.globalpsoriasisatlas.org 21 Work Stream 1 Progress Association of Psoriasis With the Risk of Risk of developing slightly higher in studies of severe Further findings Developing or Dying of Cancer: or dying of cancer: psoriasis, it was not significantly so. A number of site-specific cancers Beyond the main findings of the meta-analysis, there are several other A Systematic Review and Meta-analysis A Meta-analysis were also found to be associated with important considerations. Primarily, psoriasis, regardless of whether the Using the studies identified through for a number of the pooled estimates study considered all psoriasis severities the systematic review, it was possible of cancer incidence and mortality or just severe psoriasis, including: to conduct a meta-analysis by pooling risk, there was high heterogeneity, colorectal; kidney; laryngeal; liver; estimates of cancer incidence and potentially reflecting the lack of clarity 58 lymphoma; Non-Hodgkin lymphoma; mortality risk in psoriasis. This pooling in the association. Finally, additional keratinocyte cancers; oesophageal; was achieved through a Der-Simonian- stratification according to the 6 oral cavity; and pancreatic cancer. Laird random-effects model9, with covariates considered in the study, effect estimates combined through Cancer mortality suggested that the risk of all cancer the generic inverse variance approach. incidence was lower in studies that In contrast to cancer incidence, the took smoking, alcohol consumption studies of cancer In order to provide a more nuanced risk of all cancer mortality was only incidence and obesity into account. understanding of cancer risk, studies found to be increased in studies of were pooled according to the severity Studies screened by title, severe psoriasis (22% increased of psoriasis that was considered in abstract and full text risk). Furthermore, due to the limited their study population. number of mortality studies, there databases searched was no opportunity to consider site- systematically 15 Cancer incidence specific cancer mortality in studies The risk of all cancer incidence was of all psoriasis severities. There were found to be elevated in studies that sufficient studies to consider a limited considered all psoriasis severities number of site-specific cancers in (18% increased risk) and studies that severe psoriasis, with an increased only considered severe psoriasis (22% risk found for oesophageal, liver and studies of cancer mortality increased risk). Although the risk was pancreatic cancer. Compared to those without psoriasis 22% 22% Site-specific cancer incidence risk increased in 1. Miller IM, Ellervik C, Yazdanyar S, Jemec GB. 4. Olivier C, Robert P, Daihung D, et al. The 8. Wells G, Shea B, O’Connell J, Robertson J, severe psoriasis compared Meta-analysis of psoriasis, cardiovascular risk of depression, anxiety, and suicidality et al. The Newcastle-Ottawa Scale (NOS) to those without: disease, and associated risk factors. J Am in patients with psoriasis: A population- for assessing the quality of nonrandomised relative risk of cancer relative risk of cancer Lymphoma Acad Dermatol. 2013;69(6):1014-24. based cohort study. Arch Dermatol. studies in meta-analysis. 2011. Available occurrence in mortality in 2010;146(8):891-5. from: URL: http://www.ohri.ca/programs/ severe psoriasis severe psoriasis Oesophagus 2. Armstrong AW, Harskamp CT, Armstrong clinical_epidemiology/oxford.asp. Basal cell EJ. Psoriasis and metabolic syndrome: A 5. Coussens LM, Werb Z. Inflammation and carcinoma 18% 5% Squamous cell systematic review and meta-analysis of cancer. Nature. 2002;420(6917):860-7. 9. Chapter 9: analysing data and undertaking carcinoma (skin) observational studies. J Am Acad Dermatol. 6. Guenther L, Gulliver W. Psoriasis meta-analyses. In: Deeks JJ, Higgins JPT, (skin) 2013;68(4):654-62. Altman DG; Cochrane Statistical Methods comorbidities. J Cutan Med Surg. 3. Gelfand JM, Gladman DD, Mease PJ, Smith Group, eds. Cochrane Handbook for 2009;13(SUPPL. 2):S77-S87. Liver Systematic Reviews of Interventions. https:// N, Margolis DJ, Nijsten T, et al. Epidemiology 7. Trafford AM, Parisi R, Kontopantelis E, handbook-5-1.cochrane.org/chapter_9/9_ relative risk of cancer relative risk of cancer Pancreas of psoriatic arthritis in the population of Griffiths CEM, Ashcroft DM. Association analysing_data_and_undertaking_meta_ occurrence in all psoriasis mortality in all psoriasis the United States. J Am Acad Dermatol. of Psoriasis With the Risk of Developing analyses.htm. Published 2011. Accessed Bladder 2005;53(4):573.e1-.e13. or Dying of Cancer: A Systematic Review January 25, 2018. and Meta-analysis. JAMA Dermatology. 2019;155(12):1390-403. 22 www.globalpsoriasisatlas.org 23 Work Stream 2 Progress Table 1. Non-biological drug approval in Latin America for psoriasis Fumaric acid Acitretin Cyclosporine Leflunomid Methotrexat Tofacitinib Others esters Argentina 3 3 3 3 Brazil 3 3 3 Chile 3 3 We are pleased to present We are currently drafting the first Work Stream 2 is currently developing Colombia 3 3 3 version of the ’Psoriasis Healthcare a sampling strategy and submitted the Work Stream 2 and Facts in Latin America’ booklet. the ethical application to conduct Costa Rica 3 3 3 3 3 Ecuador progress this year for the The booklet summarises facts on the global explorative GPA PsoHealth 3 3 3 healthcare, clinical facets, disease survey on psoriasis treatment. The El Salvador 3 3 Global Psoriasis Atlas. burden and drug use amongst first steps of cooperation agreements Honduras 3 3 3 3 Work Stream 2 made great progress others in Latin America. We would with regional coordinators and dermatologists from GPA and internal Guatemala 3 3 3 in completing the Latin American field like to show our gratitude to Dr Julia- study on psoriasis healthcare. Tatjana Maul, Dr Maria Jose Valencia institute networks are going to be Mexico 3 3 3 Lopez, GPA Regional Coordinator initiated. We have completed the field research Nicaragua 3 3 Dr Claudia de la Cruz (Chile) and Dr Professor Matthias Augustin on healthcare data and drug access Peru 3 3 3 Ricardo Romiti (Brazil) and all the Latin for psoriasis in 18 Latin American countries: Dominican Republic, American dermatologists’ participants Paraguay 3 3 3 in the survey for their support Venezuela, Mexico, Peru, Panama, and knowledge. We encourage Psoriasis treatment Bolivia, Argentina, Brazil, Chile, Nicaragua, Colombia, Honduras, dermatologists around the world to in Latin America – Table 2. Non-biological drug approval in Latin America for psoriatic arthritis participate in the healthcare survey in El Salvador, Costa Rica, Ecuador, order to gain a full understanding of Drug availability Guatemala, Uruguay and Paraguay. Acitretin Cyclosporine Leflunomid Methotrexat Tofacitinib Others psoriasis healthcare. We are pleased to report that, in addition to the exploratory healthcare Argentina 3 3 3 We are also updating our desk study on psoriasis, we have also research on potential epidemiological Brazil 3 3 3 3 collected data on the availability of data sources on psoriasis on the web. approved treatments for psoriasis Chile 3 3 Potential data sources are updated and psoriatic arthritis. This survey Colombia from health ministries, national was conducted from June to August 3 Mexico registries, NGO’s, statistical/ public 2019 using an online questionnaire Costa Rica 3 3 3 3 3 Dominican Republic health and research institutes and in 18 Latin American countries. To Ecuador Honduras claims data. In the next step, the confirm the survey findings, we also Nicaragua data owners of each source will be El Salvador 3 3 Guatemala examined publicly available data El Salvador Venezuela individually contacted. Data sources from pharmaceutical companies. In Honduras 3 3 3 3 Costa Rica Panama will be reviewed for accessibility, each country, a minimum of 4 and Colombia Guatemala 3 3 3 3 methodologies and data a maximum of 10 dermatology Ecuador quality. In parallel, a Mexico 3 3 experts were recruited to report on Brazil methodology is going the approved traditional systemic Nicaragua 3 3 Peru to be developed to treatments, biologicals and biosimilars Peru test whether data for psoriasis and psoriatic arthritis. linkage between Paraguay 3 3 Bolivia Data on psoriasis and psoriatic different data sets arthritis for the following 13 countries Paraguay can be carried out on are presented in this annual report: Chile the basis of statistical Argentina, Brazil, Chile, Colombia, Uruguay modelling under the Costa Rica, Ecuador, El Salvador, One of the key findings of the and 2). Furthermore, ‘Apremilast’ is psoriatic arthritis, except in Costa leadership of a statistician from Honduras, Guatemala, Mexico, questionnaire is that Methotrexate rarely available in Latin America except Rica. Specifically, the facts must be Argentina the Hamburg team. Nicaragua, Peru and Paraguay. and ciclosporin are licensed among for Argentina, Mexico, and Costa considered that psoriatic arthritis is the non-biological drugs for psoriasis Rica. A difference is observed in the treated by rheumatologists as well, and psoriatic arthritis in almost every accessibility of Acitretin for psoriasis and possibly rheumatologists have surveyed country, while Fumaric acid and psoriatic arthritis. According to access to this particular drug (M esters and Dimethylfumarate are not the findings, the drug is approved for Abdulghani et al.). approved in Latin America (table 1 psoriasis in six countries but not for 24 www.globalpsoriasisatlas.org 25 Work Stream 2 Progress PhD Progress Table 3. Biological drug approval in Latin America for psoriasis Adalimumab Certolizumab Etanercept Guselkumab Infliximab Ixekizumab Risankizumab Secukinumab Tildrakizumab Ustekinumab Others Argentina 3 3 3 3* 3 3 3 3 Maha Abo-Tabik Brazil 3 3 3 3 3 Chile 3 3 3 3 3 The aim of my work has or video-dermoscopy), computer or questionnaire-based tests Upon completion of the Colombia 3 3 3 3 3 3 3 been to develop a clinical and traditional Chinese medicine ongoing projects, we will Costa Rica 3 3 3 3 3 3 3 3 examination-based diagnostic criteria. However, the hopefully have a validated, diagnostic accuracy of these criteria Ecuador 3 3 3 diagnostic tool for chronic varied widely across different standardised approach for El Salvador 3 3 3 plaque psoriasis in adults categories, and most of the proposed the clinical diagnosis of Honduras 3 3 3 3 3 diagnostic approaches did not undergo chronic plaque psoriasis (age 18 years and above). proper validation. Guatemala 3 3 3 3 3 in adults and a better The development of this tool provided Mexico 3 3 3 3 3 3 3 We tackled this problem in two ways; understanding of the factors the basis for my PhD project entitled firstly, by conducting a detailed review Nicaragua 3 3 “Examining the epidemiology of associated with earlier of literature targeting all studies with a Peru 3 3 3 3 3 psoriasis”. primary aim to make a clinical diagnosis diagnosis of psoriasis in the A three-step international electronic of psoriasis. From this literature, we healthcare setting. Paraguay 3 3 3 Delphi (e-Delphi) consensus method identified all possible diagnostic items was used to establish the diagnostic that could serve as proposed clinical criteria for our diagnostic tool. I am currently working on two *Guselkumab is recently approved in Argentina tool. The consensus process took Table 4. Biological drug approval in Latin America for psoriatic arthritis projects in parallel. The first one is a place between January 2019 Secondly, by using the Delphi case-control study to identify missed and August 2019. The research technique as the study methodology. opportunities for earlier diagnosis of Adalimumab Certolizumab Etanercept Infliximab Ixekizumab Risankizumab Secukinumab Tildrakizumab Ustekinumab Others methodology and initial results The Delphi method has been widely psoriasis in primary healthcare settings were presented at the University of used to answer a research question Argentina 3 3 3 3 3 3 3 using the Clinical Practice Research Manchester postgraduate summer that required experts input from the Datalink (CPRD). In this study we will Brazil 3 3 3 3 3 showcase, 2019. clinical community as these data were look retrospectively into patients’ Chile 3 3 3 3 3 The expert agreed diagnostic criteria not available in the existing literature. records to identify possible health Colombia 3 3 3 3 3 3 3 for chronic plaque psoriasis would be Another challenge was the care events such as misdiagnosis, valuable to standardise practice, to international involvement of experts treatment, referrals and hospital Costa Rica 3 3 3 3 3 3 3 assist non-dermatologists in making a in the study. However, the geographic admissions that could serve as an Ecuador correct diagnosis and to regulate case limitation has been overcome again indicator for a missed opportunity for El Salvador definition in future epidemiological by our research methodology using earlier diagnosis of psoriasis. 3 3 3 studies into psoriasis. an electronic approach (e-Delphi The second project is a validation study Honduras 3 3 3 3 3 The final results of the e-Delphi technique). for the results of the e-Delphi exercise. Guatemala 3 3 3 3 3 exercise have been accepted for a Fifty expert dermatologists from 27 We aim to conduct an international, Mexico 3 3 3 poster presentation at the 100th countries took part in this consensus multicentre, diagnostic accuracy study Nicaragua 3 3 Annual Meeting of the British exercise and this covered six regions of during the upcoming year. Association of Dermatologists in the world, giving the study a fair global Upon completion of the ongoing Peru July 2020. involvement. projects, we will hopefully have a Paraguay 3 3 3 The first challenge I faced with my We targeted expert dermatologist validated, standardised approach work was the scarcity of high- with specialist clinical and research for the clinical diagnosis of chronic quality published research related experience in the diagnosis and plaque psoriasis in adults and a Biological drugs are available Adalimumab, Etanercept, Infliximab, (February, 2020). Furthermore, Costa to the clinical diagnosis of psoriasis. management of psoriasis. The study better understanding of the factors and licensed for both psoriasis Secumkinumab, and Ustekinumab. Rica’s report showed that most Previously, there have been many participants were members of the associated with earlier diagnosis of and psoriatic arthritis and follow However, Abatacept, Brodalumab and biologics for psoriasis are authorised attempts to build diagnostic tools International Psoriasis Council (IPC) psoriasis in the healthcare setting. more or less the same trend of Tildrakizumab are not approved in including Certolizumab, Golimumab, for psoriasis including genetic and and the Global Psoriasis Atlas (GPA), availability (table 3 and 4). The the surveyed countries. Guselkumab Guselkumab and, Ixekizumab. molecular tests, histopathology, which adds further credibility to the most commonly licensed drugs are was recently approved in Argentina skin imaging (using dermoscopy research output. 26 www.globalpsoriasisatlas.org 27 PhD Progress All the systematic reviews reiterated the considerable economic impact that psoriasis exerts on the individual and society. Alex Trafford Peslie Ng’ambi In the last year, the main has been compared to the number of that they considered in order to During 2019 and 2020, This review produced a framework impact: 1) estimating the target cancer occurrences in people without understand whether this factor to enable the design and reporting population; 2) selecting a time horizon; focus of my PhD has psoriasis, in order to understand played a role in any difference in risk. my main focus was to of studies that identify, measure and 3) identifying current and projected been completing my if there is any difference in risk. In Additionally, studies were analysed understand the current value the economic impact of disease. treatment mix; 4) estimating current ongoing work, the role of other factors, according to whether they took This was the first necessary step and future drug costs; 5) estimating first piece of empirical such as psoriasis severity, smoking, smoking status, alcohol consumption evidence and identify towards improving consistency and change in disease-related costs; and work, a systematic review alcohol consumption and obesity, in any and obesity into account. Stratifying the gaps in the published coherence in understanding published 6) estimating and presenting changes difference in risk will also be explored. analysis according to these factors estimates of cost of illness and burden in annual budget impact and health and meta-analysis, and A combination of results from the has helped to give an initial insight into literature on the economic of disease. The developed framework outcomes. publishing these findings. meta-analysis and the first stage of this their potential role in the link between impact of psoriasis. was shared with academic experts in Following the breakdown of economic ongoing work was presented as part psoriasis and cancer. In our ongoing health experts for their expert opinion In order to complete this work, I first My first meta-review was conducted impact into two groups (Cost of Illness of a poster at the Division of Pharmacy primary analysis, we are focussing on and validation. This then led to the spent several weeks searching through with the aim of understanding the and Burden of Disease), future work and Optometry Showcase at the ascertaining smoking status, alcohol own going systematic review on the scientific literature for previous papers current scale and scope of the will be centred on cost of illness. University of Manchester and won the consumption and obesity levels in cost of illness and burden of disease of looking at the association between evidence base reporting estimates This research study will focus on the third-place prize. order to provide further understanding psoriasis with the aim of identifying and psoriasis and cancer. Once I had of the economic impact of psoriasis. adult population (18 years and above) into the roles of these factors. critically appraising published studies identified all the relevant studies, I then The most considerable challenge Methods used to generate the with plaque psoriasis. In addition, the that report values for the economic combined their estimates in order to in my work remains the difficulty in economic impact of psoriasis were empirical research will be restricted impact of psoriasis. summarize our current understanding establishing the true nature of the also scrutinised. The meta-review to selected case countries which will of cancer risk in psoriasis. Studies relationship between psoriasis and was conducted in order to understand Findings from these reviews have been include the UK. For the UK, we are that provided estimates of cancer cancer. Although our meta-analysis The completion of these presented at a number of conferences, currently exploring using the Hospital how my PhD could contribute to the risk according to psoriasis severity reported an increased risk of cancer works will hopefully improve existing body of knowledge. All the the most recent being an abstract at Episode Statistics (HES) database. The were combined separately so that in people with psoriasis, there was our understanding of the systematic reviews reiterated the the ISPOR Europe 2019, Copenhagen. HES is a database containing details we were able to better understand also notable variation in estimates This conference was attended by 5500 of all admissions, A and E attendances association between psoriasis considerable economic impact that how differing psoriasis severity may of cancer risk from different studies. psoriasis exerts on the individual people from 90 countries. ISPOR is the and outpatient appointments at alter risk. Preliminary results of cancer This variation reduces the strength and cancer, and pave the way largest professional society for health NHS hospitals in England. Therefore, and society. The economic impact incidence in psoriasis were presented of our understanding. Furthermore, for improved patient care. economics and outcomes research. the project will focus on people with of psoriasis has been noted to be as a poster at the 2019 British there is still a lack of clarity surrounding psoriasis being treated in hospital similar or higher than other non- During the past year, I have attended Association of Dermatologists Annual the mechanisms by which psoriasis and hence likely to have more severe communicable diseases such as a number of useful courses which Meeting in Liverpool. Following this, in influences cancer risk. Whilst psoriasis. There is also the potential pancreatic cancer, melanoma, prostate included Alternative Economic October, the full results of this work stratification according to whether In the next 12 months I hope to finalise of linking the HES dataset to the cancer and asthma. However, there Assessment for Expressing Healthcare were published in JAMA Dermatology, studies took factors such as smoking our current work on cancer recording Patient-Reported Outcome Measures was a high degree of heterogeneity in Value and Informing Resource with following media interest from and obesity into account in our meta- and cancer risk in people with psoriasis (PROMS) dataset. The PROMS the studies reporting the economic Allocation Decisions. This course publications including the New York analysis suggested that these factors using UK databases. The completion dataset is only available in people impact of psoriasis. The identified offered knowledge of alternative Times and Newsweek. may play a role in increased cancer of these works will hopefully improve who have had specific interventions heterogeneity motivated my second methodological frameworks for risk, they did not appear to explain all our understanding of the association but contains EQ5D data, so may With the completion and publication review aimed at identifying, and if economic assessment and examined of the increase in risk. Understanding between psoriasis and cancer, and allow some calculation of burden of of the meta-analysis, I then moved on necessary, developing a descriptive fiscal health modelling (FHM) which the complex mechanisms underlying pave the way for improved patient disease albeit in a limited sample of to a primary analysis of cancer risk in framework defining a nomenclature reflects the government perspective the link between psoriasis and cancer care. I also hope to synthesize the work people with psoriasis. The final country psoriasis using UK primary care (GP), system for the relevant components on population health and investments therefore remains a significant and completed over the last three years selection will be in liaison with the GPA secondary care (Hospital) and mortality and complete my PhD. and methods when identifying and in medical technologies. This is Regional Coordinators and will take important challenge. data. This work is multifaceted and quantifying the economic impact of important in establishing the economic into consideration the feasibility and all ongoing. The first step has been There are a number of ways in which disease. This was because the current impact of disease. I also attended a other relevant practical issues. to assess how cancer cases are these challenges have been addressed existing reviews showed a limited scale course on Budget Impact Analysis (BIA) recorded across our databases to and continue to be addressed. In and scope. Furthermore, there was no which described the methods used to ensure that our results are accurate. the meta-analysis of cancer risk systematic way of understanding the estimate the budget impact of a new Following this, the number of cancer in psoriasis, studies were grouped existing published estimates of the health care technology and presented occurrences in people with psoriasis according to the severity of psoriasis economic impact. six basic steps for estimating budget 28 www.globalpsoriasisatlas.org 29 Introducing Our Medical Coordinator Dr Maul presenting on the GPA and psoriasis Dr Julia-Tatjana Maul comorbidities at the University Hospital São Paulo, Brazil I am really happy to be a part of this second Latin American GPA project which would not have been possible nor successful without the great help of the GPA team, especially Professor Griffiths, Rebekah Swan, Dr Claudia de la Cruz, Dr Julia-Tatjana Maul, As epidemiological data and Dr Maul was inspired to start the Professor Ricardo Romiti and the open arms and the warm welcome of the Latin treatment registries are limited project following her first research field a board-qualified or non-existent in most of the trip to Latin America in 2018 when she American colleagues helping to conduct this study. With this humanistic project dermatologist and Latin American countries, Dr Maul ascertained that people with psoriasis and the extended collaboration with so many sites, we build the foundation to generated her own questionnaire with in the region lack access to systemic improve psoriasis care in Latin America. For me, this is an excellent basis for senior physician from the the aim of collecting prospective and and biologic therapies. future projects. I am really looking forward to returning soon. University Hospital of retrospective data. Together with the During January and February 2020, Dr Dr Julia-Tatjana Maul collaborating sites in Chile and Brazil, Zürich, Switzerland, was she conducted the survey to address Maul visited more than 35 hospitals, clinics and private practices in Chile Dr Claudia de la Cruz and Dr Ricardo patients had been included in the appointed as the Medical the limited data available. This led to and Brazil. Together with Professor Romiti, and dermatology specialists surveys in Chile and Brazil which is a an extension of the collaborative work Coordinator of the Global conducted in 2018. Griffiths, the Director of the GPA, throughout Latin America. Without significant achievement. Dr Maul started the Latin American their support, this research work Psoriasis Atlas (GPA). The survey is based on the Swiss research project in Santiago de Chile, would not have been possible. Dr Maul’s research suggests that Dermatology Network for Targeted Chile, and visited Dr Claudia de la Furthermore, Dr. Maul is also thankful there are regional differences in the She was invited to take up the Dr Maul with Dr Wagner Galvão in a psoriasis Therapies (SDNTT) and other Cruz, GPA Regional Coordinator for for the involvement of Dr Valenzuela, availability of psoriatic treatment and position by Professor Griffiths at the clinic at Hora-Cera Penha public hospital European registers (such as BADBIR Latin America. Professor Griffiths Professor Cabrera, Dr Riveros, burden of disease in Latin America. GPA Steering Committee meeting and PsoBest) in order to allow a and Dr Maul consulted together with Dr Hevia, Professor Vera Nuevo, To validate this, all datasets need to held at the European Academy of comparison of Latin America with Dr Claudia de la Cruz and Dr Daniela Dr Maul gave lectures to present Dr Amijo and Dr Pizarro from Chile be analysed after the data cutoff (end Dermatology and Venereology in Europe. The goal of the survey was to Armijo in multiple clinics and hospitals her research, the GPA, and widely and Dr Cavalho, Dr Rocha, Dr Galvão, of March 2020). Further research is October 2019. Dr Maul was awarded compare the data across regions and around central Chile. Furthermore, promoted the work of the GPA in the Dr Barboza da Silva, Dr Bortoletto, required to increase our understanding an International Psoriasis Council (IPC) countries with data from previously Dr Maul continued to investigate and region. Dr Maul is very grateful for the Dr Keiko and Dr Follador from Brazil of psoriasis in Latin America and, fellowship for the year 2020 which conducted studies. The project aims to allowed her to continue her work on research psoriasis by collecting real- engagement and assistance received who included a lot of patients. By the ultimately, to improve the life of enable psoriasis patients to access the by the GPA Regional Coordinators, end of February 2020, more than 800 psoriasis patients on a global scale. epidemiological data collection that life data with all of these centres. best available treatment and to better she began in Latin America in 2018 on understand the true disease burden Dr Maul continued her research in behalf of the GPA. Furthermore, part of psoriasis and will contribute to the São Paulo, where she worked closely of her role as Medical Coordinator is further development of the Global with Professor Ricardo Romiti, GPA Dr Maul would like to the thank the following hospitals and clinics for their kind collaboration: to coordinate and connect the GPA Psoriasis Atlas. Regional Coordinator. During her trip, Regional Coordinators around the • University Hospital of Chile • Hospital Dr. Sótero Del Río • University of Unicamp in Campinas world and thereby foster psoriasis • Clínica Alemana and the private The DermaMed practice in Hospital Universitario Polydoro practice Santiago de Chile Ernani de São Thiago research on an international scale. • Clinica Dermacross in Santiago • University Hospital of Osorno • The Teledermatology Center in On behalf of the GPA, the goal of de Chile • Clínica Alemana in Osorno Florianopolis her research trip to Latin America • Hospital San Juan de Dios • University Hospital Valparaíso • Salvador Department of was to further map psoriasis on Dermatology of the University • Hospital San Esteban in Los Andes • Medical SkinCenter in Valparaíso a local and regional level and to Hospital gain a better understanding of the • Hospital Curacavi • Institute of Bahia, Centro • Hospital Clinico Fuerza Aerea de Universitario Saude ABC in São • Professor Edgar Santos, common psoriasis characteristics, its Federal University of Bahia Chile The Military Hospital Bernardo do Campo severity, frequency of comorbidities • The Immunotherapy institute of and available treatment options. • The Catholic University Hospital • Hospital da Clinicas University of Centro International de São Paulo Bahia Furthermore, her research focuses on Estudios Clinicos • Hospital Conde de Lara • Centro Universitario Saude ABC the differences between quality of life • Clinica Las Condes • Hospital AME Maurice Pate, in São Bernado do Campo and influence of the level of education on the treatment response and also Dr Maul with GPA Regional Coordinator, Professor Ricardo Romiti, Private Practice and colleagues in São Paulo, Brazil takes account of gender and ethnicity. 30 www.globalpsoriasisatlas.org 31 Global Collaboration: Tanzania Professor Ncoza Dlova in clinic at the RDTC This kind of engagement and outreach work is a clear part of the strategy and future direction of the GPA. Working The UK government with the team at the RDTC has laid solid provided £1.5 billion foundations for future collaboration. to support projects in Professor Chris Griffiths developing countries. Kathryn Hampton from Janssen, with Maasai children Members of GPA team and the RDTC team with some of the local Maasai tribe. A portion of this money was devolved to The patients and training to Medical history, diagnosis, comorbidities and The trip culminated with the team trip to design future research studies University of Manchester Assistants and Clinical Officers. treatments available to the patients. conducting a pilot survey of skin not just in Tanzania but in other The GPA team, led by GPA Director With a population of 57 million but disease, with a particular emphasis countries in the region. The planned from the Global Challenges Professor Griffiths and Programme only 31 dermatologists, access to on psoriasis, to gather information on studies in countries where data on the Research Fund (GCRF). Manager Rebekah Swan, were based specialist care in Tanzania is limited. the prevalence of the condition in two epidemiology of psoriasis are scarce at the RDTC from 7-12 July 2019. Treatments for psoriasis in Tanzania different locations. On 10 July, the will help us to understand the burden of As part of a systematic review led by The team included Professor Darren are prohibitively expensive and so team travelled to a church at Sanya psoriasis in the region. Ultimately, this Professor Darren Ashcroft, the GPA Ashcroft (Manchester University), patients tend to opt for cheaper, Station, in Maasai Land and on 11 July will ensure that all psoriasis patients in research team identified a shortage Professor Ncoza Dlova (GPA Regional over-the-counter, products. Patients to a school at Usa River. They saw those countries will have access to the of epidemiological information on Coordinator, South Africa), and often receive their diagnosis and more than 200 people with a variety best available care, which is a key goal of psoriasis in Sub-Saharan Africa. The Manchester University dermatology treatment from non-specialist of skin diseases but not one of them the World Health Organization (WHO). team secured a grant from the GCRF trainees Dr Sidra Khan and Dr Tina healthcare workers, who in many cases had psoriasis. Common dermatoses of almost £40,000 to run a workshop Tian. In addition to the Manchester Successfully securing the GCRF grant misdiagnose psoriasis as a fungal seen included tinea capitis, pityriasis team, Nirohshah Trialonis Suthakharan has placed us in a strong position to and undertake a pilot survey on infection. Topical therapies are mainly versicolor, late onset eczema and skin (Researcher, GPA Work Stream 2) pursue further grant funding in the psoriasis epidemiology in Tanzania. coal tar, salicylic acid preparations trauma. It was concluded that the and Kathryn Hampton from Janssen future. We would like to thank Dr Daudi The workshop and survey were and betamethasone valerate. The prevalence of psoriasis may well be participated in the trip. Dr Daudi Mavura and the team at the RDTC for based at the Regional Dermatology only systemic therapy in use is close to the estimate for the country Mavura, RDTC Director and Co-PI their collaboration on this project. We Training Centre (RDTC) in Moshi, methotrexate. Treatment is invariably of less than 1%. on the GCRF grant, worked with Dr are particularly grateful for their warmth Tanzania. The RDTC is a supra-regional Rune Philemon, Research Coordinator, intermittent because of the difficulties Professor Griffiths with local It is anticipated that the GPA team will and hospitality. This trip has laid solid training, research and clinical centre. and supported the team throughout in travelling which limits follow up and dermatology specialist utilise the methodological knowledge foundations for future collaboration. It provides care to dermatological their visit. continuity of care. It was the team’s and networking gained during the impression, on this admittedly small subset of patients, that psoriasis was The purpose of the trip was to work less severe in Tanzania than in the UK, with RDTC staff and dermatology with fewer co-morbidities. specialists from across the Sub- Saharan region to conduct a workshop, The team conducted a training two pilot field surveys and to learn workshop for the dermatology more about access to care for patients specialists, staff and students from the with psoriasis in Tanzania. region. This included presentations on the GPA and case studies on Dr Mavura arranged for the team psoriasis management from the UK, to review 21 psoriasis patients South Africa and Tanzania. Professor invited to attend a follow-up Darren Ashcroft presented on the appointment for their psoriasis epidemiology of psoriasis, including management. Many of the patients the GPA systematic review of had travelled long distances, some psoriasis prevalence and incidence. up to 1,200km, for their review in He also led group work to discuss the the clinic in Moshi. The GPA team development of research methods were able to gain an understanding for future epidemiological studies of Members of the GPA team with the RDTC staff Rebekah Swan with Dr Mavura and Maasai translator of the case presentation, medical psoriasis in the region. 32 www.globalpsoriasisatlas.org 33 Success Factors for GPA: Phase II the GPA Programme 2020-2023 The next three-year phase Epidemiology of psoriasis Recognising the comorbid The conduct of our Publication in disease burden of psoriasis studies, validation of our leading scientific of the GPA, which is a long- 1. Implement regular updates to our large international dataset. 7. Conduct new studies to improve tools and the generation journals term iterative initiative, knowledge about the comorbid 2. Collaborate with the dermatology of new epidemiological Understanding is to build on the strong workstream of the Global Burden of disease burden of psoriasis with a particular focus on cancer data on psoriasis are key Increase in early of economic foundations laid in Phase I. Disease. incidence and associated mortality. diagnosis of psoriasis burden of We will continue with the same 3. Provide recommendations on the to our success. with use of validated psoriasis to the operating structure strengthened by: core data to be included in future Understand and diagnostic tool individual and Short-term success will be measured Translation of society the appointment of Professor Ashcroft epidemiological studies of psoriasis. characterise the economic by the publication of our results in as Research Director and Dr Tatjana leading scientific journals, the citation results into Maul (Zurich) as Medical Coordinator; 4. Conduct new epidemiological impact of psoriasis of those publications and international improved and the appointment of a Scientific studies in selected countries. 8. Conduct and publish an extensive recognition. management Advisory Board to provide additional Improving the early systematic review on the economic external independent oversight. burden of psoriasis. Furthermore, the longer-term success Conduct of of people with diagnosis of psoriasis of the GPA relates directly to our Our research programme (2020-2023) 9. Develop data collection tools to mission, ‘To ensure that people with new studies on psoriasis Recognised as will address existing knowledge gaps 5. Conduct a case-control study to determine the economic impact of psoriasis, including leading global examine the extent of misdiagnosis psoriasis, wherever they live in on: Epidemiology; Improving Diagnosis; psoriasis. its epidemiology, epidemiological of psoriasis. the world, have access to the best Comorbid Disease; and the Economic economic impact resource on 10. Conduct new studies to identify, and available care.’ The findings from Impact of Psoriasis. Addressing these 6. Conduct validation studies of and comorbid psoriasis then quantify, the use of healthcare our research will be used to inform key areas and how they differ from our recently developed clinical diseases resources, and associated costs to clinical guidelines on the diagnosis and country to country and region to region diagnostic criteria. management of psoriasis, help address A strong global will enable us to provide robust data as the healthcare system. the impact of other co-morbidities,and network supported we move to implement better access plan for new services and treatment by the collaborating to care for psoriasis patients worldwide. pathways based on improved organisations knowledge on the epidemiology and economic impact of psoriasis. The key to this success is the strength of our extensive network of psoriasis patient The Scope of the GPA: Phase II organisations and dermatologists supported by the global reach of our Collaborating Organisations and the CALL TO ACTION UNMET NEEDS WHO. Long-term success will ultimately People with psoriasis around the Many unmet needs in GPA FOCUS In 2014 WHO recognized be determined by the translation of world deserve the best available psoriasis as a major global understanding psoriasis: • Epidemiology our results into impact on the early prevalence and incidence, diagnosis, and management of people care wherever they live. To date, challenge and requested diagnosis, disease mechanisms, • Early diagnosis high quality epidemiological with psoriasis around the world. we only have epidemiological data data to understand the treatment options, comorbidity, • Comorbid disease burden education, awareness, recognition, • Economic impact for 19% of countries. This means burden of disease. socio-economic impact that we also lack information on the care available to them. We are determined to change that. The scope of the research programme for the GPA responds to the World Health Organization’s call to fill global knowledge gaps for this serious non-communicable disease. 34 www.globalpsoriasisatlas.org 35 Highlights Outreach 2017-2020 LEO Foundation, Copenhagen, May 2019 and Manchester, October 2019 The GPA team met with the LEO Foundation to report American Academy on progress to date and outline plans for the GPA. of Dermatology, Washington DC, March 2019 24th World Congress of Dermatology, Milan, June 2019 We held our GPA Board, During this congress, we released the video campaign for Phase I of the GPA achieved our new website as well as holding a press conference which Development of new diagnostic Steering Committee significant success, including and Funders meetings, were both well received. We also met with our Regional the conduct of high-quality criteria for psoriasis presented updates Coordinators with presentations from our work streams. research, associated on our research and publications and presentations website development. at scientific meetings and not least, the outstanding and ever-increasing number of collaborations with patient The development of organisations, dermatologists a global network of and academics from around enthusiastic regional and the world. national coordinators A corporate operational and governance infrastructure 19 % An updated systematic review of the worldwide Quarterly newsletter Chile, prevalence of psoriasis Leveraging of January 2020 revealing data for 19% of the external industry and publication Professor Griffiths and countries of the world non-industry funding his team consulted in multiple clinics and hospitals around central Chile to gain further Global research collaborations: Denmark, Israel and Taiwan insights on a local and 6th Congress of the Skin Inflammation and regional level. Dr Tatjana Psoriasis International Network, Paris, April 2019 Maul continued to travel through Latin America We attended SPIN with the International Psoriasis working with our GPA Council team to promote the GPA, meet our industry Regional Coordinators, partners and showcase our second annual report. Dr Claudia de la Cruz and Professor Ricardo Romiti. IFPAs General Assembly, Barcelona, July 2019 2017-2020 Patient representatives from IFPA were invited to participate in video interviews to recount their experiences of living with psoriasis. These stories were The Atlas has achieved IFPA Side Event to the shared on the GPA website. all of its set milestones United Nations High Level Meeting for 2017-2020 and on Universal Health Coverage, 28th Congress of the European Academy of New York, September 2019 Dermatology and Venereology, Madrid, October 2019 has established itself as a recognisable and GPA Programme Manager, We held the GPA Board, Steering Committee and Industry Rebekah Swan, was invited to Partners’ meetings and the team even met up with our respected brand presence attend this event focused on health friends from the Regional Dermatology Training Centre! Healthcare data for psoriasis A field survey on around the world. workforce and non-communicable Janssen kindly supplied videography services for our management from Latin America psoriasis in Tanzania This is only the start. disease management. Shout Outs about the Atlas and more in-depth interviews. 36 www.globalpsoriasisatlas.org 37 News LEO Foundation Meeting, Manchester 2019-2020 The GPA team, including Caroline Bach (ILDS Project Manager), met with the LEO Foundation team in Manchester on 29th October 2019, World Psoriasis Day. This was an opportunity to share the progress of the GPA, the website launch and to hear presentations from the PhD students working on the project at the University of Manchester. It was a privilege to host the LEO Foundation and to share our plans for Story interviews the future of the GPA. GPA Programme Manager, Rebekah recount their experiences of living with We are grateful to the LEO Swan, was invited to attend psoriasis. During these interviews, Foundation for their funding support the International Federation of participants were asked about during Phase I (2017-2020) and are Psoriasis Associations’ (IFPA) their experience of stigmatisation, delighted they will continue as the General Assembly, July 4th-6th, misdiagnosis, impact on work, Lead Supporter of the GPA during Members of the GPA team and the LEO Foundation, in Manchester, in Barcelona accompanied by our relationships, experience of flare ups, Phase II (2020-2023). for the launch of the Global Psoriasis Atlas website on World Psoriasis Day. digital agency, Dept. The purpose of treatment options and physical and the trip was to obtain stories from psychological impact. The videos people with psoriasis from around are available to view on our website, Dr Rosa Parisi the world. Patient representatives launched on World Psoriasis Day, 29th EADV Shout-outs Appointments from IFPA were invited to October 2019. We would like to thank participate in video interviews to IFPA for their support with this work. During the EADV Congress 2019, GPA Medical Coordinator Thank you to Janssen kindly supplied videography The GPA team would like to welcome Dr Rosa Parisi services for our Shout Outs about the Dr Tatjana Maul to the team. Dr Maul Atlas and more in-depth interviews The GPA team would like to give a was invited to take on the role of Medical with members of the GPA team. special thank you to Dr Rosa Parisi Coordinator in order to strengthen for her hard work and dedication in our collaborations with dermatology completing the largest ever systematic specialists around the world. review on the prevalence of psoriasis GPA Director of Research (Parisi R, Iskandar IY, Kontopantelis E, Professor Darren Ashcroft has been Augustin M, Griffiths CEM, Ashcroft appointed to this new role and is DM. Global, regional and country- responsible for driving the direction specific prevalence of psoriasis: of the research undertaken by the a Bayesian meta-regression of GPA team and our collaborations population-based studies). This paper Rosa Parisi, Darren Ashcroft and Rebekah Swan Professor Ncoza Dlova around the world. will be published in the British Medical Journal in the coming months. Rosa secured a promotion at The University Filming patient stories for the GPA website, of Manchester and we wish her John McCafferty from Dept. and Truong, our patient representative from Vietnam success in her new role. Dates for the diary Website Launch On World Psoriasis Day, 29th October 2019, 28th-1st November 2020 we launched the Global Psoriasis Atlas The GPA Board of Governors and Steering Committee will website. Years of hard work culminated in meet during the 29th Congress of the European Academy the launch of the atlas. The website contains of Dermatology and Venereology (Vienna, Austria) the data from the systematic analysis and modeling study and stories told by people 19th-23rd March 2021 with psoriasis from around the world. The GPA Board of Governors and Steering Committee will meet during the 79th American Academy of Dermatology (San Francisco, California) 38 www.globalpsoriasisatlas.org 39 Social Growth Engagement Following the successful launch of our social 28 days summary on twitter February 2020 The work of the Global Psoriasis The Global Psoriasis Atlas has also been supported by grants media channels, we Atlas would not be possible without and sponsorship from Abbvie, Almirall, Celgene, Eli Lilly UK and Company Limited, Janssen, Novartis Pharma AG and UCB. are continuing to see the financial support we receive Partnership is a crucial step towards achieving the ambition growing engagement from our Industry partners. of the GPA, to ensure that people around the world have with the GPA online. FOLLOWERS access to the best available care and treatment for their 1,054 Working with the collaborating The LEO Foundation are the lead supporter of the psoriasis. We recognise that innovative and strategic organisations we have developed a Global Psoriasis Atlas and we are grateful for the core, partnerships with organisations are key to delivering our coordinated social media strategy for key funding that they have provided. milestones and achieving the aims of the Atlas. the project. This has been achieved 83 by streamlining all time lines and Lead supporter The GPA work has been made possible thanks to grants and sponsorship (2019-2020) events across our three collaborating organisations and the GPA into one social media content calendar. PROFILE VIEWS TWEET IMPRESSIONS 1,449 55.2k 74.4% 5.1% We always welcome Would you like to new connections learn more about and partnerships! the work of the GPA? Here are some of the ways you can get involved; Visit our website • Provide financial support www.globalpsoriasisatlas.org • Collaborate with us Follow us on Twitter and Instagram • Support the collection of data @PsoriasisAtlas on the global burden of psoriasis Find us on Facebook • Support our research PsoriasisAtlas • Engage with us on social media Establishing a high quality GPA requires the support Subscribe to our Newsletter of industry, organisations with relevant data sets info@globalpsoriasisatlas.org and collaboration across regions and countries. 40 www.globalpsoriasisatlas.org 41 Publications, Abstracts and Presentations Trialonis-Suthakharan N , Gupta S, 2020 The Global Psoriasis Atlas: International Griffith CEM, Ashcroft DM, Augustin Psoriasis Council Masterclass, Cairo Psoriasis and the Global Psoriasis Atlas: M, Developing methodologies for Egypt – Professor Chris Griffiths. 1st International meeting of the Burma field survey of psoriasis – the Global Skincare Initiative Yangon, Myanmar – The Global Psoriasis Atlas: Clinical Psoriasis Atlas. The 5th World Psoriasis Professor Chris Griffiths. experiences on a field trip through & Psoriatic Arthritis Conference, Latin America and its psoriasis disease Stockholm, 2018. The Global Psoriasis Atlas: Department burden, Swiss Psoriasis Day Basel, Trialonis-Suthakharan N , Gupta S, of Dermatology, Santiago, Chile – Dr Julia-Tatjana Maul Griffith CEM, Ashcroft DM, Augustin Professor Chris Griffiths. 2018 M, Global Burden of Disease: A Presentation GPA Phase II: How could systematic Literature Review on we use the Atlas as Global Psoriasis Atlas overview: Scientific Publications Griffiths CEM, van der Walt JM, Trafford, AM; Parisi, R; Kontopantelis, Disability Weights for Skin Diseases. AAD corporate breakfast, San Diego, Ashcroft DM, Flohr C, Naldi L, Nijsten E; Griffiths, CEM; Ashcroft, D. an advocacy tool? Parisi R, Iskandar IY, Kontopantelis E, The 5th World Psoriasis & Psoriatic CA – Dr Alexa Kimball. T, Augustin M. The global state of Psoriasis and Cancer Mortality: A IFPA Pan-American Meeting to Augustin M, Griffiths CEM, Ashcroft Arthritis Conference, Stockholm, 2018. psoriasis disease epidemiology: a systematic review and meta-analysis be held in April in Ottawa, Canada: Global Psoriasis Atlas overview: EADV DM. National, regional and worldwide Trialonis-Suthakharan N, Gupta S, workshop report. British Journal of of observational studies. 27th Epidemiology Data on Psoriasis corporate breakfast, Paris, France – estimates of the epidemiology of Griffith CEM, Ashcroft DM, Augustin Dermatology 2017; 177(1): e4-e7. European Academy of Dermatology and Collected in South America so Far– Dr. Professor Jonathan Barker. psoriasis: A systematic analysis and M, Developing methodologies for Springate DA, Parisi R, Kontopantelis E, Venereology Congress Paris, 2018. Tatjana Maul. IPC Symposium: Health care for modelling study. British Medical Journal field survey of psoriasis – the Global 2020; in press. Reeves D, Griffiths CEM, Ashcroft DM. P.G. Ng’ambi, C. Jones, D. Ashcroft, Invitational talk RADLA (Reunion psoriasis worldwide: What do we Psoriasis Atlas. European Academy Incidence, prevalence and mortality CEM Griffiths, K. Payne, PNS14 Anual de Dermatologos know and how could we learn from Iskandar I.Y.K, Parisi R, Griffiths of Dermatology and Venereology of patients with psoriasis: a UK Towards Consistency and coherence Latinamericanos), Buenos Aires, each other? – Cancun, Mexico – C.E.M, Ashcroft D.M. Systematic Congress, Paris, 2018. population-based cohort study. British in understanding the economic impact Argentina, Dr Julia-Tatjana Maul. Dr Tatjana Maul. review examining changes over time Journal of Dermatology 2017; 176: of disease, Value in Health, Volume 22, Trialonis-Suthakharan N , Gupta S, and variation in the incidence and IPC Latin America working group: 650-658. Supplement 3, 2019, Page S765. Griffith CEM, Ashcroft DM, Augustin 2019 prevalence of psoriasis by age and Health care for psoriasis worldwide: M, Global Burden of Disease: A gender. British Journal of Dermatology Abstracts and Parisi R, Iskandar IY, Kontopantelis E, systematic Literature Review on The Global Psoriasis Atlas: Department What do we know and how could we 2020; submitted. Poster Presentations Augustin M, Griffiths CEM, Ashcroft of Dermatology Chittagong University, learn from each other? – Cancun, Disability Weights for Skin Diseases. DM. Global, regional and country- Chittagong, Bangladesh. Mexico Dr Tatjana, Maul. Trafford AM, Parisi R, Kontopantelis E, Iskandar IYK, Chen T-C, Chen L-C, Lee European Academy of Dermatology and Griffiths CEM, Ashcroft DM. Psoriasis M-S, Chan KA, Griffiths CEM, Ashcroft specific prevalence of psoriasis: Venereology Congress, Paris, 2018. The 45th Annual Meeting of Taiwanese Global Psoriasis Update: IPC Think and the risk of developing or dying DM. Population trends in the 10-year a Bayesian meta-regression of Dermatological Association, 13 - 15 Tank, Miami Beach, FL – Professor population-based studies. European Trialonis-Suthakharan N, Maul JT, from cancer: a systematic review prevalence and incidence of psoriasis December 2019, Kaohsiung Exhibition Chris Griffiths. Academy of Dermatology and Gupta S, Griffiths CEM, Ashcroft and meta-analysis of observational and psoriatic arthritis in Taiwan: Centre (KEC) – Professor Lars French. Venereology Congress, Madrid, 2019. DM, Matthias Augustin Analysis of The Global Psoriasis Atlas: Annual studies. JAMA Dermatology 2019; Nationwide, population-based cohort the Psoriasis Health care Survey in Global Psoriasis Update: IPC Think Meeting of the Tunisian Dermatological 155(12):1390-1403. study. International Conference on Parisi R, Iskandar IY, Kontopantelis E, 16 Latin American countries (pilot Tank, Lisbon, Portugal – Professor Society, Tunis, Tunisia - Professor Chris Pharmacoepidemiology and Therapeutic Augustin M, Griffiths CEM, Ashcroft study) – the Global Psoriasis Atlas. Griffiths. Schonmann Y, Ashcroft DM, Chris Griffiths & Professor Darren Risk Management, Berlin, 2020. DM. The Global Psoriasis Atlas: findings European Academy of Dermatology and Iskandar IYK, Parisi R, Sde-Or S, Ashcroft. from a systematic review of the Global Psoriasis Atlas update: 5th Comaneshter D, Batat E, Shani M, Tabik M, Parisi R, Willis S, Griffiths CEM, Venereology Congress, Madrid, 2019. incidence and prevalence of psoriasis. Global Psoriasis Atlas overview: AAD World Psoriasis and Psoriatic Arthritis Vinker S, Griffiths CEM, Cohen AD. Ashcroft DM. Clinical examination– European Academy of Dermatology and Trialonis-Suthakharan N , Gupta S, corporate breakfast, Washington, D.C, Conference, Stockholm, Sweden – Incidence and prevalence of psoriasis based diagnostic criteria for chronic Venereology Congress, Paris, 2018. Griffith CEM, Ashcroft DM, Augustin USA– Professor Jonathan Barker. Professor Chris Griffiths. in Israel 2011-2017. Journal of the plaque psoriasis in adults: A Delphi M, Developing methodologies for European Academy of Dermatology & consensus of international experts. Trialonis-Suthakharan N, Gupta S, Global Psoriasis Atlas overview: EADV 2017 field survey of psoriasis – the Global Venereology 2019; 33: 2075-2081. 100th Annual Meeting of the British Griffith CEM, Ashcroft DM, Augustin corporate breakfast, Madrid, Spain – Psoriasis Atlas, World Congress of Global Psoriasis Atlas overview: AAD Association of Dermatologists, M, Developing methodologies for field Dermatology, Milan, 2019. Professor Jonathan Barker. Parisi R, Webb RT, Kleyn CE, Carr MJ, corporate breakfast, Orlando, FL – Dr Manchester, 2020 survey of psoriasis – the Global Psoriasis Kapur N, Griffiths CEM, Ashcroft DM. Global Psoriasis Atlas overview: IPC Alexa Kimball. Trialonis-Suthakharan N , Gupta S, Psychiatric morbidity and suicidal Trafford, AM; Parisi, R; Kontopantelis, Atlas. German Congress for Health Griffith CEM, Ashcroft DM, Augustin M, Councilor meeting, Milan, Italy – Global Psoriasis Atlas overview: behaviour in psoriasis: a primary E; Griffiths, CEM; Ashcroft, D. Psoriasis Science Research (Deutscher Kongress Global Burden of Disease: A systematic Professor Peter van de Kerkhof. EADV corporate breakfast, Geneva, care cohort study. British Journal of and the risk of developing cancer: a für Versorgungsforschung), 2018. Literature Review on Disability Weights Switzerland – Dr Alexa Kimball. Dermatology 2019; 180: 108-115. systematic review and meta-analysis The Global Psoriasis Atlas: British Trialonis-Suthakharan N , Gupta S, for Skin Diseases, World Congress of of observational studies. 99th Annual Association of Dermatologists Global Global Psoriasis Atlas update: IPC Parisi R, Webb RT, Carr MJ, Moriarty KJ, Griffith CEM, Ashcroft DM, Augustin Dermatology, Milan, 2019. Meeting of the British Association of Health Day, London, UK – Professor Think Tank, London, England – Kleyn CE, Griffiths CEM, Ashcroft DM. M, Developing methodologies for Dermatologists, Liverpool , 2019. GPA Presentations 2017-2020 Chris Griffiths. Professor Chris Griffiths. Alcohol-related mortality in patients field survey of psoriasis – the Global with psoriasis: a population-based Psoriasis Atlas. German Dermatology Invited presentations on the GPA are The Global Psoriasis Atlas: Regional Global Psoriasis Atlas overview: The cohort study. JAMA Dermatology Society (Deutsche Dermatologische delivered at numerous international Dermatology Training Centre, Moshi, World Health Organization Networking 2017; 153(12): 1256-1262. Gesellschaft), 2018. conferences and meetings. Tanzania – Professor Chris Griffiths. Symposium – Professor Chris Griffiths. 42 www.globalpsoriasisatlas.org 43 www.globalpsoriasisatlas.org @PsoriasisAtlas March 2020 | DW.3566.03.20
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