Simon Francis Thomsen, et al. – Bispebjerg Hospital, Department of Dermato-Venereology: Current and Future Research Activities
Clinical databases
The department has initiated and maintains several clinical and pharmacotherapeutic research databases containing patients with various skin diseases, particularly chronic urticaria, hidradenitis suppurativa, atopic dermatitis, psoriasis, systemic sclerosis, and chronic wounds.
As of October 2017, approximately 400 patients have been treated with omalizumab( anti-IgE) at our department. Of these, 325 have chronic spontaneous urticaria and 35 have chronic inducible urticaria, whereas another 40 patients have been treated off-label for various other itching skin disorders, notably atopic dermatitis. Results from this database have shown that omalizumab leads to complete resolution of symptoms in 70 % of patients with chronic spontaneous urticaria and in 50 % with chronic inducible urticaria, but to resolution in only 25 % with detectable autoimmunity towards IgE or to the IgE receptor on mast cells and basophils( 13). Our studies originating from the database have also investigated the effectiveness and safety of omalizumab in selected patients with related diseases, e. g. atopic dermatitis and systemic mastocytosis and in pregnant woman with chronic spontaneous urticaria. Ongoing studies focus on response patterns to omalizumab based on extensive biomarker profiling.
The department is a tertiary referral centre for patients with hidradenitis suppurativa and keeps databases on treatment outcomes and clinical and paraclinical characteristics of these, approximately 125 newly referred, patients per year. Studies on these patients focus on comorbidities, sub-phenotypes and quality of life. A recent study from the database population showed that patients with hidradenitis suppurativa have a thus-far unrecognized high occurrence of undiagnosed and undertreated cardiovascular risk factors, notably dyslipidaemia, hypertension, hyperglycaemia, and elevated levels of systemic inflammatory markers, independently of age; and moreover, the systemic inflammatory load seemed to be associated with increased risk of dyslipidaemia, independently of obesity( 14). These findings signal that screening and treatment of cardiovascular risk factors are warranted in patients with hidradenitis suppurativa. Ongoing studies of the database population are focused on therapeutic response to biologic medications, deep phenotyping and disease burden.
From 2012 onwards all outpatients with atopic dermatitis referred to the department have been included in a clinical research database, allowing studies of the aetiology, natural history, management, and long-term follow-up of atopic dermatitis. With a yearly referral rate of around 150 new patients the database, at present, contains clinical and paraclinical data on ~ 700 patients with atopic dermatitis covering all ages. Studies originating from the database have so far shown that atopic dermatitis has a strong negative impact on the quality of life proportionally to the severity of the disease, and that presence of facial eczema and female sex are associated with low quality of life in patients with atopic dermatitis independently of eczema severity( 15). Current studies concern genetic and serological biomarkers of atopic dermatitis.
We actively participate in the national database for biological treatments in psoriasis, which is internationally recognized and one of the largest registries of its kind in the world. We have helped to develop the concept of biological drug survival as an endpoint for the real-life assessment of the efficacy of biological therapy( 16).
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12 Dermato-Venereology in the Nordic Countries
Forum for Nord Derm Ven 2018, Vol. 23, No. 1