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Centre of Excellence

response is obtained, can we titrate down the dose of a biologic without any problems? What is the role of anti-drug antibodies, and is there a standard way to prevent their formation? This is what intrigues us, and what we are investigating prospectively with the collaboration of patients visiting our centre. With the consent of our patients, we are establishing a biobank of blood and tissue material, to perform direct patient research. Focusing on research questions arising from clinical situations is what we do; in our Dermatology Research Unit we aim to add value to the psoriasis research field through insight obtained from psoriasis in vitro models and transdermal drug delivery research.3,4

PsoPlus 34

Quality of life in psoriasis is often affected to such a level that the indirect costs of the disease, for example, loss of work productivity in the case of palmar psoriasis, should be a real point of attention for the policy makers. We believe passionately in a more caring and preventive approach, for example, through patient education initiatives. However, we need more data to convince the budget holders of the cost-saving potential of such an approach, knowing that future healthcare budgets will not be sustainable for more high-tech drugs that

are in the pipeline. It is time that great breakthroughs and insights in psoriasis, for example, on impairment of quality of life, get translated to daily clinical practice. In Ghent, we have started a PsoPlus consultation, integrating all the knowledge gathered from research and guidelines into a structured consultation checklist file. The patient is seen by a nurse first, who performs a thorough questioning: how and when did the psoriasis start? In which form? Is it occurring in your family? Do you have other diseases or joint complaints? How about your vaccine status? What is your body mass index? What is the impact on your quality of life? After that, the dermatologist looks at the skin problem, and summarises and extensively explains the therapeutic options. The expectations of the patients are set sharp. The necessary examinations or referrals are carried out, for example, to a rheumatologist. If perceived necessary, extra education is scheduled in. Using this structured approach during consultation allows a more tailored approach. The OnderHUIDs programme does not need to be followed by everyone, as not every patient has a metabolic syndrome. The need for it, however, is explored in PsoPlus, and, according to a patient’s profile, cure and care is offered à la carte. Ideally, in the future, the

approach to psoriasis in our clinic will become a collaboration between the doctor or healthcare professional and the patient. Both have insight into the best next step in handling the disease, because of the knowledge environment that has been created.

We find it our duty, through a well-considered approach, to help create psoriasis care that adds maximal value to our patients, within the given economic context. Through an à la carte approach for a given patient with psoriasis, we continuously strive to offer the most advantageous cure and care, in its broadest sense. l

References 1. Bostoen J, Bracke S, De Keyser S, Lambert J. An educational programme for patients with psoriasis and atopic dermatitis: a prospective randomized controlled trial. Br J Dermatol 2012;167:1025–31.

2. Bostoen J, Van Praet L, Brochez L, Mielants H, Lambert J. A cross-sectional study on the prevalence of metabolic syndrome in psoriasis compared to psoriatic arthritis. J Eur Acad Dermatol 2012; [Epub ahead of print].

3. Bracke S et al. Identifying targets for topical RNAi therapeutics in psoriasis: assessment of a new in vitro psoriasis model. Arch Dermatol Res 2013; [Epub ahead of print].

4. Geusens B et al. Lipid-mediated Gene Delivery to the Skin. Eur J Pharm Sci 2011;43:199–211.


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