J M Carrascosa

Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain

Are you J M Carrascosa?

Claim your profile

Publications (126)79.37 Total impact

  • J M Carrascosa, J Notario
    Actas Dermo-Sifiliográficas 05/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Biological drugs such as the tumour necrosis factor inhibitors have revolutionized the treatment of psoriasis, but some have the potential to induce an unwanted immune response. This immunogenicity may be associated with low trough drug levels, reduced clinical efficacy, reduced drug survival and an increased risk for adverse events. This article presents a literature review of the evidence on immunogenicity of biologics used in the treatment of psoriasis and considers the implications for therapeutic decision-making in the management of patients with moderate-to-severe psoriasis.
    Journal of the European Academy of Dermatology and Venereology 05/2014; · 2.69 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Biobadaderm is the Spanish registry of psoriasis patients receiving systemic treatment in clinical practice.Objective To compare the safety of biologics and classic systemic treatment.Methods Prospective cohort of patients receiving biologics and classic systemic therapies between 2008 and 2013 in 12 hospitals are included. We registered demographic data, diagnoses, comorbidities, treatments and adverse events (AE). We obtained raw relative risks (RR) for specific AE. Multivariate analysis consisted of Cox models adjusting for age, gender, chronic hepatic disease and previous cancer.ResultsA total of 1030 patients received biologics (2061 AE in 3681 person-years), 926 patients classic systemic drugs (1015 AE in 1517 person-years). Ninety-three per cent of AE in both groups were non-serious, 6% serious and 0.003% fatal. The age- and gender-adjusted hazard ratio of AE was lower in the biologics group [hazard ratio 0.6 (95% CI: 0.5–0.7)].We found no differences in rates of serious and mortal AE. Some system organ class AE rates differed between both groups. As limitations: Prescription bias might affect the incidence of AE in both groups. Association of drug and AE was based on timing: associations might not be causal.Conclusion Patients receiving biologics had lower risk of AE. We did not find differences in the risk of serious or fatal AE.
    Journal of the European Academy of Dermatology and Venereology 03/2014; · 2.69 Impact Factor
  • C Ferrándiz, J M Carrascosa, M Toro
    [Show abstract] [Hide abstract]
    ABSTRACT: The prevalence of psoriasis in Spain was estimated to be 1.4% before the advent of biologic agents. Fifteen years later, new therapeutic options based on biologic agents have led to greater awareness of the disease and better understanding; case detection and diagnosis may have improved as a result. To investigate the current prevalence of psoriasis in Spain and compare the results with those of an earlier study that used the same methodology. Population-based cross-sectional survey. Information was collected through computer-assisted telephone interviews with a randomly selected representative sample of the Spanish population (12,711 individuals from 4,754 households). Interviews were conducted by trained personnel using a questionnaire. The prevalence was 2.3% and there were no statistically significant differences between the sexes. Prevalence increased with age (range with highest prevalence, 60-69 years). Central Spain-a region with a cold, dry climate-had the highest prevalence, but differences between regions were not significant. Psoriasis is substantially more prevalent in Spain than was previously estimated. The increase in prevalence may reflect greater awareness and better diagnosis of the disease rather than a true increase in number of cases.
    Actas Dermo-Sifiliográficas 02/2014;
  • Actas Dermo-Sifiliográficas 02/2014;
  • Y. Gilaberte, J.M. Carrascosa
    [Show abstract] [Hide abstract]
    ABSTRACT: One of the main goals of all skin cancer prevention campaigns is to protect children from ultraviolet radiation. However, little is known about how sun exposure risks differ between adults and children or about how these risks are best managed. Children's skin is more susceptible to sun damage for a number of reasons, including certain anatomical and functional aspects in children under 2 years of age and habits that predispose to greater sun exposure during the first 2 decades of life. Oil-based emulsions containing inorganic filters appear to be safest sunscreens for children, although the addition of certain organic filters is necessary to achieve a sun protection factor of 50. Oxybenzone, and probably also octocrylene, should be avoided in sunscreens for children. Sunscreen use should be part of an overall sun protection strategy that includes avoidance of exposure to midday sun and the use of protective clothing and hats. The above considerations justify the implementation of primary prevention campaigns focused on sun protection education for children and the continuation of basic and epidemiological research into specific sun protection strategies and sunscreens for each age group.
    Actas Dermo-Sifiliográficas 01/2014; 105(3):253–262.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Psoriatic arthritis, a chronic inflammatory musculoskeletal disease that is associated with psoriasis, causes joint erosions, accompanied by loss of function and quality of life. The clinical presentation is variable, with extreme phenotypes that can mimic rheumatoid arthritis or ankylosing spondylitis. Because psoriasis usually presents before psoriatic arthritis, the dermatologist plays a key role in early detection of the latter. As many treatments used in psoriasis are also used in psoriatic arthritis, treatment recommendations should take into consideration the type and severity of both conditions. This consensus paper presents guidelines for the coordinated management of psoriatic arthritis by rheumatologists and dermatologists. The paper was drafted by a multidisciplinary group (6 rheumatologists, 6 dermatologists, and 2 epidemiologists) using the Delphi method and contains recommendations, tables, and algorithms for the diagnosis, referral, and treatment of patients with psoriatic arthritis.
    Actas Dermo-Sifiliográficas 01/2014; 105(3):216–232.
  • S. Ros, L. Puig, J.M. Carrascosa
    [Show abstract] [Hide abstract]
    ABSTRACT: We now realize that moderate to severe psoriasis takes a toll on the patient's overall health beyond the effects on the skin itself, and so we use quality of life (QOL) measures to assess how the individual perceives both the impact of disease and the response to treatment. However, available instruments give us a cross-sectional assessment of QOL at a specific moment, and we lack longitudinal studies of how a disease affects each and every aspect of a patient's life over time—including physical and psychological wellbeing, social and emotional relationships, vocational and employment decisions, and how they change the individual's outlook. A new concept, cumulative life course impairment (CLCI), captures the notion of the ongoing effect of a disease, providing us with a new paradigm for assessing the impact of psoriasis on QOL. Unlike conventional measurement tools and scales, which focus on a specific moment in the patient's life, a CLCI tool investigates the repercussions of disease that accumulate over a lifetime, interfering with the individual's full potential development and altering perspectives that might have been different had psoriasis not been present. The accumulated impact will vary from patient to patient depending on circumstances that interact differently over time as the burden of stigmatization, concomitant physical and psychological conditions associated with psoriasis, coping mechanisms, and external factors come into play and are modulated by the individual's personality.
    Actas Dermo-Sifiliográficas 01/2014; 105(2):128–134.
  • J.M. Carrascosa, J. Notario
    Actas Dermo-Sifiliográficas 01/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Obesity, particularly abdominal obesity, is currently considered a chronic low-grade inflammatory condition that plays an active role in the development of the pathophysiologic phenomena responsible for metabolic syndrome and cardiovascular disease through the secretion of proinflammatory adipokines and cytokines. In recent years clear genetic, pathogenic, and epidemiologic links have been established between psoriasis and obesity, with important implications for health. The relationship between the 2 conditions is probably bidirectional, with obesity predisposing to psoriasis and psoriasis favoring obesity. Obesity also has important implications in the treatment of psoriasis, such as a greater risk of adverse effects with conventional systemic drugs and reduced efficacy and/or increased cost with biologic agents, for which dosage should be adjusted to the patient's weight.
    Actas Dermo-Sifiliográficas 01/2014; 105(1):31–44.
  • Source
    Actas Dermo-Sifiliográficas 01/2014;
  • C. Ferrándiz, J.M. Carrascosa, M. Toro
    [Show abstract] [Hide abstract]
    ABSTRACT: Introduction The prevalence of psoriasis in Spain was estimated to be 1.4% before the advent of biologic agents. Fifteen years later, new therapeutic options based on biologic agents have led to greater awareness of the disease and better understanding; case detection and diagnosis may have improved as a result. Objective To investigate the current prevalence of psoriasis in Spain and compare the results with those of an earlier study that used the same methodology. Material and methods Population-based cross-sectional survey. Information was collected through computer-assisted telephone interviews with a randomly selected representative sample of the Spanish population (12,711 individuals from 4,754 households). Interviews were conducted by trained personnel using a questionnaire. Results The prevalence was 2.3% and there were no statistically significant differences between the sexes. Prevalence increased with age (range with highest prevalence, 60-69 years). Central Spain—a region with a cold, dry climate—had the highest prevalence, but differences between regions were not significant. Conclusions Psoriasis is substantially more prevalent in Spain than was previously estimated. The increase in prevalence may reflect greater awareness and better diagnosis of the disease rather than a true increase in number of cases.
    Actas Dermo-Sifiliográficas 01/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Psoriatic arthritis, a chronic inflammatory musculoskeletal disease that is associated with psoriasis, causes joint erosions, accompanied by loss of function and quality of life. The clinical presentation is variable, with extreme phenotypes that can mimic rheumatoid arthritis or ankylosing spondylitis. Because psoriasis usually presents before psoriatic arthritis, the dermatologist plays a key role in early detection of the latter. As many treatments used in psoriasis are also used in psoriatic arthritis, treatment recommendations should take into consideration the type and severity of both conditions. This consensus paper presents guidelines for the coordinated management of psoriatic arthritis by rheumatologists and dermatologists. The paper was drafted by a multidisciplinary group (6rheumatologists, 6dermatologists, and 2epidemiologists) using the Delphi method and contains recommendations, tables, and algorithms for the diagnosis, referral, and treatment of patients with psoriatic arthritis.
    Actas Dermo-Sifiliográficas 09/2013;
  • [Show abstract] [Hide abstract]
    ABSTRACT: IMPORTANCE Variability in genes encoding proteins involved in the immunological pathways of biological therapy may account for the differences observed in outcomes of anti-tumor necrosis factor (TNF) treatment of psoriasis. OBJECTIVE To assess the role of 2 Fcγ receptor (FcγR) polymorphisms in the response to anti-TNF therapy in psoriasis. DESIGN Retrospective series of patients with psoriasis who received anti-TNF therapy (infliximab, adalimumab, or etanercept) from January 1, 2007, through December 31, 2010. Patients were followed up for 12 weeks. SETTING Two psoriasis referral centers. PARTICIPANTS Seventy treatment-naive patients with moderate to severe psoriasis who received anti-TNF agents. INTERVENTION Patients underwent FcγRIIA-H131R and FcγRIIIA-V158F polymorphism genotyping. MAIN OUTCOMES AND MEASURES The Psoriasis Area and Severity Index and the body surface area were assessed at baseline and at treatment weeks 6 to 8 and 12. The polymorphism genotypes were correlated with the treatment outcomes. RESULTS Bivariate analysis showed a nonsignificant association between FcγR low-affinity genotypes and greater improvement in the Psoriasis Area and Severity Index and body surface area at the end of treatment. Conversely, patients harboring high-affinity alleles presented a greater reduction in body surface area at the intermediate point, which remained independent in the multivariate analysis. We also detected an additive effect of both polymorphisms in the multivariate analysis. High-affinity alleles may contribute to a quicker response owing to a more efficient removal of relevant cells expressing TNF. CONCLUSIONS AND RELEVANCE Preliminary results of this pilot study on the pharmacogenetics of FcγR and biological therapy in psoriasis suggest a role with clinical implications for FcγRIIA-H131R and FcγRIIIA-V158F polymorphisms in the outcome of anti-TNF treatment of psoriasis. These results might help dermatologists in guiding therapeutic decisions, especially in very severe cases where a quick response is needed.
    JAMA dermatology (Chicago, Ill.). 07/2013;
  • Y Gilaberte, J M Carrascosa
    [Show abstract] [Hide abstract]
    ABSTRACT: One of the main goals of all skin cancer prevention campaigns is to protect children from ultraviolet radiation. However, little is known about how sun exposure risks differ between adults and children or about how these risks are best managed. Children's skin is more susceptible to sun damage for a number of reasons, including certain anatomical and functional aspects in children under 2 years of age and habits that predispose to greater sun exposure during the first 2 decades of life. Oil-based emulsions containing inorganic filters appear to be safest sunscreens for children, although the addition of certain organic filters is necessary to achieve a sun protection factor of 50. Oxybenzone, and probably also octocrylene, should be avoided in sunscreens for children. Sunscreen use should be part of an overall sun protection strategy that includes avoidance of exposure to midday sun and the use of protective clothing and hats. The above considerations justify the implementation of primary prevention campaigns focused on sun protection education for children and the continuation of basic and epidemiological research into specific sun protection strategies and sunscreens for each age group.
    Actas Dermo-Sifiliográficas 07/2013;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Phototherapy, classic systemic treatments (methotrexate, acitretin, and ciclosporin), and biologic agents (etanercept, infliximab, adalimumab, and ustekinumab) constitute a broad therapeutic arsenal that increases the likelihood of achieving control of severe and extensive disease in patients with psoriasis. Acitretin continues to be a very valuable tool in both monotherapy, in which it is combined with other systemic treatments (classic or biologic), and in sequential therapy. Thanks to its lack of a direct immunosuppressive effect and its ability to achieve a long-term response, acitretin has an important role in the treatment of psoriasis, although this has not always been acknowledged in relevant treatment guidelines. We present consensus guidelines for the use of acitretin in psoriasis drawn up by the Psoriasis Group of the Spanish Academy of Dermatology and Venereology. These guidelines provide a detailed account of acitretin, including pharmacological properties, indications and contraindications, adverse effects, and factors that should be taken into account to enhance the safe use of this drug. They also propose treatment strategies for use in routine clinical practice. The overall aim of these guidelines is to define the criteria for the use and management of acetretin in psoriasis.
    Actas Dermo-Sifiliográficas 07/2013;
  • [Show abstract] [Hide abstract]
    ABSTRACT: There are few data on the prevalence of obesity in the general psoriasis population and on the real impact of obesity on the management of psoriasis patients in the clinical setting. To evaluate the prevalence of overweight and obesity in patients with moderate-to-severe psoriasis compared to the general population and to assess the relationship between Body Mass Index (BMI) and the risk of discontinuing treatment. Patients registered on Biobadaderm, a prospective registry, were grouped according the different categories of BMI and compared to the general Spanish population. Drug survival was analysed considering only drug withdrawal due to lack of effectiveness, remission and adverse events. A total of 1162 moderate-to-severe psoriasis patients on systemic conventional or biological treatment were recruited. The prevalence of obesity was found to be significantly higher in psoriasis patients than in the general Spanish population (P < 0.001). In multivariate analysis a 5-unit increase in BMI, similar to a change in BMI category from normal weight to overweight and from overweight to obesity, was associated with a 12% increased risk of discontinuing therapy due to lack of effectiveness (HR 1.12, 95% CI: 1.01-1.24) and with a 17% increased risk of having an adverse event (HR 1.17, 95% CI: 1.02-1.36), both independently of the drug used. Patients with moderate-to-severe psoriasis had a higher prevalence of obesity than the general population. Increased BMI was associated with an increased risk of treatment discontinuation due to lack of effectiveness and a higher risk of adverse events.
    Journal of the European Academy of Dermatology and Venereology 07/2013; · 2.69 Impact Factor
  • A Plana, J M Carrascosa, M Vilavella, C Ferrandiz
    [Show abstract] [Hide abstract]
    ABSTRACT: Imatinib, a kinase inhibitor, is currently approved for the treatment of chronic myeloid leukaemia, gastrointestinal stromal tumours (GIST), and other malignant conditions such as dermatofibrosarcoma protuberans. Treatment with imatinib is generally well tolerated, but some cutaneous adverse events (AEs), such as exanthematous papular eruptions and Stevens-Johnson syndrome have been reported. We report a case of a pityriasis rubra pilaris (PRP)-like eruption associated with this drug. Although cutaneous AEs associated with imatinib are relatively common (up to 69% of cases), no previous cases of PRP-like eruptions related to this drug have been described previously, to our knowledge.
    Clinical and Experimental Dermatology 07/2013; 38(5):520-2. · 1.33 Impact Factor
  • J.M. Carrascosa, A. Plana, C. Ferrándiz
    [Show abstract] [Hide abstract]
    ABSTRACT: IntroductionPalmoplantar psoriasis is an uncommon clinical form of psoriasis. Although localized to the palms and soles, it has a considerable impact on the patient's function and quality of life.Objectives To study the effectiveness and safety of psoralen-UV-A (PUVA) therapy in palmoplantar psoriasis and investigate predictors of clinical response.Material and methodsWe performed a retrospective chart review of all patients with palmoplantar psoriasis treated with topical PUVA therapy at our hospital between 2008 and 2011. Data were collected on effectiveness (using physician global assessment [PGA] scores), safety, and a range of clinical, epidemiological, and treatment-related variables.ResultsWe studied 48 patients (33 women and 15 men) with a mean age of 51 years. Treatment was considered to be effective (PGA score of 0 or 1) in 63% of cases. In addition to PUVA, systemic therapy was required in 47.9% of patients; the drug most often used was acitretin. Adverse effects were reported for 25% of patients during treatment. The most common effect was mild erythema, present in 18% of cases.Conclusions In our experience, topical PUVA is an appropriate treatment alternative for palmoplantar psoriasis; it offers similar response rates to systemic treatments, but has a better tolerance and safety profile. Associated systemic treatment, with acitretin in most cases, improved the probability of a satisfactory response to PUVA and should be considered in patients who do not respond adequately after 8 to 10 sessions.
    Actas Dermo-Sifiliográficas 06/2013; 104(5):418–425.
  • J M Carrascosa, A Plana, C Ferrándiz
    [Show abstract] [Hide abstract]
    ABSTRACT: INTRODUCTION: Palmoplantar psoriasis is an uncommon clinical form of psoriasis. Although localized to the palms and soles, it has a considerable impact on the patient's function and quality of life. OBJECTIVES: To study the effectiveness and safety of psoralen-UV-A (PUVA) therapy in palmoplantar psoriasis and investigate predictors of clinical response. MATERIAL AND METHODS: We performed a retrospective chart review of all patients with palmoplantar psoriasis treated with topical PUVA therapy at our hospital between 2008 and 2011. Data were collected on effectiveness (using physician global assessment [PGA] scores), safety, and a range of clinical, epidemiological, and treatment-related variables. RESULTS: We studied 48 patients (33 women and 15 men) with a mean age of 51 years. Treatment was considered to be effective (PGA score of 0 or 1) in 63% of cases. In addition to PUVA, systemic therapy was required in 47.9% of patients; the drug most often used was acitretin. Adverse effects were reported for 25% of patients during treatment. The most common effect was mild erythema, present in 18% of cases. CONCLUSIONS: In our experience, topical PUVA is an appropriate treatment alternative for palmoplantar psoriasis; it offers similar response rates to systemic treatments, but has a better tolerance and safety profile. Associated systemic treatment, with acitretin in most cases, improved the probability of a satisfactory response to PUVA and should be considered in patients who do not respond adequately after 8 to 10 sessions.
    Actas Dermo-Sifiliográficas 05/2013;

Publication Stats

319 Citations
79.37 Total Impact Points

Institutions

  • 1996–2014
    • Hospital Universitari Germans Trias i Pujol
      • Department of Dermatology
      Badalona, Catalonia, Spain
  • 2013
    • Aragon Health Sciences Institute
      Caesaraugusta, Aragon, Spain
  • 2009–2013
    • Hospital de la Santa Creu i Sant Pau
      Barcino, Catalonia, Spain
  • 2011
    • University of Barcelona
      • Departament de Biologia Cel·lular
      Barcelona, Catalonia, Spain
  • 2010
    • Hospital Universitario de La Princesa
      • Servicio de Dermatología
      Madrid, Madrid, Spain
    • Universidad de Las Palmas de Gran Canaria
      Las Palmas, Canary Islands, Spain
  • 2008–2009
    • Autonomous University of Barcelona
      Cerdanyola del Vallès, Catalonia, Spain
  • 2007–2008
    • Hospital Universitari Arnau de Vilanova
      Lérida, Catalonia, Spain
    • Complexo Hospitalario De Pontevedra
      Pontevedra, Galicia, Spain