ROBERTO TAKAOKA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- When does atopic dermatitis warrant systemic therapy? Recommendations from an expert panel of the International Eczema Council(2017) SIMPSON, Eric L.; BRUIN-WELLER, Marjolein; FLOHR, Carsten; ARDERN-JONES, Michael R.; BARBAROT, Sebastien; DELEURAN, Mette; BIEBER, Thomas; VESTERGAARD, Christian; BROWN, Sara J.; CORK, Michael J.; DRUCKER, Aaron M.; EICHENFIELD, Lawrence F.; FOELSTER-HOLST, Regina; GUTTMAN-YASSKY, Emma; NOSBAUM, Audrey; REYNOLDS, Nick J.; SILVERBERG, Jonathan I.; SCHMITT, Jochen; SEYGER, Marieke M. B.; SPULS, Phyllis I.; STALDER, Jean-Francois; SU, John C.; TAKAOKA, Roberto; TRAIDL-HOFFMANN, Claudia; THYSSEN, Jacob P.; SCHAFT, Jorien van der; WOLLENBERG, Andreas; IRVINE, Alan D.; PALLER, Amy S.Background: Although most patients with atopic dermatitis (AD) are effectively managed with topical medication, a significant minority require systemic therapy. Guidelines for decision making about advancement to systemic therapy are lacking. Objective: To guide those considering use of systemic therapy in AD and provide a framework for evaluation before making this therapeutic decision with the patient. Methods: A subgroup of the International Eczema Council determined aspects to consider before prescribing systemic therapy. Topics were assigned to expert reviewers who performed a topic-specific literature review, referred to guidelines when available, and provided interpretation and expert opinion. Results: We recommend a systematic and holistic approach to assess patients with severe signs and symptoms of AD and impact on quality of life before systemic therapy. Steps taken before commencing systemic therapy include considering alternate or concomitant diagnoses, avoiding trigger factors, optimizing topical therapy, ensuring adequate patient/caregiver education, treating coexistent infection, assessing the impact on quality of life, and considering phototherapy. Limitations: Our work is a consensus statement, not a systematic review. Conclusion: The decision to start systemic medication should include assessment of severity and quality of life while considering the individual's general health status, psychologic needs, and personal attitudes toward systemic therapies.
- Report from the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)(2016) CHALMERS, J. R.; SIMPSON, E.; APFELBACHER, C. J.; THOMAS, K. S.; KOBYLETZKI, L. von; SCHMITT, J.; SINGH, J. A.; SVENSSON, A.; WILLIAMS, H. C.; ABUABARA, K.; AOKI, V.; ARDELEANU, M.; AWICI-RASMUSSEN, M.; BARBAROT, S.; BERENTS, T. L.; BLOCK, J.; BRAGG, A.; BURTON, T.; CLEMMENSEN, K. K. Bjerring; CRESWELL-MELVILLE, A.; DINESEN, M.; DRUCKER, A.; ECKERT, L.; FLOHR, C.; GARG, M.; GERBENS, L. A. A.; GRAFF, A. L. B.; HANIFIN, J.; HEINL, D.; HUMPHREYS, R.; ISHII, H. A.; KATAOKA, Y.; LESHEM, Y. A.; MARQUORT, B.; MASSUEL, M. -A.; MERHAND, S.; MIZUTANI, H.; MUROTA, H.; MURRELL, D. F.; NAKAHARA, T.; NASR, I.; NOGRALES, K.; OHYA, Y.; OSTERLOH, I.; PANDER, J.; PRINSEN, C.; PURKINS, L.; RIDD, M.; SACH, T.; SCHUTTELAAR, M. -L. A.; SHINDO, S.; SMIRNOVA, J.; SULZER, A.; GJERDE, E. Synnove; TAKAOKA, R.; TALMO, H. Vestby; TAUBER, M.; TORCHET, F.; VOLKE, A.; WAHLGREN, C. -F.; WEIDINGER, S.; WEISSHAAR, E.; WOLLENBERG, A.; YAMAGA, K.; ZHAO, C. Y.; SPULS, P. I.This article is a report of the fourth meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in Malmo, Sweden on 23-24 April 2015 (HOME IV). The aim of the meeting was to achieve consensus over the preferred outcome instruments for measuring patient-reported symptoms and quality of life for the HOME core outcome set for atopic eczema (AE). Following presentations, which included data from systematic reviews, consensus discussions were held in a mixture of whole group and small group discussions. Small groups were allocated a priori to ensure representation of different stakeholders and countries. Decisions were voted on using electronic keypads. For the patient-reported symptoms, the group agreed by vote that itch, sleep loss, dryness, redness/inflamed skin and irritated skin were all considered essential aspects of AE symptoms. Many instruments for capturing patient-reported symptoms were discussed [ including the Patient-Oriented SCOring Atopic Dermatitis index, Patient-Oriented Eczema Measure (POEM), Self-Administered Eczema Area and Severity Index, Itch Severity Scale, Atopic Dermatitis Quickscore and the Nottingham Eczema Severity Score] and, by consensus, POEM was selected as the preferred instrument to measure patient-reported symptoms. Further work is needed to determine the reliability and measurement error of POEM. Further work is also required to establish the importance of pain/soreness and the importance of collecting information regarding the intensity of symptoms in addition to their frequency. Much of the discussion on quality of life concerned the Dermatology Life Quality Index and Quality of Life Index for Atopic Dermatitis; however, consensus on a preferred instrument for measuring this domain could not be reached. In summary, POEM is recommended as the HOME core outcome instrument for measuring AE symptoms.
- Topical corticosteroid phobia in atopic dermatitis: International feasibility study of the TOPICOP score(2017) STALDER, J. -F.; AUBERT, H.; ANTHOINE, E.; FUTAMURA, M.; MARCOUX, D.; MORREN, M. -A.; TRZECIAK, M.; SZALAI, Z.; VERES, K.; DELEURAN, M.; VESTERGAARD, C.; BORALEVI, F.; CHU, C. -Y.; RAEVE, L. De; SVENSSON, A.; FOELSTER-HOLST, R.; BUCHNER, M.; TAKAOKA, R.; AOKI, V.; CHERNYSHOV, P.; CHERNYSHOVA, L.; MURRELL, D. F.; ZHAO, C.; MCKINSTER, C. D.; KOBYLETZKY, L. Von; EICHENFIELD, L.; TOTRI, C.; LIO, P.; SENESCHAL, J.; MORET, L.; BARBAROT, S.BackgroundAdherence to topical corticosteroids (TCS) is essential for the effective treatment of atopic dermatitis but can be limited by concerns about their use. This study examined the feasibility of applying the validated TOPICOP score for assessing TCS phobia across different countries. MethodsThis was a prospective multicentre feasibility study conducted in 21 hospitals in 17 countries. Patients >3 months of age with atopic dermatitis or their parents or legal representatives completed a validated translation of the TOPICOP questionnaire in the country's native language. Respondents also completed questionnaires collecting opinions about the feasibility and acceptability of the TOPICOP questionnaire. ResultsA total of 1564 participants in 15 countries were included in the analysis. 81% of respondents considered the questions clear or very clear, and 79% reported that it took less than 5 minutes to complete. Each of the individual items in the TOPICOP questionnaire was considered to be not at all difficult to answer by 49% to 74% of participants. The mean global TOPICOP score was 44.7%20.5. Mean TOPICOP subscores were 37.0 +/- 22.8% for knowledge and beliefs, 54.7 +/- 27.8% for fears and 50.1 +/- 29.1% for behaviours. Global scores and subscores differed between countries, although the subscores did not always vary in parallel, suggesting different levels of TCS phobia and different drivers for each country. ConclusionsThe TOPICOP score can be feasibly applied across countries and may therefore be useful for obtaining qualitative and quantitative data from international studies and for adapting patient education and treatment.
- Global Allergy Forum and 3rd Davos Declaration 2015: Atopic dermatitis/Eczema: challenges and opportunities toward precision medicine(2016) BIEBER, T.; AKDIS, C.; LAUENER, R.; TRAIDL-HOFFMANN, C.; SCHMID-GRENDELMEIER, P.; SCHAEPPI, G.; ALLAM, J. -P.; APFELBACHER, C.; AUGUSTIN, M.; BECK, L.; BIEDERMANN, T.; BRAUN-FAHRLANDER, C.; CHEW, F. T.; CLAVEL, T.; CRAMERI, R.; DARSOW, U.; DELEURAN, M.; DITTLEIN, D.; DUCHNA, H. -W.; EICHENFELD, L.; EYERICH, K.; FREI, R.; GELMETTI, C.; GIELER, U.; GILLES, S.; GLATZ, M.; GRANDO, K.; GREEN, J.; GUTERMUTH, J.; GUTTMAN-YASSKY, E.; HANIFIN, J.; HIJNEN, D.; HOETZENECKER, W.; IRVINE, A.; KALWEIT, A.; KATOH, N.; KNOL, E.; KOREN, H.; MOHRENSCHLAGER, M.; MUENCH, D.; NOVAK, N.; O'MAHONY, L.; PALLER, A. S.; RHYNER, C.; RODUIT, C.; SCHIESSER, K.; SCHROEDER, J.; SIMON, D.; SIMON, H. -U.; SOKOLOWSKA, M.; SPULS, P.; STALDER, J. -F.; STRAUB, D.; SZALAI, Z.; TAIEB, A.; TAKAOKA, R.; TODD, G.; TODOROVA, A.; VESTERGAARD, C.; WERFEL, T.; WOLLENBERG, A.; RING, J.
- Report from the third international consensus meeting to harmonise core outcome measures for atopic eczema/dermatitis clinical trials (HOME)(2014) CHALMERS, J. R.; SCHMITT, J.; APFELBACHER, C.; DOHIL, M.; EICHENFIELD, L. F.; SIMPSON, E. L.; SINGH, J.; SPULS, P.; THOMAS, K. S.; ADMANI, S.; AOKI, V.; ARDELEANU, M.; BARBAROT, S.; BERGER, T.; BERGMAN, J. N.; BLOCK, J.; BOROK, N.; BURTON, T.; CHAMLIN, S. L.; DECKERT, S.; DEKLOTZ, C. C.; GRAFF, L. B.; HANIFIN, J. M.; HEBERT, A. A.; HUMPHREYS, R.; KATOH, N.; KISA, R. M.; MARGOLIS, D. J.; MERHAND, S.; MINNILLO, R.; MIZUTANI, H.; NANKERVIS, H.; OHYA, Y.; RODGERS, P.; SCHRAM, M. E.; STALDER, J. F.; SVENSSON, A.; TAKAOKA, R.; TEPER, A.; TOM, W. L.; KOBYLETZKI, L. von; WEISSHAAR, E.; ZELT, S.; WILLIAMS, H. C.This report provides a summary of the third meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in San Diego, CA, U.S.A., 6-7 April 2013 (HOME III). The meeting addressed the four domains that had previously been agreed should be measured in every eczema clinical trial: clinical signs, patient-reported symptoms, long-term control and quality of life. Formal presentations and nominal group techniques were used at this working meeting, attended by 56 voting participants (31 of whom were dermatologists). Significant progress was made on the domain of clinical signs. Without reference to any named scales, it was agreed that the intensity and extent of erythema, excoriation, oedema/papulation and lichenification should be included in the core outcome measure for the scale to have content validity. The group then discussed a systematic review of all scales measuring the clinical signs of eczema and their measurement properties, followed by a consensus vote on which scale to recommend for inclusion in the core outcome set. Research into the remaining three domains was presented, followed by discussions. The symptoms group and quality of life groups need to systematically identify all available tools and rate the quality of the tools. A definition of long-term control is needed before progress can be made towards recommending a core outcome measure.
- Therapeutic Patient Education in Atopic Dermatitis: Worldwide Experiences(2013) STALDER, Jean-Francois; BERNIER, Claire; BALL, Alan; RAEVE, Linda De; GIELER, Uwe; DELEURAN, Mette; MARCOUX, Danielle; EICHENFIELD, Lawrence F.; LIO, Peter; LEWIS-JONES, Sue; GELMETTI, Carlo; TAKAOKA, Roberto; CHIAVERINI, Christine; MISERY, Laurent; BARBAROT, SebastienTherapeutic patient education (TPE) has proven effective in increasing treatment adherence and improving quality of life (QoL) for patients with numerous chronic diseases, especially atopic dermatitis (AD). This study was undertaken to identify worldwide TPE experiences in AD treatment. Experts from 23 hospitals, located in 11 countries, responded to a questionnaire on 10 major items. Patients in TPE programs were mainly children and adolescents with moderate to severe AD or markedly affected QoL. Individual and collective approaches were used. Depending on the center, the number of sessions varied from one to six (corresponding to 2 to 12hours of education), and 20 to 200 patients were followed each year. Each center's education team comprised multidisciplinary professionals (e.g., doctors, nurses, psychologists). Evaluations were based on clinical assessment, QoL, a satisfaction index, or some combination of the three. When funding was obtained, it came from regional health authorities (France), insurance companies (Germany), donations (United States), or pharmaceutical firms (Japan, Italy). The role of patient associations was always highlighted, but their involvement in the TPE process varied from one country to another. Despite the nonexhaustive approach, our findings demonstrate the increasing interest in TPE for managing individuals with AD. In spite of the cultural and financial differences between countries, there is a consensus among experts to integrate education into the treatment of eczema.
conferenceObject GLOBAL EPIDEMIOLOGY SURVEY OF PREVALENCE, DISEASE SEVERITY, TREATMENT PATTERNS IN ATOPIC DERMATITIS: RESULTS FOR 2 LATIN AMERICAN COUNTRIES(2021) TAKAOKA, Roberto; SILVERBERG, Jonathan I.; WOLLENBERG, Andreas; EGEBERG, Alexander; LEHRHAUPT, Kerri; JENKINS, Matthew P.; FRAJZYNGIER, Vera; MYERS, Daniela E.; LEON, Dario Ponce de; GUTTMAN-YASSKY, Emma