Research

The LITE Study is a large pragmatic randomized study to compare the effectiveness, safety (tolerability), and duration of treatment response at 12 weeks of home versus office-based narrowband ultraviolet B phototherapy for the treatment of plaque or guttate psoriasis.  The study’s design differs from a clinical trial in that it aims to reflect real world practice. LITE is guided by committee representatives of dermatology experts, patients with psoriasis, and leaders in health care insurance. The study hopes to narrow the gap in knowledge for patients, dermatologists, and healthcare plan payers on the effectiveness of home versus office-based phototherapy.

For more information, please visit the LITE Study website and the PCORI website.

Funded by the National Psoriasis Foundation’s Psoriasis Prevention Initiative (PPI), the goal of CP3 is to increase the lifespan and health of individuals living with psoriatic disease by decreasing barriers to appropriate CVD prevention care per guidelines from the American Academy of Dermatology (AAD)/National Psoriasis Foundation (NPF) and the American Heart Association(AHA)/American College of Cardiology(ACC), which target psoriasis patients as a population needing enhanced CVD prevention efforts. To achieve this goal, we are developing an innovative care coordination model in which patients with early CVD risk factors are referred by their dermatologist or rheumatologist to a care coordinator who will guide patients through the AHA/ACC risk calculations, review their risk profile, share resources and help them develop an action plan for diet, exercise, and medication (statin) management (as needed), and connect them with a primary care provider. 

CP3 includes a multi-disciplinary and institutional team of investigators. Along with Dr. Gelfand, Dr. Nehal Mehta, MD, MSCE (Cardiovascular Inflammatory Specialist, Clinical Professor of Medicine at George Washington University) serves as a PI. Our co-principal investigators include Dr. April Armstrong, MD, MPH (Professor of Dermatology University of Southern California, expert in pragmatic trials and telemedicine), Dr. Rinad Biedas, PhD (Department Chair and Ralph Seal Paffenbarger Professor of Medical Social Sciences at Northwestern University Feinberg School of Medicine, expert in implementation science), Dr. Alexis Ogdie, MD, MSCE (Associate Professor of Medicine (Rheumatology) and Epidemiology, Director of the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania, expert in psoriatic arthritis, clinical epidemiology, and trials) and Dr. John Barbieri, MD, MBA (Assistant Professor of Dermatology at Harvard Medical School and Director of the Advanced Acne Theraputics Clinic).   

If you are a rheumatologist or dermatologist or a patient with psoriatic disease and would like to learn more about participating in the CP3 Study, please contact us at cp3study@pennmedicine.upenn.edu.

To better understand associations between skin diseases and various co-morbidities in population-based settings, the Gelfand Clinical Research Lab creates case-control cohorts of patients using The Health Improvement Network (THIN) data source to conduct pharmacoepidemiology studies. THIN is a population-based medical records database in the United Kingdom created in 2002 and continuously updated with prospectively collected data. To date, studies have focused on patients with psoriasis, psoriatic arthritis, rheumatoid arthritis, and atopic dermatitis.  Comorbidities evaluated have included major cardiovascular events, serious infections, opportunistic infections, chronic kidney disease, liver disease, malignancy, lymphoproliferative disorders, hematologic disorders, asthma, fractures, Alzheimer’s disease, anxiety, depression, suicidality, and suicide. Selected major findings can be found in the Publications tab.

The Incident Health Outcomes and Psoriasis Events (iHOPE) cohort was created for a population-based, cross-sectional study in The Health Improvement Network (THIN) to validate the psoriasis diagnosis codes and determine the distribution of disease severity using questionnaires sent to general practitioners (GPs) of patients identified as having psoriasis.  At the time of sampling, patients had to be between the ages of 25-64 , and have a psoriasis diagnosis code in the two years prior.  Up to 10 control patients (i.e. with no history of psoriasis diagnostic code) were randomly matched based on age and general practice.  This cohort has been extensively used to determine associations between psoriasis severity and various comorbidities. Selected major findings can be found in the Publications tab.

Acne is a common illness of adolescents and young adults which is associated with substantial morbidity. While topical treatments are often sufficient for mild acne, moderate to severe acne is often treated with systemic medications such as oral antibiotics. With growing concerns about bacteria becoming resistant to antibiotics, there is a need to determine whether non-antibiotic treatments have similar effectiveness to oral antibiotics. Sebum overproduction is fundamental to the pathogenesis of acne.  Given the influence of hormones on sebum production, therapies that address underlying hormonal factors, such as spironolactone, represent potentially underutilized treatment options for women with acne and could help decrease the use of long-term oral antibiotics in this patient population. 

To determine whether spironolactone is non-inferior to the oral tetracycline-class antibiotic doxycycline hyclate for the treatment of acne in women, we are conducting the SD-Acne Study, a randomized, double-blind, multi-center comparative effectiveness study with patients aged 16-40 who have moderate to severe acne.

For more information, please visit ClinicalTrials.gov or the Penn Medicine Research Portal.

In 2006, Dr. Gelfand and his research team were the first to demonstrate that psoriasis, especially when severe, may be an independent risk factor for myocardial infarction.  To investigate the impact psoriasis treatment may have on key markers of cardiovascular risk such as lipid metabolism and aortic inflammation, Dr. Gelfand and his clinical research team conducted the Vascular Inflammation in Psoriasis studies.  The studies evaluated systemic vascular inflammation using FDG PET/CT (fluorodeoxgylucose-positron emission tomography/computed tomography) and blood samples for cardiometabolic identifiers including markers of high cholesterol, cholesterol efflux function, metabolic factors, and inflammation. The VIP studies also assessed patient-reported quality of life outcomes with validated instruments.  

To learn more about the individual VIP studies, click on the links below:

Vascular Inflammation in Psoriasis – adalimumab (VIP)

Vascular Inflammation in Psoriasis – adalimumab (VIP-Extension)

 Vascular Inflammation in Psoriasis – ustekinumab (VIP-U)

 Vascular Inflammation in Psoriasis – apremilast (VIP-A)

The G5P study is a retrospective cases series of patients with generalized pustular psoriasis (GPP) and palmar plantar pustulosis (PPP) treated by dermatologists from 20 academic medical centers across the United States (US). The purpose of this study is to better characterize the epidemiology and natural course of GPP and PPP in the US and describe the clinical characteristics, treatments, longitudinal disease course, and disease-specific health care utilization among patients with GPP and PPP. This is the first multicenter study of patients with GPP and patients with PPP from across the US. Selected major findings can be found in the Publications tab.