Plaque Psoriasis
Conditions
Brief summary
This study is to evaluate available local data in Iraqi patients with moderate to severe psoriasis on Enbrel treatment with regards to efficacy, treatment regimen adherence and patient characterization (i.e. age, gender, smoking status) using data from the Dermatologists in Baghdad Teaching Hospital registry
Interventions
As provided in real world practice
Sponsors
Study design
Eligibility
Inclusion criteria
* Confirmed diagnosis of moderate to severe plaque psoriasis receiving etanercept treatment for a minimum duration of 1 year. * Age ≥18 years old. * No history of using a biological treatment, other than etanercept, for treatment of moderate to severe plaque psoriasis or any other reason.
Exclusion criteria
* Etanercept use for treatment moderate to severe plaque psoriasis less than 1 year duration. * Previous use of other biological treatments for any reason
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline in Psoriasis Area and Severity Index (PASI) Score at Month 12 | Baseline, Month 12 (from the data retrieved and observed in approximately 2.8 months of this study) | The PASI quantifies the severity of a participant's psoriasis based on both, lesion severity and the percent of BSA affected. PASI is a composite scoring by the investigator of degree of erythema, induration, and scaling (each scored separately) for each of 4 body regions (head and neck, upper limbs, trunk \[including axillae and groin\], and lower limbs \[including buttocks\]), with adjustment for the percent of BSA involved for each body region and for the proportion of the body region to the whole body. The PASI score can vary in increments of 0.1 and range from 0.0 (no disease) to 72.0 (maximum disease), with higher scores representing greater severity of psoriasis. |
| Change From Baseline in Percent Body Surface Area (BSA) at Month 12 | Baseline, Month 12 (from the data retrieved and observed in approximately 2.8 months of this study) | Four body regions were evaluated: head and neck, upper limbs, trunk (including axillae and groin) and lower limbs (including buttocks). Scalp, palms and soles were excluded. BSA was calculated using handprint method. Number of handprints (size of participant's full palmer hand) fitting in affected area of a body region was counted. Maximum number of handprints were 10 for head and neck, 20 for upper limbs, 30 for trunk and 40 for lower limbs. Surface area of body region equivalent to 1 handprint: 1 handprint equal to (=) 10 percent (%) for head and neck, 5% for upper limbs, 3.33% for trunk and 2.5% for lower limbs. Percent BSA for a body region = total number of handprints in a body region \* % surface area equivalent to 1 handprint. Overall % BSA for an individual: arithmetic mean of % BSA of all 4 body regions, ranged from 0 to 100%. Higher % BSA = greater severity of psoriasis. |
| Change From Baseline in Dermatology Life Quality Index (DLQI) Score at Month 12 | Baseline, Month 12 (from the data retrieved and observed in approximately 2.8 months of this study) | DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life over the last week. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicated more impact on quality of life. Scores from all 10 questions added up to give DLQI total score range from 0 (not at all) to 30 (very much). Higher scores indicated more impact on quality of life of participants. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Dermatology Life Quality Index (DLQI) Score at Baseline, Month 4 and Month 12 in Participants Adherent and Not Adherent to Treatment | Baseline, Month 4 and Month 12 (from the data retrieved and observed in approximately 2.8 months of this study) | DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life over the last week. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicated more impact on quality of life. Scores from all 10 questions added up to give DLQI total score range from 0 (not at all) to 30 (very much). Higher scores indicated more impact on quality of life of participants. This outcome measure evaluated comparison in DLQI score between participants adherent and not adherent to treatment at Baseline, Month 4 and 12. |
| Percent Body Surface Area (BSA) at Baseline, Month 4, and Month 12 in Participants Adherent and Not Adherent to Treatment | Baseline, Month 4 and Month 12 (from the data retrieved and observed in approximately 2.8 months of this study) | Four body regions were evaluated: head and neck, upper limbs, trunk (including axillae and groin) and lower limbs (including buttocks). Scalp, palms and soles were excluded. BSA was calculated using handprint method. Number of handprints (size of participant's full palmer hand) fitting in affected area of body region was counted. Maximum number of handprints were 10 for head and neck,20 for upper limbs,30 for trunk and 40 for lower limbs. Surface area of body region equivalent to 1 handprint: 1 handprint = 10% for head and neck, 5% for upper limbs, 3.33% for trunk and 2.5% for lower limbs. % BSA for body region=total number of handprints in a body region \* % surface area equivalent to 1 handprint. Overall % BSA for individual: arithmetic mean of % BSA of all 4 body regions, ranged from 0 to 100%. Higher % BSA=greater severity of psoriasis. This outcome measure evaluated comparison in % BSA between participants adherent and not adherent to treatment at Baseline, Month 4 and 12. |
| Psoriasis Area and Severity Index (PASI) Score at Baseline, Month 4 and Month 12 in Participants Adherent and Not Adherent to Treatment | Baseline, Month 4 and Month 12 (from the data retrieved and observed in approximately 2.8 months of this study) | The PASI quantifies the severity of a participant's psoriasis based on both, lesion severity and the percent of BSA affected. PASI is a composite scoring by the investigator of degree of erythema, induration, and scaling (each scored separately) for each of 4 body regions (head and neck, upper limbs, trunk \[including axillae and groin\], and lower limbs \[including buttocks\]), with adjustment for the percent of BSA involved for each body region and for the proportion of the body region to the whole body. The PASI score can vary in increments of 0.1 and range from 0.0 (no disease) to 72.0 (maximum disease), with higher scores representing greater severity of psoriasis. This outcome measure evaluated comparison in PASI score between participants adherent and not adherent to treatment at Baseline, Month 4 and 12. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline in Percent Body Surface Area (BSA) at Month 4 | Baseline, Month 4 (from the data retrieved and observed in approximately 2.8 months of this study) | Four body regions were evaluated: head and neck, upper limbs, trunk (including axillae and groin) and lower limbs (including buttocks). Scalp, palms and soles were excluded. BSA was calculated using handprint method. Number of handprints (size of participant's full palmer hand) fitting in affected area of a body region was counted. Maximum number of handprints were 10 for head and neck, 20 for upper limbs, 30 for trunk and 40 for lower limbs. Surface area of body region equivalent to 1 handprint: 1 handprint = 10 % for head and neck, 5% for upper limbs, 3.33% for trunk and 2.5% for lower limbs. Percent BSA for a body region = total number of handprints in a body region \* % surface area equivalent to 1 handprint. Overall % BSA for an individual: arithmetic mean of % BSA of all 4 body regions, ranged from 0 to 100%. Higher % BSA = greater severity of psoriasis. |
| Change From Baseline in Psoriasis Area and Severity Index (PASI) Score at Month 4 | Baseline, Month 4 (from the data retrieved and observed in approximately 2.8 months of this study) | The PASI quantifies the severity of a participant's psoriasis based on both, lesion severity and the percent of BSA affected. PASI is a composite scoring by the investigator of degree of erythema, induration, and scaling (each scored separately) for each of 4 body regions (head and neck, upper limbs, trunk \[including axillae and groin\], and lower limbs \[including buttocks\]), with adjustment for the percent of BSA involved for each body region and for the proportion of the body region to the whole body. The PASI score can vary in increments of 0.1 and range from 0.0 (no disease) to 72.0 (maximum disease), with higher scores representing greater severity of psoriasis. |
| Change From Baseline in Dermatology Life Quality Index (DLQI) Score at Month 4 | Baseline, Month 4 (from the data retrieved and observed in approximately 2.8 months of this study) | DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life over the last week. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicated more impact on quality of life. Scores from all 10 questions added up to give DLQI total score range from 0 (not at all) to 30 (very much). Higher scores indicated more impact on quality of life of participants. |
Countries
Iraq
Participant flow
Recruitment details
Data of Iraq's participants aged greater than or equal to (\>=) 18 years, who received etanercept for at least 1 year for treatment of moderate to severe plaque psoriasis at dermatology center in the Baghdad teaching hospital were included in the study. Available data of maximum 5 years were evaluated in approximately 2.8 months of this retrospective, observational study.
Participants by arm
| Arm | Count |
|---|---|
| Etanercept Participants received etanercept to treat moderate-to-severe plaque psoriasis for at least 1 year under standard real world clinical practice. (In Iraq, the recommended dose of etanercept \[Enbrel\] is 25 mg administered twice weekly or 50 mg administered once weekly. Alternatively, 50 mg given twice weekly might be used for up to 12 weeks followed, if necessary, by a dose of 25 mg twice weekly or 50 mg once weekly). Data of these participants were studied for approximately 2.8 months in this study. | 486 |
| Total | 486 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Participants Who Did Not Meet Entrance Criteria | 50 |
Baseline characteristics
| Characteristic | Etanercept | — |
|---|---|---|
| Age, Continuous | 32.5 years STANDARD_DEVIATION 10.6 | — |
| Race and Ethnicity Not Collected | — | — Participants |
| Sex: Female, Male Female | 240 Participants | — |
| Sex: Female, Male Male | 246 Participants | — |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 0 |
| other Total, other adverse events | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 |
Outcome results
Change From Baseline in Dermatology Life Quality Index (DLQI) Score at Month 12
DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life over the last week. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicated more impact on quality of life. Scores from all 10 questions added up to give DLQI total score range from 0 (not at all) to 30 (very much). Higher scores indicated more impact on quality of life of participants.
Time frame: Baseline, Month 12 (from the data retrieved and observed in approximately 2.8 months of this study)
Population: Analysis was performed on all participants whose data were included in this study for retrospective observation. Here, Overall Number of Participants Analyzed signifies number of participants evaluable for this outcome measure.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Etanercept | Change From Baseline in Dermatology Life Quality Index (DLQI) Score at Month 12 | -17.2 units on a scale | Standard Deviation 5.632051136 |
Change From Baseline in Percent Body Surface Area (BSA) at Month 12
Four body regions were evaluated: head and neck, upper limbs, trunk (including axillae and groin) and lower limbs (including buttocks). Scalp, palms and soles were excluded. BSA was calculated using handprint method. Number of handprints (size of participant's full palmer hand) fitting in affected area of a body region was counted. Maximum number of handprints were 10 for head and neck, 20 for upper limbs, 30 for trunk and 40 for lower limbs. Surface area of body region equivalent to 1 handprint: 1 handprint equal to (=) 10 percent (%) for head and neck, 5% for upper limbs, 3.33% for trunk and 2.5% for lower limbs. Percent BSA for a body region = total number of handprints in a body region \* % surface area equivalent to 1 handprint. Overall % BSA for an individual: arithmetic mean of % BSA of all 4 body regions, ranged from 0 to 100%. Higher % BSA = greater severity of psoriasis.
Time frame: Baseline, Month 12 (from the data retrieved and observed in approximately 2.8 months of this study)
Population: Analysis was performed on all participants whose data were included in this study for retrospective observation. Here, Overall Number of Participants Analyzed signifies number of participants evaluable for this outcome measure.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Etanercept | Change From Baseline in Percent Body Surface Area (BSA) at Month 12 | -21 Percent BSA | Standard Deviation 17.12191578 |
Change From Baseline in Psoriasis Area and Severity Index (PASI) Score at Month 12
The PASI quantifies the severity of a participant's psoriasis based on both, lesion severity and the percent of BSA affected. PASI is a composite scoring by the investigator of degree of erythema, induration, and scaling (each scored separately) for each of 4 body regions (head and neck, upper limbs, trunk \[including axillae and groin\], and lower limbs \[including buttocks\]), with adjustment for the percent of BSA involved for each body region and for the proportion of the body region to the whole body. The PASI score can vary in increments of 0.1 and range from 0.0 (no disease) to 72.0 (maximum disease), with higher scores representing greater severity of psoriasis.
Time frame: Baseline, Month 12 (from the data retrieved and observed in approximately 2.8 months of this study)
Population: Analysis was performed on all participants whose data were included in this study for retrospective observation. Here, Overall Number of Participants Analyzed signifies number of participants evaluable for this outcome measure.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Etanercept | Change From Baseline in Psoriasis Area and Severity Index (PASI) Score at Month 12 | -16.44 units on a scale | Standard Deviation 9.062008607 |
Dermatology Life Quality Index (DLQI) Score at Baseline, Month 4 and Month 12 in Participants Adherent and Not Adherent to Treatment
DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life over the last week. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicated more impact on quality of life. Scores from all 10 questions added up to give DLQI total score range from 0 (not at all) to 30 (very much). Higher scores indicated more impact on quality of life of participants. This outcome measure evaluated comparison in DLQI score between participants adherent and not adherent to treatment at Baseline, Month 4 and 12.
Time frame: Baseline, Month 4 and Month 12 (from the data retrieved and observed in approximately 2.8 months of this study)
Population: Analysis was performed on all participants whose data were included in this study for retrospective observation. Here, Number Analyzed signifies participants evaluable at specific time points.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Etanercept | Dermatology Life Quality Index (DLQI) Score at Baseline, Month 4 and Month 12 in Participants Adherent and Not Adherent to Treatment | Baseline | 24.50 units on a scale | Standard Deviation 4.438 |
| Etanercept | Dermatology Life Quality Index (DLQI) Score at Baseline, Month 4 and Month 12 in Participants Adherent and Not Adherent to Treatment | Month 4 | 16.6 units on a scale | Standard Deviation 6.3 |
| Etanercept | Dermatology Life Quality Index (DLQI) Score at Baseline, Month 4 and Month 12 in Participants Adherent and Not Adherent to Treatment | Month 12 | 6.6 units on a scale | Standard Deviation 4.5 |
| Etanercept: Participants Not Adherent to Treatment | Dermatology Life Quality Index (DLQI) Score at Baseline, Month 4 and Month 12 in Participants Adherent and Not Adherent to Treatment | Baseline | 24.94 units on a scale | Standard Deviation 2.838 |
| Etanercept: Participants Not Adherent to Treatment | Dermatology Life Quality Index (DLQI) Score at Baseline, Month 4 and Month 12 in Participants Adherent and Not Adherent to Treatment | Month 4 | 21.1 units on a scale | Standard Deviation 6.8 |
| Etanercept: Participants Not Adherent to Treatment | Dermatology Life Quality Index (DLQI) Score at Baseline, Month 4 and Month 12 in Participants Adherent and Not Adherent to Treatment | Month 12 | 11.3 units on a scale | Standard Deviation 7.2 |
Percent Body Surface Area (BSA) at Baseline, Month 4, and Month 12 in Participants Adherent and Not Adherent to Treatment
Four body regions were evaluated: head and neck, upper limbs, trunk (including axillae and groin) and lower limbs (including buttocks). Scalp, palms and soles were excluded. BSA was calculated using handprint method. Number of handprints (size of participant's full palmer hand) fitting in affected area of body region was counted. Maximum number of handprints were 10 for head and neck,20 for upper limbs,30 for trunk and 40 for lower limbs. Surface area of body region equivalent to 1 handprint: 1 handprint = 10% for head and neck, 5% for upper limbs, 3.33% for trunk and 2.5% for lower limbs. % BSA for body region=total number of handprints in a body region \* % surface area equivalent to 1 handprint. Overall % BSA for individual: arithmetic mean of % BSA of all 4 body regions, ranged from 0 to 100%. Higher % BSA=greater severity of psoriasis. This outcome measure evaluated comparison in % BSA between participants adherent and not adherent to treatment at Baseline, Month 4 and 12.
Time frame: Baseline, Month 4 and Month 12 (from the data retrieved and observed in approximately 2.8 months of this study)
Population: Analysis was performed on all participants whose data were included in this study for retrospective observation. Here, Number Analyzed signifies participants evaluable at specific time points.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Etanercept | Percent Body Surface Area (BSA) at Baseline, Month 4, and Month 12 in Participants Adherent and Not Adherent to Treatment | Baseline | 27.56 Percent BSA | Standard Deviation 19.03 |
| Etanercept | Percent Body Surface Area (BSA) at Baseline, Month 4, and Month 12 in Participants Adherent and Not Adherent to Treatment | Month 4 | 20.1 Percent BSA | Standard Deviation 11.7 |
| Etanercept | Percent Body Surface Area (BSA) at Baseline, Month 4, and Month 12 in Participants Adherent and Not Adherent to Treatment | Month 12 | 8.7 Percent BSA | Standard Deviation 6.8 |
| Etanercept: Participants Not Adherent to Treatment | Percent Body Surface Area (BSA) at Baseline, Month 4, and Month 12 in Participants Adherent and Not Adherent to Treatment | Baseline | 32.84 Percent BSA | Standard Deviation 21.324 |
| Etanercept: Participants Not Adherent to Treatment | Percent Body Surface Area (BSA) at Baseline, Month 4, and Month 12 in Participants Adherent and Not Adherent to Treatment | Month 4 | 31.7 Percent BSA | Standard Deviation 21.8 |
| Etanercept: Participants Not Adherent to Treatment | Percent Body Surface Area (BSA) at Baseline, Month 4, and Month 12 in Participants Adherent and Not Adherent to Treatment | Month 12 | 11.1 Percent BSA | Standard Deviation 8.9 |
Psoriasis Area and Severity Index (PASI) Score at Baseline, Month 4 and Month 12 in Participants Adherent and Not Adherent to Treatment
The PASI quantifies the severity of a participant's psoriasis based on both, lesion severity and the percent of BSA affected. PASI is a composite scoring by the investigator of degree of erythema, induration, and scaling (each scored separately) for each of 4 body regions (head and neck, upper limbs, trunk \[including axillae and groin\], and lower limbs \[including buttocks\]), with adjustment for the percent of BSA involved for each body region and for the proportion of the body region to the whole body. The PASI score can vary in increments of 0.1 and range from 0.0 (no disease) to 72.0 (maximum disease), with higher scores representing greater severity of psoriasis. This outcome measure evaluated comparison in PASI score between participants adherent and not adherent to treatment at Baseline, Month 4 and 12.
Time frame: Baseline, Month 4 and Month 12 (from the data retrieved and observed in approximately 2.8 months of this study)
Population: Analysis was performed on all participants whose data were included in this study for retrospective observation. Here, Number Analyzed signifies participants evaluable at specific time points.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Etanercept | Psoriasis Area and Severity Index (PASI) Score at Baseline, Month 4 and Month 12 in Participants Adherent and Not Adherent to Treatment | Baseline | 21.980 units on a scale | Standard Deviation 10.0055 |
| Etanercept | Psoriasis Area and Severity Index (PASI) Score at Baseline, Month 4 and Month 12 in Participants Adherent and Not Adherent to Treatment | Month 4 | 14.5 units on a scale | Standard Deviation 8.8 |
| Etanercept | Psoriasis Area and Severity Index (PASI) Score at Baseline, Month 4 and Month 12 in Participants Adherent and Not Adherent to Treatment | Month 12 | 4.8 units on a scale | Standard Deviation 3.9 |
| Etanercept: Participants Not Adherent to Treatment | Psoriasis Area and Severity Index (PASI) Score at Baseline, Month 4 and Month 12 in Participants Adherent and Not Adherent to Treatment | Baseline | 22.458 units on a scale | Standard Deviation 12.6765 |
| Etanercept: Participants Not Adherent to Treatment | Psoriasis Area and Severity Index (PASI) Score at Baseline, Month 4 and Month 12 in Participants Adherent and Not Adherent to Treatment | Month 4 | 21.7 units on a scale | Standard Deviation 15.8 |
| Etanercept: Participants Not Adherent to Treatment | Psoriasis Area and Severity Index (PASI) Score at Baseline, Month 4 and Month 12 in Participants Adherent and Not Adherent to Treatment | Month 12 | 9.7 units on a scale | Standard Deviation 6.4 |
Change From Baseline in Dermatology Life Quality Index (DLQI) Score at Month 4
DLQI is a 10-item questionnaire that measures the impact of skin disease on participant's quality of life over the last week. Each question was evaluated on a 4-point scale ranging from 0 (not at all) to 3 (very much); where higher scores indicated more impact on quality of life. Scores from all 10 questions added up to give DLQI total score range from 0 (not at all) to 30 (very much). Higher scores indicated more impact on quality of life of participants.
Time frame: Baseline, Month 4 (from the data retrieved and observed in approximately 2.8 months of this study)
Population: Analysis was performed on all participants whose data were included in this study for retrospective observation. Here, Overall Number of Participants Analyzed signifies number of participants evaluable for this outcome measure.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Etanercept | Change From Baseline in Dermatology Life Quality Index (DLQI) Score at Month 4 | -7.3 units on a scale | Standard Deviation 5.70876519 |
Change From Baseline in Percent Body Surface Area (BSA) at Month 4
Four body regions were evaluated: head and neck, upper limbs, trunk (including axillae and groin) and lower limbs (including buttocks). Scalp, palms and soles were excluded. BSA was calculated using handprint method. Number of handprints (size of participant's full palmer hand) fitting in affected area of a body region was counted. Maximum number of handprints were 10 for head and neck, 20 for upper limbs, 30 for trunk and 40 for lower limbs. Surface area of body region equivalent to 1 handprint: 1 handprint = 10 % for head and neck, 5% for upper limbs, 3.33% for trunk and 2.5% for lower limbs. Percent BSA for a body region = total number of handprints in a body region \* % surface area equivalent to 1 handprint. Overall % BSA for an individual: arithmetic mean of % BSA of all 4 body regions, ranged from 0 to 100%. Higher % BSA = greater severity of psoriasis.
Time frame: Baseline, Month 4 (from the data retrieved and observed in approximately 2.8 months of this study)
Population: Analysis was performed on all participants whose data were included in this study for retrospective observation. Here, Overall Number of Participants Analyzed signifies number of participants evaluable for this outcome measure.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Etanercept | Change From Baseline in Percent Body Surface Area (BSA) at Month 4 | -6.8 Percent BSA | Standard Deviation 17.39310208 |
Change From Baseline in Psoriasis Area and Severity Index (PASI) Score at Month 4
The PASI quantifies the severity of a participant's psoriasis based on both, lesion severity and the percent of BSA affected. PASI is a composite scoring by the investigator of degree of erythema, induration, and scaling (each scored separately) for each of 4 body regions (head and neck, upper limbs, trunk \[including axillae and groin\], and lower limbs \[including buttocks\]), with adjustment for the percent of BSA involved for each body region and for the proportion of the body region to the whole body. The PASI score can vary in increments of 0.1 and range from 0.0 (no disease) to 72.0 (maximum disease), with higher scores representing greater severity of psoriasis.
Time frame: Baseline, Month 4 (from the data retrieved and observed in approximately 2.8 months of this study)
Population: Analysis was performed on all participants whose data were included in this study for retrospective observation. Here, Overall Number of Participants Analyzed signifies number of participants evaluable for this outcome measure.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Etanercept | Change From Baseline in Psoriasis Area and Severity Index (PASI) Score at Month 4 | -6.64 units on a scale | Standard Deviation 10.35036231 |