Real-world outcomes in 2,646 psoriasis patients: One in five has PASI ≥ 10 and/or DLQI ≥ 10 under ongoing systemic therapy
Norlin JM, Calara PS, Persson U & Schmitt-Egenolf M
A substantial part of people, one in five, undergoing systemic treatment for psoriasis till have considerable problems with their disease. This according to a study with 2,646 Swedish psoriasis patients conducted at Umeå University and the Swedish Institute for Health Economics, and recently published in the Journal of Dermatological Treatment.
The results suggest that the currently available treatments are not sufficiently treating patients with moderate-to-severe psoriasis and that more patients need access to the currently available biologic agents and new more efficacious treatments in order to manage their disease.
More than a decade ago, developments in biologics transformed the treatment of moderate-to-severe psoriasis by providing new ways for better skin clearance rates, low toxicity, and improved quality-of-life for patients. Nonetheless, the study shows that despite having an ongoing systemic treatment, 18 percent of patients still had extensive psoriasis lesions and/or suffered impairment of their skin-related quality-of-life.
The study was based on PsoReg, which is the Swedish quality register for systemic treatment of psoriasis. 2,646 psoriasis patients who had been receiving systemic treatment for at least three months were included in the study, which analyzed their most recent visit registered in PsoReg. Disease severity was measured either by the physician’s clinical assessment and/or by the patient’s own assessment of their skin-related quality of life.
Compared to the larger patient group, the subgroup of patients with suboptimal therapy-response were younger and had higher BMI. They were also more often suffering from psoriasis arthritis and were more often smokers. The subgroup with higher persisting psoriasis severity also reported worse overall quality-of-life, measured with the EQ-5D.
Based on the results, the authors make several suggestions. For patients with moderate-to-severe psoriasis, who are using conventional systemic treatments, biologics should be considered. Patients with moderate-to-severe psoriasis, who already receive biologics, new treatment options may be needed. And lastly, the patients should also receive support in improving lifestyle factors.
Journal of Dermatological Treatment, 2017 Sep; 28(6): 500-504