Effect of pharmacologic treatment on dermatologic-specific quality of life (qol): a comparison of botulinum toxin type-a (bt-a) for primary focal hyperhidrosis (hh) to medical treatments for other dermatological diseases

Abstract

Objectives: To review and compare via the Dermatology Life Quality Index (DLQI): 1) the effect of primary focal HH on QOL relative to other dermatological diseases; 2) the QOL treatment effect of BT-A for HH to the QOL treatment effect reported for other dermatological treatments and diseases.Methods: The DLQI is a 10 item dermatology-specific QOL questionnaire with a total score ranging from 0 to 30 (with 30 representing the worst impact on QOL). A literature search identified all publications reporting pre- and post-pharmacologic treatment DLQI scores for a variety of diseases. Using studies with data on at least 20 adult subjects to ensure sufficient sample size, an evidence table was constructed listing the pre- and post-pharmacologic DLQI score by dermatological disease and treatment. QOL treatment effect was defined as the reported mean or median difference in the pre- and post-treatment DLQI score.Results: 7 of 8 studies with pre- and post-pharmacologic treatment DLQI total scores reported data for at least 20 adult patients (3 on HH, 3 on moderate to severe psoriasis, and 1 on moderate to severe acne). Baseline DLQI total scores ranged from 9.1 to 18 for HH, 8.4 to 11.9 for psoriasis, and 8.3 to 9.2 for acne. Treatment effects ranged from −7.3 to −13 for BT-A in HH, −7 to −10 for cyclosporin in psoriasis, −2.4 to −6 for alefacept in psoriasis, and −5.8 to −6.1 for various treatments (oral isotretinoin, oral and topical antibiotics, and anti-androgens) in acne.Conclusion: The effect of primary focal hyperhidrosis on QOL as reported in the literature was similar to or greater than that reported at baseline for moderate to severe psoriasis and acne. In addition, the beneficial improvement in QOL reported for HH patients following the use of BT-A was similar to or greater than the magnitude of improvement in QOL reported for moderate to severe psoriasis following systemic treatment, and also was similar to or greater than the QOL benefit reported for moderate to severe acne following systemic and/or topical treatments. Objectives: To review and compare via the Dermatology Life Quality Index (DLQI): 1) the effect of primary focal HH on QOL relative to other dermatological diseases; 2) the QOL treatment effect of BT-A for HH to the QOL treatment effect reported for other dermatological treatments and diseases. Methods: The DLQI is a 10 item dermatology-specific QOL questionnaire with a total score ranging from 0 to 30 (with 30 representing the worst impact on QOL). A literature search identified all publications reporting pre- and post-pharmacologic treatment DLQI scores for a variety of diseases. Using studies with data on at least 20 adult subjects to ensure sufficient sample size, an evidence table was constructed listing the pre- and post-pharmacologic DLQI score by dermatological disease and treatment. QOL treatment effect was defined as the reported mean or median difference in the pre- and post-treatment DLQI score. Results: 7 of 8 studies with pre- and post-pharmacologic treatment DLQI total scores reported data for at least 20 adult patients (3 on HH, 3 on moderate to severe psoriasis, and 1 on moderate to severe acne). Baseline DLQI total scores ranged from 9.1 to 18 for HH, 8.4 to 11.9 for psoriasis, and 8.3 to 9.2 for acne. Treatment effects ranged from −7.3 to −13 for BT-A in HH, −7 to −10 for cyclosporin in psoriasis, −2.4 to −6 for alefacept in psoriasis, and −5.8 to −6.1 for various treatments (oral isotretinoin, oral and topical antibiotics, and anti-androgens) in acne. Conclusion: The effect of primary focal hyperhidrosis on QOL as reported in the literature was similar to or greater than that reported at baseline for moderate to severe psoriasis and acne. In addition, the beneficial improvement in QOL reported for HH patients following the use of BT-A was similar to or greater than the magnitude of improvement in QOL reported for moderate to severe psoriasis following systemic treatment, and also was similar to or greater than the QOL benefit reported for moderate to severe acne following systemic and/or topical treatments.