PSS11 - A Systematic Review and Meta-Analysis of Health State Utility Values in Psoriasis

Abstract

To perform a systematic review and meta-analysis of published literature on health state utility values (HSUVs) for psoriasis. A total of 7 databases were searched in November 2017. These were Pubmed, EMBASE, Cochrane Library databases, Web of Science, Wiley online library, Scopus, and EBSCO. A systematic review of literature was conducted to estimate mean EQ-5D utility scores using random-effects meta-analysis, as well as to explore degree of heterogeneity in the HSUVs across a variety of clinical and study characteristics using univariate meta-regression. Fifty studies were selected for meta-analysis. A total of 69 HSUVs were identified: 26 for plaque psoriasis, 22 for psoriasis as a general condition, and 21 for psoriatic arthritis. “Self-care” showed the lowest and “pain/discomfort” showed the highest percentages of reporting any problems in the EQ-5D dimensions. The mean (95% CIs) of the pooled HSUV for psoriasis as a general condition was estimated to be 0.763（0.727, 0.799） , and the I2 statistic in Cochran’s Q test was 0.989. For plaque psoriasis, the mean (95% CIs; I2) of the HSUV estimate was 0.762 (0.737, 0.787；=0.986). For psoriasis arthritis, the mean (95% CIs; I2) of the HSUV estimate was 0.580 (0.533, 0.628；=0.982). HSUV difference between plaque psoriasis and psoriasis as a general condition was not statistically significant. The HSUVs for psoriasis arthritis were significantly lower than that of psoriasis, with a mean difference of 0.181. For psoriasis as a general condition and plaque psoriasis, factors such as countries of the study, different tariffs of EQ-5D, disease severities were all significantly. For psoriasis arthritis, different EQ-5D tariffs were found to have no significant influence on the HSUVs. Psoriasis imposes a substantial impairment on patients’ quality of life, especially in the dimension of pain/discomfort. Heterogeneity exists among different EQ-5D utility values derived from literature.