Abstract
The Dermatology Life Quality Index (DLQI) is commonly used to assess the quality of life of patients with skin diseases. Clinical trials confirm the positive effect of the use of biologics and new molecules on the quality of life of patients with plaque psoriasis. Investigation of the effect of infliximab, adalimumab, ixekizumab, secukinumab and tofacitinib on Health-Related Quality of Life (HRQOL) measured by the DLQI in adult plaque psoriatic patients with respect to the patients' race, type of used agent/placebo, agent's dosage and treatment duration as well as the DLQI score prior to and after commencement of treatment. Systematic literature searching for referential papers written in English using four databases: PubMed, EMBASE, Scopus, ClinicalTrials.gov as well as and manual searching (Google) Cochran's (Q) and I2 tests were used for evaluation of heterogeneity or the degree of variation in the true effect size estimates between the analysed studies. The standardized mean difference (the SMD; Hedge's g score) was applied to measure the differences between the two means (i.e. two groups: treated vs non-treated or treated vs placebo). The data coding and Hedge's g values were calculated according to the guidance of MetaXL software version 5.3. 43 studies, in total 25,898 individuals, were evaluated by the DLQI and weighted mean scores were derived for the analysis. The mean DLQI scores ranged from 6.83 to 17.8 with the overall DLQI score of 12.12 (95%CI: 11.24 to 13.06). A random-effects model demonstrated significant considerable heterogeneity of the study results (I2 = 98%; p<0.001). Infliximab, adalimumab, ixekizumab, secukinumab and tofacitinib in adult plaque psoriatic patients improved HRQOL measured by the DLQI. The patients with lower quality of life before treatment obtained better results.
Highlights
Psoriasis, an incurable chronic inflammatory disease affecting approximately 2% of people worldwide, with the lowest incidence in the Asian and some African populations as well as the highest rate, i.e. up to 11%, in the Caucasian and Scandinavian populations, is most commonly observed in the form of plaque psoriasis [1, 2]
Infliximab, adalimumab, ixekizumab, secukinumab and tofacitinib in adult plaque psoriatic patients improved Health-Related Quality of Life (HRQOL) measured by the Dermatology Life Quality Index (DLQI)
HRQOL measured by the DLQI–study characteristics
Summary
An incurable chronic inflammatory disease affecting approximately 2% of people worldwide, with the lowest incidence in the Asian and some African populations as well as the highest rate, i.e. up to 11%, in the Caucasian and Scandinavian populations, is most commonly observed in the form of plaque psoriasis (in 80% of all diagnosed cases) [1, 2] It is often accompanied by various comorbidities, such as psoriatic arthritis, Crohn’s disease, metabolic syndrome, cardiovascular diseases, all of which account for the psoriatic patients’ compromised quality of life frequently manifested by social withdrawal and hampered daily activities [3, 4]. Investigation of the effect of infliximab, adalimumab, ixekizumab, secukinumab and tofacitinib on Health-Related Quality of Life (HRQOL) measured by the DLQI in adult plaque psoriatic patients with respect to the patients’ race, type of used agent/placebo, agent’s dosage and treatment duration as well as the DLQI score prior to and after commencement of treatment
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