Abstract

BackgroundPlaque psoriasis significantly affects patients’ health-related quality of life. To aid treatment decisions, not only objective assessment by physicians but also subjective assessment by patients is important. ObjectiveTo assess the significance of Dermatology Life Quality Index (DLQI) evaluation at the time of biologics introduction in clinical practice in Japanese patients with plaque psoriasis. MethodsThis was a single-arm, open-label, multicenter study. At baseline, Psoriasis Area and Severity Index (PASI) and DLQI scores were measured and stratified based on DLQI scores ≥6/≤5 and PASI scores ≤10/>10. Other patient-reported outcomes assessed included EQ-5D-5L, itch numerical rating scale (NRS), skin pain NRS, Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-8 (PHQ-8), Sleep Problem Index-II (SPI-II), and Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9). ResultsOf the 73 enrolled patients, 23 had PASI scores ≤10. Those with PASI/DLQI scores >10/≥6 had a significantly higher median PASI score than those with PASI/DLQI scores >10/≤5 (p = 0.0125). Regardless of PASI scores (>10/≤10), median itch NRS and GAD-7 scores were significantly higher in patients with DLQI scores ≥6 than in those with DLQI scores ≤5 (itch NRS, p = 0.0361 and p = 0.0086, respectively; GAD-7, p = 0.0167 and p = 0.0273, respectively). Patients with PASI/DLQI scores ≤10/≥6 had significantly higher skin pain NRS (p = 0.0292) and PHQ-8 (p = 0.0255) scores and significantly lower median SPI-II scores (p = 0.0137) and TSQM-9 Effectiveness domain scores (p = 0.0178) than those with PASI/DLQI scores ≤10/≤5. ConclusionDLQI may be useful for assessing patients’ concerns that cannot be identified by PASI alone while initiating biologics or switching from other biologics in clinical practice.

Highlights

  • Psoriasis is a chronic, multisystem, inflammatory disease with an estimated prevalence of 0.34 %–3.2 % worldwide [1,2,3]

  • Psoriasis Area and Severity Index (PASI) score is considered the gold standard for assessing the severity of psoriasis and is widely used by clinicians, while Dermatology Life Quality Index (DLQI) is evaluated by patients using a questionnaire and measures the impact of psoriasis on their health-related quality of life (HRQoL) [7]

  • As monotherapy or in combination with other topical or systemic medications, have a high benefit-to-risk ratio [5] and have significantly changed the approach toward psoriasis management owing to their high efficacy (PASI 90 or above, i.e., 90 % reduction in PASI scores) and acceptable safety profiles [8,9]

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Summary

Introduction

Multisystem, inflammatory disease with an estimated prevalence of 0.34 %–3.2 % worldwide [1,2,3]. 75 % of patients experience a significant negative impact on their health-related quality of life (HRQoL) owing to psoriasis [4]. PASI score is considered the gold standard for assessing the severity of psoriasis and is widely used by clinicians, while DLQI is evaluated by patients using a questionnaire and measures the impact of psoriasis on their HRQoL [7]. Plaque psoriasis significantly affects patients’ health-related quality of life. Objective: To assess the significance of Dermatology Life Quality Index (DLQI) evaluation at the time of biologics introduction in clinical practice in Japanese patients with plaque psoriasis. Other patient-reported outcomes assessed included EQ-5D-5L, itch numerical rating scale (NRS), skin pain NRS, Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-8 (PHQ-8), Sleep Problem Index-II (SPI-II), and Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9).

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