Real-world outcomes in 2646 psoriasis patients: one in five has PASI ≥10 and/or DLQI ≥10 under ongoing systemic therapy

Abstract

Background: Although biologics introduced a new era in psoriasis care when available a decade ago, it is unclear to what extent the available systemic treatments treat patients adequately.

Objective: To analyse the clinical severity and quality of life of the psoriasis population in Sweden treated with systemics.

Methods: Data included 2646 patients from the Swedish Registry for Systemic Treatment of Psoriasis. Average Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI) and EQ-5D were reported. A subgroup of persisting moderate-to-severe psoriasis as defined by PASI ≥10 and/or DLQI ≥10 after >12 weeks treatment was analysed.

Results: Mean (SD) PASI, DLQI and EQ-5D were 4.12 (4.57), 4.11 (5.24) and 0.79 (0.22). Eighteen percent had persisting moderate-to-severe psoriasis (n = 472). These patients were younger, had higher BMI, had psoriasis arthritis and were smoking to a larger extent (p < 0.01) compared with lower-severity patients (n = 2174). Mean (SD) EQ-5D was also considerably lower 0.63 (0.29) vs. 0.82 (0.19) (p < 0.01).

Conclusion: Almost one in every five patients had persisting moderate-to-severe psoriasis, despite ongoing systemic treatment. Both comorbidities and life style factors were associated with persisting moderate-to-severe psoriasis. The considerably lower generic quality of life in these patients demonstrates an unmet need. Subsequently, improved access to biologics and continuous drug development is needed in psoriasis.

Keywords:

• Psoriasis
• PASI
• DLQI
• EQ-5D

Acknowledgements

We would like to thank Rikard Althin and Katarina Steen Carlsson for their beneficial comments on the manuscript. We would also like to thank all patients and health care professionals for using and advancing PsoReg.

Disclosure statement

MSE is responsible for dermatology in the project management for the national guidelines for psoriasis at the Swedish Board of Health and Welfare. J.M. Norlin, P.S. Calara, U. Persson have no further conflict of interest to declare.

Ethical approval

The study has been approved by Umeå ethical review board, Sweden. The study was in accordance with the 1964 Helsinki Declaration and its later amendments. Informed consent was obtained electronically from all individual participants included in the study.

Additional information

Funding

PsoReg receives financial support from the Swedish Board of Health and Welfare, Swedish Association of Local Authorities and Regions and Västerbotten County Council. The research has received financial support from Celgene, Eli Lilly, Janssen Cilag and Novartis. Sponsors had no access to data. None of the authors has any conflict of interest in connection to the article. The authors had full independence regarding data collection, manuscript preparation, decision to publish, study design, interpretation and analysis.