Treatment goals and preferences of pediatric psoriasis patients, young adults, and parents

Figures & data

Table 1. Respondent characteristics.

Characteristic	Pediatric patients^a (n = 64)	Young adults^b (n = 131)	All young patients^c (n = 195)	Parents^d (n = 45)
Age patient, years, mean (SD)	12.8 (3.3)	23.8 (3.8)	20.2 (6.3)	12.3 (5.3)
Gender patients, n (%) female	39 (60.9)	96 (73.3)	135 (69.2)	28 (62.2)
Age parent, years, mean (SD)	–	–	–	44.4 (7.3)
Parents relation to child
Mother	–	–	–	39 (86.6)
Father	–	–	–	6 (13.3)
Psoriasis duration
<5 years	41 (65.1)	25 (19.4)	66 (34.4)	26 (57.8)
≥5 years	22 (34.9)	104 (80.6)	126 (65.6)	19 (42.2)
Self-reported psoriasis severity^A, mean (SD)	4.1 (2.5)	4.7 (2.4)	4.5 (2.5)	5.0 (3.2)
Treating practitioner, n (%)
Dermatologist	61 (95.3)	98 (74.8)	159 (81.5)	44 (97.8)
General practitioner	1 (1.6)	10 (7.6)	11 (5.6)	0 (0.0)
No practitioner	2 (3.1)	23 (17.6)	25 (12.9)	1 (2.2)
Psoriasis type^B
Plaque psoriasis	59 (92.2)	113 (86.3)	172 (88.2)	43 (95.6)
Pustular psoriasis	0 (0.0)	7 (5.3)	7 (3.6)	2 (4.4)
Scalp psoriasis	58 (90.6)	112 (85.5)	170 (87.2)	37 (82.2)
Inverse psoriasis	19 (29.7)	44 (33.6)	63 (32.3)	17 (37.8)
Genital psoriasis	22 (34.4)	40 (30.5)	62 (31.8)	19 (42.2)
Psoriatic arthritis	1 (1.6)	24 (18.3)	25 (12.8)	3 (6.7)
Psoriasis unguium	10 (15.6)	34 (26.0)	44 (22.6)	5 (11.1)
Lesions visible for others	40 (62.5)	88 (67.2)	128 (65.6)	34 (75.6)
Current therapy^B
No treatment	6 (9.4)	12 (9.2)	18 (8.7)	5 (11.1)
Topical treatment^C	47 (73.4)	90 (68.7)	137 (70.3)	30 (66.7)
UV therapy	1 (1.6)	5 (3.8)	6 (3.1)	1 (2.2)
Conventional systemic treatment^D	13 (20.3)	22 (16.8)	35 (17.9)	10 (22.2)
Biologics^E	3 (4.7)	32 (24.4)	35 (17.9)	6 (13.3)

^aAged ≥6 to ≤17 years.

^bAged ≥18 to ≤30 years.

^cPediatric patients and young adults combined.

^dParent of a child (n = 44) or children (n = 1) with psoriasis, reporting about their children.

^APatients reported disease severity on a scale from 0 (very mild) to 10 (very severe).

^BMultiple answers could be given by a single respondent, therefore the sum of the percentages shown is not 100%.

^CIncluding emollients, corticosteroids, dithranol, vitamin D derivates, calcineurin inhibitors, and coal tar.

^DIncluding methotrexate, fumaric acid esters, cyclosporin, and acitretin.

^EBiologics and small molecule inhibitors (n = 1) were grouped together.

Figure 1. Main treatment goals (A) and main treatment characteristic preferences (B) of young psoriasis patients and parents. Respondents mentioned their most important treatment goal (A) and their most important treatment characteristic (B) preference out of a predefined list of items. Each respondent mentioned one treatment goal and one treatment characteristic.

Table 2. Treatment goals and characteristic preferences of pediatric patients compared to young adult patients and parents.

Item	Pediatric patients^a				Young adult patients^b				p Value^C	Parents^c				p Value^D	All respondents^d
	n	Mean (SD)	Important^A (%)	NA^B, n	n	Mean (SD)	Important^A (%)	NA^B, n		n	Mean (SD)	Important^A (%)	NA^B, n		n	Mean (SD)	Important^A (%)	NA^B, n
Treatment goals
Preventing new psoriasis lesions	61	2.61 (0.71)	93.4	2	123	2.75 (0.52)	95.9	0	.197	45	2.69 (0.51)	96.2	0	.831	229	2.70 (0.58)	95.6	2
Reduction of psoriasis lesions	61	2.66 (0.68	95.1	1	123	2.63 (0.58)	96.7	1	.452	45	2.67 (0.48)	100.0	0	.545	229	2.65 (0.59)	96.9	2
No itch	61	2.34 (0.87)	86.9	4	123	2.48 (0.72)	93.5	2	.439	45	2.71 (0.59)	97.8	1	.015	229	2.49 (0.75)	92.6	7
No psoriasis lesions	60	2.40 (0.94)	81.7	1	123	2.28 (0.87)	78.9	1	.216	44	2.30 (0.73)	88.6	–	.145	227	2.32 (0.87)	81.5	2
Feeling more confident	61	1.48 (1.26)	54.1	19	123	2.10 (1.08)	74.0	12	.001	45	1.78 (1.30)	66.7	14	.213	229	1.87 (1.20)	67.3	45
Living a normal everyday life	61	1.59 (1.35)	57.4	23	123	1.71 (1.22)	64.2	33	.728	45	2.04 (1.24)	75.6	11	.092	229	1.74 (1.26)	64.6	67
Better functioning at school or work	61	1.05 (1.22)	42.6	33	123	1.70 (1.20)	62.6	32	.001	45	1.89 (1.23)	73.3	12	.001	229	1.56 (1.25)	59.4	77
Better quality of sleep	61	1.23 (1.26)	49.2	28	123	1.63 (1.21)	63.4	37	.045	44	1.50 (1.29)	59.1	17	.278	228	1.50 (1.24)	58.8	82
Not being different from peers	61	1.56 (1.34)	55.7	16	123	1.32 (1.14)	43.1	23	.249	36	1.80 (1.10)	68.9	9	.497	229	1.48 (1.20)	51.5	48
Being less of a burden to family and friends	39	1.15 (1.23)	46.2	16	123	1.59 (1.12)	59.3	28	.050	44	1.39 (1.35)	52.3	19	.391	206	1.46 (1.20)	55.3	63
Being able to have a normal sex life/being intimate	39	0.77 (1.14)	33.3	24	123	1.58 (1.26)	57.7	37	.000	–	–	–	–	–	162	1.38 (1.28)	51.9	61
Less bullying because of skin	60	0.53 (0.93)	16.7	38	123	1.43 (1.22)	49.6	32	.000	44	1.27 (1.26)	50.0	20	.002	227	1.16 (1.22)	41.0	90
Being able to have more contact with peers	60	1.02 (1.17)	38.3	27	123	1.11 (1.12)	39.0	35	.493	44	1.41 (1.25)	54.5	17	.109	227	1.15 (1.16)	41.9	79
Feeling less depressed or sad	61	0.90 (1.17)	29.5	28	70	0.96 (1.13)	30.9	53	.643	44	1.07 (1.11)	40.9	17	.398	228	0.96 (1.13)	32.5	98
Less joint pain	60	0.53 (0.98)	21.7	44	50	0.85 (1.19)	30.9	73	.077	43	0.67 (1.09)	27.9	30	.520	226	0.73 (1.12)	27.9	147
Treatment characteristics
Safe on long-term	38	2.63 (0.49)	100.0	–	121	2.60 (0.57)	95.9	–	.981	45	2.84 (0.37)	100.0	–	.027	204	2.66 (0.52)	97.5	–
High effectiveness	59	2.54 (0.50)	100.0	–	121	2.55 (0.52)	99.2	–	.924	45	2.49 (0.51)	100.0	–	.590	225	2.53 (0.51)	99.6	–
Safe on short-term	38	2.34 (0.63)	97.4	–	121	2.45 (0.59)	95.0	–	.368	45	2.62 (0.49)	100.0	–	.033	204	2.47 (0.58)	96.6	–
Can be used for a long time	38	2.18 (0.61)	89.5	–	121	2.29 (0.70)	89.3	–	.268	45	2.36 (0.65)	91.1	–	.189	204	2.28 (0.67)	89.7	–
No side effects	59	2.07 (0.83)	79.7	–	121	2.06 (0.69)	79.3	–	.655	45	2.38 (0.61)	93.3	–	.065	225	2.12 (0.72)	82.2	–
Consumes little time	59	1.97 (0.91)	67.8	–	121	2.06 (0.80)	77.7	–	.569	45	1.76 (0.74)	66.7	–	.182	225	1.97 (0.82)	72.9	–
Not sticky/greasy^E	59	2.07 (0.91)	76.3	–	121	2.00 (0.91)	75.2	–	.629	45	1.69 (0.87)	64.4	–	.025	225	1.96 (0.91)	73.3	–
Quick results	59	2.14 (0.78)	79.7	–	121	1.91 (0.81)	69.4	–	.074	45	1.73 (0.72)	57.8	–	.006	225	1.93 (0.79)	69.8	–
Easy to travel with	59	1.93 (0.81)	71.2	–	121	1.88 (0.81)	74.4	–	.809	45	1.64 (0.74)	57.8	–	.061	225	1.85 (0.80)	70.2	–
No/few blood samples needed	59	1.95 (1.00)	62.7	–	121	1.28 (0.97)	36.4	–	.000	45	1.47 (0.79)	42.2	–	.009	225	1.49 (0.98)	44.4	–
No/few hospital visits	59	1.54 (0.90)	50.8	–	121	1.33 (0.86)	42.1	–	.147	45	1.22 (0.74)	31.1	–	.055	225	1.36 (0.85)	42.2	–
Not expensive	38	1.29 (0.96)	42.1	–	121	1.42 (0.97)	50.4	–	.445	45	1.20 (0.73)	33.3	–	.704	204	1.35 (0.92)	45.1	–
Can be used during conception and pregnancy	–	–	–	–	121	1.48 (1.13)	49.6	–	–	44	0.95 (1.08)	36.4	–	–	165	1.34 (1.14)	46.1	–
Can be used in combination with alcohol/drugs	38	0.71 (0.93)	15.8	–	121	1.21 (0.94)	38.0	–	.003	44	0.75 (0.92)	18.2	–	.799	203	1.01 (0.96)	29.6	–

Respondents scored the relevance of treatment goals and characteristics on a 4-point Likert scale, corresponding with the following scores: 0 = not important or not applicable, 1 = not really important, 2 = important, 3 = very important. Means (SD) are presented to improve comprehensibility of the outcomes. Goals and characteristics are sorted by overall importance.

^aPatients aged ≥6 to ≤17 years, mean age 12.8 ± 3.4 years.

^bPatients aged ≥18 to ≤30 years, mean age 23.6 ± 3.7 years.

^cParents of young psoriasis patients, reporting their children to be aged 12.3 ± 5.3 years. Parents reported their own perceived importance.

^dAll young patients and parents combined.

^APercentage of respondents that rated the item 2 (important) or 3 (very important).

^BNumber of respondents that filled out ‘not applicable’.

^CMean scores on the Likert scales are compared between pediatric patients and young adult patients using a Mann–Whitney U test.

^DMean scores on the Likert scales are compared between pediatric patients and parents using a Mann–Whitney U test.

^ERegarding topical therapy.