Assessment of the benefit of achieving complete versus almost complete skin clearance in psoriasis: a patient’s perspective

Abstract

Background

Psoriasis is characterized by thick and scaly plaques. The Dermatology Life Quality Index (DLQI) and Physician Global Assessment (PGA) can be used to define its severity.

Objective

To assess the impact of complete clearance of skin versus almost clear skin across various disease measures.

Methods

Data were collected in a survey of US dermatologists and patients with psoriasis from November 2016–January 2017. Dermatologists completed a 6-point PGA (0 = clear skin, 1 = almost clear skin). Patients completed the DLQI and Work Productivity and Activity Impairment questionnaire (WPAI). Patients with clear and almost clear skin were compared using analysis of covariance for continuous variables, and multivariate logistic regression analysis for categorical variables.

Results

Data for 99 and 160 patients with clear and almost clear skin, respectively, were included in the analyses. Patients with clear skin reported less frequent and lower intensity itching, lower total DLQI score (indicating better health-related quality of life), and less impairment of overall work productivity than patients with almost clear skin (all: p < 0.05).

Limitations

Limitations relating to general survey methodology.

Conclusion

Patients perceived a meaningful difference between clear and almost clear skin. Clear skin is now a realistic treatment target with newer biologics approved in psoriasis.

Keywords:

• Psoriasis
• quality of life
• physician global assessment
• patient reported
• clear skin
• skin clearance

Acknowledgments

The authors thank all patients and physicians who participated in the Adelphi Real World Psoriasis Disease Specific Program.

Declarations

IRB exemption was granted for this study through Western IRB under the US Department of Health & Human Services. Prior to participation in any study-related activities, patients consented to participate in the study by signing the Adelphi Real World informed consent form. This written consent complies with HIPAA and equivalent EU guidelines (43–45).

Disclosure statement

Neil J Korman is a Professor of Dermatology at University Case Medical Center; he has been an investigator and speaker for Lilly, and has received honoraria for his participation in this project; has also served on the advisory board for AbbVie, Celgene, Genentech, Glaxo, Immune Pharma, Janssen, Principia, Regeneron, and Sun and Valeant; has been a speaker for AbbVie, Janssen, Novartis and Regeneron; and an investigator for Celgene, Dermira, Leo, Merck, Pfizer, Prothena, Regeneron, Rhizen, Syntimmune and UCB, receiving grants, honoraria and residency/fellowship program funding.

William Malatestinic, Orin M Goldblum, Mwangi J Murage, Lisa Renda and Chen-Yen Lin are employed by, and hold stock in, Lilly USA, LLC, who funded this study.

James Lucas, Chloe Middleton and Steven Lobosco are employed by Adelphi Real World.

Data availability statement

Data collection was undertaken by Adelphi Real World as part of a syndicated survey, entitled the Psoriasis Disease Specific Program (DSP), subscribed to by multiple pharmaceutical companies of which one was Lilly USA, LLC. Lilly did not influence the original survey through either contribution to the design of questionnaires or data collection. The analysis described here using data from the Psoriasis DSP was funded by Lilly, and all authors contributed to the analysis and interpretation of the data, the writing of the manuscript and the decision to submit it for publication.<\FS>

IRB approval/exemption statement

The study has been reviewed and exempted by IRB.

Additional information

Funding

Medical writing support under the guidance of the authors was provided by Carole Evans, PhD on behalf of Adelphi Real World, and was funded by Lilly USA, LLC, in accordance with Good Publication Practice (GPP3) guidelines (Ann Intern Med 2015;163:461-464).