BACKGROUND: Psoriasis is a chronic inflammatory condition that diminishes patients’ quality of life (QoL; Armstrong AW, et al. Adv Ther 2022).
OBJECTIVE: This study aimed to assess and compare the humanistic burden in patients with moderate to severe psoriasis.
METHODS: In this non-interventional, cross-sectional survey study conducted in adult patients with moderate to severe psoriasis in the United States, patients were grouped based on treatment at the time of the survey. The survey collected demographics, clinical characteristics and outcomes associated with humanistic burden, via the Dermatology Life Quality Index (DLQI), the Work Productivity and Activity Impairment Questionnaire–Psoriasis (WPAI-PSO), and additional questions on disease-related anxiety and depression. Data were analyzed descriptively; bivariate comparisons evaluated differences across treatment groups.
RESULTS: The study included 882 patients (mean age, 45.7 [±12.8] years; female, 67.7%; White, 74.9%), 92.8% of whom were currently receiving treatment (mean duration, 2.9 [±4.8] years). Of all patients, 76.8% reported experiencing anxiety and 57.4% reported experiencing depression over the past 30 days because of their psoriasis. Compared with other treatment groups, patients in the untreated/nonprescription group experienced more depression (78.0%) and anxiety (94.0%). The topical/phototherapy and untreated/nonprescription groups had the smallest percentage of patients who believed their anxiety decreased (either definitely or probably) since initiating their current treatment (26.5% and 27.8%, respectively). Similar results were seen for depression, with 23.4% of topical/phototherapy users and 27.7% of the exploratory group reporting that their depression decreased since starting treatment. Compared with TNFi and ustekinumab users, apremilast users reported lower reduction in depression (50.4%. 52.1%, and 43.6%, respectively; all P<0.001). Mean (SD) DLQI global score overall was 8.9 (7.2). Ustekinumab users had the lowest DLQI score (7.6 [6.9]), indicating better QoL, compared with 8.1 (7.2) for apremilast users, 8.8 (7.6) for TNFi users, 10.3 (5.7) for topical/phototherapy users, and 11.3 (7.3) for the untreated/nonprescription group (P<0.001). Among the 528 employed patients, the mean (SD) absenteeism score was 6.0 (14.3), presenteeism score was 25.4 (24.3), total work productivity impairment score was 27.9 (26.8), and the activity impairment score was 29.3 (25.4). Patients in the topical/phototherapy and exploratory groups and those receiving TNFis indicated worse productivity than those receiving apremilast or ustekinumab.
CONCLUSIONS: Patients’ current treatment, or lack thereof, influences how psoriasis affects QoL, anxiety, depression, and productivity.
