INTRODUCTION & OBJECTIVES: Patients with psoriasis (PsO) experience decreased health-related quality of life due to the physical and psychological burdens; however, limited data are available to understand the extent to which changes in the severity of clinical outcomes correlate with changes in dermatology-specific quality of life. This retrospective pooled analysis assessed the correlation of the change between Psoriasis Area and Severity Index (PASI) score and select Dermatology Life Quality Index (DLQI) domains in patients with moderate-to-severe PsO and those with PsO and comorbid psoriatic arthritis (PsA).
MATERIALS & METHODS: This post-hoc analysis of four phase III clinical trials (ERASURE [NCT01365455], FIXTURE [NCT01358578], FEATURE [NCT01555125], and JUNCTURE [NCT01636687]) included patients with moderate-to-severe PsO randomized to secukinumab 150/300 mg, etanercept, or placebo. PASI and DLQI scores collected at each time point (from screening to Week 52) were analyzed using latent growth models, which estimate the overall trend of change (growth trajectory) for each individual patient across all timepoints simultaneously. Pairwise models were applied to assess the correlation between change in PASI scores (range 0–72) and changes in 3 DLQI domains (daily activities, leisure activities, and symptoms/feelings; range 0–6 for each domain). These 3 DLQI domains have been previously identified as having the most salience to patient experience and quality of life.1 The models controlled for previous biologic therapy, presence of PsA at baseline, weight (< 80 kg or ≥ 80 kg), and smoking history. The initial (baseline to Week 12) and sustained (> Week 12 to Week 52) treatment exposures were assessed. Correlations between changes in PASI and DLQI were analyzed by population type (total, PsO-only, and PsO with comorbid PsA) and by treatment arm (secukinumab, etanercept, or placebo).
RESULTS: Among the total population, PASI change was positively correlated with change in each assessed DLQI domain; correlations were moderate over the initial treatment exposure period (β range 0.3–0.4, all P < 0.001) and strong over the sustained exposure period (β range 0.6–0.7, all P < 0.001). Similar trends were observed regardless of the presence of comorbid PsA. These relationships were confirmed among patients treated with secukinumab, etanercept, or placebo, although the strength of relationship varied by treatment.
CONCLUSIONS: In patients with moderate-to-severe PsO, improvements in PASI scores were directly related to improvements in DLQI domains from initiation of treatment and extended over time, regardless of presence of comorbid PsA or treatment received.
