Introduction & Objectives: Moderate to severe psoriasis is associated with a significant burden of disease and negatively impacts an individual’s quality of life. Here we evaluated the patient-reported burden of illness of patients with moderate to severe psoriasis enrolled in phase 3 clinical trials of secukinumab.
Materials & Methods: Baseline data from four phase 3 trials of secukinumab were pooled for analysis. Patient-reported burden of illness was evaluated using skin-related quality of life assessed with the Dermatology Life Quality Index (DLQI) and EuroQoL 5-Dimensions visual analog scale (EQ-5D VAS). Patient-reported severity of psoriasis-related symptoms (itching, pain, and scaling) were assessed with the Psoriasis Symptom Diary (PSD). Each PSD item was completed using a 0-to-10 numeric rating scale. Descriptive statistics (mean, standard deviation and ranges for continuous variables and frequencies and percentages for categorical variables) were computed and summarized by psoriasis severity at baseline assessed by Psoriasis Area Severity Index (PASI) (moderate: PASI ≤20 or severe: PASI>20), and previous biologic therapy status (naïve or experienced).
Results: Of 2403 patients randomized across 4 trials, 1151 (48%) were classified with severe disease at baseline and were mostly male (72%) with mean age of 44 years and mean (SD) baseline PASI score of 30.3 (9.0). At baseline, most patients had previous experience with biologic therapy—severe: n=959 (83%); moderate: n=942 (75%). Patients with severe disease reported worse baseline scores than those with moderate disease: DLQI total score, 14.3 vs 12.0, respectively; mean EQ-5D VAS score, 59.1 vs 66.6; and mean psoriasis-related itching (6.7 vs 6.0), pain (5.7 vs 4.9), and scaling (6.7 vs 6.1). Among the patients with severe disease, those with previous biologic therapy were slightly younger than the naïve patients (43.9 vs 46.6), baseline PASI scores were similar (30.1 vs 30.9). Patients naive to previous biologics reported worse scores for all PRO measures than those with previous biologic therapy.
Conclusions: The burden of illness for psoriasis patients with severe disease is high. Further, patients with severe disease with no previous biologic experience report greater impact on PROs than those with previous biologic experience. Ensuring adequate treatment to achieve clear skin is essential to optimize patient outcomes.
