INTRODUCTION & OBJECTIVES: Various treatments for psoriasis are available, yet evidence reveals substantial humanistic burden remains. This study assessed the humanistic burden among patients with moderate to severe psoriasis.
MATERIALS & METHODS: This non-interventional, cross-sectional survey study in adult patients with moderate to severe psoriasis in the USA grouped patients based on treatment at time of 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 questions on disease-related anxiety and depression.
RESULTS: Within this study population of 882 patients, 92.8% were currently receiving treatment (mean duration=2.9 [±4.8] years). Over the past 30 days, 76.8% experienced anxiety and 57.4% experienced depression due to psoriasis. Of the 677 patients with anxiety due to psoriasis, 58.6%, 20.5%, and 12.6% experienced it for several days, more than half the days, and nearly every day, respectively. Of 506 patients who experienced depression due to psoriasis, 67.2%, 16.4%, and 8.5% experienced it for several days, more than half the days, and nearly every day, respectively. Compared with other treatment groups, patients in the untreated/nonprescription group experienced more depression (78.0%) and anxiety (94.0%). Topical/phototherapy and untreated/nonprescription groups had the smallest percentage of patients who believed their anxiety had decreased (yes definitely, probably yes) 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%, 43.6% respectively) (all P <0.001). Mean DLQI global score overall was 8.9. Ustekinumab users had the lowest DLQI score (7.6), indicating better quality of life (QoL), compared with 8.1 for apremilast users, 8.8 for TNFi users, 10.3 for topical/phototherapy users, and 11.3 for the untreated/nonprescription group (P<0.001). DLQI scores increased with psoriasis severity (P<0.001). Of 528 employed patients, the mean absenteeism score was 6.0, presenteeism score was 25.4, total work productivity impairment score was 27.9, and activity impairment score was 29.3. Topical/phototherapy and exploratory group patients and those receiving TNFis had greater presenteeism and activity impairment scores, indicating worse productivity, than those receiving apremilast or ustekinumab.
CONCLUSIONS: Patients’ current treatment, or lack thereof, influences how psoriasis impacts QoL, anxiety and depression, and productivity. We recommend physicians consider QoL in addition to symptom management when making treatment decisions.
