A systematic literature review to compare quality of life in psoriasis with other chronic diseases using EQ-5D-derived utility values

BACKGROUND: Psoriasis is a chronic, immune-mediated dermatological disease associated with substantial economic, clinical, and humanistic burden. OBJECTIVE: The aim of this study was to understand the disutility of patients with psoriasis vulgaris, using mean baseline EuroQoL five dimensions (EQ-5D) index scores reported in the published literature, and to compare this to patients with other chronic diseases. METHODS: Two systematic literature searches were conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Searches were conducted in ten databases including Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials (CENTRAL). The first search (December 2013) used search terms psoria* AND (EQ5D OR EQ OR EUROQoL). Only publications of original research, which reported baseline EQ-5D scores for mild/moderate/severe psoriasis, were included. The second search (March 2014) used the terms (systematic review) AND (EQ5D OR EQ 5D OR EuroQoL). Titles were screened by two independent reviewers. Four independent reviewers reviewed titles and full-length papers. EQ-5D scores for psoriasis patients were qualitatively compared with scores from patients with other chronic diseases identified through the literature search. RESULTS: Of 133 publications on psoriasis, 12 met the inclusion criteria. The mean EQ-5D index scores for psoriasis (all severities) ranged from 0.52 (standard deviation: 0.39) to 0.9 (standard deviation: 0.1). Of the 48 results from the second search, six met the inclusion criteria. The reported EQ-5D lower limit for other diseases ranged from 0.20 (Type 2 diabetes mellitus) to 0.66 (liver diseases). The highest EQ-5D estimates for other diseases ranged from 0.79 (liver diseases) to 0.93 (cancer patients). Both lower and upper EQ-5D estimates in psoriasis patients were within the range of those reported for other chronic diseases. CONCLUSION: Comparative studies of morbidity are relevant in health care studies and patient advocacy. This systematic review demonstrates that the ranges of disutility among psoriasis patients are within the ranges of other chronic diseases (cardiovascular diseases, diabetes, end-stage renal diseases, liver diseases, cancer, and visual disorders).