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Impact of psoriasis severity on patient-reported clinical symptoms, health-related quality of life and work productivity among US patients: real-world data from the Corrona Psoriasis Registry

OBJECTIVES: This analysis examined the association between psoriasis severity, assessed by body surface area (BSA) and the Investigator’s Global Assessment (IGA; previously used only in clinical trials), and patient-reported outcomes (PROs) in a real-world setting. DESIGN: Cross-sectional analysis w...

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Autores principales: Strober, Bruce, Greenberg, Jeffrey D, Karki, Chitra, Mason, Marc, Guo, Ning, Hur, Peter, Zhao, Yang, Herrera, Vivian, Lin, Feng, Lebwohl, Mark
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500315/
https://www.ncbi.nlm.nih.gov/pubmed/31005939
http://dx.doi.org/10.1136/bmjopen-2018-027535
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author Strober, Bruce
Greenberg, Jeffrey D
Karki, Chitra
Mason, Marc
Guo, Ning
Hur, Peter
Zhao, Yang
Herrera, Vivian
Lin, Feng
Lebwohl, Mark
author_facet Strober, Bruce
Greenberg, Jeffrey D
Karki, Chitra
Mason, Marc
Guo, Ning
Hur, Peter
Zhao, Yang
Herrera, Vivian
Lin, Feng
Lebwohl, Mark
author_sort Strober, Bruce
collection PubMed
description OBJECTIVES: This analysis examined the association between psoriasis severity, assessed by body surface area (BSA) and the Investigator’s Global Assessment (IGA; previously used only in clinical trials), and patient-reported outcomes (PROs) in a real-world setting. DESIGN: Cross-sectional analysis within the Corrona Psoriasis Registry, an independent, prospective registry. SETTING: 70 dermatology practices in the USA. PARTICIPANTS: 1529 adult patients with psoriasis being treated with biological or non-biological systemic psoriasis treatment by 31 May 2016. PRIMARY AND SECONDARY OUTCOME MEASURES: Psoriasis severity was assessed by percentage of affected BSA (mild (0%–5%), moderate (>5%–10%), severe (>10%–15%), very severe (>15%)) and IGA scores (clear/almost clear (0–1), mild (2), moderate (3), severe (4)). PROs (pain, itch, fatigue; Dermatology Life Quality Index [DLQI]; EuroQoL Visual Analogue Scale [EQ-VAS]; Work Productivity and Activity Impairment [WPAI]) were compared across BSA and IGA levels using analysis of variance and X(2) tests. The association between psoriasis severity and PROs was examined using multivariable regression models. RESULTS: The mean age was 50.6 years and 47% of patients were female. Consistently with more severe psoriasis, symptoms worsened, DLQI scores increased (p<0.05 for each level of BSA and IGA), EQ-VAS decreased (p<0.05 for each level of BSA and IGA) and WPAI scores increased. By BSA score, moderate to very severe psoriasis was associated with poorer outcomes for the ‘impairment while working’ and ‘daily activities impaired’ WPAI domains (all p<0.05 vs mild psoriasis). Very severe psoriasis was associated with increased ‘work hours missed’ and ‘work hours affected’ (both p<0.05 vs mild psoriasis) Findings were similar by IGA. Results were confirmed by multivariable regression analyses. CONCLUSIONS: In a real-world setting, more severe psoriasis, assessed by BSA and IGA, was consistently associated with worse PROs.
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spelling pubmed-65003152019-05-21 Impact of psoriasis severity on patient-reported clinical symptoms, health-related quality of life and work productivity among US patients: real-world data from the Corrona Psoriasis Registry Strober, Bruce Greenberg, Jeffrey D Karki, Chitra Mason, Marc Guo, Ning Hur, Peter Zhao, Yang Herrera, Vivian Lin, Feng Lebwohl, Mark BMJ Open Dermatology OBJECTIVES: This analysis examined the association between psoriasis severity, assessed by body surface area (BSA) and the Investigator’s Global Assessment (IGA; previously used only in clinical trials), and patient-reported outcomes (PROs) in a real-world setting. DESIGN: Cross-sectional analysis within the Corrona Psoriasis Registry, an independent, prospective registry. SETTING: 70 dermatology practices in the USA. PARTICIPANTS: 1529 adult patients with psoriasis being treated with biological or non-biological systemic psoriasis treatment by 31 May 2016. PRIMARY AND SECONDARY OUTCOME MEASURES: Psoriasis severity was assessed by percentage of affected BSA (mild (0%–5%), moderate (>5%–10%), severe (>10%–15%), very severe (>15%)) and IGA scores (clear/almost clear (0–1), mild (2), moderate (3), severe (4)). PROs (pain, itch, fatigue; Dermatology Life Quality Index [DLQI]; EuroQoL Visual Analogue Scale [EQ-VAS]; Work Productivity and Activity Impairment [WPAI]) were compared across BSA and IGA levels using analysis of variance and X(2) tests. The association between psoriasis severity and PROs was examined using multivariable regression models. RESULTS: The mean age was 50.6 years and 47% of patients were female. Consistently with more severe psoriasis, symptoms worsened, DLQI scores increased (p<0.05 for each level of BSA and IGA), EQ-VAS decreased (p<0.05 for each level of BSA and IGA) and WPAI scores increased. By BSA score, moderate to very severe psoriasis was associated with poorer outcomes for the ‘impairment while working’ and ‘daily activities impaired’ WPAI domains (all p<0.05 vs mild psoriasis). Very severe psoriasis was associated with increased ‘work hours missed’ and ‘work hours affected’ (both p<0.05 vs mild psoriasis) Findings were similar by IGA. Results were confirmed by multivariable regression analyses. CONCLUSIONS: In a real-world setting, more severe psoriasis, assessed by BSA and IGA, was consistently associated with worse PROs. BMJ Publishing Group 2019-04-20 /pmc/articles/PMC6500315/ /pubmed/31005939 http://dx.doi.org/10.1136/bmjopen-2018-027535 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Dermatology
Strober, Bruce
Greenberg, Jeffrey D
Karki, Chitra
Mason, Marc
Guo, Ning
Hur, Peter
Zhao, Yang
Herrera, Vivian
Lin, Feng
Lebwohl, Mark
Impact of psoriasis severity on patient-reported clinical symptoms, health-related quality of life and work productivity among US patients: real-world data from the Corrona Psoriasis Registry
title Impact of psoriasis severity on patient-reported clinical symptoms, health-related quality of life and work productivity among US patients: real-world data from the Corrona Psoriasis Registry
title_full Impact of psoriasis severity on patient-reported clinical symptoms, health-related quality of life and work productivity among US patients: real-world data from the Corrona Psoriasis Registry
title_fullStr Impact of psoriasis severity on patient-reported clinical symptoms, health-related quality of life and work productivity among US patients: real-world data from the Corrona Psoriasis Registry
title_full_unstemmed Impact of psoriasis severity on patient-reported clinical symptoms, health-related quality of life and work productivity among US patients: real-world data from the Corrona Psoriasis Registry
title_short Impact of psoriasis severity on patient-reported clinical symptoms, health-related quality of life and work productivity among US patients: real-world data from the Corrona Psoriasis Registry
title_sort impact of psoriasis severity on patient-reported clinical symptoms, health-related quality of life and work productivity among us patients: real-world data from the corrona psoriasis registry
topic Dermatology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500315/
https://www.ncbi.nlm.nih.gov/pubmed/31005939
http://dx.doi.org/10.1136/bmjopen-2018-027535
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