Introduction/Aim. Psoriasis is a chronic, relapsing, non-infectious dermatosis, affecting patients' quality of life. There is still insufficient evidence from routine clinical practice on how the biological therapy improves the quality of life of patients with psoriasis. The aim of our study was to examine the effectiveness of biological therapy, regardless of the drug type, on health-related quality of life (HRQoL) in patients with psoriasis. Methods. We performed a prospective observational pilot study at the Clinic of Dermatovenerology, University Clinical Center Niš in the period from from October 1, 2019 to March 1, 2020. The study involved 29 patients with psoriasis vulgaris (11 females, 18 males) on biological therapeutics regardless of the type of the drug. The severity of psoriatic lesions and the patient's response to treatment was assessed using the Psoriasis Area and Severity Index (PASI) before the treatment with secukinumab and ustekinumab and after 10 weeks. Dermatology Life Quality Index (DLQI) was determined at the beginning of biological treatment as well as after 10 weeks. Results. The average age of participants was 49.69 ± 12.75 years and the sample consisted mainly of men (62.1%). The average disease duration among men was 16.44 ± 10.05 years, and among women 17.82 ± 12.79 years. The mean DLQI decreased from 15.62 ± 7.79 to 6.34 ± 7.19 after biological treatment. The initial mean PASI and DLQI scores differed significantly from the average control scores (t-test for paired samples, p < 0.0001). Conclusion. Biological therapies of psoriasis, in addition to improving the clinical picture, demonstrated an improvement in the patients' HRQoL very quickly and they should be considered during evaluating the benefits and risks of this type of therapy.
References
1.
van Lümig PPM, van de Kerkhof PCM, Boezeman JBM, Driessen RJB, de Jong EMGJ. Adalimumab therapy for psoriasis in real‐world practice: efficacy, safety and results in biologic‐naïve vs. non‐naïve patients. Journal of the European Academy of Dermatology and Venereology. 2013;27(5):593–600.
2.
Hjalte F, Carlsson KS, Schmitt‐Egenolf M. Sustained Psoriasis Area and Severity Index, Dermatology Life Quality Index and EuroQol‐5D response of biological treatment in psoriasis: 10 years of real‐world data in the Swedish National Psoriasis Register. British Journal of Dermatology. 2018;178(1):245–52.
3.
Jungo P, Maul JT, Djamei V, von Felten S, Kolios AGA, Czernielewsk J, et al. Superiority in Quality of Life Improvement of Biologics over Conventional Systemic Drugs in a Swiss Real-Life Psoriasis Registry. Dermatology. 2016;232(6):655–63.
4.
Iskandar IYK, Ashcroft DM, Warren RB, Lunt M, McElhone K, Smith CH, et al. Comparative effectiveness of biological therapies on improvements in quality of life in patients with psoriasis. British Journal of Dermatology. 2017;177(5):1410–21.
5.
Foley P, Spelman L, Murrell DF, Mate E, Tronnberg R, Lowe PM. Secukinumab treatment showed improved quality of life in patients with chronic plaque psoriasis in Australia: Results from the <scp>HOPE</scp> study. Australasian Journal of Dermatology. 2022;63(3):312–20.
6.
Norris D, Photiou L, Tacey M, Dolianitis C, Varigos G, Foley P, et al. Biologics and dermatology life quality index (DLQI) in the Australasian psoriasis population. Journal of Dermatological Treatment. 2017;28(8):731–6.
7.
Frieder J, Kivelevitch D, Fiore CT, Saad S, Menter A. The impact of biologic agents on health-related quality of life outcomes in patients with psoriasis. Expert Review of Clinical Immunology. 2018;14(1):1–19.
8.
Basra MKA, Salek MS, Camilleri L, Sturkey R, Finlay AY. Determining the Minimal Clinically Important Difference and Responsiveness of the Dermatology Life Quality Index (DLQI): Further Data. Dermatology. 2015;230(1):27–33.
9.
Hongbo Y, Thomas CL, Harrison MA, Sam Salek M, Finlay AY. Translating the Science of Quality of Life into Practice: What Do Dermatology Life Quality Index Scores Mean? Journal of Investigative Dermatology. 2005;125(4):659–64.
10.
Badia, Mascaró, Lozano. Measuring health-related quality of life in patients with mild to moderate eczema and psoriasis: clinical validity, reliability and sensitivity to change of the DLQI. British Journal of Dermatology. 1999;141(4):698–702.
11.
FINLAY AY, KHAN GK. Dermatology Life Quality Index (DLQI)-a simple practical measure for routine clinical use. Clinical and Experimental Dermatology. 1994;19(3):210–6.
12.
Parisi R, Iskandar IYK, Kontopantelis E, Augustin M, Griffiths CEM, Ashcroft DM. National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study. BMJ. :m1590.
13.
Zweegers J, Otero M, Reek J, Lümig P, Driessen R, Kievit W, et al. Effectiveness of Biologic and Conventional Systemic Therapies in Adults with Chronic Plaque Psoriasis in Daily Practice: A Systematic Review. Acta Dermato Venereologica. 2016;96(4):453–8.
14.
Ražnatović M. Kvalitet života obolelih od psorijaze. Биомедицинска истраживања. 2012;3(1):60–7.
15.
Mahmutovic J, Zukic M, Pasalic A, Brankovic S, Jaganjac A, Katana B. Correlation Between Quality of Life and Depression Among Persons Suffering from Psoriasis. Medical Archives. 2017;71(5):341.
16.
Kouwenhoven TA, van der Ploeg JAM, van de Kerkhof PCM. Treatment goals in psoriasis from a patient perspective: a qualitative study. Journal of Dermatological Treatment. 2020;31(1):13–7.
17.
Mei Y xia, Wu H, Zhang H yun, Hou J, Zhang Z xiang, Liao W, et al. Health-related quality of life and its related factors in coronary heart disease patients: results from the Henan Rural Cohort study. Scientific Reports. 11(1).
18.
Spasić A, Radovanović RV, Đorđević AC, Stefanović N, Cvetković T. Quality of Life in Type 2 Diabetic Patients. Acta Facultatis Medicae Naissensis. 2014;31(3):193–200.
19.
Rønholt K, Iversen L. Old and New Biological Therapies for Psoriasis. International Journal of Molecular Sciences. 18(11):2297.
20.
Armstrong AW, Read C. Pathophysiology, Clinical Presentation, and Treatment of Psoriasis. JAMA. 2020;323(19):1945.
21.
Rendon A, Schäkel K. Psoriasis Pathogenesis and Treatment. International Journal of Molecular Sciences. 20(6):1475.
22.
Griffiths CEM, Armstrong AW, Gudjonsson JE, Barker JNWN. Psoriasis. The Lancet. 2021;397(10281):1301–15.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
