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

Br J Dermatol. 2018 Jan;178(1):245-252. doi: 10.1111/bjd.15757. Epub 2018 Jan 9.

Abstract

Background: Few studies have analysed the long-term effects of biological treatment in psoriasis. PsoReg, the Swedish national register for systemic psoriasis treatment, started in 2006 and now includes 10 years of real-world data on the effectiveness of biological treatment.

Objectives: To analyse the long-term real-world outcome data of patients who are biologically naïve with moderate-to-severe psoriasis after switching to biological treatment.

Methods: An observational study of patients who are biologically naïve with at least one registration of outcome before switching to biological treatment while included in PsoReg and at least one follow-up visit. Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI) and EuroQol-5D (EQ-5D) values were analysed at 3-5 months, 6-11 months and at least once after ≥ 1 year, up to 9 years after the switch to biological treatment.

Results: In total, 583 patients fulfilled the inclusion criteria. Of these, 399, 395 and 373 patients had observed outcome data beyond 1 year on the PASI, DLQI and EQ-5D, respectively, and 164, 168 and 152, respectively, were observed in at least three time periods after the switch. Significant (P < 0·01) improvement in PASI, DLQI and EQ-5D scores was observed 3-5 months after the switch and sustained under the whole observation period. The mean PASI, DLQI and EQ-5D changed from 13·5 ± 9·1, 9·0 ± 8·1 and 0·74 ± 0·22, respectively, before the switch, to 4·0 ± 3·5, 3·7 ± 4·7 and 0·79 ± 0·21, respectively, 1-5 years after the switch.

Conclusions: Biological treatment, as used in clinical practice, shows a stable long-term effectiveness in all the measured dimensions, PASI, DLQI and EQ-5D.

Publication types

  • Observational Study

MeSH terms

  • Adalimumab / therapeutic use
  • Biological Products / therapeutic use*
  • Dermatologic Agents / therapeutic use*
  • Dermatology
  • Drug Substitution
  • Female
  • Humans
  • Infliximab / therapeutic use
  • Male
  • Middle Aged
  • Psoriasis / drug therapy*
  • Psoriasis / psychology
  • Quality of Life / psychology*
  • Quality-Adjusted Life Years
  • Registries
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Sweden
  • Treatment Outcome
  • Ustekinumab / therapeutic use

Substances

  • Biological Products
  • Dermatologic Agents
  • Infliximab
  • Ustekinumab
  • Adalimumab