Analyzing Psoriasis Treatment Goals by Patient Age, Severity, and Gender

Patient-reported treatment goals for psoriasis showed varied preferences according to characteristics such as age, severity, and gender, but the top goal overall was to have confidence in the therapy. Results were published today in Advances in Therapy.

In evaluating evidence-based guidelines developed by dermatologists for the management of psoriasis, the study authors noted that treatment goals are usually based on objective measures derived via Body Surface Area (BSA) or Psoriasis Area and Severity Index (PASI)—despite research showing that patients focus more on symptoms such as itch, pain, scaling, and flaking.

“Besides causing significant disease burden, psoriasis also impairs quality of life (QOL), emotional, and physical well-being,” they added. “Since psoriasis affects all elements of QOL, it is important to address treatment goals representing different health domains to understand patient-relevant benefits of various therapies.”

Researchers utilized the Patient Needs Questionnaire (PNQ), the first part of the Patient Benefit Index (PBI), to better quantify patient perspectives on psoriasis treatment goals.

A total of 1200 US adult patients with self-reported psoriasis (mean [SD] age, 51.5 [13.9] years; mean [SD] disease duration, 22.8 [17.3] years; 65.3% female) were involved in the online cross-sectional survey-based analysis conducted with National Psoriasis Foundation, in which participants responded to the PNQ portion of the PBI by indicating how much they valued different treatment attributes.

Treatment attributes were classified on a 5-point Likert scale (0 = not important; 4 = very important), with goals obtained for the overall population and subgroups based on severity of disease Patient Global Assessment (PGA), age, gender, and Dermatology Life Quality Index (DLQI) total score.

Of the study cohort, 46.4% of patients had psoriatic arthritis and 43.4% had self-described moderate psoriasis (BSA ≤ 2).

The top treatment goal in the overall population was “to have confidence in the therapy” (mean [SD], 3.46 [1.01]), followed by “to regain control of the disease” (3.46 [1.03]), “to have no fear that the disease will become worse” (3.41 [1.03]), “to get better skin quickly” (3.27 [1.11]), and “to be free of itching” (3.27 [1.19]).

Several psoriasis treatment goals were found to be unique to patient characteristics of severity, age group, gender, and quality of life burden:

• The subgroup of patients with higher severity of psoriasis (PGA ≥ 3) identified “to find a clear diagnosis and therapy” as a top 5 goal, whereas “to get better skin quickly” was indicated by those with lesser severity (PGA < 3).
• Patients younger than 40 years identified “to be free of itching” (mean [SD], 3.36 [0.99]) as a unique top 5 goal, whereas it was “to get better skin quickly” (3.27 [1.12]) in the group 40 years or older.
• Women and men noted “to be free of itching” (mean [SD], 3.38 [1.13]) and “to get better skin quickly” (3.20 [1.09]) as top 5 goals, respectively.
• Patients with DLQI scores of at least 10 expressed “to regain control of the disease” as their highest treatment goal (mean [SD], 3.66 [0.67]), compared with those with DLQI scores of less than 10, who had “to have confidence in the therapy” (3.40 [1.11]) as their top treatment goal.

“This study shows that to have confidence in the therapy, get better skin quickly, and to be free of itching were among the top needs for patients with psoriasis,” concluded the study authors. “Understanding and meeting patient expectations for a therapy may improve treatment satisfaction, adherence, and longterm outcomes.”

Reference

Armstrong A, Edson-Heredia E, Zhu B, et al. Treatment goals for psoriasis as measured by Patient Benefit Index: results of a National Psoriasis Foundation Survey. Adv Ther. Published online April 11, 2022. doi:10.1007/s12325-022-02124-2