Study Finds Majority of Patients With Psoriatic Disease Unaware of Comorbidity Risk, Systemic Implications

Although characterized as a chronic, systemic immune‐mediated condition, a majority of patients with psoriatic disease (PsD) were found to be unaware of their increased risk for comorbidities, with nearly half reporting that they have never discussed treatment goals with health care professionals (HCPs).

In a study published this week in Dermatology and Therapy, researchers highlighted that patients’ perspectives on their understanding of their disease are becoming increasingly important in the holistic management of PsD, which includes psoriasis and psoriatic arthritis (PsA).

Moreover, recent findings have indicated that patients feel empowered when they have a broader understanding of their disease and treatment options.

“Despite advances in the treatment of psoriasis and the various manifestations of PsD, medical unmet needs remain, including diagnostic delays and undertreatment,” said the study authors. “The study aim was to determine patients’ understanding of the systemic nature of psoriasis and PsA and the associated burden of living with these diseases. The relationship between patient and HCP was also evaluated.”

They conducted a cross-sectional, quantitative online survey, called Psoriasis and Beyond: The Global Psoriatic Disease Survey, involving patients with moderate to severe plaque psoriasis with or without concomitant PsA.

A total of 1678 responses (mean age, 40.1 years; 52% women) from 11 countries (data collection, November 2020-May 2021) were collected for the interim results. Participants were given a questionnaire consisting of a combination of validated tools such as the Dermatology Life Quality Index, Work Productivity and Activity Index, and the Psoriasis Epidemiology Screening Tool.

At baseline, 63% and 37% of patients reported having, at worst, moderate (body surface area [BSA] > 5 to < 10) and severe (BSA ≥ 10) psoriasis, respectively. Approximately 31% of patients with psoriasis reported concomitant PsA, of whom 80% considered their PsA severity as moderately or highly active.

Overall, 63% of participants had heard the term “psoriatic disease.” Despite one-third of patients with psoriasis being at risk of developing PsA during the course of their disease, only 29% of patients had heard about PsA. Few patients were aware of psoriasis manifestations (axial symptoms, 18%) or comorbidities (obesity, 21%; cardiovascular disease, 18%).

Among patients with psoriasis and concomitant PsA, 70% reported swollen and tender joints, especially of the finger(s) and/or toe(s). Most patients (84%) experienced stigma and discrimination and reported a negative impact of their disease on work, emotions, and relationships.

Regarding HCP relationships, 42% of patients had never discussed treatment goals, and 15% and 14% of those with psoriasis and psoriasis with PsA, respectively, reported dissatisfaction with their current treatment. Incomplete relief of skin symptoms (57%) and joint symptoms (45%) were noted as primary reasons for dissatisfaction among these patients.

“These interim findings underscore the need for increasing awareness of the systemic aspect of PsD and need for patient educational programs, since PsD impacts patients’ physical and mental health,” concluded researchers.

“Evaluation of the impact of disease, treatment burden, productive patient–HCP dialogue, shared decision-making, and understanding of patients’ perspectives is important so that improved strategies can be implemented to enhance overall quality of life of patients.”

Reference

Armstrong A, Bohannan B, Mburu S, et al. Impact of psoriatic disease on quality of life: interim results of a global survey. Dermatol Ther (Heidelb). Published online March 14, 2022. doi:10.1007/s13555-022-00695-0