Superiority in Quality of Life Improvement of Biologics over Conventional Systemic Drugs in a Swiss Real-Life Psoriasis Registry.

Jungo, Pierre; Maul, Julia-Tatjana; Djamei, Vahid; von Felten, Stefanie; Kolios, Antonios G A; Czernielewsk, Justine; Yawalkar, Nikhil; Odermatt, Olivia; Laffitte, Emmanuel; Anliker, Mark; Streit, Markus; Augustin, Matthias; Conrad, Curdin; Hafner, Jürg; Boehncke, Wolf-Henning; Gilliet, Michel; Itin, Peter; French, Lars E; Navarini, Alexander A and Häusermann, Peter (2016). Superiority in Quality of Life Improvement of Biologics over Conventional Systemic Drugs in a Swiss Real-Life Psoriasis Registry. Dermatology, 232(6), pp. 655-663. Karger 10.1159/000455042

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BACKGROUND Randomized controlled trials have shown the efficacy of systemic treatments in moderate-to-severe psoriasis. Clinical outcomes in psoriasis patients under real-world conditions are less well understood. OBJECTIVE This study compared Psoriasis Area and Severity Index (PASI) and Dermatological Life Quality Index (DLQI) improvement in all psoriasis patients registered in the Swiss Dermatology Network for Targeted Therapies. We asked whether outcomes differed between 4 treatment strategies, namely biologic monotherapy versus conventional systemic monotherapy, versus combined biologic and conventional systemic drugs, and versus therapy adaptation (switching from one type to another). METHODS PASI and DLQI within 1 year after onset of systemic treatment, measured at 3, 6, and 12 months, were compared among the 4 groups using generalized linear mixed-effects models. RESULTS Between March 2011 and December 2014, 334 patients were included; 151 received conventional systemic therapeutics, 145 biologics, 13 combined treatment, and 25 had a therapy adaptation. With regard to the absolute PASI, neither the biologic cohort nor the combined treatment cohort significantly differed from the conventional systemic therapeutics cohort. The odds of reaching PASI90 was significantly increased with combined therapy compared to conventional systemic therapeutics (p = 0.043) and decreased with a higher body mass index (p = 0.041). At visits 3 and 4, the PASI was generally lower than at visit 2 (visit 3 vs. visit 2, p = 0.0019; visit 4 vs. visit 2, p < 0.001). After 12 months, patients with biologic treatment had a significantly lower DLQI than those with conventional systemic therapeutics (p = 0.001). CONCLUSION This study suggests that after 1 year of treatment, biologics are superior in improving the subjective disease burden compared to conventional systemic drugs.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Dermatology

UniBE Contributor:

Yawalkar, Nikhil

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1018-8665

Publisher:

Karger

Language:

English

Submitter:

Sandra Nyffenegger

Date Deposited:

15 May 2018 15:23

Last Modified:

15 May 2018 15:23

Publisher DOI:

10.1159/000455042

PubMed ID:

28103601

Uncontrolled Keywords:

Biologicals Dermatological Life Quality Index Psoriasis Psoriasis Area and Severity Index Real world Registry data

BORIS DOI:

10.7892/boris.110268

URI:

https://boris.unibe.ch/id/eprint/110268

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