Shinichi Imafuku1, Yasumasa Kanai2, Kenta Murotani3, Takanobu Nomura2, Kei Ito4, Chika Ohata5, Fumikazu Yamazaki6, Takuya Miyagi7, Hidetoshi Takahashi8, Yukari Okubo9, Hidehisa Saeki10, Masaru Honma11, Yayoi Tada12, Tomotaka Mabuchi13, Mari Higashiyama14, Satomi Kobayashi15, Yuki Hashimoto16, Mariko Seishima17, Tatsuyuki Kakuma3. 1. Department of Dermatology, Fukuoka University Faculty of Medicine, Fukuoka, Japan. Electronic address: dermatologist@mac.com. 2. Medical Affairs, Kyowa Kirin Co., Ltd., Tokyo, Japan. 3. Biostatistics Center, Kurume University, Fukuoka, Japan. 4. Department of Dermatology, JR Sapporo Hospital, Sapporo, Hokkaido, Japan. 5. Department of Dermatology, Osaka General Medical Center, Osaka, Japan. 6. Department of Dermatology, Kansai Medical University, Osaka, Japan. 7. Department of Dermatology, University of the Ryukyus, Okinawa, Japan. 8. Takagi Dermatological Clinic, Hokkaido, Japan. 9. Department of Dermatology, Tokyo Medical University, Tokyo, Japan. 10. Department of Dermatology, Nippon Medical School, Tokyo, Japan. 11. Department of Dermatology, Asahikawa Medical University, Hokkaido, Japan. 12. Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan. 13. Department of Dermatology, Tokai University School of Medicine, Kanagawa, Japan. 14. Department of Dermatology, Nippon Life Hospital, Osaka, Japan. 15. Department of Dermatology, Seibo International Catholic Hospital, Tokyo, Japan. 16. Department of Dermatology, Toho University School of Medicine, Tokyo, Japan. 17. Department of Dermatology, Gifu University Graduate School of Medicine, Gifu, Japan.
Abstract
BACKGROUND: Plaque psoriasis significantly affects patients' health-related quality of life. To aid treatment decisions, not only objective assessment by physicians but also subjective assessment by patients is important. OBJECTIVE: To assess the significance of Dermatology Life Quality Index (DLQI) evaluation at the time of biologics introduction in clinical practice in Japanese patients with plaque psoriasis. METHODS: This was a single-arm, open-label, multicenter study. At baseline, Psoriasis Area and Severity Index (PASI) and DLQI scores were measured and stratified based on DLQI scores ≥6/≤5 and PASI scores ≤10/>10. Other patient-reported outcomes assessed included EQ-5D-5L, itch numerical rating scale (NRS), skin pain NRS, Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-8 (PHQ-8), Sleep Problem Index-II (SPI-II), and Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9). RESULTS: Of the 73 enrolled patients, 23 had PASI scores ≤10. Those with PASI/DLQI scores >10/≥6 had a significantly higher median PASI score than those with PASI/DLQI scores >10/≤5 (p = 0.0125). Regardless of PASI scores (>10/≤10), median itch NRS and GAD-7 scores were significantly higher in patients with DLQI scores ≥6 than in those with DLQI scores ≤5 (itch NRS, p = 0.0361 and p = 0.0086, respectively; GAD-7, p = 0.0167 and p = 0.0273, respectively). Patients with PASI/DLQI scores ≤10/≥6 had significantly higher skin pain NRS (p = 0.0292) and PHQ-8 (p = 0.0255) scores and significantly lower median SPI-II scores (p = 0.0137) and TSQM-9 Effectiveness domain scores (p = 0.0178) than those with PASI/DLQI scores ≤10/≤5. CONCLUSION: DLQI may be useful for assessing patients' concerns that cannot be identified by PASI alone while initiating biologics or switching from other biologics in clinical practice.
BACKGROUND:Plaque psoriasis significantly affects patients' health-related quality of life. To aid treatment decisions, not only objective assessment by physicians but also subjective assessment by patients is important. OBJECTIVE: To assess the significance of Dermatology Life Quality Index (DLQI) evaluation at the time of biologics introduction in clinical practice in Japanese patients with plaque psoriasis. METHODS: This was a single-arm, open-label, multicenter study. At baseline, Psoriasis Area and Severity Index (PASI) and DLQI scores were measured and stratified based on DLQI scores ≥6/≤5 and PASI scores ≤10/>10. Other patient-reported outcomes assessed included EQ-5D-5L, itch numerical rating scale (NRS), skin pain NRS, Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-8 (PHQ-8), Sleep Problem Index-II (SPI-II), and Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9). RESULTS: Of the 73 enrolled patients, 23 had PASI scores ≤10. Those with PASI/DLQI scores >10/≥6 had a significantly higher median PASI score than those with PASI/DLQI scores >10/≤5 (p = 0.0125). Regardless of PASI scores (>10/≤10), median itch NRS and GAD-7 scores were significantly higher in patients with DLQI scores ≥6 than in those with DLQI scores ≤5 (itch NRS, p = 0.0361 and p = 0.0086, respectively; GAD-7, p = 0.0167 and p = 0.0273, respectively). Patients with PASI/DLQI scores ≤10/≥6 had significantly higher skin pain NRS (p = 0.0292) and PHQ-8 (p = 0.0255) scores and significantly lower median SPI-II scores (p = 0.0137) and TSQM-9 Effectiveness domain scores (p = 0.0178) than those with PASI/DLQI scores ≤10/≤5. CONCLUSION: DLQI may be useful for assessing patients' concerns that cannot be identified by PASI alone while initiating biologics or switching from other biologics in clinical practice.