Outcomes in randomized controlled trials in psoriasis: what has changed over the last 20 years?

Abstract

Objective: In 1989, Marks et al. reviewed the different assessment tools employed in the evaluation of psoriasis severity before 1986. Our objective was to reproduce this seminal review to describe the changes over the last 20 years with regard to the evaluation of psoriasis severity in randomized clinical trials.

Data sources: MeSH search on Pubmed for articles about psoriasis.

Study selection: Randomized clinical trials published in Archives of Dermatology, British Journal of Dermatology, Clinical and Experimental Dermatology and Journal of the American Academy of Dermatology from 1 January 2004 to 31 December 2005.

Data synthesis: Recent psoriasis trials implemented various clinical scoring systems in an attempt to assess psoriasis severity, but this is done without any apparent uniformity making direct comparisons between trials difficult. The predominant difference, which has occurred in the outcomes of psoriasis trials over the past 20 years, appears to be the introduction of an assessment of the patients' quality of life.

Conclusion: The past 20 years have brought some improvements to the field of psoriasis evaluation but they also bring emphasis to the need for uniformity with regard to trial outcomes to ensure comparability and make better pooling of data from different randomized clinical trials possible for future meta-analyses.