A prospective, interventional assessment of psoriasis quality of life using a nonskin-specific validated instrument that allows comparison with other major medical conditions

Abstract

Background: Psoriasis significantly impacts patients' quality of life.

Objectives: The purpose of this study was to prospectively assess the quality-of-life impact of treatment for moderate to severe plaque psoriasis by using a validated quality-of-life psychometric instrument that has been widely used in nondermatologic settings.

Methods: In all, 32 patients with moderate to severe plaque psoriasis received 24 weeks of adalimumab treatment. Patients completed the Psychological General Well-Being (PGWB) Index, which evaluates 6 domains including anxiety and depression. The primary end point was the change in total PGWB score at weeks 12 and 24 of adalimumab treatment compared with baseline.

Results: Statistically significant improvement in the total PGWB score was documented by week 4. By week 24, all 6 PGWB domains showed statistically significant improvement from the pretreatment baseline.

Limitations: One limitation of this study is that the comparison between our psoriasis data and PGWB data from other major medical conditions was not conducted in a head-to-head manner. Another limitation is that we did not have a controlled (placebo) arm.

Conclusion: Based on PGWB scores, patients with untreated psoriasis have as much impairment in psychological well-being as patients with other major medical diseases including breast cancer, coronary artery disease, congestive heart failure, and diabetes and that potent intervention improves psychological well-being to where it is comparable with that of patients with asymptomatic hypertension. A prompt intervention with an effective dermatologic treatment is not only critical, but capable of restoring the physical and psychological well-being of patients with psoriasis.

Keywords: PASI; PGWB; Psoriasis Area and Severity Index; Psychological General Well-Being; Psychological General Well-Being Index; QoL; adalimumab; biologics; psoriasis; quality of life.