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. 2022 Jan;12(1):61-78.
doi: 10.1007/s13555-021-00635-4. Epub 2021 Oct 25.

Evolution of Patient Perceptions of Psoriatic Disease: Results from the Understanding Psoriatic Disease Leveraging Insights for Treatment (UPLIFT) Survey

Mark Lebwohl  1 , Richard G Langley  2 , Carle Paul  3 , Lluis Puíg  4 , Kristian Reich  5 , Peter van de Kerkhof  6 , Hsiuan-Lin Wu  7 , Sven Richter  7 , Shauna Jardon  7 , Paolo Gisondi  8
Affiliations

Evolution of Patient Perceptions of Psoriatic Disease: Results from the Understanding Psoriatic Disease Leveraging Insights for Treatment (UPLIFT) Survey

Mark Lebwohl et al. Dermatol Ther (Heidelb). 2022 Jan.

Erratum in

Abstract

Introduction: Since the 2012 Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) survey, several systemic treatments for psoriasis (PsO) and/or psoriatic arthritis (PsA) have been approved. The population-based UPLIFT survey was conducted to understand how perceptions of treatment-related outcomes have evolved, particularly for patients with mild to moderate PsO and/or PsA and their dermatologists.

Methods: This population- and web-based survey was conducted from 2 March to 3 June 2020, in North America, Europe, and Japan. Adults with self-reported healthcare practitioner (HCP)-diagnosed PsO and/or PsA and dermatologists who spent > 50% of time treating patients and treated ≥ 20 patients with PsO, including plaque PsO, per month were included. Patient participants were recruited at random from online panels; dermatologists were recruited randomly from representative physician panels.

Results: Of 264,054 patient responses, 3806 who self-reported an HCP diagnosis of PsO and/or PsA were included in the final sample; 67% had PsO alone, 28% had PsO and PsA, and 5% had PsA alone. The estimated population prevalence of psoriatic disease was 7% (PsO only: 4%; PsO and PsA: 2%; PsA only: 1%). Most patients (78%) reported PsO-involved body surface area (BSA) ≤ 3 palms, and ~ 90% or more reported itching, redness, flaking, and scales. Many PsO patients without diagnosed PsA reported musculoskeletal symptoms suggestive of PsA (63%). Across BSA categories, approximately one in four patients was not currently receiving treatment and > 50% had Dermatology Life Quality Index score > 5. Patients and dermatologists had different perceptions of PsO severity, office visit discussions, treatment goals, and treatment satisfaction. The survey was conducted during the coronavirus disease 2019 (COVID-19) pandemic, which could have affected assessments of patient-reported outcomes and ability to have in-person HCP visits.

Conclusions: Patients with PsO and PsA in UPLIFT reported high disease burden, including patients with limited skin involvement. An opportunity exists to align patient and dermatologist perceptions to optimize management of PsO and PsA.

Infographic: DIGITAL FEATURE: This article is published with digital features, including an infographic, to facilitate understanding of the article. To view digital features for this article go to https://doi.org/10.6084/m9.figshare.17104586 .

Keywords: Health survey; Patient satisfaction; Psoriasis; Psoriatic arthritis; Quality of life; Special area; Symptom; Treatment.

Plain language summary

In recent years, several new treatments for psoriasis and psoriatic arthritis have become available. The UPLIFT survey was conducted to understand how viewpoints on psoriatic disease outcomes have changed, especially for patients whose disease is mild or moderate. UPLIFT was a large, online, population-based survey conducted in North America, Europe, and Japan. Adults with psoriasis and/or psoriatic arthritis and dermatologists who treated at least 20 patients with psoriasis per month were included. There were 3806 patients who participated; of these, most had psoriasis and few had psoriatic arthritis. Most patients (78%) with mild to moderate psoriasis had a limited area of skin affected by psoriasis. Psoriasis symptoms were common and included itching, redness, flaking, and scales. Many patients without a diagnosis of psoriatic arthritis reported symptoms that could be related to this disease (such as joint discomfort). Although many patients had psoriasis symptoms, approximately one in four was not currently receiving treatment and more than half reported psoriasis impacted their quality of life. Patients and dermatologists had different perceptions of psoriasis severity, office visit discussions, treatment goals, and treatment satisfaction. There is an opportunity to improve treatment of psoriasis and psoriatic arthritis and to better align patient and physician perceptions of psoriasis. This survey was conducted during the COVID-19 pandemic, which could have partially affected some assessments and the ability to have in-person doctor visits.

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Figures

Fig. 1
Fig. 1
Severity of current PsO symptoms by self-reported BSA category (assessed by number of palms)a. aIn response to the question: On a scale of 1–10, where “1” is “very mild” and “10” is “very severe,” please tell us… a. How severe is your psoriasis currently? bIn response to the question: Based on the amount of psoriasis that could be covered by the palm of your hand (including fingers), how many palms of psoriasis would you say you currently have? BSA psoriasis-involved body surface area, PsA psoriatic arthritis, PsO psoriasis
Fig. 2
Fig. 2
Current PsO treatment by level of BSA involvement (assessed by number of palms) in patients with PsO (alone or with PsA) currently experiencing PsO symptoms. BSA psoriasis-involved body surface area, OTC over the counter, PsA psoriatic arthritis, PsO psoriasis, Rx prescription, Oral + biologic oral Rx + biologic, topical Rx + oral Rx + biologic, biologic biologic only, biologic + topical Rx, oral oral Rx only, oral Rx + topical Rx, topical only topical Rx only, other other only, phototherapy only, phototherapy + other (i.e., anything other than prescription oral/biologic/topical therapy or phototherapy), no Rx treatment no treatment other than oral OTC or topical OTC
Fig. 3
Fig. 3
DLQI total score categories by special area involvement. Patients could have involvement in more than one special area. Brackets show patients with at least a moderate effect. DLQI Dermatology Life Quality Index, PsO psoriasis
Fig. 4
Fig. 4
Mean DLQI question scores in patients with and without special area involvement. Error bars represent standard deviation. DLQI Dermatology Life Quality Index, PsO psoriasis
Fig. 5
Fig. 5
Prevalence of PsO in special areas in patients reporting at least moderate burden versus lower burden associated with topical therapies. Patients could have involvement in more than one special area. PsO psoriasis
See this image and copyright information in PMC

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