Patient perceptions of psoriatic disease in Japan: Results from the Japanese subgroup of the Understanding Psoriatic Disease Leveraging Insights for Treatment (UPLIFT) survey

Abstract

The population-based Understanding Psoriatic Disease Leveraging Insights for Treatment (UPLIFT) survey was designed to better understand patient and dermatologist perceptions of the disease burden of psoriasis (PsO) and their treatment expectations. UPLIFT was a cross-sectional, quantitative, online survey conducted in Europe, North America, and Japan between 2 March and 3 June 2020. In Japan, 391 patients reporting a diagnosis of PsO and/or psoriatic arthritis (PsA) were surveyed (75% had PsO alone, 23% had PsO and PsA, and 2% had PsA alone). Self-reported body surface area (BSA) data were available for 309 Japanese patients, with the majority (80%) reporting PsO-involved BSA ≤3 palms. Current symptoms of PsO were rated as moderate or severe by 43% of Japanese patients with BSA ≤3 palms, and severe by 44% of patients with BSA 4-10 palms. PsO frequently occurred in ≥1 special areas, most commonly the scalp in 76% of Japanese patients with BSA ≤3 palms, and ≥90% of those with BSA ≥4 palms. Furthermore, musculoskeletal symptoms in 42% of patients with PsO alone were suggestive of PsA. Whereas Japanese patients with BSA ≤3 palms mainly reported receiving topical therapy alone (34%) or no treatment (32%), 64% patients with BSA 4-10 palms reported receiving systemic therapy. Overall, 21% of Japanese patients with self-perceived mild symptoms of PsO and 48% of patients with special area involvement experienced at least a moderate impact of disease on quality of life (Dermatology Life Quality Index score >5). Moreover, patients and dermatologists differed in their perceptions of determinants of PsO severity and treatment, and office visit discussions. In general, these findings from the Japanese subgroup of the UPLIFT survey demonstrated that a high proportion of patients perceived their symptoms to be moderate or severe irrespective of the level of skin involvement, suggesting a persistent unmet treatment need.

Keywords: Japan; population survey; psoriasis; quality of life; treatment goal.

FIGURE 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 = “very mild” and 10 = “very severe”, please tell us… a. How severe is your psoriasis currently? ^bIn response to the question: Based on the amount of PsO that could be covered by the palm of your hand (including fingers), how many palms of PsO would you say you currently have? BSA, body surface area; PsO, psoriasis

FIGURE 2

Special area involvement according to self‐reported BSA categories.BSA, body surface area

FIGURE 3

Current PsO treatment by level of BSA involvement (assessed by number of palms) in patients with PsO (with or without PsA) currently experiencing PsO symptoms. ^aOral prescription + biologic or topical + oral prescription + biologic. ^bBiologic only or biologic + topical prescription. ^cOral prescription only or oral + topical prescription. ^dTopical prescription only. ^eOther only, phototherapy only, phototherapy + other (i.e., anything other than prescription oral/biologic/topical therapy or phototherapy). ^fNo treatment other than oral or topical OTC therapy. BSA, body surface area; OTC over‐the‐counter; PsA, psoriatic arthritis; PsO, psoriasis

FIGURE 4

DLQI total score categories by special area involvement. Patients could have involvement in >1 special area. Brackets show patients reporting at least a moderate effect. DLQI, Dermatology Life Quality Index; PsO, psoriasis

FIGURE 5

DLQI scores >5 by self‐perceived severity of PsO (mild‐to‐severe). DLQI, Dermatology Life Quality Index; PsO, psoriasis

FIGURE 6

Patient and dermatologist perceptions of determinants of PsO severity and treatment. Percentages were calculated by dividing the sum of scores by the maximum possible score. Separate responses were provided regarding patients in different severity categories (mild, moderate, or severe in the dermatologists' estimation). The aggregate of the three categories is shown. BSA, body surface area; PsO, psoriasis

FIGURE 7

Patient and dermatologist perceptions of office visit discussions. PsO, psoriasis