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Observational Study
. 2025 Mar;64(3):531-538.
doi: 10.1111/ijd.17509. Epub 2024 Oct 7.

Residual disease is the main, but not the only factor impacting satisfaction in psoriatic patients undergoing biological therapies

Giacomo Caldarola  1   2 , Eleonora De Luca  1   2 , Gennaro Marco Falco  1   2 , Lucia Di Nardo  2 , Enrico Bocchino  1   2 , Magda D'Agostino  1   2 , Ketty Peris #  1   2 , Clara De Simone #  1   2
Affiliations
Observational Study

Residual disease is the main, but not the only factor impacting satisfaction in psoriatic patients undergoing biological therapies

Giacomo Caldarola et al. Int J Dermatol. 2025 Mar.

Abstract

Background: Despite advancements in psoriasis treatment, a gap remains in aligning patient satisfaction with clinical outcomes. Our study aimed to evaluate which clinical and psychological factors may impact treatment satisfaction in psoriatic patients undergoing long-term biological therapies.

Methods: We performed an observational, cross-sectional, single-center study involving adult patients with moderate-to-severe psoriasis treated with biologics for at least 12 months. We collected sociodemographic characteristics and data on the course of the psoriasis. We also assessed the absolute (residual) Psoriasis Area and Severity Index (PASI), the site of the residual disease, and the severity of pruritus through the Visual Analogue Scale (VAS). Satisfaction was evaluated using the Treatment Satisfaction Questionnaire for Medication (TSQMv.II). The Type D Personality Scale (DS14 questionnaire and Patient Health Questionnaire-9 assessed the psychological profile.

Results: Overall, 146 patients were included, and 82.1% were globally satisfied (global satisfaction TSQM score >75). Linear regression analysis showed a negative correlation between global satisfaction scoring and residual PASI. The multivariable analysis found a higher VAS-pruritus score (OR = 1.20, 95% CI = 1.01-1.44; P = 0.043) and not reaching a residual PASI < 2 (OR = 0.30, 95% CI = 0.09-0.94, P = 0.039) as the strongest predictors of global unsatisfied patients (TSQM < 75%). Other factors unrelated to residual disease, such as gender, class of biologic agent, and type D personality, have also been found to impact patient satisfaction.

Conclusions: Our study's findings underscore the complexity of patient satisfaction in psoriasis management and highlight the multifactorial nature of treatment success beyond traditional clinical measures.

Keywords: biologics; inflammatory diseases; psoriasis; quality of life; satisfaction; therapies.

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Figures

Figure 1
Figure 1
Calculated prediction from a linear regression of residual PASI on global TSQM‐9 and the resulting fitted line
Figure 2
Figure 2
Calculated prediction from a linear regression of DLQI on global TSQM‐9 and the resulting fitted line
See this image and copyright information in PMC

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