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. 2025 Dec;12(4):525-539.
doi: 10.1007/s40801-025-00499-6. Epub 2025 Aug 29.

Patient Experiences with Psoriatic Disease in the USA: Results from the Psoriasis and Beyond Global Study

April W Armstrong  1 , Sicily Mburu  2 , George C Gondo  3 , Elena Kornyeyeva  4 , Susan Frade  4 , Alexis Ogdie  5
Affiliations

Patient Experiences with Psoriatic Disease in the USA: Results from the Psoriasis and Beyond Global Study

April W Armstrong et al. Drugs Real World Outcomes. 2025 Dec.

Abstract

Background: Psoriatic disease (PsD) is a chronic, multisystem, inflammatory disorder encompassing psoriasis, psoriatic arthritis (PsA), and their associated comorbidities.

Objective: The aim of this subanalysis of the global "Psoriasis and Beyond" study was to evaluate patients' experiences of living with PsD in the USA.

Methods: The study included a cross-sectional, quantitative, 25-min online survey of adults with self-reported, healthcare professional-diagnosed, moderate-to-severe psoriasis, with or without PsA. USA-based patients were recruited through online panels by the Institut de Publique Sondage D'Opinion Secteur and The National Psoriasis Foundation.

Results: This analysis included 793 US patients with psoriasis; 43% also had PsA. Overall, 75% of patients knew that their disease was systemic, and 65% had heard the term "psoriatic disease." Of patients without diagnosed PsA, 50% screened positive for PsA using the Psoriasis Epidemiology Screening Tool. Psoriasis negatively affected emotional well-being and quality of life (QoL) in the majority of patients (87% and 91%, respectively). Overall, 29% of patients reported that they could not work or study in the week prior to the survey; of these, 98% responded that psoriasis had a very or extremely large impact on their QoL. Mean diagnostic delays of 3.7 and 3.3 years for psoriasis and PsA, respectively, were reported.

Conclusions: This analysis of USA-based patients with PsD highlights the profound impact of PsD on emotional well-being and QoL and suggests potential underdiagnosis of PsA. There is a need to ensure early PsD diagnosis and to provide holistic treatment, including mental health support.

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Conflict of interest statement

Declarations. Funding: The study, medical writing support, and open access fee for this manuscript were funded by Novartis AG. Conflicts of Interest: A.W.A. has served as a research investigator, scientific advisor, and/or speaker at AbbVie, Almirall, Arcutis, ASLAN, Beiersdorf, BI, BMS, EPI, Incyte, LEO Pharma, UCB, Janssen, Lilly, Mindera, Nimbus, Novartis, Ortho Dermatologics, Sun, Dermavant, Dermira, Sanofi, Regeneron, and Pfizer. S.M. receives no individual compensation and is employed by IFPA. In the past 12 months, IFPA has accepted grants and funding from AbbVie, Almirall, Amgen, Bristol Myers Squibb, Boehringer Ingelheim, Janssen, Leo Pharma, Eli Lilly, Novartis, Pfizer, and UCB. G.C.G. is an employee of The National Psoriasis Foundation. E.K. was a full-time employee of Novartis Pharma AG, Basel, Switzerland. S.F. is a full-time employee of Novartis Pharma AG, Basel, Switzerland. A.O. serves as a consultant of AbbVie, Amgen, BMS, Celgene, CorEvitas, Eli Lilly, GSK, Gilead, Janssen, Merck, Novartis, Pfizer, Spyre Therapeutics, Takeda, Treg Therapeutics, and UCB Pharma and has received grants and/or research support from AbbVie, Amgen, BMS, Janssen, Novartis, Pfizer, UCB, Forward/National Databank for Rheumatic Diseases, NIH/NIAMS, PPACMAN, Rheumatology Research Foundation, and The National Psoriasis Foundation. Availability of Data and Materials: Results analyzed during this study are included in this published article and its supplementary information files; additional data may be available upon request from Novartis on a case-by-case basis. Ethics Approval: An institutional review board (Pearl IRB) considered this study to be exempt from ethics approval according to FDA 21 CFR 56.104 and 45CFR46.104(b)(2):(2). Consent to Participate: Informed digital consent was obtained from patients before study participation. The procedure for obtaining electronic informed consent was outlined in the Psoriasis and Beyond study protocol, which was reviewed and approved according to local laws and regulations. Consent for Publication: Not applicable. Code Availability: Not applicable. Author Contributions: A.W.A., A.O., S.F., and S.M.: study conception and design, data interpretation, and writing/revision of the manuscript. E.K. and G.C.G.: data interpretation and writing/revision of the manuscript. All authors reviewed and approved the final version of the manuscript for submission.

Figures

Fig. 1
Fig. 1
Patients’ understanding of PsD. a Proportion of patients who had heard that psoriasis or PsA was part of a systemic disease. b Proportion of patients who had heard the term “psoriatic disease.” c Proportion of patients aware of manifestations that may be related to PsD. d Proportion of patients aware of comorbidities that may be related to PsD; N = 793. aIn patients without a diagnosis of PsA. GI gastrointestinal, PsA psoriatic arthritis, PsD psoriatic disease
Fig. 2
Fig. 2
Manifestations of psoriasis at the time of the survey. a Severity of psoriasis at the time of the survey. b Proportion of patients experiencing psoriasis signs and symptoms by psoriasis severity at the time of the survey. c Proportion of patients with body parts currently affected by psoriasis. Orange dashed boxes denote hard-to-treat body areas. d Proportion of patients with sensitive body areas affected by psoriasis severity at the time of the survey; N = 793
Fig. 3
Fig. 3
Comorbidities experienced by patients with PsD. a Average number of comorbidities experienced by patients. b Proportion of patients with diagnosed comorbidities by psoriasis severity at the time of the survey; N = 793. aIncluding irritable bowel syndrome, indigestion, ulcerative colitis, Crohn’s disease, heartburn, and gastritis. bIncluding cardiac/heart failure, arrhythmia, cardiomyopathy, coronary artery disease, and hypertension. cIncluding ankylosing spondylitis and nonradiographic axial spondyloarthritis. GI gastrointestinal
Fig. 4
Fig. 4
Proportion of patients with PsA experiencing PsA signs and symptoms by psoriasis severity at the time of the survey. N = 343. PsA psoriatic arthritis
Fig. 5
Fig. 5
Impact of PsD on QoL using DLQI. a Effect of skin symptoms on QoL in the week prior to the survey by psoriasis severity at the time of the survey. b Effect of skin symptoms on QoL in the week prior to the survey by the number of hard-to-treat body areas affected. N = 793. DLQI Dermatology Life Quality Index, PsD psoriatic disease, QoL quality of life
Fig. 6
Fig. 6
Impact of disease on patients’ experiences of work or study. a Proportion of patients prevented from working or studying owing to skin symptoms in the week prior to the survey by psoriasis severity. N = 793. b Impact of skin symptoms on work or study for those able to work or study during the week prior to the survey by psoriasis severity. N = 436. c Proportion of patients prevented from working or studying owing to skin symptoms in the week prior to the survey by quality of life. N = 793. d Impact of skin symptoms on work for those able to work during the week prior to the survey, by QoL. N = 436. QoL quality of life
Fig. 7
Fig. 7
Time between the first manifestation of psoriasis or PsA and diagnosis. PsA psoriatic arthritis
Fig. 8
Fig. 8
Reasons for dissatisfaction with treatment. All patients dissatisfied with psoriasis (n = 114) or PsA (n = 60) treatment. aOnly shown to patients with PsA. bToo expensive or not covered by medical system. PsA psoriatic arthritis, QoL quality of life
Fig. 9
Fig. 9
Mean monthly out-of-pocket costs for PsD (USD). a Monthly out-of-pocket costs for PsD by psoriasis severity at the time of the survey. b Monthly total out-of-pocket costs for PsD by hard-to-treat body areas affected. N = 793. PsD psoriatic disease
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