Comparing the slopes and intercepts of the regression lines revealed PLASI as the most reliable measure for the severity and therapeutic improvement in patients with moderate-to-severe chronic plaque psoriasis. PLASI proved to be a marginally more accurate than PASI, and much more accurate than SAPASI and BSA. The superiority of PLASI may be a result of the logarithmic scale of the affected skin surface.

Background: The introduction of biological agents has considerably changed the treatment of moderate to severe psoriasis. So far only limited data on their cost-effectiveness exist. Objective: Determination of the cost-effectiveness of biologicals from a German third payer’s perspective, assessed over a 12-week period. Methods: Efficacies of the biologicals were determined by a literature review. Treatment modalities were taken from the European S3 psoriasis guideline. Costs were calculated on the basis of the German physicians’ fee schedule. Cost-effectiveness was determined and a sensitivity analysis performed. Results: Infliximab at a dose of 3 mg/kg was the most cost-effective agent, directly followed by adalimumab, infliximab 5 mg/kg and ustekinumab. The least cost-effective agent was etanercept 2 × 50 mg/week. Sensitivity analysis showed considerable overlap of the cost-effectiveness ratios. Conclusion: Under the conditions of the German health care system, biological agents for psoriasis differ in their cost-effectiveness ratios. Differences are small, however. A major limitation of the study is the short time horizon of 12 weeks.

Background: The Patient Benefit Index (PBI) is a recently developed instrument to assess patient satisfaction with treatment. It has been applied to only a limited number of psoriasis patients. Objective: Characterization of patient-reported outcomes (PRO) in patients with moderate to severe psoriasis Methods: 1,787 patients with plaque psoriasis were documented. Psoriasis Area and Severity Index (PASI), body surface area (BSA), Dermatology Life Quality Index (DLQI) and PBI were determined. Correlations were calculated and the persistence of PBI improvement and strength of treatment effect were evaluated. A regression analysis was performed to characterize predictors of PBI and DLQI improvements. Results: Significant correlations exist between ΔPASI/ΔBSA and ΔDLQI. Also, DLQI and PBI are correlated. Improvement in the skin condition has a positive and sustainable impact on all need dimensions of the PBI. The best early predictor for PBI was PASI 75 at treatment week 8, relevant factors predicting quality of life were PBI/subscale 4, (reducing physical impairment), ΔBSA and ΔPASI. Conclusion: Improvement in skin condition correlates with improvements in quality of life in patients with plaque psoriasis. Successful treatment leads to significant and sustainable patient benefit. While PBI subscale 4 is a good predictor for quality of life, more work is necessary to identify potential predictors for patient benefit.

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