A European subset analysis from the population‐based Multinational Assessment of Psoriasis and Psoriatic Arthritis shows country‐specific features: results from psoriasis patients in Spain

Abstract

BackgroundThe Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) survey data were not analysed to account for cultural and healthcare system differences across European countries (EC).ObjectiveTo utilize MAPP data to characterize psoriasis in Spanish patients, including severity assessment and Dermatology Life Quality Index (DLQI).MethodsThe MAPP survey was conducted between June and August 2012. This analysis included 1700 patients with self‐reported psoriasis (without psoriatic arthritis) from France (n = 349), Germany (n = 311), Italy (n = 359), Spain (n = 354) and the United Kingdom (n = 327).ResultsPatients from Spain vs. other EC self‐reported higher mean body mass index (26.9 vs. 25.6, P ≤ 0.001), lower prevalence of depression (6% vs. 12%, P = 0.002) and higher mean self‐perceived psoriasis severity at its worst (5.92 vs. 5.33, P < 0.001) despite lower estimated body‐surface‐area involvement. Overall, patients from Spain vs. other EC had lower mean global DLQI scores (4.70 vs. 6.06, P = 0.001) and lower mean scores for each DLQI dimension [all P < 0.001, except leisure (P = 0.002), treatment (P = 0.002), and work and school (P = 0.005)]. Higher DLQI values were inversely associated with age and directly correlated with perceived severity. Palmoplantar, nail and scalp psoriasis were reported less frequently in Spanish patients (P = 0.026) and were associated with higher DLQI values (P < 0.01). Spanish patients were more likely to have seen multiple healthcare providers (HCPs; P < 0.001) and achieve therapeutic goals (P < 0.001), but current treatments were similar to patients in other EC.ConclusionsIn the MAPP survey, Spanish patients differed from other EC in several characteristics, including comorbidities, extent and distribution of psoriasis lesions, perception of severity and impact on quality of life. Their perception of psoriasis severity was higher despite a lower estimated extent, and DLQI scores were significantly lower. Spanish patients had more HCP visits and a higher rate of therapeutic goal achievement. These differences might be attributed to cultural factors, phenotypical variation and differences in HCP access.

Treating to Target(s) With Interleukin-17 Inhibitors

“…IL-17 inhibitors were also found to be effective in the management of patients with the palmoplantar phenotype, which is found in 20% to 40% of psoriasis patients. 43-46 GESTURE was a PPP-specific, double-blind phase IIIb trial that randomized 205 patients with moderate to severe PPP (≥ 3 on the 5-point Palmoplantar Investigator Global Assessment [ppIGA] scale) and at least 1 additional plaque not on the palms or soles to confirm plaque psoriasis (ie, low nonpalmoplantar involvement) to secukinumab (300 mg or 150 mg) or placebo. 47 At 16 weeks, secukinumab was associated with significant achievement of clear or almost clear palms and soles on the (ppIGA 0-1) vs placebo (Table 5).…”

“…Scalp involvement develops in 40% to 90% of psoriasis patients, and the scalp is the first site to be affected in up to one-half of cases. 44,58-61 Evaluations of QoL in patients with scalp psoriasis indicate that it is associated with a disproportionately negative impact relative to the BSA affected. More than one-half of patients indicated that their condition was socially and psychologically distressing, and itching and scaling were identified as the most common and most troubling symptoms.…”

Clinical experience of secukinumab in the treatment of erythrodermic psoriasis: a case series

“…Six of these 10 patients (60%) were resistant to at least one previous biological agent and three of them (30%) were resistant to more than one biological agent. However, in real‐world practice, most patients on secukinumab have previously received biologics . Our series might more accurately represent the population receiving secukinumab in the clinic.…”

“…However, in real-world practice, most patients on secukinumab have previously received biologics. 7 Our series might more accurately represent the population receiving secukinumab in the clinic. It suggests that the real treatment effects of biologics may be compromised in comparison with the original studies.…”

New Treatment for Psoriasis: Therapeutic Efficiency in Patients and Antiinflammatory Effect in Vitro

“…Medical therapy for psoriasis has classically included topical and systemic treatments such as phototherapy, retinoids, methotrexate, and cyclosporine [3]. In the last few years, biologic treatment has become the established therapeutic standard for significant improvement of the quality of life of patients with moderate to severe psoriasis [4]. The involvement of oxidative stress in the pathogenesis of psoriasis has been recently proposed.…”