Correlation Between Dermatology Life Quality Index and Psoriasis Area and Severity Index in Patients with Psoriasis Treated with Ustekinumab

Hesselvig, J.H.; Egeberg, Alexander; Loft, Nikolai; Zachariae, Claus; Kofoed, Kristian; Skov, Lone

doi:10.2340/00015555-2833

Cited by 25 publications

(24 citation statements)

References 12 publications

(15 reference statements)

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“…In the current study, correlations between changes in PASI and DLQI were highly dependent on how these changes were assessed; relative changes in both PASI and DLQI yielded the highest correlation coefficient, and relative changes in PASI and absolute changes in DLQI the lowest. The correlations were similar to those reported in previous studies (13,14,29). Patients achieving higher PASI response had lower mean DLQI and higher reductions in absolute DLQI.…”

Section: Discussionsupporting

confidence: 88%

“…The first question on "Symptoms and feelings" demonstrated the strongest correlation with PASI, and changes in PASI for the individual questions of DLQI, and contributed most to the overall DLQI. Previous studies have demonstrated weak correlations between relative changes in PASI and DLQI from baseline to weeks 10-16 (13,14), moderate correlation for percentage changes in both PASI and DLQI (29) and in a systematic review of randomized clinical trials (RCT) a strong correlation was demonstrated between mean percentage reduction in PASI and mean reduction in DLQI (34). In the same review patients achieving PASI75 showed clinically meaningful higher reductions in mean DLQI compared with those achieving PASI50-75 and PASI < 50 (34) and in RCTs, patients achieving PASI90 reported lower DLQI than those achieving PASI75-89 (11), and a higher proportion of patients achieving PASI100 report a DLQI of 0 or 1 compared with patients achieving PASI75-< 100 (35).…”

Section: Discussionmentioning

confidence: 95%

“…The correlation between changes in PASI and DLQI were assessed for the periods: baseline to 3 months, 3 to 12 months, and baseline to 12 months. The correlations were evaluated based on absolute changes in PASI and DLQI relative changes in both PASI and DLQI, and for relative change in PASI and absolute change in DLQI, as all outcomes have been used in prior studies (13,14,29). We then investigated the correlation between changes in PASI and changes in the newly proposed DLQI-R (30).…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, patients achieving PASI90 report lower Dermatology Life Quality Index (DLQI) than patients achieving PASI75-89 (11) and patients with clear skin based on Physicians Global Assessment (PGA) report lower DLQI compared with those with almost clear skin (12). However, in smaller studies, changes in PASI during the first 3 months of treatment do not correlate fully with changes in DLQI (13,14) and reported correlations between PASI and DLQI range from negligible (13,15) to strong (16,17). This apparent dissociation between PASI and DLQI is not yet fully elucidated, but pruritus has been shown to affect this relationship (18).…”

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confidence: 99%

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Patient-reported Outcomes During Treatment in Patients with Moderate-to-severe Psoriasis: A Danish Nationwide Study

Loft

Egeberg²,

Rasmussen³

et al. 2019

Acta Derm Venereol

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The Danish clinical database DERMBIO collects routine information during the treatment of psoriasis with biolo gics or small molecules. These include physicians' evalua tion of severity, with the Psoriasis Area Severity Index, and the influence on patients' lives, with the Dermatology Life Quality Index. Among 1,677 patients the correlation between Psoriasis Area Severity Index and Dermatology Life Quality Index was weaktomoderate during a 5year treatment period. The changes in Psoriasis Area Severity Index correlated weaktomoderately with changes in Der matology Life Quality Index during the first 12 months of treatment, with the strongest correlation seen during the first 3 months. Symptoms were the most important fac tor in the Dermatology Life Quality Index. Measuring and monitoring of patients' symptoms are important, and ad ditional measures to capture symptoms might be beneficial in daily practice. The initiation and evaluation of treatment with biologics for psoriasis is based on the Psoriasis Area Severity Index (PASI) and/or Dermatological Life Quality Index (DLQI). However, these indices do not always correlate well, and changes in the DLQI do not always follow changes in the PASI. Based on data from the Danish national registry (DERMBIO), this study investigated the correlation between changes in PASI and DLQI in a cohort of patients with moderate-to-severe psoriasis treated with biologics or apremilast using Spearman's rank correlation analyses. The correlation analysis of 1,677 patients, of whom 276 had available data after 5 years, showed weak-to-moderate correlation between PASI and DLQI during a 5-year period and between changes in PASI and DLQI: 0.58 (p < 0.0001) for baseline to 3 months and 0.42 (p < 0.0001) for 3 to 12 months. The first question on "Symptoms and feelings" made up the largest proportion of the overall DLQI. The correlation between PASI and DLQI is weakto-moderate and varies over time. Changes in PASI correlate weak-to-moderately with changes in DLQI during the first 12 months of treatment, with symptoms being the most important factor contributing to impaired quality of life.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Patient-reported Outcomes During Treatment in Patients with Moderate-to-severe Psoriasis: A Danish Nationwide Study

Loft

Egeberg²,

Rasmussen³

et al. 2019

Acta Derm Venereol

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“…4 Several studies have demonstrated various degrees of correlation between PASI response and DLQI improvement; however, the DLQI is not specific for psoriasis. [5][6][7][8][9] In the pivotal VOYAGE 1 and 2 clinical trials of guselkumab in psoriasis, clinician-determined PASI and IGA outcomes were highly correlated with DLQI; 10,11 however, about 20% to 30% of patients achieving clear skin (ie, 100% improvement in PASI score [PASI 100]) still reported a DLQI score >1 in VOYAGE 1, indicating psoriasis still had an impact on daily life. 12 Recently, greater emphasis has been placed on patientreported assessments of the severity of psoriasis and improvement after treatment.…”

Section: Introductionmentioning

confidence: 99%

Correlation of Physician-Assessed Psoriasis Area and Severity Index Scores With Patient-Reported Psoriasis Symptoms and Signs Diary Scores Among Patients With Moderate-to-Severe Psoriasis: Results From VOYAGE 1 and VOYAGE 2 Studies

Gordon

Han

et al. 2019

Journal of Psoriasis and Psoriatic Arthritis

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Background: Patient-reported and clinician-determined outcomes do not always correlate in clinical trials for psoriasis, even among those with clear skin. Objective: To compare clinical responses with patient-reported outcomes among patients with psoriasis enrolled in 2 phase 3, double-blind, controlled trials of guselkumab (VOYAGE 1 and VOYAGE 2). Methods: Overall, 1432 patients randomized to guselkumab, placebo, or adalimumab at baseline were included in the pooled patient population; measures were assessed at baseline and week 16. End points included proportions of patients achieving 100% improvement in their Psoriasis Area and Severity Index (PASI 100) score and summary scores = 0 on the Psoriasis Symptoms and Signs Diary (PSSD). Proportions of patients with PSSD symptom/sign summary scores = 0 and mean PSSD summary scores were summarized by PASI 100 status. Association between PASI and PSSD scores were evaluated using Pearson correlation coefficients. Results: Among week-16 PASI 100 responders, 46.8% and 34.1% reported PSSD symptom and sign summary scores = 0, respectively, and 30.9% and 49.0% reported minimal symptoms/signs (scores = 1 to <10), respectively; mean scores (scale 0-100) were 6.4 for symptoms and 5.8 for signs. Among PASI 100 nonresponders, only 11.1% (symptoms) and 7.5% (signs) reported PSSD summary scores = 0; mean scores were 25.7 and 26.7, respectively. Correlation coefficients between overall PASI response and PSSD scores were 0.63 (symptoms) and 0.68 (signs; both P < .0001). Conclusion: While PASI and PSSD scores were highly correlated and most PASI 100 responders reported no/minimal symptoms or signs at week 16, substantial discrepancies were found between complete clearance from the clinician’s view versus symptom/sign-free status from patients’ perspectives.

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Outcomes Following a Mandatory Nonmedical Switch From Adalimumab Originator to Adalimumab Biosimilars in Patients With Psoriasis

et al. 2021

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MAIN OUTCOMES AND MEASURESThe primary outcome was 1-year drug retention in patients switching to adalimumab biosimilars compared with patients treated with adalimumab originator. Crude and adjusted retention rates for the adalimumab biosimilar cohort were compared with the adalimumab originator cohort with Cox proportional hazards regression using robust variance.RESULTS A total of 348 patients were included in the adalimumab biosimilar cohort (mean [SD] age, 52.2 [13.6] years; 251 [72.1%] male) and 378 patients in the adalimumab originator cohort (mean [SD] age, 51.1 [14.1] years; 272 [72.0%] male). The 1-year drug retention rates were 92.0% (95% CI, 89.0%-94.9%) for the adalimumab biosimilar cohort and 92.1% (95% CI, 89.4%-94.8%) for the adalimumab originator cohort. Similar hazard ratios were observed between the 2 cohorts. The crude hazard ratios were 1.02 (95% CI, 0.61-1.70; P = .94) for all causes of drug discontinuation, 0.82 (95% CI, 0.39-1.73; P = .60) for insufficient effect, and 1.41 (95% CI, 0.52-3.77; P = .50) for adverse events for the adalimumab biosimilar cohort when compared with the adalimumab originator cohort.

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Correlation Between Dermatology Life Quality Index and Psoriasis Area and Severity Index in Patients with Psoriasis Treated with Ustekinumab

Cited by 25 publications

References 12 publications

Patient-reported Outcomes During Treatment in Patients with Moderate-to-severe Psoriasis: A Danish Nationwide Study

Patient-reported Outcomes During Treatment in Patients with Moderate-to-severe Psoriasis: A Danish Nationwide Study

Correlation of Physician-Assessed Psoriasis Area and Severity Index Scores With Patient-Reported Psoriasis Symptoms and Signs Diary Scores Among Patients With Moderate-to-Severe Psoriasis: Results From VOYAGE 1 and VOYAGE 2 Studies

Outcomes Following a Mandatory Nonmedical Switch From Adalimumab Originator to Adalimumab Biosimilars in Patients With Psoriasis

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