Dermatology Life Quality Index in Patients with Psoriasis Treated with Biologic Versus Non-biologic Treatment in Malaysia: A Retrospective Cross-Sectional Study

Abstract

Background Psoriasis imposes a substantial burden on patients’ social, emotional, physical, and family life. Although psoriasis has no complete cure, various treatments are available to control its symptoms and improve a patients’ quality of life. Objective We aimed to compare the effectiveness of biologic versus non-biologic treatments on health-related quality of life among patients with psoriasis in Malaysia. Methods This retrospective cross-sectional study evaluated data of adult patients diagnosed with psoriasis during 2007–18 from the Malaysian Psoriasis Registry. Baseline demographics, disease, and treatment characteristics were described. For a subset of patients treated with biologics and non-biologics who had baseline and 6-month follow-up data available, changes in the mean Dermatology Life Quality Index scores and the proportion of patients with a clinically relevant improvement (≥ 4 points) post-treatment were assessed. Results Overall, 15,238 adult patients with psoriasis from the Malaysian Psoriasis Registry were included in the analysis. Patients receiving biologics showed a statistically significant reduction in the mean Dermatology Life Quality Index scores after 6 months compared with those receiving non-biologic treatment (− 5.7 vs − 0.8%; p < 0.001). The proportion of patients who achieved a ≥ 4-point improvement in Dermatology Life Quality Index scores was approximately two times greater in the biologic-treated group versus the non-biologic-treated group (56.4 vs 27.7%). Conclusions Biologic treatment showed a greater reduction in the Dermatology Life Quality Index scores of patients with psoriasis versus non-biologic treatment. These results highlight the importance of early treatment with more efficacious treatment options, such as biologic therapies, to improve the overall health-related quality of life of patients with psoriasis.

Properties and Use of the Dermatology Life Quality Index in Patients with Psoriasis

“…Показатели ДИКЖ обычно коррелируют с данными оценки по PASI и результатами применения других шкал оценки качества жизни. Большинство научных публикаций посвящено применению ДИКЖ в рамках клинических исследований, в том числе анализу эффективности биологической тера- Robinson, 2023 [25] необходимости назначения современного лекарственного лечения большему числу пациентов [1,33]. Таким образом, возможные недостатки ДИКЖ могут быть устранены путем проведения дополнительных клинических исследований.…”

“…В практике оценки эффективности биологической терапии (начало терапии или смена биологического препарата) показатели ДИКЖ оказываются полезными для оценки субъективных жалоб пациента, не включенных в шкалу PASI [24]. В крупном малазийском исследовании эффективности биологической терапии в отношении качества жизни (КЖ) по ДИКЖ изучались регистрационные записи по взрослым пациентам (Robinson et al [25]). В анализ были включены 15 238 пациентов.…”

“…Таким образом, в данном исследовании было сложно установить корреляцию между результатами оценок по ДИКЖ и PASI. Тем не менее с помощью применения оценок по ДИКЖ было показано, что биологическая терапия обладает преимуществами и способствует значительному улучшению качества жизни пациентов [25].…”

Impact of residual skin lesions and previous biologic treatment failure on patient‐reported outcomes in patients with psoriasis receiving biologic treatment

“…7,8 These clinical improvements are paralleled by enhancements in patientreported outcome measures, including the Dermatology Life Quality Index (DLQI). [8][9][10][11][12][13][14][15][16][17] However, it is imperative to note that achieving clear skin does not guarantee an optimal quality of life for all patients. Several studies have revealed that approximately 20% of patients with clear skin still report a negative impact of psoriasis on their quality of life, as indicated by DLQI scores exceeding 1.…”

“…Recent advances in biologic treatments have revolutionized psoriasis management, offering patients the potential for near or complete skin clearance 7,8 . These clinical improvements are paralleled by enhancements in patient‐reported outcome measures, including the Dermatology Life Quality Index (DLQI) 8–17 …”