Quality of life (QoL) is an important issue in psoriatic disease that should be included when assessing therapeutic efficacy of treatments. The objective of this study was to compare improvement in the dermatology life quality index (DLQI) between patients treated with adalimumab and ustekinumab.
Methods:
Analysis was based on two separate open-label 24-week clinical trials assessing DLQI and the Psoriasis Area and Severity Index (PASI) at four-week intervals in adult subjects with moderate to severe psoriasis treated with adalimumab or ustekinumab.
Results:
There were no statistically significant differences in the improvement in DLQI and PASI between the adalimumab and ustekinumab groups except at week 12 for DLQI and week 8 for PASI (ustekinumab > adalimumab).
Discussion:
Both adalimumab and ustekinumab improve QoL, but further research is necessary to determine specific factors that improve QoL and if one medication improves QoL more than another.
FavaG.A.PeriniG.I.SantonastoP.FornasaC.V.. Life events and psychological distress in dermatologic disorders: psoriasis, chronic urticaria, and fungal infections.Br J Med Psychol.1980; 53: 277–82.
2.
GuptaM.A.GuptaA.K.SchorkN.J.GorrS.K.EllisC.N.VoorheesJ.J.. A psychocutaneous profile of psoriasis patients who are stress reactors: a study of 127 patients.Gen Hosp Psych.1989; 11: 166–73.
3.
HatchM.L.ParadisC.FriedmanS.PopkinM.ShalitaA.R.. Obsessive compulsive disorder in patients with chronic pruritic conditions: case studies and discussion.J Am Acad Dermatol.1992; 26: 549–51.
4.
HughesJ.E.BarracloughB.M.HamblinL.G.WhiteJ.E.. Psychiatric symptoms in dermatology patients.Br J Psychiatry.1983; 143: 51–4.
5.
HardyG.E.CotterillJ.A.. A study of depression and obsessionality in dysmorpho-phobic and psoriatic patients.Br J Psychiatry.1982; 140: 19–22.
6.
LyketsosG.C.StratigosJ.TawilG.PsarasM.LyketsosC.G.. Hostile personality characteristics, dysthymic states, and neurotic symptoms in urticaria, psoriasis, and alopecia.Psychother Psychosom.1985; 44: 122–31.
7.
JowettS.RyanT.. Skin disease and handicap: an analysis of the impact of skin conditions.Soc Sci Med.1985; 20: 425–9.
8.
MatussekP.AgererD.SiebtG.. Aggression in depressives and psoriatics.Psychother Psychosom.1985; 43: 120–5.
9.
RappS.R.ExumM.L.ReboussinD.M.FeldmanS.R.FleischerA.ClarkA.. The physical, psychological, and social impact of psoriasis.J Health Psychol.1997; 2: 525–37.
10.
SanbornP.R.SanbornC.J.CimbolicP.NiswanderG.P.. Suicide and stress related dermatoses.Dis Nerv Syst.1972 Jun; 33(6): 391–4.
11.
SevilleR.H.. Psoriasis and stress.Br J Dermatol.1977; 97: 297–302.
12.
WeinsteinM.Z.. Psychosocial perspectives on psoriasis.Dermatol Clin.1984; 2: 507–15.
13.
PerrottS.B.MurrayA.H.LoweJ.MathiesonC.M.. The psychosocial impact of psoriasis: physical severity, quality of life, and stigmatization.Physiol Behav.2000; 70: 567–71.
14.
PearceD.J.SinghS.BalkrishnanR.KulkarniA.FleischerA.B.FeldmanS.R.. The negative impact of psoriasis on the workplace.J Dermatolog Treat.2006; 17: 24–8.
15.
GuptaM.A.GuptaA.K.. Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis.Br J Dermatol.1998; 139: 846–50.
16.
FinlayA.Y.KhanG.K.. Dermatology life quality Index – a simple practical measure for routine clinical use.Clin Exp Dermatol.1994: 19(3): 210–6.
17.
BasraM.K.HussainS.. Application of the dermatology life quality index in clinical trials of biologics for psoriasis.Chin Integr Med.2012: 18(3): 179–85.
18.
RevickiD.A.WilliamM.K.MenterA.Impact of adalimumab treatment on patient-reported outcomes: results from a Phase III clinical trial in patients with moderate to severe plaque psoriasis.J Dermatol Treat.2007; 18(6): 341–50.
19.
RivickiD.WillianM.SauratJ.H.Impact of adalimumab treatment on health-related quality of life and other patient-reported outcomes: results from a 16-week randomized controlled trial in patients with moderate to severe plaque psoriasis.Br J Dermatol.2008; 158(3): 549–57.
20.
ShikiarR.HeffernanM.LangleyR.G.WillianM.L.OkunM.M.RevickiD.A.. Adalimumab treatment is associated with improvement in health-related quality of life in psoriasis: patient-reported outcomes from a phase II randomized controlled trial.J Dermatol Treat.2007; 18(1): 25–31.
21.
StroberB.E.SobellJ.M.DuffinK.C.Sleep quality and other patient-reported outcomes improve after patients with psoriasis with suboptimal response to other systemic therapies are switched to adalimumab: results from PROGRESS, an open-label Phase IIIB trial.Br J Dermatol.2012: 167(6): 1374–81.
22.
GuentherL.HanC.SzaparyP.Impact of ustekinumab on health-related quality of life and sexual difficulties associated with psoriasis: results from two phase III clinical trials.J Eur Acad Dermatol Venereol.2011; 25(7): 851–7.
23.
LebwohlM.PappL.HanC.Ustekinumab improves health-related quality of life in patients with moderate-to-severe psoriasis: results from PHOENIX 1 trial.Br J Dermatol.2010; 162(1): 137–46.
24.
LinV.W.RingoldS.DevineE.B.. Comparison of ustekinumab with other biological agents for the treatment of moderate to severe plaque psoriasis: a Bayesian Network meta-analysis.Arch Dermatol.2012; 148(12): 1403–10.
25.
ReichK.BurdenA.D.EatonJ.N.HawkinsN.S.. Efficacy of biologics in the treatment of moderate to severe psoriasis: a network meta-analysis of randomized controlled trials.Br J Dermatol.2012; 166(1): 179–88.
26.
PuigL.LopezA.VilarrasaE.GarciaI.. Efficacy of biologics in the treatment of moderate-to-severe plaque psoriasis: a systematic review and meta-analysis of randomized controlled trials with different time points.J Eur Acad Dermatol Venereol.2014; 28(12): 1633–53.
27.
SignorovitchJ.E.BettsK.A.YanY.S.Comparative efficacy of biological treatments for moderate-to-severe psoriasis: a network meta-analysis adjusting for cross-trial differences in reference arm response.Br J Dermatol.2015; 172(2): 504–12.
28.
NastA.SporbeckB.RosumeckS.Which antipsoriatic drug has the fastest onset of action? Systematic review on the rapidity of the onset of action.J Invest Dermatol.2013; 133(8): 1963–70.
29.
LuckaT.C.PathiranaD.SammainA.Efficacy of systemic therapies for moderate-to-severe psoriasis: a systematic review and meta-analysis of long-term treatment.J Eur Acad Dermatol Venereol.2012; 26(11): 133–44.
30.
MarksR.BartonS.P.ShuttleworthD.FinlayA.Y.. Assessment of disease progress in psoriasis.Arch Dermatol.1989; 125: 235–40.
31.
KimN.ThrashB.MenterA.. Comorbidities in psoriasis patients.Semin Cutan Med Surg.2010; 29(1): 10–5.
32.
BasraM.K.A.SalekM.S.CamilleriL.SturkeyR.FinalyA.Y.. Determining the minimal clinically important difference and responsiveness of the dermatology life quality index (DLQI): further data.Dermatol.2015; 230: 27–33.
