Quality of Life Questionnaire Key in Managing Hidradenitis Suppurativa

Researchers from the European Academy of Dermatology and Venerology discuss the value of evaluating quality of life in patients with hidradenitis suppurativa and present updated information on instruments to measure health-related quality of life specific to hidradenitis suppurativa.

Physicians who treat patients with hidradenitis suppurativa should regularly assess patients for health-related quality of life (HRQoL) issues using the Dermatology Life Quality Index (DLQI), according to a position statement published in the Journal of the European Academy of Dermatology and Venereology.

Together, researchers on the European Academy of Dermatology and Venerology (EADV) Task Force on Quality of Life (QoL) and Patient-Oriented Outcomes and the EADV task force on acne, rosacea, and hidradenitis  suppurativa published a position statement that addressed current knowledge and challenges in clinical trials and issued practical recommendations for quality of life assessment in hidradenitis suppurativa.

Investigators performed a literature review, searching PubMed from 1980 through September 2018 to identify articles focused on hidradenitis suppurativa QoL included in the final analysis.

The researchers identified 18 clinical trials that examined the efficacy of 4 different drugs (7 trials of infliximab, 6 trials of adalimumab, 3 trials of etanercept, and 2 trials of ustekinumab). Five articles assessed surgical treatment, 2 assessed photodynamic therapy, and 1 examined surgical treatment plus photodynamic therapy. Additional treatment methods examined included antibiotics, metformin, and hyperbaric oxygen therapy. The investigators primarily measured HRQoL with the DLQI.

Patients with self-reported hidradenitis suppurativa had a higher impaired HRQoL score vs the general population; similarly, QoL was more affected in hidradenitis suppurativa compared with “several other dermatologic conditions,” including psoriasis. Researchers also found a “strong positive correlation” between DLQI scores and clinical severity of hidradenitis suppurativa and more instances of sexual dysfunction distress vs matched control participants.

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The researchers noted that among patients with hidradenitis suppurativa, “[c]linical signs and the secondary effects on daily and social life… often cause significant impairment of [HRQoL].” This QoL impairment is frequently higher than the impairment found in “most other chronic skin diseases.”

The following position statement on hidradenitis suppurativa was issued: “HRQoL assessment should be widely used in the management of [patients with hidradenitis suppurativa].”

The researches indicated that, however, because of a “lack of sufficient validation,” it is not recommended to use the existing hidradenitis suppurativa-specific instruments in clinical studies; the dermatology-specific DLQI questionnaire is recommended for use in this patient population.

“The EADV [task forces] encourage further development, validation, and use of other [hidradenitis suppurativa]-specific, dermatology-specific, and generic instruments,” the researchers concluded.

Multiple authors report receiving fees from pharmaceutical companies. See the reference for complete disclosure information.

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Chernyshov PV, Zouboulis CC, Tomas-Aragones L, et al. Quality of life measurement in hidradenitis suppurativa: position statement of the European Academy of Dermatology and Venerology task forces on quality of life and patient-oriented outcomes and acne, rosacea and hidradenitis suppurativa [published online April 29, 2019]. J Eur Acad Dermatol Venereol. doi:10.1111/jdv.15519