Biologic Therapy Improves Skin Clearance, QoL in Real-World Patients With Psoriasis

The relationship between patient-reported symptoms and HRQoL vs physician-reported psoriasis severity was examined in this study.

Skin clearance associated with biologic agents significantly improved patient-reported quality of life (QoL) in the real world and similar to that observed in clinical trials, according to study findings published in Dermatology and Therapy.

In this 12-month multinational, prospective, real-world, non-interventional study (PSO-BIO-REAL), investigators enrolled patients ≥18 years of age with moderate to severe plaque psoriasis who used biologic therapy. Patients were either biologic naïve or they had switched to a different biologic agent. Patients were from 5 countries, including the United States, France, Italy, Germany, and the United Kingdom.

At baseline, 6 months, and 12 months after treatment, the Psoriasis Symptom Inventory (PSI) was used to assess psoriasis symptoms, whereas the Dermatology Life Quality Index (DLQI) was used to examine health-related QoL (HRQoL). The researchers assessed potential associations between psoriasis symptoms and HRQoL with psoriasis severity (Psoriasis Area and Severity Index [PASI]).

Approximately 25.5% of patients achieved PSI 0 at 12 months, suggesting roughly one-quarter of patients have no disease activity 12 months after using biologic therapy. In addition, 51.2% achieved DLQI 0/1, indicating that half of patients reported no effect of the disease on their life.

Compared with patients experienced with biologic therapy, a greater percentage of patients who were biologic-agent naïve achieved PSI 0 (17.6% vs 31.0%) and DLQI 0/1 (46.1% vs 54.6%) at 12 months. Also, patients with greater degrees of skin clearance were more likely to achieve PSI 0 and DLQI 0/1.

In regard to the type of biologic agent, achievement of DLQI 0 and DLQI 0/1 at 6 months ranged from 20.2% with etanercept to 36.9% with adalimumab for DLQI 0, and from 39.3% with etanercept to 53.0% with ustekinumab for DLQI 0/1.

A limitation of this study, according to the researchers, was the potential overestimation of response rates of patients, as the patients who discontinued were not included in the final analysis.

The investigators added that their findings emphasize “the importance of considering both patient-reported outcomes and physician-reported outcomes when assessing treatment outcomes” to biologic therapy for patients with psoriasis.

Disclosure: This clinical trial was supported by Amgen and AstraZeneca. Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Lacour JP, Bewley A, Hammond E, et al. Association between patient- and physician-reported outcomes in patients with moderate-to-severe plaque psoriasis treated with biologics in real life (PSO-BIO-REAL). Dermatol Ther (Heidelb). Published online Aug 6, 2020. doi:10.1007/s13555-020-00428-1