Objective
To describe the relationship between disease severity (as measured by Body Surface Area 
[BSA]%) on patient-reported outcomes among US psoriasis (PsO) patients using the Adelphi 
PsO Disease Specific Programme (DSP).

Methods
This study is based on real world survey data obtained from US adult patients with a diagnosis 
of PsO and their treating dermatologists. Patients were invited to self-complete a form containing 
the EuroQol 5 dimensions (EQ-5D), Work Productivity Activity Impairment (WPAI) and the 
Dermatology Life Quality Index (DLQI) questionnaires and questions regarding their level of 
satisfaction with current treatment. Three groups of patients were identified based on physician 
reports of BSA% with PsO achieved with treatment at the time of completing the survey; BSA 
0-2%= Mild, 3-10%= Moderate, >10%= Severe. Several factors including demographics, DLQI, 
WPAI and EQ-5D were compared across these patient groups. Patient groups were compared 
using analysis of variance and chi-square tests. Kruskal-Wallis, Fisher’s Exact and Student’s 
T-Test where used where appropriate.

Results
 ■ Of the 261 patients included; 132 had mild disease, 98 had moderate disease and 31 had 
severe disease activity at the time of completing the survey.

 ■ All groups had a similar age [mean (M)±standard deviation (SD) for each]; mild 47.5±17.2, 
moderate 48.5±14.7, severe 49.0±16.4. 

 ■ Proportions of females was 50.8% [mild], 44.9% [moderate], 35.5% [severe]. 
 ■ Of the mild patients 47% were prescribed a biologic at the time of completing the survey 
vs. 42.9% of moderate patients, and 67.7% of severe patients. 

 ■ At initiation of current biologic 89.3% of currently mild patients had a BSA% of moderate 
to severe

 ■ At time of completing the survey, duration on a biologic in weeks was [M±SD] mild; 72.3±66.2, 
moderate 48.4±52.3, severe 34.4±59.6 (Table 1). 

Table 1. Patient Demographics

Currently Mild 
(n=132)

Currently 
Moderate 
(n=98)

Currently Severe 
(n=31)

Mean Age (±SD) 47.5 (±17.2) 48.5 (±14.7) 49.0 (±16.4)
Patient Sex (%)

Male 49.2 55.1 64.5
Female 50.8 44.9 35.5

Proportion of patients on Biologics: n (%) 62 (47%) 42 (42.9%) 21 (67.7%)
Proportion patients moderate to severe BSA at 
initiation of biologic: n (%)

50 (89.3%) 42 (100%) 25 (100%)

Duration on biologic in weeks (±SD) 72.3 (±66.2) 48.4 (±52.3) 34.4 (±59.6)

 ■ Patient-reported satisfaction with treatment was significantly higher for patients who achieved 
a BSA% consistent with mild disease after treatment 86.2% vs. both moderate disease 
58.7% (p<0.001) and severe disease 37.0% (p<0.001) (Figure 1).

Figure 1. Patient Recorded Satisfaction with Treatment

86.2%*

58.7%

37.0%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Patient recorded satisfaction
Mild Moderate Severe

*Denotes statistical significance

 ■ Mean EQ-5D score was significantly greater for patients who achieved a BSA% consistent 
with mild disease after treatment 0.927 vs. both moderate disease 0.881 (p<0.013) and 
severe disease 0.748 (p<0.001) (Figure 2).

Figure 2. EQ-5D Score

Mild Moderate Severe

0.927*
0.881

0.748

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1

EQ-5D Score

*Denotes statistical significance

 ■ Mean DLQI score was significantly better for patients who achieved a BSA% consistent with 
mild disease after treatment 2.76 vs. both moderate disease 6.14 (p<0.001) and severe 
disease 9.64 (p<0.001) (Figure 3).

Figure 3. DLQI Score

Mild Moderate Severe

2.76*

6.14

9.64

0

2

4

6

8

10

12

DLQI Score

*Denotes statistical significance

 ■ Work Productivity Loss was lower for patients who had a BSA% consistent with mild disease 
after treatment 6.6% vs both, moderate disease 14.9% (p<0.008) and severe disease 26.5% 
(p=0.001), with activity impairment lower for patients who had a BSA% consistent with mild 
disease after treatment 11.5% vs. both moderate disease 18.6% (p<0.013) and severe 
disease 31.4% (p<0.001). Presenteeism was lower for patients who had a BSA% consistent 
with mild disease after treatment 5.6% vs. both moderate disease 14.3% (p<0.002) and 
severe disease 25.0% (p<0.001) (Figure 4).

Figure 4. Work Productivity and Activity Impairment (Patient Reported) 

Mild Moderate Severe

6.6%*
5.6%*

14.9%

18.6%

11.5%*

14.3%

26.5%

31.4%

25.0%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

Work Productivity Loss Activity Impairment Presenteeism

*Denotes statistical significance

Conclusions
 ■ Patients with plaque PsO who achieved a lower severity consistent with mild disease after 
treatment (as measured by BSA% affected), had higher levels of self-reported satisfaction 
with treatment, less productivity loss, and a better QoL than patients with higher disease 
severity. 

 ■ Plaque PsO patients who achieved a lower severity consistent with mild disease after 
treatment were also more likely to have a longer duration of biologic treatment, suggesting 
that biologics have a positive impact on real-world patient reported outcomes.

References
1. Kim J, Krueger JG. The immunopathogenesis of psoriasis. Dermatologic clinics. 2015;33(1):13-23.
2. Di Meglio P, Villanova F, Nestle FO. Psoriasis. Cold Spring Harbor perspectives in medicine. 2014;4(8).
3. Parisi R, Symmons DP, Griffiths CE, Ashcroft DM. Global epidemiology of psoriasis: a systematic review of incidence 

and prevalence. The Journal of investigative dermatology. 2013;133(2):377-385.

This study was supported by Janssen Scientific Affairs, LLC

Assessing the Relationship Between Disease Severity and Patient-Reported Outcomes in Psoriasis Patients in 
the US 
J. Lucas,1 A. Teeple,2 J. Hetherington,1 E. Muser2
1Adelphi Real World; 2Janssen Scientific Affairs, LLC