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Introduction: Psoriasis is a chronic, inflammatory, immune-mediated disease. This study assessed the time at which patients switched from a conventional oral systemic treatment to a biologic therapy; patient clinical and quality of life (QoL) outcomes associated with oral systemic treatments; and the proportion of patients who persisted on oral therapy (nonswitchers), despite reported suboptimal clinical and QoL outcomes. Methods: This data analysis used the Adelphi Real World Psoriasis Disease Specific Programme, a non-interventional, retrospective, cross-sectional survey conducted in the USA, France, Germany, and United Kingdom (August 2018–April 2019). Kaplan–Meier (KM) analysis assessed switching from oral to biologic therapy in patients treated ≥ 3 years at survey completion (n = 597). The severity of psoriasis was reported by physicians as the percentage of body surface area (BSA) affected by psoriasis. Dermatology Life Quality Index (DLQI) scores were calculated for three groups: nonswitchers who met treatment failure criteria, nonswitchers who did not meet failure criteria, and switchers to a biologic therapy. Results: In KM analysis, approximately 50% of the patient population switched by 24 months. A substantial portion of nonswitchers continued to have moderate-to-severe psoriasis. Among nonswitchers, 57–77% had BSA ≥ 3% and 16–24% had BSA ≥ 10% at the time of the survey compared with 37% of switchers who had BSA of ≥ 3% and 9% who had BSA of ≥ 10%. QoL was poor among nonswitchers. The mean [standard deviation (SD)] DLQI scores for nonswitchers meeting treatment failure criteria, nonswitchers not meeting failure criteria, and switchers were 6.11 (4.55), 2.62 (3.29), and 2.25 (4.23), respectively. Conclusion: There is a clear unmet need for more effective oral therapies, and further research into the reasons for patients remaining undertreated, which may include patient preference for oral treatments (despite lack of response), contraindications, or insurance/formulary-related barriers to access, are needed. Plain Language Summary: Psoriasis is a common skin disease that causes itchy, painful, scaly sores. Patients may feel stigmatized, which can impact their quality of life and productivity. About 1 in 5 patients have severe psoriasis, which is harder to treat and may require pills or shots. Both shots and pills are effective at treating psoriasis; however, many patients choose to continue taking pills, even if their psoriasis worsens, for reasons including a desire to avoid needles. We described patients with moderate-to-severe psoriasis who started on pills and either remained on pills or switched to shots by the time of the survey. We looked at the reasons they gave for switching, as well as at quality of life measures reported by the patients. To do this, we analyzed data from a survey called the Adelphi Real World Psoriasis Disease Specific Programme. This survey was conducted among doctors who treat skin diseases and their patients. Participating doctors and patients from the USA, France, Germany, and the United Kingdom were asked questions about the patients' health and how psoriasis affects their lives. Survey results showed that nearly half of patients switched to shots by 24 months, and most who switched cited treatment failure as the reason. Those who continued to take their pills despite having more severe psoriasis symptoms had more itching and pain and had lower quality of life than those who switched to shots. This suggests that there is a need for more effective oral treatments for patients with psoriasis. [ABSTRACT FROM AUTHOR]

There is a lack of validated information of both physician and patient-reported treatment satisfaction, and association with outcomes in psoriasis. Data from the 2015 Adelphi Psoriasis Disease Specific Programme were used to compare self-reported satisfaction with biologic and non-biologic therapy for psoriasis in physicians and their consulting patients in the United States (USA) and five European countries (EU5). Disease severity and health-related quality of life (HRQoL) were assessed using Body Surface Area (BSA) affected by psoriasis and the Dermatology Life Quality Index (DLQI), respectively. Patients satisfied with biologic therapy reported better HRQoL than unsatisfied patients, whereas a greater proportion of unsatisfied patients on biologic therapy had moderate-to-severe psoriasis (USA: 95.1% versus 52.4%, EU5; 86.4% versus 43.1%, P<0.0001). Multivariate logistic regression indicated that having a BSA affected by psoriasis of >10% was associated with lower likelihoods of physician and patient treatment satisfaction versus <3% (P<0.0001). A one-unit increase in the DLQI score lowered the likelihood of a patient being satisfied by approximately 20% (P<0.0001). Patients were ~60% more likely to be satisfied on biologic therapy than non-biologic therapy (P=0.0012). Physician and patient-reported treatment satisfaction was associated with greater HRQoL and lesser disease severity.

Background: Patients with ulcerative colitis (UC) experience periods of recurring and episodic clinical signs and symptoms. This study sought to establish the association between disease activity and health-related quality of life (HRQoL) and other patient-reported outcomes., Methods: United States (US) and European Union 5 ([EU5]; i.e., France, Germany, Italy, Spain, and the United Kingdom) data from the 2015 and 2017 Adelphi Inflammatory Bowel Disease-Specific Programme (IBD-DSP) were used. The IBD-DSP is a database of retrospective patient chart information integrated with patient survey data (EuroQoL-5 Dimensions [EQ-5D], Short Quality of Life in Inflammatory Bowel Disease Questionnaire [SIBDQ], and Work Productivity and Activity Impairment-Ulcerative Colitis [WPAI-UC] questionnaire). Using available chart information, physicians classified their moderate-to-severe patients into one of the following categories: remission with a Mayo endoscopic score = 0 ("deep remission"), remission without a Mayo endoscopic score = 0 ("remission"), or active disease. Differences among disease activity categories with respect to patient-reported outcomes were analyzed using generalized linear models, controlling for confounding variables., Results: N = 289 and N = 1037 patient charts with linked surveys were included from the US and EU5, respectively. The disease activity distribution was as follows: active disease = 40.1% (US) and 33.6% (EU5); remission = 48.0 and 53.0%; deep remission = 11.9 and 13.3%. Patients with active disease reported significantly lower levels of EQ-5D health state utilities (adjusted mean [AdjM] = 0.87 [US] and 0.78 [EU5]) compared with remission (AdjM = 0.92 and 0.91) and deep remission (AdjM = 0.93 and 0.91) (all P < 0.05 compared with active disease within each region). Similar findings were observed with the scores from the SIBDQ and the WPAI-UC. No significant differences were observed between remission categories., Conclusions: Among patients with moderate-to-severe UC in the US and EU5, active disease was associated with significant impairments in HRQoL, work and leisure activities. These results reinforce the importance, to both the patient and society, of achieving some level of remission to restore generic and disease-related HRQoL and one's ability to work productively.