Psoriasis is an autoimmune disease that alters the life-cycle of skin cells. The skin becomes red and flaky. Crusty patches covered with silvery scales begin to appear on the skin.
A substantial part of people, one in five, undergoing systemic
treatment for psoriasis (i.e. pills taken orally, injections or
infusions) still have considerable problems with their disease. This is
according to a study with 2,646 Swedish psoriasis patients conducted by
researchers at Umeň University and the Swedish Institute for Health
Economics, and recently published in the Journal of Dermatological Treatment
‘Almost one in five patients with psoriasis had highly active disease activity, despite ongoing systemic treatment.’
"Our results suggest that the currently available treatments are not
sufficiently treating patients with moderate-to-severe psoriasis. So in
order to manage their disease, more patients need access to currently
available biologic agents as well as other new and more efficacious
treatments," says Marcus Schmitt-Egenolf, researcher at the Department
of Public Health and Clinical Medicine at Umeň University and
corresponding author of the study.
More than a decade ago, developments in biologics transformed the
treatment of moderate-to-severe psoriasis by providing new ways for
better skin clearance rates, low toxicity, and improved quality-of-life
for patients. Nonetheless, the study led by Marcus Schmitt-Egenolf shows
that despite having an ongoing systemic treatment, 18% of
patients still had extensive psoriasis lesions and/or suffered
impairment of their skin-related quality-of-life.
The study was based on PsoReg, which is the Swedish quality register
for systemic treatment of psoriasis. 2,646 psoriasis patients who had
been receiving systemic treatment for at least three months were
included in the study, which analyzed their most recent visit registered
in PsoReg. Disease severity was measured either by the physician's
clinical assessment and/or by the patient's own assessment of their
skin-related quality of life.
Compared to the larger patient group, the subgroup of patients with
suboptimal therapy-response were younger and had higher BMI. They were
also more often suffering from psoriasis arthritis and were more often
smokers. The subgroup with higher persisting psoriasis severity also
reported worse overall quality-of-life, measured with the standard
evaluation method EQ-5D questionnaire.
"That almost one in five patients had highly active disease
activity, despite ongoing systemic treatment, is concerning," says
Based on the results, the authors make several suggestions. For
patients with moderate-to-severe psoriasis, who are using conventional
systemic treatments, biologics should be considered. Patients with
moderate-to-severe psoriasis, who already receive biologics, may need
new treatment options. And lastly, the patients should also receive
support in improving lifestyle factors.