Deeper than just skin, World Psoriasis Day spotlights the disease's human impact

New Canadian data shows that people living with psoriasis are compromising quality of life and amplifying serious comorbidities

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TORONTO, Oct. 25, 2017 /CNW/ - Eli Lilly Canada is pleased to share new insights into how Canadians living with psoriasis are impacted by the disease. As the international psoriasis community prepares to commemorate a day of awareness and education on World Psoriasis Day on October 29, the results of a new survey provide a better understanding of the physical and emotional struggles Canadians with psoriasis live with every day. Stress, social life, relationships, isolation, and treatment satisfaction are at the top of the list of concerns for Canadians.

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According to the data, over sixty-five per cent of Canadian respondents report feelings of daily stress due to psoriasis symptoms. Almost half (46%) indicate their social lives are negatively impacted by the condition. This has an effect on individuals' romantic relationships, and can create intimacy issues (37%) between partners. Isolation is extremely common for patients, with fifty-nine per cent feeling they have no one to turn to. Low self-esteem is constant, and more than half (57%) report psoriasis is the main reason for low confidence levels. Feelings of self-consciousness, depression, and anxiety all rank as major obstacles for people living with psoriasis.

"Every day we talk to people who echo exactly what the survey data is telling us: the 'human' toll of this disease is significant, and this is a message we want to share during World Psoriasis Day," says Kathryn Andrews-Clay, Executive Director, Canadian Association of Psoriasis Patients.

"If you have it, everything is affected—whether it's a person's career, social relationships, family pressures and even mental health, psoriasis hits them all,' says Glenn Hendricks, Executive Director, Canadian Psoriasis Network.

The Canadian results are part of a larger global survey of 1,457 people with moderate-to-severe psoriasis from nine countries. Along with the complex emotional impact of psoriasis, treatment success was also evaluated to better understand goals and outcomes. The majority of Canadian respondents with psoriasis (61%) report the most important aspect of treatment is skin clearance. When asked what type of information would be of most interest to someone living with psoriasis, respondents indicated itch management (56%), disease awareness (44%), diet education (42%), and stress management (38%) as their top priorities.

The international data suggest that while two thirds (67.2%) of people with psoriasis had set treatment goals, they may be settling for sub-optimal outcomes from their treatment, as the majority report only moderate satisfaction across key areas including overall skin improvement and, speed and duration of effect.ⁱ 

"Imagine a disease that can limit your ability to touch, a fundamental human gesture that for people with psoriasis is often missing," says Doron Sagman, Vice President, Medical Affairs, Lilly Canada. "Touch avoidance has a profound impact on quality of life for Canadians with uncontrolled symptoms.  Whether it is a handshake or a hug, patients can be apprehensive and further isolate themselves."

The results demonstrate that psoriasis affects all aspects of everyday life and is significantly increased by the presence of comorbidities (e.g., depression, asthma and psoriatic arthritis).

"I feel it is very important to engage my patients in a conversation where we can establish treatment goals together, this is where we see the best possible outcomes, but this is not mirrored in the survey. There is still a gap between patients and doctors and we should work together to improve this," says Dr. Loukia Mitsos, dermatologist. "Through an ongoing dialogue, physicians can better identify any unmet need and work collaboratively with patients toward treatment success."

About PsoriasisPsoriasis is a chronic, immune disease that affects the skin. It occurs when the immune system sends out faulty signals that speed up the growth cycle of skin cells. Psoriasis affects approximately 1 million Canadians.ⁱⁱ The most common form is plaque psoriasis, which affects approximately 90 per cent of patients.ⁱⁱⁱ Psoriasis can occur on any part of the body and is associated with other serious health conditions, such as diabetes, heart disease and some cancers.^iv The most common form of psoriasis, plaque psoriasis, appears as raised, red patches covered with a silvery white build-up of dead skin cells.^v

About the International Patient SurveyBetween 06 July and 22 December 2016, a total of 1,457 patients (mean age: 41.5, 45.6% male) with moderate-to-severe psoriasis from the UK, France, Germany, Italy, Spain, Canada, Denmark, The Netherlands, Sweden and Switzerland were interviewed as part of an international quantitative survey. Data were collected from people with moderate-to-severe psoriasis using a structured online survey.^vi

In the first analysis, the influence of psoriasis on the different aspects of daily life were rated using a 10-point scale (1: no impact; 10: very high impact): everyday life (e.g., bathing, cooking); work life; social life; family life; relationship with partner; and intimacy with partner. The impacts of demographics, disease, treatment and social parameters on these aspects of life were then measured using multivariate linear regression analysis corrected for baseline differences.^vii Factors with a significant influence (p<0.05) were classed as either decreasing or increasing the impact of psoriasis, and data were presented as mean estimates of differences in expected values. Results showed that psoriasis' impact on specific aspects of daily life increases with:

• A greater percentage of body surface affected by psoriasis (>10% body surface area, BSA, affected)
• The presence of certain comorbidities (psoriatic arthritis, depression, diabetes and asthma)
• Certain disease locations (genitals, hands, feet, nails, chest and back)
• Country of residence (France)

In the second analysis, treatment satisfaction was evaluated with respect to: overall disease improvement; improvement in specific areas of the body involved; frequency of drug administration; ease of drug use; rapidity of efficacy onset; duration of efficacy; and treatment overall. Satisfaction in each category was measured using a visual analogue scale (VAS) ranging from 0 to 10, with higher values representing greater satisfaction.^viii Results showed:

• 62.7% (n=913) of people with psoriasis had set treatment goals; 37.3% (n=544) did not set treatment goals
• Of people who did not set treatment goals (37.3%, n=544), only 15% proactively requested a treatment plan from their physician
• Of people with psoriasis with set treatment goals, the most commonly desired outcomes at the start of treatment were to reduce itchiness (61.6%), reduce flaking (55.6%) and improve skin clearance (51.7%)
• In 32.1% of cases, physicians and people with psoriasis had equal input into setting treatment goals; in 42.1% goals were set mainly by physicians and in 15.7% of cases, people with psoriasis had no input into treatment goals
• The frequency of treatment goal review varied from monthly (31.7% of cases) to every six months or less (34.1%)

About Eli Lilly Canada Inc.

Eli Lilly and Company is a global healthcare leader that unites caring with discovery to make life better for people around the world. We were founded more than a century ago by Colonel Eli Lilly, who was committed to creating high quality medicines that meet people's needs, and today we remain true to that mission in all our work. Lilly employees work to discover and bring life-changing medicines to those who need them, improve the understanding and management of disease, and contribute to our communities through philanthropy and volunteerism. Eli Lilly Canada was established in 1938, the result of a research collaboration with scientists at the University of Toronto which eventually produced the world's first commercially-available insulin. Lilly Canada now employs more than 600 people across the country, working in the areas of oncology, diabetes, autoimmunity, neurodegeneration, and pain. To learn more about Lilly Canada, please visit us at www.lilly.ca.

References

ⁱ Vender R, Wilhelm S, Dickson R, et al. Impact of Treatment Goals on Patient Satisfaction With Treatment of Moderate-to-Severe Psoriasis: Results From an International Quantitative Survey. Poster P1999 presented at EADV Congress 2017.

ⁱⁱ http://www.canadianpsoriasisnetwork.com/what-is-psoriasis/

ⁱⁱⁱ http://www.canadianpsoriasisnetwork.com/what-is-psoriasis/

^iv International Federation of Psoriasis Associations (IFPA). Psoriasis is a serious disease deserving global attention. Available at: https://ifpa-pso.com/wp-content/uploads/2017/01/Brochure-Psoriasis-is-a-serious-disease-deserving-global-attention.pdf. Accessed: August 2017. Chiesa Fuxench ZC, Shin DB, Ogdie Beatty A, et al. The risk of cancer in patients with psoriasis. JAMA Dermatology. 2016;152(3):282-290.

^v International Federation of Psoriasis Associations (IFPA). Psoriasis is a serious disease deserving global attention. Available at: https://ifpa-pso.com/wp-content/uploads/2017/01/Brochure-Psoriasis-is-a-serious-disease-deserving-global-attention.pdf. Accessed: August 2017.

^vi Vender R, Wilhelm S, Dickson R, et al. Impact of Treatment Goals on Patient Satisfaction With Treatment of Moderate-to-Severe Psoriasis: Results From an International Quantitative Survey. Poster P1999 presented at EADV Congress 2017.

^vii Van de Kerkhof P, Dossenbach M, Saure D, et al. The Impact of Life Factors on Patients Living With Psoriasis: An International, Quantitative Survey. Poster P1998 presented at EADV Congress 2017.

^viii Vender R, Wilhelm S, Dickson R, et al. Impact of Treatment Goals on Patient Satisfaction With Treatment of Moderate-to-Severe Psoriasis: Results From an International Quantitative Survey. Poster P1999 presented at EADV Congress 2017.

SOURCE Eli Lilly Canada Inc.