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.
"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.
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 Marcus Schmitt-Egenolf.
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.