Biologics and dermatology life quality index (DLQI) in the Australasian psoriasis population

Introduction: Psoriasis is a chronic disease that may require long-term treatment. This analysis utilises the data from the Australasian Psoriasis Registry with particular attention to the impact of biologic therapy on DLQI, and the differences between the biologics in terms of DLQI score change.
Methods: A retrospective review of patients enrolled in the Australasian Psoriasis Registry from April 2008 to August 2016 was conducted. All subjects from the registry that had DLQI and PASI scores recorded at a baseline time-point of treatment commencement, in addition to at week 12 and 24 post commencement were included in the study. A window of +/-3 weeks was permitted at these time-points. Multivariate linear regression analysis was used to identify significant predictors associated with change in DLQI.
Results: Significant predictors of reduction in DLQI and PASI score from baseline to wk 24 include use of Adalimumab, Infliximab, Secukinumab, and Ustekinumab. Other therapies, including Etanercept and oral systemic agents did not show significant change. Each class of biologic showed significant reductions in DLQI score, with IL-12/24 showing the greatest reduction. Significant predictors of lack of reduction in DLQI score include a Baseline PASI score <16, diabetes, alcoholism, and uveitis.
Conclusion: Patients with moderate to severe chronic plaque psoriasis who are treated with biologics show the greatest reduction in DLQI score, compared with other treatments. Australian dermatologists are prescribing biologics when patients qualify for them.

Dr. Diana Norris

National Skin Centre, Singapore