Physical, socioeconomic and psychological burdens of Psoriasis

According to recent data from a phase three study, the burden faced by psoriasis patients is a growing worldwide concern.

Psoriasis is a non-contagious skin disease that affects 80 million people worldwide. It is a common inflammatory skin condition that results from rapid multiplication of skin cells leading to the thickening and scaling of the skin causing the affected skin to become dry and unsightly. In addition, psoriasis is linked to several co-morbidities such as metabolic syndrome, cardiovascular disease and stroke.

The secondary analysis of the phase three trial, involving 1,230 patients with moderate to severe psoriasis, was published in the Journal of the American Academy of Dermatology (JAAD). Sufferers of this non-contagious skin disease are often faced with anxiety and depression.

The study reported that at the time of enrollment, 40.3 percent and 26.7 percent of patients reported symptoms of anxiety and depression respectively, and 54.6 percent reported Dermatology Life Quality Index scores greater than 10, indicating a very high impact of psoriasis on health-related quality of life (HRQoL).

The average scores of depression and anxiety reported by these patients are comparable to, or worse than patients diagnosed with breast cancer, further demonstrating the overall impact of psoriasis on patients’ health-related quality of life.

The study also found that ustekinumab significantly improves symptoms of anxiety, depression, and skin-related quality of life in patients with moderate-to-severe psoriasis, while effectively clearing psoriasis lesions.

A separate secondary analysis of the international study, published in JAAD, on psoriasis and sexual function further illustrates the gravity of the burden psoriasis patients have to shoulder.

According to Dr Peter Foley, dermatologist, Skin & Cancer Foundation and St. Vincent Hospital Melbourne, Australia, “Sexual function is an integral aspect of our quality of life. The study revealed the extent of impaired sexual function amongst patients with moderate to severe psoriasis and points to how treatment with ustekinumab significantly improves patients’ sexual function. Initially 22.4 percent of patients had reported impaired sexual function but after 12 weeks of treatment with ustekinumab, only 2.7 percent reported impaired sexual function.”

The burden of psoriasis patients resonates with Singaporeans as well. Up to 50 000 people suffer from this condition which is one of the top 10 skin disorders in Singapore. Dr Lim Kar Seng, consultant dermatologist at the National Skin Centre, explains that, “A recent local study revealed that some patients were unemployed due to their condition. And for those who were employed, 17 percent were missing days of work because of their psoriasis.”

Treatment options for psoriasis include phototherapy using UV light, oral immunosuppressant drugs and creams such as topical steroid. For those with moderate to severe psoriasis however, new advances such as biologics give psoriasis sufferers a new lease on life.

“Psoriasis is a complex disease which requires alternative treatment choices as it can become resistant to some treatments. Its severity varies between individuals and some may develop side effects from their current medication. Biologics, like ustekinumab, are effective in managing psoriasis with minimal disruptions to the patients’ normal lives due to the convenient dosing. It has been proven effective for some patients who have failed other forms of treatment.” says Dr Lim.