Effects of alefacept on health-related quality of life in patients with psoriasis: results from a randomized, placebo-controlled phase II trial.
BACKGROUND
Chronic plaque psoriasis has a profound impact on patient quality of life (QOL), including adverse psychosocial effects, impaired daily activities, anxiety, and depression.


OBJECTIVE
To assess health-related QOL in a randomized phase II trial of alefacept (human LFA-3/IgG(1) fusion protein), a selective immunomodulator for psoriasis.


METHODS
Multicenter, randomized, placebo-controlled, double-blind trial.


METHODS
229 patients with moderate to severe psoriasis were randomized to alefacept (0.025, 0.075, or 0.150 mg/kg) or placebo by 30-second intravenous bolus once weekly for 12 weeks and followed for 12 additional weeks. Patients completed a general (SF-36) Health Survey) and dermatology-specific (Dermatology Life Quality Index [DLQI] and Dermatology Quality Of Life Scales [DQOLS]) QOL surveys at each study visit.


RESULTS
Patients treated with alefacept had significantly greater improvements on dermatology-specific QOL scales compared with patients receiving placebo (p < 0.05). Patients who achieved a >or=50% or a >or=75% reduction in Psoriasis Area and Severity Index (PASI) reported similar improvement in QOL, which was significantly greater than that of other patients.


CONCLUSIONS
The clinical effect of alefacept on psoriasis is associated with an improvement in patients' QOL. Among patients with moderate to severe psoriasis, an improvement in PASI of 50% or more is associated with better QOL scores.
Ellis
Charles N
CN
Department of Dermatology, University of Michigan Medical School, Ann Arbor 48109-0314, USA.
Mordin
Margaret M
MM
Adler
Ellen Y
EY
D000328:Adult; D000077944:Alefacept; D000704:Analysis of Variance; D003879:Dermatologic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy* / Q000523:psychology*; D011594:Psychometrics; D011788:Quality of Life; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D003879:Dermatologic Agents; D011993:Recombinant Fusion Proteins; D000077944:Alefacept