title: Clinical meaningfulness of complete skin clearance in psoriasis.
abstract: BACKGROUND
  New psoriasis therapies have increased the ability to achieve skin clearance. However, insufficient evidence exists on the impact of total skin clearance from the patient perspective.
  
  
  OBJECTIVE
  We sought to determine if complete skin clearance is clinically meaningful compared with treatment responses without clearance.
  
  
  METHODS
  Pooled data from 3 phase-III trials were used to compare results for patients with complete skin clearance (Psoriasis Area and Severity Index [PASI] 100 or static Physician Global Assessment score 0) with patients without complete skin clearance (PASI 75 to <100 or static Physician Global Assessment score 1) based on Psoriasis Symptom Inventory and Dermatology Life Quality Index.
  
  
  RESULTS
  Percentages of patients with Psoriasis Symptom Inventory score 0 were 45% for those achieving PASI 100 and 8% for PASI 75 to <100 (P < .001). Respective percentages with Dermatology Life Quality Index score 0/1 were 80% and 55% (P < .001). PASI 100 resulted in incremental improvement over PASI 90 to <100 (incremental differences of 28% for Psoriasis Symptom Inventory score 0 and 18% for Dermatology Life Quality Index score 0). Similar results were observed for static Physician Global Assessment scores 0 versus 1.
  
  
  CONCLUSIONS
  Complete skin clearance represents a clinically meaningful end point and outcome for patients, reflected in experiences of no psoriasis symptoms and no impairment on health-related quality of life.
authors.affiliation: University of Connecticut School of Medicine, Farmington, Connecticut. Electronic address: strober@uchc.edu.
authors.forename: Bruce
authors.initials: B
authors.lastname: Strober
authors.affiliation: Probity Medical Research, Waterloo, Ontario, Canada; K. Papp Medical Research, Waterloo, Ontario, Canada.
authors.forename: Kim A
authors.initials: KA
authors.lastname: Papp
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Mark
authors.initials: M
authors.lastname: Lebwohl
authors.affiliation: Dermatologikum Hamburg, Hamburg, Germany.
authors.forename: Kristian
authors.initials: K
authors.lastname: Reich
authors.affiliation: Paul Sabatier University, Toulouse, France.
authors.forename: Carle
authors.initials: C
authors.lastname: Paul
authors.affiliation: Oregon Medical Research Center, Portland, Oregon.
authors.forename: Andrew
authors.initials: A
authors.lastname: Blauvelt
authors.affiliation: Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Kenneth B
authors.initials: KB
authors.lastname: Gordon
authors.affiliation: Amgen Inc, Thousand Oaks, California.
authors.forename: Cassandra E
authors.initials: CE
authors.lastname: Milmont
authors.affiliation: Amgen Inc, Thousand Oaks, California.
authors.forename: Hema N
authors.initials: HN
authors.lastname: Viswanathan
authors.affiliation: Amgen Inc, Thousand Oaks, California.
authors.forename: Joanne
authors.initials: J
authors.lastname: Li
authors.affiliation: Amgen Inc, Thousand Oaks, California.
authors.forename: Lionel
authors.initials: L
authors.lastname: Pinto
authors.affiliation: Amgen Inc, Thousand Oaks, California.
authors.forename: David J
authors.initials: DJ
authors.lastname: Harrison
authors.affiliation: Amgen Inc, Thousand Oaks, California.
authors.forename: Greg
authors.initials: G
authors.lastname: Kricorian
authors.affiliation: Amgen Inc, Thousand Oaks, California.
authors.forename: Ajay
authors.initials: A
authors.lastname: Nirula
authors.affiliation: Amgen Inc, Thousand Oaks, California.
authors.forename: Paul
authors.initials: P
authors.lastname: Klekotka
mesh_terms: D000328:Adult; D017326:Clinical Trials, Phase III as Topic; D004890:Erythema / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011537:Pruritus / Q000209:etiology; D011565:Psoriasis / Q000150:complications / Q000188:drug therapy* / Q000523:psychology*; D011788:Quality of Life; D012074:Remission Induction; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Dermatology Life Quality Index; Psoriasis Area and Severity Index; Psoriasis Symptom Inventory; health-related quality of life; patient-reported outcomes; plaque psoriasis; static Physician Global Assessment