title: Superiority in Quality of Life Improvement of Biologics over Conventional Systemic Drugs in a Swiss Real-Life Psoriasis Registry.
abstract: BACKGROUND
  Randomized controlled trials have shown the efficacy of systemic treatments in moderate-to-severe psoriasis. Clinical outcomes in psoriasis patients under real-world conditions are less well understood.
  
  
  OBJECTIVE
  This study compared Psoriasis Area and Severity Index (PASI) and Dermatological Life Quality Index (DLQI) improvement in all psoriasis patients registered in the Swiss Dermatology Network for Targeted Therapies. We asked whether outcomes differed between 4 treatment strategies, namely biologic monotherapy versus conventional systemic monotherapy, versus combined biologic and conventional systemic drugs, and versus therapy adaptation (switching from one type to another).
  
  
  METHODS
  PASI and DLQI within 1 year after onset of systemic treatment, measured at 3, 6, and 12 months, were compared among the 4 groups using generalized linear mixed-effects models.
  
  
  RESULTS
  Between March 2011 and December 2014, 334 patients were included; 151 received conventional systemic therapeutics, 145 biologics, 13 combined treatment, and 25 had a therapy adaptation. With regard to the absolute PASI, neither the biologic cohort nor the combined treatment cohort significantly differed from the conventional systemic therapeutics cohort. The odds of reaching PASI90 was significantly increased with combined therapy compared to conventional systemic therapeutics (p = 0.043) and decreased with a higher body mass index (p = 0.041). At visits 3 and 4, the PASI was generally lower than at visit 2 (visit 3 vs. visit 2, p = 0.0019; visit 4 vs. visit 2, p < 0.001). After 12 months, patients with biologic treatment had a significantly lower DLQI than those with conventional systemic therapeutics (p = 0.001).
  
  
  CONCLUSIONS
  This study suggests that after 1 year of treatment, biologics are superior in improving the subjective disease burden compared to conventional systemic drugs.
authors.affiliation: Department of Dermatology, University Hospital Basel, Basel, Switzerland.
authors.forename: Pierre
authors.initials: P
authors.lastname: Jungo
authors.forename: Julia-Tatjana
authors.initials: JT
authors.lastname: Maul
authors.forename: Vahid
authors.initials: V
authors.lastname: Djamei
authors.forename: Stefanie
authors.initials: S
authors.lastname: von Felten
authors.forename: Antonios G A
authors.initials: AGA
authors.lastname: Kolios
authors.forename: Justine
authors.initials: J
authors.lastname: Czernielewsk
authors.forename: Nikhil
authors.initials: N
authors.lastname: Yawalkar
authors.forename: Olivia
authors.initials: O
authors.lastname: Odermatt
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Laffitte
authors.forename: Mark
authors.initials: M
authors.lastname: Anliker
authors.forename: Markus
authors.initials: M
authors.lastname: Streit
authors.forename: Matthias
authors.initials: M
authors.lastname: Augustin
authors.forename: Curdin
authors.initials: C
authors.lastname: Conrad
authors.forename: Jürg
authors.initials: J
authors.lastname: Hafner
authors.forename: Wolf-Henning
authors.initials: WH
authors.lastname: Boehncke
authors.forename: Michel
authors.initials: M
authors.lastname: Gilliet
authors.forename: Peter
authors.initials: P
authors.lastname: Itin
authors.forename: Lars E
authors.initials: LE
authors.lastname: French
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Navarini
authors.forename: Peter
authors.initials: P
authors.lastname: Häusermann
mesh_terms: D001688:Biological Products / Q000627:therapeutic use*; D017281:Cost of Illness; D006801:Humans; D011565:Psoriasis / Q000188:drug therapy / Q000628:therapy*; D011788:Quality of Life; D012042:Registries; D013557:Switzerland
chemical_list: D001688:Biological Products
keywords: Biologicals; Dermatological Life Quality Index; Psoriasis; Psoriasis Area and Severity Index; Real world; Registry data