Impact of psoriasis disease severity and special area involvement on patient-reported outcomes in the real world: an analysis from the CorEvitas psoriasis registry

The impact of psoriasis in special areas (i.e., scalp, nails, palms, soles, genitals) on patient physical functioning, health-related quality of life (HRQoL), and work abilities has not been fully characterized. We assessed associations between disease severity and special area involvement in psoriasis symptoms, HRQoL, and work/activity impairment. Patients with psoriasis from the CorEvitas Psoriasis Registry who initiated systemic treatment between 04/2015–06/2020 were included. Outcomes were change from baseline in psoriasis symptoms, Dermatology Life Quality Index (DLQI), and work/activity impairment at 6 months stratified by baseline disease severity and special area involvement. Among 2620 patients, increasing disease severity was associated with worsening patient-reported outcomes. Patients with (46.0%; N = 1205) versus without (54.0%; N = 1415) psoriasis in special areas reported greater HRQoL and work/activity impairment. Over 6 months, patients with unchanged or worsening disease severity had reduced HRQoL and increased symptom severity; incremental increases in patient HRQoL and decreases in symptom severity were associated with improved disease severity. Higher disease severity and special area involvement was associated with worse outcomes and impaired work abilities. These data highlight the significant impact that adequate treatment of severe psoriasis and/or special area involvement may have on patient HRQoL and function.特殊受累部位（包括头皮、指甲、手掌、足底及生殖器）的银屑病对患者躯体功能、健康相关生活质量（health-related quality of life, HRQoL）以及工作能力的影响尚未得到充分阐明。本研究旨在探讨银屑病症状、HRQoL及工作/活动功能受损程度与疾病严重程度及特殊部位受累情况之间的关联。本研究纳入了2015年4月至2020年6月期间启动系统性治疗的CorEvitas银屑病登记队列中的银屑病患者。主要结局指标为治疗6个月时，按基线疾病严重程度及特殊部位受累情况分层后，银屑病症状、皮肤病生活质量指数（Dermatology Life Quality Index, DLQI）及工作/活动功能受损程度较基线的变化值。在2620例入组患者中，疾病严重程度越高，患者报告结局越差。合并特殊部位受累的患者占比46.0%（n=1205），未合并者占比54.0%（n=1415）；前者的HRQoL受损及工作/活动功能受损程度均显著高于后者。在6个月的随访周期内，疾病严重程度未发生变化或出现加重的患者，其HRQoL有所下降且症状严重程度升高；患者HRQoL的逐步改善与症状严重程度的降低均与疾病严重程度的缓解相关。更高的疾病严重程度及特殊部位受累均与更差的结局指标及工作能力受损相关。本研究数据提示，对重度银屑病及/或合并特殊部位受累的患者给予充分治疗，或可对患者的HRQoL及躯体功能产生显著的积极影响。