Table_1_Disease severity, treatment patterns, and quality of life in patients with moderate-to-severe psoriasis routinely managed with systemic treatment: results of the CRYSTAL observational study in Central and Eastern European countries.docx

Psoriasis is a common, life-long skin disease with a significant negative health and societal impact. Data on rates of disease control and treatment strategies are lacking in Central and Eastern European countries. We aimed to describe the real-world disease severity, control, and treatment strategies for psoriasis in patients from Central and Eastern European countries. CRYSTAL (EUPAS36459) was a cross-sectional, retrospective study in adults (18–75 years) from Bulgaria, Estonia, Hungary, Latvia, Lithuania, Romania, and Russia. We enrolled patients with moderate-to-severe psoriasis receiving continuous systemic treatment for ≥24 weeks. We used the Psoriasis Area and Severity Index (PASI) to describe disease severity and the Dermatology Life Quality Index (DLQI) to assess quality of life (QoL) and collected other outcomes [psoriasis work productivity and activity impairment (WPAI-PSO), patient satisfaction] at enrollment. Analyses were descriptive. A total of 690 patients were included in the analyses. Median disease duration was 11.8 years. Current treatment was monotherapy for most patients (95.8%) with either biological (BIO group; 88.4%) or conventional (NON-BIO group; 7.4%) agents. Mean (± standard deviation) absolute PASI scores were 3.5 ± 5.7, 3.1 ± 5.3, and 6.6 ± 7.4 in the overall population, the BIO group, and the NON-BIO group, respectively. Among patients treated with monotherapy, absolute PASI scores ≤1, ≤3, and ≤5 were observed for 44.1%, 72.0%, and 82.6% of BIO patients and 21.6%, 33.3%, and 49.0% of NON-BIO patients. Mean DLQI total score was 3.3 ± 5.1; higher scores were noted for higher absolute PASI. The most impacted WPAI-PSO domain was presenteeism; for all domains, impact increased with increased absolute PASI. A total of 91.8% of BIO patients and 74.5% of NON-BIO patients were satisfied with the current treatment. We observed a better disease control in BIO than NON-BIO patients. However, around half of BIO patients did not reach clear skin status and reported an impact on QoL. An improvement in treatment strategies is still needed in Central and Eastern European countries to optimize outcomes of moderate-to-severe psoriasis.

银屑病是一种常见的终身性皮肤病，对患者健康与社会均造成显著负面影响。中东欧国家目前缺乏关于该病控制率与治疗策略的相关数据。本研究旨在描述中东欧国家银屑病患者的真实世界疾病严重程度、控制情况及治疗策略。
CRYSTAL（EUPAS36459）是一项针对保加利亚、爱沙尼亚、匈牙利、拉脱维亚、立陶宛、罗马尼亚及俄罗斯成年（18~75岁）患者开展的横断面回顾性研究。研究纳入接受持续系统治疗≥24周的中重度银屑病患者。本研究采用银屑病面积与严重性指数（Psoriasis Area and Severity Index, PASI）评估疾病严重程度，使用皮肤病生活质量指数（Dermatology Life Quality Index, DLQI）评价患者生活质量（Quality of Life, QoL），并在入组时收集其他结局指标[包括银屑病工作生产力与活动障碍量表（psoriasis work productivity and activity impairment, WPAI-PSO）、患者满意度]。分析采用描述性统计方法。
本研究共纳入690例患者进行分析。患者中位病程为11.8年。多数患者（95.8%）采用单一药物治疗，其中生物制剂组（BIO组；88.4%）与传统药物组（NON-BIO组；7.4%）。总体人群、BIO组及NON-BIO组的平均（±标准差）绝对PASI评分分别为3.5±5.7、3.1±5.3及6.6±7.4。在单一治疗患者中，BIO组患者绝对PASI评分≤1、≤3及≤5的比例分别为44.1%、72.0%及82.6%，NON-BIO组对应比例分别为21.6%、33.3%及49.0%。
平均DLQI总分为3.3±5.1；评分随绝对PASI升高而升高。受影响最显著的WPAI-PSO维度为出勤主义（presenteeism）；所有维度的影响程度均随绝对PASI评分升高而加重。91.8%的BIO组患者与74.5%的NON-BIO组患者对当前治疗表示满意。
本研究观察到BIO组患者的疾病控制情况优于NON-BIO组。然而，仍有约半数BIO组患者未达到皮肤完全清除状态，且报告生活质量受疾病影响。中东欧国家仍需优化治疗策略，以改善中重度银屑病患者的临床结局。