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Pruritus and quality of life in moderate‐to‐severe plaque psoriasis: post hoc explorative analysis from the PRISTINE study
Author(s) -
Mrowietz U.,
Chouela E.N.,
Mallbris L.,
Stefanidis D.,
Marino V.,
Pedersen R.,
Boggs R. L.
Publication year - 2015
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.12761
Subject(s) - medicine , dermatology life quality index , itching , psoriasis , quality of life (healthcare) , post hoc analysis , visual analogue scale , etanercept , anxiety , pittsburgh sleep quality index , hospital anxiety and depression scale , psoriasis area and severity index , dermatology , physical therapy , sleep quality , insomnia , psychiatry , rheumatoid arthritis , nursing
Background Pruritus is a clinically important symptom of psoriasis that has a major impact on quality of life (QoL). Objective The objective of this study was to examine pruritus and QoL in patients with moderate‐to‐severe psoriasis treated with etanercept (ETN) in the PRISTINE clinical trial. Methods Patients were randomized (1 : 1, double‐blind) to ETN 50 mg QW or 50 mg BIW for 12 weeks, followed by 50 mg QW for 12 weeks. Pruritus was reported as 0 (no itching) to 5 (severe itching). Associations were examined between pruritus and Psoriasis Area and Severity Index, Dermatology Life Quality Index ( DLQI ), Hospital Anxiety and Depression Screening ( HADS ), Functional Assessment of Chronic Illness Therapy‐Fatigue ( FACIT ‐Fatigue), Euro‐Qol 5D ( EQ ‐5D) and Medical Outcomes Study ( MOS ) Sleep Index II . Results At baseline, patients ( n = 270) had a mean pruritus level of 3.6. Itching (level ≥1) was reported by 96% of patients, 62% of whom had severe itching (level ≥4) and 26% had the highest level of itching. DLQI , HADS ‐Anxiety, HADS ‐Depression, FACIT ‐Fatigue, EQ ‐5D visual analog scale, and MOS Sleep Index II were significantly associated with itch. At week 12, mean pruritus improvement in the ETN BIW / QW group was greater than in the QW / QW group (2.4 vs. 1.6, P < 0.001), but not at week 24 (2.2 vs. 2.0, P = 0.180). Patients with the most severe itching at baseline (score of 5) had a mean score of 1.7 at week 24. Overall, patients with clinically meaningful pruritus improvement at week 24 reported greater improvement in QoL measures than other patients. Conclusion Most patients with moderate‐to‐severe psoriasis in this study (96%) reported pruritus. Pruritus improved significantly with ETN therapy and was strongly associated with improvements in QoL. These data support the clinical relevance of pruritus as an important symptom of patients with moderate/severe psoriasis.