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Background  The  REFINE  study examined the efficacy and safety of adding topical corticosteroid therapy to etanercept when stepping down from the initial dose of etanercept to the maintenance dose. Clinical responses were shown to be similar in patients who remained on etanercept 50 mg twice weekly ( BIW ) and those who received etanercept 50 mg once weekly ( QW ) plus topical therapies through week 24.    Objective  The purpose of this analysis was to evaluate the effect of treatment on health‐related quality of life ( HRQ oL) for patients in  REFINE .    Methods  All patients received etanercept 50 mg  BIW  for 12 weeks and were then randomized to etanercept 50 mg  BIW  or etanercept 50 mg  QW  plus topical corticosteroid as required to clear through week 24.  HRQ oL measures included the Dermatology Life Quality Index ( DLQI ), Treatment Satisfaction Questionnaire for Medication ( TSQM ) and the Economic Implications of Psoriasis Patient Questionnaire. No comparative testing was performed for this descriptive analysis. Missing data were imputed using the last observation carried forward.    Results  For 287 randomized patients (144 etanercept; 143 etanercept plus topical), the mean change [standard deviation ( SD )] in  DLQI  from baseline to week 24 was 10.7 (7.8) for etanercept and 9.9 (6.9) for etanercept plus topical. Mean change ( SD ) in  TSQM  effectiveness, convenience, side‐effects and global satisfaction was 27.1 (36.1), 14.8 (25.9), −0.7 (22.0) and 26.7 (32.5) for the etanercept arm and 32.5 (40.3), 18.5 (29.0), 1.3 (19.4) and 28.4 (35.9) for etanercept plus topical. Economic implications, including healthcare visits, employment status, work productivity, ability to perform daily activities and out‐of‐pocket expenses were similar between treatment arms.    Conclusion  At week 24 of  REFINE , measures of  HRQ oL were numerically similar in patients who stayed on etanercept 50 mg  BIW  and patients who received etanercept 50 mg  QW  plus topical therapies.

Improvements in patient‐reported outcomes in patients with psoriasis receiving etanercept plus topical therapies: results from REFINE