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Impact of Psoriasis Area and Severity Index (PASI) on patient reported outcomes in patients with psoriasis: Results from the Corrona Psoriasis Registry
4405
5347
Impact of Psoriasis Area and Severity Index (PASI) on patient reported outcomes in patients with psoriasis: Results from the Corrona Psoriasis Registry Bruce Strober, MD, University of Connecticut Health Center; Chitra Karki, MPH, Corrona, LLC; Marc A Mason, MS, Corrona, LLC; Jeffery D Greenberg, MD, NYU School of Medicine and Corrona, LLC; Mark Webohl, MD, Icahn School of Medicine at Mount Sinai Objectives: Disease severity and patient reported outcomes (PROs) has become increasingly important for defining effective treatment options. Objective of this study is to examine the association between disease severity measured by Psoriasis Area and Severity Index (PASI) and PROs at enrollment in the Corrona Psoriasis (PsO) registry, a prospective observational cohort of PsO patients. Methods: This study included all adult patients enrolled in the Corrona Registry with non-missing data on PASI. Demographics, disease characteristics, PROs (pain, fatigue, itch (VAS 0-100), dermatology quality of life index (DLQI), overall health status (EQ-5D), work productivity (WPAI)) and treatment use were analyzed at registry enrollment for overall population and stratified by PASI categories: mild: # 5; moderate: [5 and #12; severe:[12 and #20; very severe:[20 using t-tests/chisquare tests as appropriate. Multivariable ordinal regression examined the association between PASI and PROs adjusting for age, sex, duration of PsO and treatment initiation at enrollment/previous 12 months. Results: 1526 patients were included in the study: mean age of 50.6 yrs, 53% males and mean disease duration of 15.7 yrs. There were 61.3%, 26.7%, 7.9% and 4.1% in the PASI mild/moderate/severe/very severe categories respectively. Mean scores for investigator global assessment (IGA): 1.7, 3.0, 3.3 and 3.7; ‘worst body surface area ever’: 20.0, 24.5, 32.3 and 56.4; and PASI: 1.9, 7.8, 15.5 and 29.6 for mild/moderate/severe/very severe categories resp., P\.0001. Differences were found in patient reported pain (16.3, 30.6, 42.2 and 50.4), itch (26.3, 46.8, 59.4 and 61.9) and fatigue (27.2, 35.9, 39.9 and 42.0) with higher scores in the higher severity categories, P \ .0001. Differences were also seen in all domains of WPAI, EQ-5D and DLQI with higher activity impairment and poorer quality of life in more severe categories, P \ .0001. The DLQI 0/1 response rate was 31% in the mild category vs. 5% in the very severe category. Multivariable regression modeling showed significant associations between PASI categories and PROs after adjusting for covariates demonstrating that increase in disease severity was associated with worse pain, itch, fatigue; overall work impairment and poorer quality of life (DLQI and EQ-5D).
Impact of psoriasis severity on patient-reported clinical symptoms, health-related quality of life, and work productivity among US patients: Real-world data from the Corrona Psoriasis Registry Bruce Strober, MD, University of Connecticut Health Center; Jeffrey Greenberg, MD, Corrona LLC; Chitra Karki, MPH, Corrona LLC; Marc Mason, MS, Corrona LLC; Ning Guo, Corrona LLC; Peter Hur, PharmD, University of Maryland School of Pharmacy; Vivian Herrera, DDS, Novartis Pharmaceuticals Corporation; Feng Lin, PhD, Novartis Pharmaceuticals Corporation; Mark Lebwohl, MD, Icahn School of Medicine at Mount Sinai Introduction: Psoriasis (PsO) has a significant impact on patients’ health-related quality of life and work productivity. However, limited real-world data exist on PsO severity and its influence on patient-reported outcomes (PROs). Objective: Examine the impact of PsO severity on PROs among PsO patients in a realworld setting. Methods: A cross-sectional study was conducted between April 2015 and May 2016 of adult patients at enrollment into the Corrona Psoriasis Registry, an independent, prospective US observational registry. PsO severity was measured by affected body surface area (BSA [%]; mild: 0e5, moderate: [ 5e10, severe: [ 10e15, very severe: [ 15) and Investigator’s Global Assessment (IGA) scores (clear/almost clear: 0e1, mild: 2, moderate: 3, severe: 4). PROs (pain, itch, fatigue; Dermatology Life Quality Index [DLQI] scores; EuroQoL Five Dimensions Questionnaire [EQ-5D] scores; and Work Productivity and Activity Impairment [WPAI] scores) were compared across BSA and IGA severity levels using a Chi-square test. The association between PsO severity and PROs was examined using multivariable regression models. Results: Among the 1,525 patients, the mean age was 50.6 years. When evaluated by BSA, 57.3%, 20.7%, 7.2%, and 14.9% of patients had mild, moderate, severe, and very severe PsO, respectively. When assessed by IGA, 24.6%, 26.5%, 38.4%, and 10.6% of patients were in the clear/almost, mild, moderate, and severe PsO categories, respectively. Mean scores differed across BSA severity levels for pain (mild: 15.2, moderate: 29.7, severe: 34.4, very severe: 41.7), itch (mild: 24.7, moderate: 47.4, severe: 50.2, very severe: 55.7), and fatigue (mild: 26.5, moderate: 35.5, severe: 40.2, very severe: 38.3) (all P \.05) and increased with BSA severity. Pain and itch scores were at least 2 times higher for the very severe vs. mild group. DLQI 0/1 response rates (mild: 32%, moderate: 14%, severe: 10%, very severe: 7%, P \.05) differed across BSA severity levels and decreased with BSA severity ([4 times lower for very severe vs. mild patients). WPAI and EQ-5D scores differed across BSA severity levels (all P \.05) and worsened with BSA severity (except severe BSA for WPAI). Findings were similar across IGA categories. Similar results were confirmed by multivariable regression analyses.
Conclusions: In this real-world study, mean scores for BSA and IGA were higher for the more severe PASI categories and also showed that higher PASI scores was significantly associated with poorer PROs and quality of life. Commercial support: This study is sponsored by Corrona, LLC. The Corrona Psoriasis Registry is funded by Novartis Pharmaceutical Corporation and Eli Lilly and Company. Corrona, LLC, has been supported through contracted subscriptions in the last two years by AbbVie and Amgen.
Conclusions: Among psoriasis patients in the real world, increased PsO severity (IGA and BSA) resulted in worse patient-reported outcomes (pain, fatigue, itch, DLQI, EQ5D, and WPAI). Commercial support: This study is sponsored by Corrona, LLC. The Corrona Psoriasis Registry is funded by Novartis Pharmaceutical Corporation and Eli Lilly and Company. Corrona, LLC. has been supported through contracted subscriptions in the last two years by AbbVie and Amgen.
4824 Impact of psoriasis on medical utilization and productivity in the trucker population Joseph Merola, MD, Brigham and Women’s Hospital; Vivian Herrera, DDS, Novartis Pharmaceuticals Corporation; Robert Freeman, PhD, University of Maryland Eastern Shore School of Pharmacy; The Freeman Group, LLC; Ian Cook, Med MatRx, LLC; F. Robert Fritzky, Med MatRx, LLC; Jacqueline Palmer, PharmD, Novartis Pharmaceuticals Corporation Objective: There are 7 million long-haul truckers in the United States. Serious health problems such as psoriasis can occur at a high rate in truckers and may contribute to a nationwide driver shortage. This study assessed the impact of psoriasis on the health care utilization costs and productivity of truckers. Methods: This 12-month retrospective analysis included 400 long-haul truckers (n ¼ 200 with psoriasis [PsO], and n ¼ 200 without psoriasis [non-PsO]). Demographics (eg, age, sex and comorbidities), health care costs (pharmacy costs and medical costs [outpatient, professional and diagnostic services]) and measures of productivity (eg, hours driving and weekly revenue) were compared between the PsO and non-PsO groups. Results: Truckers in the PsO and non-PsO groups were similar in terms of age (mean, z35 to 37 years), race (100% white), and sex (z90% male). A higher number of truckers in the PsO group experienced nonpsoriasis comorbidities compared with the non-PsO group (76 vs 27), and at a higher rate (2 vs 1 comorbidity per trucker). The total health care costs per year were much higher for the whole PsO cohort compared with the non-PsO cohort ($445,311 vs $65,778). Of the total health care cost in the PsO group, 46% were for pharmacy costs and 50% were for medical costs related to professional, outpatient and diagnostic services. By comparison, pharmacy and medical costs accounted for 28% and 72%, respectively, of the total health care costs in the non-PsO group. Notably, 65 truckers (32.5%) in the PsO group requested medical leave, vs none in the non-PsO cohort. Truckers with psoriasis had fewer driving hours (15 vs 33) and generated less weekly revenue for their fleets ($2567 vs $2872). Conclusions: Truckers with psoriasis had reduced productivity and profitability, with increased health care utilization costs, compared with truckers without psoriasis. Better health care and education programs for affected truckers could alleviate symptoms of psoriasis while increasing productivity and profitability. Commercial support: This study was sponsored by Novartis Pharmaceuticals Corporation, East Hanover, NJ.
AB406
J AM ACAD DERMATOL
JUNE 2017
5347
Impact of Psoriasis Area and Severity Index (PASI) on patient reported outcomes in patients with psoriasis: Results from the Corrona Psoriasis Registry Bruce Strober, MD, University of Connecticut Health Center; Chitra Karki, MPH, Corrona, LLC; Marc A Mason, MS, Corrona, LLC; Jeffery D Greenberg, MD, NYU School of Medicine and Corrona, LLC; Mark Webohl, MD, Icahn School of Medicine at Mount Sinai Objectives: Disease severity and patient reported outcomes (PROs) has become increasingly important for defining effective treatment options. Objective of this study is to examine the association between disease severity measured by Psoriasis Area and Severity Index (PASI) and PROs at enrollment in the Corrona Psoriasis (PsO) registry, a prospective observational cohort of PsO patients. Methods: This study included all adult patients enrolled in the Corrona Registry with non-missing data on PASI. Demographics, disease characteristics, PROs (pain, fatigue, itch (VAS 0-100), dermatology quality of life index (DLQI), overall health status (EQ-5D), work productivity (WPAI)) and treatment use were analyzed at registry enrollment for overall population and stratified by PASI categories: mild: # 5; moderate: [5 and #12; severe:[12 and #20; very severe:[20 using t-tests/chisquare tests as appropriate. Multivariable ordinal regression examined the association between PASI and PROs adjusting for age, sex, duration of PsO and treatment initiation at enrollment/previous 12 months. Results: 1526 patients were included in the study: mean age of 50.6 yrs, 53% males and mean disease duration of 15.7 yrs. There were 61.3%, 26.7%, 7.9% and 4.1% in the PASI mild/moderate/severe/very severe categories respectively. Mean scores for investigator global assessment (IGA): 1.7, 3.0, 3.3 and 3.7; ‘worst body surface area ever’: 20.0, 24.5, 32.3 and 56.4; and PASI: 1.9, 7.8, 15.5 and 29.6 for mild/moderate/severe/very severe categories resp., P\.0001. Differences were found in patient reported pain (16.3, 30.6, 42.2 and 50.4), itch (26.3, 46.8, 59.4 and 61.9) and fatigue (27.2, 35.9, 39.9 and 42.0) with higher scores in the higher severity categories, P \ .0001. Differences were also seen in all domains of WPAI, EQ-5D and DLQI with higher activity impairment and poorer quality of life in more severe categories, P \ .0001. The DLQI 0/1 response rate was 31% in the mild category vs. 5% in the very severe category. Multivariable regression modeling showed significant associations between PASI categories and PROs after adjusting for covariates demonstrating that increase in disease severity was associated with worse pain, itch, fatigue; overall work impairment and poorer quality of life (DLQI and EQ-5D).
Impact of psoriasis severity on patient-reported clinical symptoms, health-related quality of life, and work productivity among US patients: Real-world data from the Corrona Psoriasis Registry Bruce Strober, MD, University of Connecticut Health Center; Jeffrey Greenberg, MD, Corrona LLC; Chitra Karki, MPH, Corrona LLC; Marc Mason, MS, Corrona LLC; Ning Guo, Corrona LLC; Peter Hur, PharmD, University of Maryland School of Pharmacy; Vivian Herrera, DDS, Novartis Pharmaceuticals Corporation; Feng Lin, PhD, Novartis Pharmaceuticals Corporation; Mark Lebwohl, MD, Icahn School of Medicine at Mount Sinai Introduction: Psoriasis (PsO) has a significant impact on patients’ health-related quality of life and work productivity. However, limited real-world data exist on PsO severity and its influence on patient-reported outcomes (PROs). Objective: Examine the impact of PsO severity on PROs among PsO patients in a realworld setting. Methods: A cross-sectional study was conducted between April 2015 and May 2016 of adult patients at enrollment into the Corrona Psoriasis Registry, an independent, prospective US observational registry. PsO severity was measured by affected body surface area (BSA [%]; mild: 0e5, moderate: [ 5e10, severe: [ 10e15, very severe: [ 15) and Investigator’s Global Assessment (IGA) scores (clear/almost clear: 0e1, mild: 2, moderate: 3, severe: 4). PROs (pain, itch, fatigue; Dermatology Life Quality Index [DLQI] scores; EuroQoL Five Dimensions Questionnaire [EQ-5D] scores; and Work Productivity and Activity Impairment [WPAI] scores) were compared across BSA and IGA severity levels using a Chi-square test. The association between PsO severity and PROs was examined using multivariable regression models. Results: Among the 1,525 patients, the mean age was 50.6 years. When evaluated by BSA, 57.3%, 20.7%, 7.2%, and 14.9% of patients had mild, moderate, severe, and very severe PsO, respectively. When assessed by IGA, 24.6%, 26.5%, 38.4%, and 10.6% of patients were in the clear/almost, mild, moderate, and severe PsO categories, respectively. Mean scores differed across BSA severity levels for pain (mild: 15.2, moderate: 29.7, severe: 34.4, very severe: 41.7), itch (mild: 24.7, moderate: 47.4, severe: 50.2, very severe: 55.7), and fatigue (mild: 26.5, moderate: 35.5, severe: 40.2, very severe: 38.3) (all P \.05) and increased with BSA severity. Pain and itch scores were at least 2 times higher for the very severe vs. mild group. DLQI 0/1 response rates (mild: 32%, moderate: 14%, severe: 10%, very severe: 7%, P \.05) differed across BSA severity levels and decreased with BSA severity ([4 times lower for very severe vs. mild patients). WPAI and EQ-5D scores differed across BSA severity levels (all P \.05) and worsened with BSA severity (except severe BSA for WPAI). Findings were similar across IGA categories. Similar results were confirmed by multivariable regression analyses.
Conclusions: In this real-world study, mean scores for BSA and IGA were higher for the more severe PASI categories and also showed that higher PASI scores was significantly associated with poorer PROs and quality of life. Commercial support: This study is sponsored by Corrona, LLC. The Corrona Psoriasis Registry is funded by Novartis Pharmaceutical Corporation and Eli Lilly and Company. Corrona, LLC, has been supported through contracted subscriptions in the last two years by AbbVie and Amgen.
Conclusions: Among psoriasis patients in the real world, increased PsO severity (IGA and BSA) resulted in worse patient-reported outcomes (pain, fatigue, itch, DLQI, EQ5D, and WPAI). Commercial support: This study is sponsored by Corrona, LLC. The Corrona Psoriasis Registry is funded by Novartis Pharmaceutical Corporation and Eli Lilly and Company. Corrona, LLC. has been supported through contracted subscriptions in the last two years by AbbVie and Amgen.
4824 Impact of psoriasis on medical utilization and productivity in the trucker population Joseph Merola, MD, Brigham and Women’s Hospital; Vivian Herrera, DDS, Novartis Pharmaceuticals Corporation; Robert Freeman, PhD, University of Maryland Eastern Shore School of Pharmacy; The Freeman Group, LLC; Ian Cook, Med MatRx, LLC; F. Robert Fritzky, Med MatRx, LLC; Jacqueline Palmer, PharmD, Novartis Pharmaceuticals Corporation Objective: There are 7 million long-haul truckers in the United States. Serious health problems such as psoriasis can occur at a high rate in truckers and may contribute to a nationwide driver shortage. This study assessed the impact of psoriasis on the health care utilization costs and productivity of truckers. Methods: This 12-month retrospective analysis included 400 long-haul truckers (n ¼ 200 with psoriasis [PsO], and n ¼ 200 without psoriasis [non-PsO]). Demographics (eg, age, sex and comorbidities), health care costs (pharmacy costs and medical costs [outpatient, professional and diagnostic services]) and measures of productivity (eg, hours driving and weekly revenue) were compared between the PsO and non-PsO groups. Results: Truckers in the PsO and non-PsO groups were similar in terms of age (mean, z35 to 37 years), race (100% white), and sex (z90% male). A higher number of truckers in the PsO group experienced nonpsoriasis comorbidities compared with the non-PsO group (76 vs 27), and at a higher rate (2 vs 1 comorbidity per trucker). The total health care costs per year were much higher for the whole PsO cohort compared with the non-PsO cohort ($445,311 vs $65,778). Of the total health care cost in the PsO group, 46% were for pharmacy costs and 50% were for medical costs related to professional, outpatient and diagnostic services. By comparison, pharmacy and medical costs accounted for 28% and 72%, respectively, of the total health care costs in the non-PsO group. Notably, 65 truckers (32.5%) in the PsO group requested medical leave, vs none in the non-PsO cohort. Truckers with psoriasis had fewer driving hours (15 vs 33) and generated less weekly revenue for their fleets ($2567 vs $2872). Conclusions: Truckers with psoriasis had reduced productivity and profitability, with increased health care utilization costs, compared with truckers without psoriasis. Better health care and education programs for affected truckers could alleviate symptoms of psoriasis while increasing productivity and profitability. Commercial support: This study was sponsored by Novartis Pharmaceuticals Corporation, East Hanover, NJ.
AB406
J AM ACAD DERMATOL
JUNE 2017