Takeshita Junko, Callis Duffin Kristina, Shin Daniel B, Krueger Gerald G, Robertson Andrew D, Troxel Andrea B, Van Voorhees Abby S, Gelfand Joel M
Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah.
J Am Acad Dermatol. 2014 Oct;71(4):633-41. doi: 10.1016/j.jaad.2014.05.001. Epub 2014 Jun 11.
There is little evidence to guide the establishment of treatment goals for moderate to severe psoriasis in the clinical setting.
We sought to compare Dermatology Life Quality Index scores and prescription topical medication use between patients with clear versus almost clear skin.
This was a multicenter cross-sectional study of 97 patients with clear skin and 441 patients with almost clear skin receiving current systemic therapy or phototherapy for a primary indication of plaque psoriasis evaluated at 1 of 10 US outpatient dermatology sites participating in the Dermatology Clinical Effectiveness Research Network.
In adjusted analyses, patients with clear versus almost clear skin were more likely to report no impact of psoriasis on quality of life (relative risk 1.60; 95% confidence interval 1.37-1.86). Patients with clear versus almost clear skin were also more likely to report no prescription topical medication use in the preceding week (relative risk 2.08; 95% confidence interval 1.73-2.49).
Cross-sectional design prohibits longitudinal assessment of outcomes.
Clinically important differences in quality of life and prescription topical medication use exist between patients with clear versus almost clear skin. Collectively, our results indicate that achievement of clear skin may be an important clinical distinction among patients with moderate to severe psoriasis.
在临床环境中,几乎没有证据可指导中重度银屑病治疗目标的设定。
我们试图比较皮肤清除与几乎清除的患者之间的皮肤病生活质量指数评分及外用处方药的使用情况。
这是一项多中心横断面研究,研究对象为97例皮肤清除的患者和441例皮肤几乎清除的患者,这些患者因斑块状银屑病的主要指征接受当前的全身治疗或光疗,在美国参与皮肤病临床疗效研究网络的10个门诊皮肤科站点中的1个进行评估。
在调整分析中,皮肤清除的患者与几乎清除的患者相比,更有可能报告银屑病对生活质量无影响(相对风险1.60;95%置信区间1.37 - 1.86)。皮肤清除的患者与几乎清除的患者相比,在前一周也更有可能报告未使用外用处方药(相对风险2.08;95%置信区间1.73 - 2.49)。
横断面设计禁止对结果进行纵向评估。
皮肤清除与几乎清除的患者在生活质量和外用处方药使用方面存在临床上的重要差异。总体而言,我们的结果表明,皮肤清除可能是中重度银屑病患者之间的一个重要临床区别。