Rosmarin David, Soliman Ahmed M, Piercy James, Marwaha Simran, Anderson Peter, Camp Heidi S
Department of Dermatology, Indiana University School of Medicine, EH 139, DERM, IN, Indianapolis, IN, 46202, USA.
AbbVie Inc, Chicago, IL, USA.
Dermatol Ther (Heidelb). 2024 Jun;14(6):1633-1647. doi: 10.1007/s13555-024-01187-z. Epub 2024 Jun 2.
Vitiligo was historically regarded as a cosmetic disorder; however, it is an autoimmune disease. As a visible condition, it affects patient well-being. We assessed the impact of disease severity, lesion location, and body surface area (BSA) affected on patient health-related quality of life (HRQoL).
Retrospective data were from the Adelphi Real World Vitiligo Disease Specific Programme: a cross-sectional survey of physicians and their patients with vitiligo (10/2021-07/2022). Patient-reported outcomes were assessed by the Vitiligo-Specific Quality of Life Instrument (VitiQoL), Hospital Anxiety and Depression Scale (HADS), and EQ-5D-5L. The Work Productivity and Impairment Questionnaire (WPAI) questionnaire was used to assess disease-related impairment of daily activities. Data were stratified by physician-reported disease severity, presence/absence of vitiligo on the face, and BSA percentage affected.
In total, 1388 patients were included. Mean (SD) VitiQoL, HADS depression, and anxiety scores were higher for those with severe disease [40.5 (26.1), 5.2 (4.4), and 6.8 (4.7)] than those with mild [24.8 (18.8), 3.6 (3.8), 4.2 (3.8)] or moderate [27.1 (22.6), 3.8 (4.5), 4.3 (4.4)] disease. Patients with face affected reported higher VitiQoL [30.0 (22.3) versus 23.2 (19.3)], and HADS scores [depression, 4.3 (4.3) versus 3.2 (3.9); anxiety, 5.0 (4.3) versus 3.8 (3.9)] than those without. Patients with ≥ 5% BSA affected had higher VitiQoL, depression and anxiety scores [27.9 (21.8), 4.0 (4.4), and 4.5 (4.2)] than those with 0-5% [24.6 (19.7), 3.4 (3.7), and 4.3 (4.1)]. Patients with severe vitiligo, facial lesions, or ≥ 5% BSA reported higher activity impairment. Mean EQ-5D-5L-utility score was approximately 0.9 regardless of disease severity or total BSA affected.
These data demonstrate the impact disease severity can have on HRQoL and daily activities for patients with vitiligo. Lesions that are more severe, on the face, or covering a greater BSA are more often associated with poorer outcomes and activity impairment. These data also highlight the potential insensitivity of commonly used HRQoL measures and a need for more sensitive disease-specific measures.
白癜风在历史上被视为一种美容疾病；然而，它是一种自身免疫性疾病。作为一种可见病症，它会影响患者的幸福感。我们评估了疾病严重程度、病变部位和受影响的体表面积（BSA）对患者健康相关生活质量（HRQoL）的影响。
回顾性数据来自阿德尔菲真实世界白癜风特定疾病项目：一项对医生及其白癜风患者的横断面调查（2021年10月 - 2022年7月）。通过白癜风特定生活质量量表（VitiQoL）、医院焦虑抑郁量表（HADS）和EQ - 5D - 5L评估患者报告的结局。使用工作效率和活动能力受损问卷（WPAI）评估与疾病相关的日常活动受损情况。数据按医生报告的疾病严重程度、面部是否存在白癜风以及受影响的BSA百分比进行分层。
总共纳入了1388名患者。重度疾病患者的平均（标准差）VitiQoL、HADS抑郁和焦虑评分[40.5（26.1）、5.2（4.4）和6.8（4.7）]高于轻度[24.8（18.8）、3.6（3.8）、4.2（3.8）]或中度[27.1（22.6）、3.8（4.5）、4.3（4.4）]疾病患者。面部受累的患者报告的VitiQoL[30.0（22.3）对23.2（19.3）]和HADS评分[抑郁，4.3（4.3）对3.2（3.9）；焦虑，5.0（4.3）对3.8（3.9）]高于未受累患者。BSA受累≥5%的患者的VitiQoL、抑郁和焦虑评分[27.9（21.8）、4.0（4.4）和4.5（4.2）]高于0 - 5%的患者[24.6（19.7）、3.4（3.7）和4.3（4.1）]。重度白癜风、面部病变或BSA≥5%的患者报告的活动受损更高。无论疾病严重程度或受影响的总BSA如何，平均EQ - 5D - 5L效用评分约为0.9。
这些数据表明疾病严重程度对白癜风患者的HRQoL和日常活动有影响。更严重、位于面部或覆盖更大BSA的病变更常与较差的结局和活动受损相关。这些数据还凸显了常用HRQoL测量方法可能存在的不敏感性以及对更敏感的疾病特异性测量方法的需求。
