Department of Dermatology and Venereology, University of Tartu, Dermatology Clinic, Tartu University Hospital, Tartu, Estonia.
Department of Dermatology and Venereology, Faculty of Medicine, Riga Stradins University, Riga, Latvia.
Front Immunol. 2024 May 23;15:1410540. doi: 10.3389/fimmu.2024.1410540. eCollection 2024.
Psoriasis is a common, life-long skin disease with a significant negative health and societal impact. Data on rates of disease control and treatment strategies are lacking in Central and Eastern European countries. We aimed to describe the real-world disease severity, control, and treatment strategies for psoriasis in patients from Central and Eastern European countries. CRYSTAL (EUPAS36459) was a cross-sectional, retrospective study in adults (18-75 years) from Bulgaria, Estonia, Hungary, Latvia, Lithuania, Romania, and Russia. We enrolled patients with moderate-to-severe psoriasis receiving continuous systemic treatment for ≥24 weeks. We used the Psoriasis Area and Severity Index (PASI) to describe disease severity and the Dermatology Life Quality Index (DLQI) to assess quality of life (QoL) and collected other outcomes [psoriasis work productivity and activity impairment (WPAI-PSO), patient satisfaction] at enrollment. Analyses were descriptive. A total of 690 patients were included in the analyses. Median disease duration was 11.8 years. Current treatment was monotherapy for most patients (95.8%) with either biological (BIO group; 88.4%) or conventional (NON-BIO group; 7.4%) agents. Mean (± standard deviation) absolute PASI scores were 3.5 ± 5.7, 3.1 ± 5.3, and 6.6 ± 7.4 in the overall population, the BIO group, and the NON-BIO group, respectively. Among patients treated with monotherapy, absolute PASI scores ≤1, ≤3, and ≤5 were observed for 44.1%, 72.0%, and 82.6% of BIO patients and 21.6%, 33.3%, and 49.0% of NON-BIO patients. Mean DLQI total score was 3.3 ± 5.1; higher scores were noted for higher absolute PASI. The most impacted WPAI-PSO domain was presenteeism; for all domains, impact increased with increased absolute PASI. A total of 91.8% of BIO patients and 74.5% of NON-BIO patients were satisfied with the current treatment. We observed a better disease control in BIO than NON-BIO patients. However, around half of BIO patients did not reach clear skin status and reported an impact on QoL. An improvement in treatment strategies is still needed in Central and Eastern European countries to optimize outcomes of moderate-to-severe psoriasis.
银屑病是一种常见的、终身性皮肤疾病，对健康和社会有重大负面影响。有关中东欧国家疾病控制率和治疗策略的数据尚缺乏。我们旨在描述中东欧国家银屑病患者的真实疾病严重程度、控制和治疗策略。CRYSTAL（EUPAS36459）是一项在保加利亚、爱沙尼亚、匈牙利、拉脱维亚、立陶宛、罗马尼亚和俄罗斯的成年人（18-75 岁）中进行的回顾性、横断面研究。我们招募了正在接受≥24 周连续系统治疗的中重度银屑病患者。我们使用银屑病面积和严重程度指数（PASI）来描述疾病严重程度，使用皮肤病生活质量指数（DLQI）来评估生活质量（QoL），并在入组时收集其他结果[银屑病工作生产力和活动障碍（WPAI-PSO）、患者满意度]。分析为描述性。共纳入 690 例患者进行分析。中位疾病持续时间为 11.8 年。大多数患者（95.8%）正在接受单药治疗，包括生物制剂（BIO 组；88.4%）或常规药物（NON-BIO 组；7.4%）。总体人群、BIO 组和 NON-BIO 组的平均（±标准差）绝对 PASI 评分分别为 3.5±5.7、3.1±5.3 和 6.6±7.4。在接受单药治疗的患者中，BIO 患者中分别有 44.1%、72.0%和 82.6%的患者绝对 PASI 评分≤1、≤3 和≤5，NON-BIO 患者中分别有 21.6%、33.3%和 49.0%。平均 DLQI 总分 3.3±5.1；绝对 PASI 越高，得分越高。受影响最大的 WPAI-PSO 领域是缺勤；对于所有领域，随着绝对 PASI 的增加，影响增加。BIO 组患者中 91.8%和 NON-BIO 组患者中 74.5%对当前治疗满意。我们观察到 BIO 患者的疾病控制优于 NON-BIO 患者。然而，大约一半的 BIO 患者没有达到清除皮肤的状态，并报告对 QoL 有影响。在中东欧国家，仍需要改善治疗策略，以优化中重度银屑病的治疗效果。
