Baseline characteristics of patients with moderate-to-severe psoriasis according to previous systemic treatment exposure: the PROSE study population

Introduction Psoriatic disease is associated with considerable impairment of Quality of Life (QoL). The PROSE study (NCT02752776) examined the impact of secukinumab on patient-reported outcomes in patients with moderate-to-severe psoriasis (PsO) stratified by previous exposure to systemic treatment. Methods In this prospective, non-randomized, multicentre study, patients were categorized at baseline according to previous exposure to systemic treatment: naive [naive to any systemic treatment (N = 663)], conventional systemic [previously exposed to >= 1 conventional systemic therapy (N = 673)] and biologics [previously exposed to >= 1 biologic (N = 324)]. Baseline demographics including age, gender, race, body weight and body mass index, disease characteristics and patient-reported QoL outcomes [Dermatology Life Quality Index (DLQI), Family DLQI (F-DLQI)] of patients enrolled in the study are reported here. Results Baseline demographic characteristics were well balanced across the three subpopulations. Naive patients had a shorter time since diagnosis (15.5 +/- 12.1 years) compared with the conventional systemic (19.1 +/- 12.5 years) and biologic patients (23.0 +/- 12.5 years), and lower rates of psoriatic arthritis (6.6% vs. 17.4% and 27.8%, respectively). Metabolic syndrome (37.6-43.5%), obesity (16.9-19.1%), hyperlipidaemia (15.3-21.9%) and diabetes mellitus (6.8-14.2%) were reported at numerically higher rate in the biologic group. The mean PASI (19.7 +/- 7.9), affected Body Surface Area (28.2 +/- 15.3%) as well as the Investigator Global Assessment score (patients with score 4: 33.7%) indicated severe disease at baseline and were comparable for the three groups. QoL impairment was evident from mean DLQI (14.1 +/- 7.1: naive = 13.5 +/- 6.8; conventional systemic = 14.3 +/- 7.0; biologic = 14.8 +/- 7.7) and mean F-DLQI (11.5 +/- 7.0: naive = 11.3 +/- 7.1; conventional systemic = 11.4 +/- 6.7; biologic = 12.1 +/- 7.7) also indicated derangement of QoL of patients and their families. Conclusion Patients naive to systemic treatment had shorter disease journey compared with patients previously exposed to systemic treatments; despite this, the severe impact of disease on patient and family QoL outcomes can be as apparent in naive patients as in systemically treated patients at baseline.