Archives of Dermatological Research

, Volume 308, Issue 2, pp 69–78 | Cite as

Patient-relevant treatment goals in psoriasis

  • Christine BlomeEmail author
  • Ramona Gosau
  • Marc A. Radtke
  • Kristian Reich
  • Stephan J. Rustenbach
  • Christina Spehr
  • Diamant Thaçi
  • Matthias Augustin
Original Paper


Patient-oriented care requires therapeutic decisions to agree with the patients’ treatment needs and goals. This study addressed the following questions: What is important to psoriasis patients starting systemic treatment? How stable are these preferences within the first year of treatment? Are treatment goals associated with age, gender, or treatment success? The importance of treatment goals was assessed for patients with moderate-to-severe psoriasis in the German Psoriasis Registry (PsoBest) at baseline (onset of a systemic treatment; n = 3066) and at a 1-year follow-up (n = 1444) using the Patient Benefit Index (PBI). Treatment success was measured with PBI global score and Psoriasis Area Severity Index (PASI). Patients with moderate-to-severe psoriasis pursued a wide range of different goals. The most general treatment goals were rated most relevant, including skin healing and quick skin improvement (94.8/94.5 % “quite” or “very” important), confidence in the therapy (93.0 %), control over the disease (92.3 %), and a clear diagnosis and therapy (89.6 %). Further important goals related to not being in fear of the disease getting worse (84.8 %), reduction in itching (83.9 %), burning (70.6 %), and pain (60.6 %) as well as attaining a normal everyday life (78.4 %) and low treatment burden (64.2–77.9 %). Goals were mostly not associated with sex and gender. Goal importance slightly increased with treatment success. In a substantial proportion of patients (30.3–54.7 %) goal importance changed within 1 year after onset of systemic treatment. We conclude that treatment goal importance should be assessed in clinical practice on a regular basis.


Psoriasis Patient preferences Treatment goals Patient Benefit Index Health-related quality of life 


Compliance with ethical standards


The study was supported by the German Federal Ministry of Education and Research (BMBF) within the context of the Hamburg Centre for Health Economics (HCHE), Grant No. 01EH1101B. The German Psoriasis Registry PsoBest is commissioned by the Professional Society of German Dermatologists (BVDD) and the German Society of Dermatology (DDG). It is also funded by changing pharmaceutic companies.

Conflict of interest

Blome C has received speaker honoraria, research grants, awards, and/or travel grants from Janssen-Cilag, Kreussler, Lilly, and medi.  Gosau R has no conflicts of interest to declare. Radtke MA has received honoraria and travel expenses from Biogen, Pfizer, Abbvie, Celgene, Janssen, MSD, Amgen, Mundipharma, Leo, Almirall and Galderma. Reich K has served as consultant and paid speaker for and participated in clinical trials sponsored by companies that manufacture drugs used for the treatment of psoriasis including Abbvie, Amgen, Biogen, Elgene, Entocor, Ovagen, Forward Pharma, GSK, Janssen- ilag, Leo, Lilly, Medac, MSD, Novartis, Pfizer, Vertex, Takeda. Rustenbach SJ is an employee at the University Medical Center Hamburg-Eppendorf (UKE). Spehr C is an employee at the University Medical Center Hamburg-Eppendorf (UKE). Thaçi D has served as a consultant, investigator, and speaker, and has participated in advisory boards for AbbVie, Amgen, Biogen, Celgene, Eli Lilly, Janssen, Leo Pharma, MSD, Novartis, and Pfizer Inc; and has received research/educational Grants from Abbvie and Pfizer Inc. Augustin M has received honoraria and travel expenses from Abbott, Almirall, Amgen, Biogen, Celgene, Centocor, Janssen-Cilag, Leo, Medac, MSD (formerly Essex, Schering-Plough), Novartis, Pfizer (formerly Wyeth).

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


  1. 1.
    Augustin M, Radtke MA, Zschocke I, Blome C, Behechtnejad J, Schäfer I, Reusch M, Mielke V, Rustenbach SJ (2009) The patient benefit index: a novel approach in patient-defined outcomes measurement for skin diseases. Arch Dermatol Res 301:561–571CrossRefPubMedGoogle Scholar
  2. 2.
    Augustin M, Spehr C, Radtke MA, Boehncke WH, Luger T, Mrowietz U, Reusch M, Strömer K, Wozel G, von Kiedrowski R, Rustenbach SJ, Purwins S, Reich K (2014) German psoriasis registry PsoBest: objectives, methodology and baseline data. JDDG 12:48–58PubMedGoogle Scholar
  3. 3.
    Blome C, Costanzo A, Dauden E, Ferrandiz C, Girolomoni G et al (2015) Patient-relevant needs and treatment goals in nail psoriasis. Qual Life Res (epub ahead of print) Google Scholar
  4. 4.
    Boehncke W, Menter A (2013) Burden of disease: psoriasis and psoriatic arthritis. Am J Clin Dermatol 14:377–388CrossRefPubMedGoogle Scholar
  5. 5.
    Feuerhahn J, Blome C, Radtke M, Augustin M (2012) Validation of the patient benefit index for the assessment of patient-relevant benefit in the treatment of psoriasis. Arch Dermatol Res 304:433–441CrossRefPubMedGoogle Scholar
  6. 6.
    Fredriksson T, Pettersson U (1978) Severe psoriasis—oral therapy with a new retinoid. Dermatologica 157:238–244CrossRefPubMedGoogle Scholar
  7. 7.
    Gisondi P, Cazzaniga S, Chimenti S, Giannetti A, Maccarone M, Picardo M, Girolomoni G, Naldi L, Psocare Study Group (2013) Metabolic abnormalities associated with initiation of systemic treatment for psoriasis: evidence from the Italian Psocare Registry. J Eur Acad Dermatol Venereol 27:e30–e41CrossRefPubMedGoogle Scholar
  8. 8.
    Kimball AB, Gieler U, Linder D, Sampogna F, Warren RB, Augustin M (2010) Psoriasis: is the impairment to a patient’s life cumulative? J Eur Acad Dermatol Venereol 24:989–1004PubMedGoogle Scholar
  9. 9.
    Menter A, Gottlieb A, Feldman SR, Van Voorhees AS, Leonardi CL et al (2008) Guidelines of care for the management of psoriasis and psoriatic arthritis: section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol 58(5):826–850CrossRefPubMedGoogle Scholar
  10. 10.
    Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM et al (2011) Guidelines of care for the management of psoriasis and psoriatic arthritis: section 6. Guidelines of care for the treatment of psoriasis and psoriatic arthritis: case-based presentations and evidence-based conclusions. J Am Acad Dermatol 65(1):137–174CrossRefPubMedGoogle Scholar
  11. 11.
    Nast A, Boehncke WH, Mrowietz U et al (2012) German S3-guidelines on the treatment of psoriasis vulgaris (short version). Arch Dermatol Res 304:87–113CrossRefPubMedGoogle Scholar
  12. 12.
    Pallesen S, Sivertsen B, Nordhus IH, Bjorvatn B (2014) A 10-year trend of insomnia prevalence in the adult Norwegian population. Sleep Med 15(2):173–179CrossRefPubMedGoogle Scholar
  13. 13.
    Papp KA, Strober B, Augustin M, Calabro S, Londhe A, Chevrier M, PSOLAR investigators and Steering Committee (2012) PSOLAR: design, utility, and preliminary results of a prospective, international, disease-based registry of patients with psoriasis who are receiving, or are candidates for, conventional systemic treatments or biologic agents. J Drugs Dermatol 11:1210–1217PubMedGoogle Scholar
  14. 14.
    Parisi R, Symmons DP, Griffiths CE, Ashcroft DM, IMPACT project team (2013) Global epidemiology of psoriasis: a systematic review of incidence and prevalence. J Invest Dermatol 133:377–385CrossRefPubMedGoogle Scholar
  15. 15.
    Raho G, Koleva DM, Garattini L, Naldi L (2012) The burden of moderate to severe psoriasis: an overview. Pharmacoeconomics 30:1005–1013CrossRefPubMedGoogle Scholar
  16. 16.
    Rapp SR, Feldman SR, Exum M, Fleischer AB Jr, Reboussin DM (1999) Psoriasis causes as much disability as other major medical diseases. J Am Acad Dermatol 41:401–407CrossRefPubMedGoogle Scholar
  17. 17.
    Schäfer I, Hacker J, Rustenbach SJ, Radtke M, Franzke N, Augustin M (2010) Concordance of the Psoriasis Area and Severity Index (PASI) and patient-reported outcomes in psoriasis treatment. Eur J Dermatol 20:62–67PubMedGoogle Scholar
  18. 18.
    Schäfer I, Rustenbach SJ, Radtke M, Augustin J, Glaeske G, Augustin M (2011) Epidemiology of psoriasis in Germany—analysis of secondary health insurance data. Gesundheitswesen 73:308–313CrossRefPubMedGoogle Scholar
  19. 19.
    Silverstein B (2002) Gender differences in the prevalence of somatic versus pure depression: a replication. Am J Psychiatry 159(6):1051–1052CrossRefPubMedGoogle Scholar
  20. 20.
    Stern RS, Nijsten T, Feldman SR, Margolis DJ, Rolstad T (2004) Psoriasis is common, carries a substantial burden even when not extensive, and is associated with widespread treatment dissatisfaction. J Investig Dermatol Symp Proc 9:136–139CrossRefPubMedGoogle Scholar
  21. 21.
    Warren RB, Smith CH, Yiu ZZ, Ashcroft DM, Barker JN et al (2015) Differential drug survival of biologic therapies for the treatment of psoriasis: a prospective observational cohort study from the British Association of Dermatologists Biologic Interventions Register (BADBIR). J Invest Dermatol 135(11):2632–2640CrossRefPubMedGoogle Scholar
  22. 22.
    Zschocke I, Hammelmann U, Augustin M (2005) Therapeutic benefits in dermatological therapy. Evaluation of therapy from the physician’s und patient’s perspective in psoriasis and atopic dermatitis. Hautarzt 56:839–884CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Christine Blome
    • 1
  • Ramona Gosau
    • 1
  • Marc A. Radtke
    • 1
  • Kristian Reich
    • 2
  • Stephan J. Rustenbach
    • 1
  • Christina Spehr
    • 1
  • Diamant Thaçi
    • 3
  • Matthias Augustin
    • 1
  1. 1.German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP)University Medical Center Hamburg-Eppendorf (UKE)HamburgGermany
  2. 2.Dermatologikum HamburgHamburgGermany
  3. 3.Comprehensive Center for Inflammation MedicineUniversity of LübeckLübeckGermany

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