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Comparison of physical and mental functioning among moderate-to-severe psoriasis patients on biologic versus oral therapy

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Abstract

With the extensive variety of available treatments for psoriasis, it is paramount that clinicians understand the differences between therapies. A critical literature gap exists regarding the effects of different systemic therapies on physical and mental functioning in the US psoriasis population. We sought to compare the impact of biologic versus oral therapy on measures of physical and mental functioning among US adults with moderate-to-severe psoriasis. We performed a nationwide, cross-sectional study of 2,431,282 (weighted) (183 non-weighted) US adults with psoriasis on biologic or oral therapy using the 2003–2015 Medical Expenditure Panel Survey (MEPS). Physical and mental functioning were measured with the Short Form-12 version 2 (SF-12v2) Physical Component Summary (PCS) and Mental Component Summary (MCS), respectively. The mean PCS score among patients on biologic therapy was significantly higher than that of patients on oral therapy (46.25 [95% CI 43.91–48.59] versus 42.39 [95% CI 41.05–43.73]; P < 0.01). The mean MCS score among patients on biologic therapy was also significantly higher than that of patients on oral therapy (52.46 [95% CI 50.51–54.41] versus 50.19 [95% CI 49.00–51.38]; P < 0.05). Based on adjusted multiple linear regression, biologic therapy was associated with a significantly greater increase in measures of physical functioning (P < 0.05) and mental functioning (P < 0.001) as compared to oral therapy. In conclusion, clinicians need to account for physical and mental health when making treatment decisions. Biologic therapy is associated with significantly greater increases in measures of physical and mental functioning when compared to oral therapy in the US adult psoriasis population.

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Acknowledgements

This study was conducted with publicly available, de-identified data from the Agency for Health Care Research and Quality’s (AHRQ) Medical Expenditure Panel Survey (MEPS).

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Authors and Affiliations

  1. University of California, Irvine School of Medicine, 1001 Health Sciences Rd, Irvine, CA, 92617, USA

    Nicole Salame

  2. Department of Dermatology, Keck School of Medicine of University of Southern California, 1441 Eastlake Ave, NTT3427, Los Angeles, CA, USA

    Nazanin Ehsani-Chimeh

  3. Department of Dermatology, Keck School of Medicine of University of Southern California, 1975 Zonal Avenue, KAM 510, MC 9034, Los Angeles, CA, USA

    April W. Armstrong

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  1. Nicole Salame
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Correspondence to April W. Armstrong.

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Nicole Salame and Nazanin Ehsani-Chimeh declare that they have no conflict of interest. April W. Armstrong has no relevant financial conflict of interest; other disclosures include her role as an investigator, consultant, advisor, and/or speaker to AbbVie, Janssen, Lilly, Novartis, Sanofi, Regeneron, Leo, Science 37, Modmed, Pfizer, Ortho Dermatologics, and Modernizing Medicine.

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Salame, N., Ehsani-Chimeh, N. & Armstrong, A.W. Comparison of physical and mental functioning among moderate-to-severe psoriasis patients on biologic versus oral therapy. Arch Dermatol Res 311, 453–460 (2019). https://doi.org/10.1007/s00403-019-01918-9

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  • DOI: https://doi.org/10.1007/s00403-019-01918-9

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