PSSD and biologic therapy: real-life data in 417 patients with moderate to severe psoriasis

Background: Psoriasis is a chronic relapsing immune-mediated disease leading to a strong impact on patient's quality of life. The treatment of psoriasis has undergone a revolution with the advent of biological therapies. Currently, Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) scores are in use to assess the overall severity of pathology. A new self-administered questionnaire, the Psoriasis Symptoms and Signs Diary (PSSD), assesses the severity of six psoriasis symptoms (itch, skin tightness, burning, stinging, and pain,) and five signs (dryness, cracking, scaling, shedding/flaking, redness, and bleeding). Objective: To evaluate and compare the efficacy of biologic therapies through PSSD in patients with moderate to severe psoriasis. Methods: The PSSD questionnaire was administered to all the patients at the beginning and after 6 months of biologic therapy (anti-TNFalpha, anti-IL17, anti-IL23, anti-IL12/23 and phhosphodiesterase-4 Inhibitors). Results: The study population included 417 adult patients with moderate to severe psoriasis in treatment with biologic drugs. All the drugs contributed to a significant improvement in mean total PSSD at t 24; anti-IL17 and anti-IL23 led to a significantly greater reduction at t 24 mean PSSD when compared to other therapies. Conclusion: The PSSD, is a new validated instrument useful for capturing psoriasis patient's quality of life and evaluating treatment efficacy. In our study, this score has been useful to put in evidence significant differences between biological drugs.