Poster Presentation Australasian Society for Dermatological Research Annual Scientific Meeting 2017

Assessment tool with absolute values are useful in the evaluation of a patient with achieving DLQI remission (#43)

Emi Nishida 1 , Kyoko Ikumi , Shinnosuke Muramatsu , Akimichi Morita
  1. Nagoya City University Graduate School of Medical Sciences, Nagoya, AICHI, Japan

In general, the Psoriasis Area Severity Index (PASI) improvement rate is used to assess the amelioration of psoriasis and determine the treatment goals for psoriasis. With the advent of several effective biologics, the treatment goal has been moved from PASI 75 to PASI 90/100. It is troublesome for dermatologists to calculate the PASI improvement rate based on daily medical examination. Assessment of the absolute PASI value, Body Surface Area(BSA) and Physician Global Assessment (PGA) at the initial consultation can be used to guide treatment at an early stage and help patients to achieve a Dermatology Quality of Life Index (DLQI) 0/1 status (DLQI remission). Therefore, we analysed 158 psoriasis vulgaris patients who were treated with one of six biologics (infliximab, adalimumab, ustekinumab, secukinumab, brodalumab, or ixekizumab) at Nagoya City University Hospital, and a total of 2663 data-points from pre-dose to post-dose (max 345 weeks). We evaluated the receiver operating characteristic curves based on univariate logistic regression. The analysis revealed that a PASI score of 1.6 was needed to achieve a DLQI remission (AUC=0.7636), BSA of 1 (AUC=0.7809) and PGA score less than 3 (AUC=0.7841) were the cut-off point to achieve a DLQI remission. In contrast, 83.0% of the patients who achieved a PASI 100 were DLQI remission. Surprisingly, 1.3% of the patients with PASI clear had a DLQI of more of 10. These patients are all male. Even patients with no eruption could have an impaired quality of life. We should keep in mind that psoriasis patients perceive much stigma against their disease itself and their situation, and may gradually begin to cope with their disease during treatment. Assessment tool with absolute values are useful in the evaluation of a patient with achieving DLQI remission.

 

 

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