Supplementary Material for: Superiority in Quality of Life Improvement of Biologics over Conventional Systemic Drugs in a Swiss Real-Life Psoriasis Registry
<p><b><i>Background:</i></b> Randomized controlled trials have shown the
efficacy of systemic treatments in moderate-to-severe psoriasis.
Clinical outcomes in psoriasis patients under real-world conditions are
less well understood. <b><i>Objective:</i></b> This study compared
Psoriasis Area and Severity Index (PASI) and Dermatological Life Quality
Index (DLQI) improvement in all psoriasis patients registered in the
Swiss Dermatology Network for Targeted Therapies. We asked whether
outcomes differed between 4 treatment strategies, namely biologic
monotherapy versus conventional systemic monotherapy, versus combined
biologic and conventional systemic drugs, and versus therapy adaptation
(switching from one type to another). <b><i>Methods:</i></b> PASI and
DLQI within 1 year after onset of systemic treatment, measured at 3, 6,
and 12 months, were compared among the 4 groups using generalized linear
mixed-effects models. <b><i>Results:</i></b> Between March 2011 and
December 2014, 334 patients were included; 151 received conventional
systemic therapeutics, 145 biologics, 13 combined treatment, and 25 had a
therapy adaptation. With regard to the absolute PASI, neither the
biologic cohort nor the combined treatment cohort significantly differed
from the conventional systemic therapeutics cohort. The odds of
reaching PASI90 was significantly increased with combined therapy
compared to conventional systemic therapeutics (<i>p</i> = 0.043) and decreased with a higher body mass index (<i>p</i> = 0.041). At visits 3 and 4, the PASI was generally lower than at visit 2 (visit 3 vs. visit 2, <i>p</i> = 0.0019; visit 4 vs. visit 2, <i>p</i>
< 0.001). After 12 months, patients with biologic treatment had a
significantly lower DLQI than those with conventional systemic
therapeutics (<i>p</i> = 0.001). <b><i>Conclusion:</i></b> This study
suggests that after 1 year of treatment, biologics are superior in
improving the subjective disease burden compared to conventional
systemic drugs.</p
