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Patient-Relevant Outcomes in PsoriasisA Systematic Review

To identify the key insights or developments described in this article
1 Credit CME
Key Points

Question  Which outcomes do we need to assess to capture the value we create for patients with psoriasis?

Findings  This systematic review of heterogenous outcomes in patients with psoriasis found 24 studies reporting on 23 317 patients with a total of 273 (154 unique) items retrieved; these items were aggregated into 23 outcomes and were then further grouped into 4 core areas.

Meaning  This systematic review examined which outcomes were relevant to patients when managing their psoriasis; incorporating these in the clinical care path may aid the transition to a value-based treatment approach.


Importance  There is a need to define which outcomes matter to patients with psoriasis to deliver value for the patient when managing their condition.

Objectives  To generate a comprehensive overview of all outcomes relevant in the management of psoriasis as defined by patients.

Evidence Review  A systematic review was performed by searching 3 databases (MEDLINE, Embase, and Web of Science) from August 1, 2019, until March 27, 2021, using a comprehensive search strategy consisting of 4 concepts including psoriasis, patients, outcomes, and relevance. A (citing) reference search was also performed of all retrieved articles. Two independent reviewers screened the retrieved records by title/abstract against the eligibility criteria. Studies were eligible for inclusion if they reported on the importance of outcomes for patients with psoriasis. No language restrictions were used. Data extraction and quality assessment were also performed independently. Quality assessment was done using the QUALSYST tool.

Findings  In total, 10 365 records were screened for eligibility, of which 24 studies were included for synthesis. A total of 23 317 patients were evaluated, and 273 (154 unique) items were retrieved. These items were aggregated into 23 outcomes: (almost) complete clearance; symptom control; difficult location clearance; time to clearance; treatment efficacy, sustainability, safety, tolerability, and convenience; comorbidity control; daily and social activity; emotional well-being; intimate relationships; productivity; health-related quality of life; confidence in care; control of disease; communication with care professional; information from other sources than care professional; and cost of care (societal and for the patient). These were then further grouped into 4 core areas: physical/clinical, life impact, resource use, and adverse effects. The mean overall quality of the studies was 75.6% (range, 35.7%-100%).

Conclusions and Relevance  This systematic review analyzed patient-relevant outcomes reported in patients with psoriasis to aid in the transition to a value-based treatment approach.

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Article Information

Accepted for Publication: April 6, 2022.

Published Online: June 8, 2022. doi:10.1001/jamadermatol.2022.1756

Corresponding Author: Isabelle Hoorens, MD, PhD, Department of Dermatology, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium (isabelle.hoorens@uzgent.be).

Author Contributions: Drs Hilhorst had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. These authors equally contributed to the work Dr Niels and Ms Deprez.

Concept and design: Hilhorst, Deprez, Grine, Lambert, Hoorens.

Acquisition, analysis, or interpretation of data: Hilhorst, Deprez, Pauwels, Hoorens.

Drafting of the manuscript: Hilhorst, Deprez, Lambert, Hoorens.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Hilhorst, Deprez, Hoorens.

Obtained funding: Hilhorst, Deprez, Lambert.

Administrative, technical, or material support: Hilhorst, Deprez.

Supervision: Grine, Lambert, Hoorens.

Conflict of Interest Disclosures: Dr Hilhorst reported research activities funding from Novartis by a Novartis Research Collaboration Agreement during the conduct of the study. Dr Deprez reported grants from Janssen-Cilag NV during the conduct of the study. Dr Grine reported speaker’s fees from AbbVie , Webinar fees from R-Biopharm , and speaker’s fees from Union Chimique Belge outside the submitted work. Dr Hoorens reported grants from Research Foundation Flanders (FWO) 12Y2420N during the conduct of the study. No other disclosures were reported.

Funding/Support: Novartis Research Collaboration Agreement, Value In Psoriasis chair Janssen-Cilag and Scientific Research Foundation-Flanders (FWO junior postdoctoral mandate: 12Y2420N). Reviewers were contracted by the Ghent University (UGent) and Ghent University Hospital (UZ Gent). The research activities of Dr Hilhorst and Ms Deprez are funded by a Novartis Research Collaboration Agreement and a chair Value In Psoriasis from Janssen-Cilag, respectively. The research activities of Dr Hoorens are supported by the Scientific Research Foundation-Flanders (FWO junior postdoctoral mandate: 12Y2420N).

Role of the Funder/Sponsor: The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. They therefore accept no responsibility for the contents.

Additional Contributions: We thank all authors who provided us with additional data, thereby aiding us in obtaining a complete overview of the literature.

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Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

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