Acta Dermato-Venereologica 99-2CompleteContent | Page 12

158 CLINICAL REPORT The Importance of Achieving Clear or Almost Clear Skin for Patients: Results from the Nordic Countries of the Global ”Clear about Psoriasis” Patient Survey Mads Kirchheiner RASMUSSEN 1 , Martin ENGER 2 , Anna-Karin DAHLBORN 3 , Siri JUVIK 4 , Laura FAGERHED 5 , Rikke DODGE 6 and Charlotta ENERBÄCK 7 Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark, 2 Oslo Hudlegesenter, Oslo, Norway, 3 Novartis Healthcare AB, Kemistvägen, Sweden, 4 Novartis Norge AS, Oslo, Norway, 5 Novartis Finland Oy, Espoo, Finland, 6 Novartis Healthcare, Copenhagen, Denmark, and 7 Department of Dermatology, Linköping University Hospital, Linköping, Sweden 1 Psoriasis is a stigmatizing chronic skin condition in which impairment of quality of life is associated with visibility of skin lesions, disease activity and severity. The ultimate goal of treatment is complete clearance of skin symptoms. The worldwide “Clear About Psoria- sis” survey explored patients’ perspectives on clear/ almost clear skin and the impact of psoriasis on daily life. We report here results from the Nordic countries (n  = 609). Of respondents, 44% achieved clear/almost clear skin with their current treatment, of which 71% were comfortable discussing this expectation with their physician, compared with only 46% of patients who had not achieved clear/almost clear skin. Of pa- tients who achieved clear/almost clear skin, 85% re- ported treatment satisfaction vs. 39% who had not. Psoriasis profoundly affected daily life, with 88% of respondents reporting discrimination/humiliation and 61% reporting an impact on their professional life. This report highlights stigmatization among Nordic pa- tients with psoriasis and the potential to improve phy- sician–patient communication. Key words: psoriasis; clear skin; patient survey; Nordic countri- es. Accepted Sep 23, 2018; E-published Sep 24, 2018 Acta Derm Venereol 2019; 99: 158–163. Corr: Rikke Dodge, Novartis Healthcare, DK-2300 Copenhagen, Denmark. E-mail: [email protected] P soriasis is a common inflammatory, immune-med- iated disease that affects 2–4% of the population worldwide (1–3); higher prevalence rates have been reported in countries that are distant from the equator (e.g. in Northern Europe) compared with countries that are closer, due to environmental and genetic factors (4). One of the key goals of psoriasis treatment is to achieve complete clearance of skin symptoms (5). Psoriasis Area and Severity Index (PASI) is the most commonly used metric to evaluate the extent of disease and lesions by their characteristics such as redness, thickness and scaliness (5, 6). Traditional treatments for psoriasis, including topi- cal medications and systemic therapy, are considered doi: 10.2340/00015555-3048 Acta Derm Venereol 2019; 99: 158–163 SIGNIFICANCE Psoriasis is a chronic, painful, disfiguring and disabling di- sease, currently without a cure. The disease can occur at any age, and at least 100 million people worldwide are af- fected, causing the WHO to consider psoriasis as a serious global problem. This article presents the Nordic results from the global patient survey “Clear About Psoriasis”,  which was completed by 609 Nordic patients. This article illumi- nates the patients’ perspective on disease activity and how the disease affects their lives. It shows the importance of a well-defined treatment goal and good communication with healthcare professionals. effective if they achieve ≥ 75% improvement in PASI (PASI 75) from baseline values (7). Biological therapies targeting the interleukin (IL)-17A or IL-23 pathways, or tumour necrosis factor-α, have demonstrated 90% improvement in skin lesions (i.e. PASI 90; clear/almost clear skin) in a significant proportion of patients (8–10). Results of a systematic review and meta-analysis suggest that patients who achieve clear/almost clear skin (i.e. PASI 90) may achieve improved quality of life (QoL) compared with patients who achieve lower PASI respon- ses (11). PASI 90 has therefore gained wide recognition among dermatologists, who consider it the standard for optimal treatment efficacy (12). The worldwide “Clear About Psoriasis” patient sur- vey was conducted in more than 8,000 patients with moderate-to-severe psoriasis in order to understand patients’ views on clear/almost clear skin and how living with psoriasis affects their everyday life. Results from the global patient sample suggested that many patients with psoriasis are still not achieving clear/almost clear skin, and many are unaware that this might be possible (13). This report explores the results of respondents from the Nordic countries (Denmark, Finland, Norway and Sweden) in order to understand if their perspectives regarding clear/almost clear skin and the impact of psoriasis are different from those of the global patient population. This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Journal Compilation © 2019 Acta Dermato-Venereologica.