Abstract | BACKGROUND: To determine the prevalence of joint and nail symptoms, impact of these symptoms on health-related quality of life (HR-QoL), and the effects of etanercept on them in patients with moderate-to-severe plaque psoriasis. METHODS: In CRYSTEL, patients with psoriasis received etanercept continuously (n = 357) or as paused therapy (n = 363) for 54 weeks. In post hoc analyses, baseline characteristics and after-treatment changes were evaluated in patients with baseline joint pain or nail psoriasis, pooling across treatment groups. Assessments of symptom severity and HR-QoL included the Subject Global Assessment question on joint pain, NAPSI, DLQI and EQ-5D. RESULTS: Of 711 patients, 64% reported joint pain and 79% nail psoriasis at baseline. Patients with baseline joint pain or nail psoriasis had significantly worse HR-QoL than unaffected patients. Mean baseline differences between patients with and without joint pain in DLQI (3.3), EQ-5D utility (0.2), and EQ-5D VAS (7.3) were clinically meaningful. In patients with nail psoriasis, a clinically meaningful difference in EQ-5D VAS (5.0) was seen. Etanercept significantly improved symptom severity and HR-QoL. Patients with joint pain had improvements of 47%, 61%, 29%, and 23% in mean joint pain score, DLQI, EQ-5D utility, and EQ-5D VAS, respectively, at Week 54. Patients with nail psoriasis had improvements of 51%, 63%, and 24% in NAPSI, DLQI, and EQ-5D VAS. CONCLUSION: In this study of moderate-to-severe plaque psoriasis, joint and nail symptoms were prevalent and patients with these symptoms had significantly greater HR-QoL impairment at baseline than unaffected patients. Etanercept provided significant improvement in symptom severity and HR-QoL.
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Authors | T A Luger, J Barker, J Lambert, S Yang, D Robertson, J Foehl, C T Molta, R Boggs |
Journal | Journal of the European Academy of Dermatology and Venereology : JEADV
(J Eur Acad Dermatol Venereol)
Vol. 23
Issue 8
Pg. 896-904
(Aug 2009)
ISSN: 1468-3083 [Electronic] England |
PMID | 19453794
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-Inflammatory Agents, Non-Steroidal
- Immunoglobulin G
- Receptors, Tumor Necrosis Factor
- Etanercept
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Topics |
- Adult
- Anti-Inflammatory Agents, Non-Steroidal
(therapeutic use)
- Arthralgia
(drug therapy, etiology, psychology)
- Dose-Response Relationship, Drug
- Etanercept
- Female
- Humans
- Immunoglobulin G
(therapeutic use)
- Male
- Middle Aged
- Nail Diseases
(drug therapy, etiology, psychology)
- Psoriasis
(complications, drug therapy, psychology)
- Psychology
- Quality of Life
(psychology)
- Receptors, Tumor Necrosis Factor
(therapeutic use)
- Severity of Illness Index
- Treatment Outcome
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