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Author Spotlight: Self-Assessment Protocol for Predicting Psoriatic Arthritis in Psoriasis Patients
Published on: March 1, 2024
344
Patient-Reported Outcomes by Baseline Body Surface Area Involvement Among Individuals Initiating Biologic Therapy:
April W Armstrong1, Steven R Feldman2, Timothy Fitzgerald3
1University of California Los Angeles, Los Angeles, CA, USA.
Dermatology and Therapy
|June 11, 2025
Summary
Patients with low body surface area (BSA) psoriasis can experience significant disease burden, similar to those with higher BSA. This suggests biologic therapies may be appropriate for low BSA patients with high symptom burden.
Area of Science:
- Dermatology
- Immunology
- Clinical Research
Background:
- Psoriasis severity is often assessed by body surface area (BSA), with >10% BSA typically required for systemic therapy.
- Patients with less than 10% BSA, even as low as 3%, can experience substantial disease burden and face challenges accessing advanced treatments like biologics.
Purpose of the Study:
- To evaluate the patient-reported outcomes (PROs) and disease burden in systemic treatment-naïve patients initiating biologic therapy across different body surface area (BSA) categories (≤10%).
- To compare the disease burden of patients with low (≤3% BSA) and medium (3-10% BSA) involvement to those with high (>10% BSA) involvement.
Main Methods:
- Analysis of 1640 systemic treatment-naïve patients initiating biologics from the CorEvitas Psoriasis Registry (April 2015-September 2023).
- Patients were categorized into low (<3%), medium (3-10%), and high (>10% BSA) groups.
- Patient-reported outcomes including quality of life, itch, pain, and fatigue were assessed at biologic initiation. Overlap statistics were used to compare disease burden between BSA groups.
Main Results:
- Patients with medium (46.9%) and high (46.2%) BSA showed similar disease burden (overlap 0.52-0.59) when compared to each other.
- Patients with high BSA had slightly higher disease burden than those with low BSA (7.0%) (overlap 0.60-0.70).
- Psoriasis disease characteristics and medical history showed near complete overlap across low, medium, and high BSA groups (overlap 0.44-0.58).
Conclusions:
- A significant overlap in patient-reported outcomes exists across different BSA categories in patients initiating biologic therapy.
- Patients with low BSA psoriasis can experience a quality of life and symptom burden comparable to those with higher BSA.
- These findings support the consideration of biologic therapies for patients with low BSA psoriasis who exhibit indicators of high disease burden.
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