Post on 16-Jan-2016
description
Prof. Dr. W.-H. BoehnckeDept. of Dermatology
Johann Wolfgang Goethe-University
Frankfurt/Main
Prof. Dr. W.-H. BoehnckeDept. of Dermatology
Johann Wolfgang Goethe-University
Frankfurt/Main
measuring QOL in psoriasis: status quo
the instrumentsthe instruments
• DLQI– most widely used
• SF-36
• other approaches– EuroQoL 5D (EQ-5D)– „self-made“ questionnaires
• focus on self- esteem etc.
Psoriasis is Third only to Chronic Lung Disease and Depression When Considering the Mental Impact of the Disease1
Psoriasis is Third only to Chronic Lung Disease and Depression When Considering the Mental Impact of the Disease1
Reference: 1. Rapp SR et al. J Am Acad Dermatol 1999; 41: 401–7.
Depre
ssio
n
Chronic
Lung
Disea
se
Psoria
sis
Derm
atiti
s
Arthrit
is
Cance
r
Congestiv
e
Heart
Failu
re
Myo
card
ial
Infa
rctio
n
Type
2 Dia
betes
Hyper
tensi
on
Health
y Adults
0
10
20
30
40
50
60
Mea
n S
core
Psoriasis is Second only to CHF When Considering the Physical Impact of the Disease1
Psoriasis is Second only to CHF When Considering the Physical Impact of the Disease1
0
10
20
30
40
50
60
Congestiv
e
heart
failu
re
Psoria
sis
Type
2 dia
betes
Chronic
lung
disea
se
Myo
card
ial
infa
rctio
n
Arthrit
is
Hyper
tensi
on
Depre
ssio
n
Cance
r
Derm
atiti
s
Health
y ad
ults
Mea
n s
core
Reference: 1. Rapp SR et al. J Am Acad Dermatol 1999; 41: 401–7.
the resultsthe results
• robust finding: instruments measuring QOL indicate improvement when the disease is treated effectively
Patient Quality of Life Significantly Improved within 2 Weeks1,2
Patient Quality of Life Significantly Improved within 2 Weeks1,2
0
10
20
30
40
50
60
70
80
0 4 8 12
Mea
n %
Imp
rov
emen
t F
rom
Ba
selin
e Placebo ENBREL* 25 mg BiWk ENBREL 50 mg BiWk
Weeks2
‡
‡
‡
‡
65%
70%
References 1.van der Kerkhof PCN et al. ESDR 2004 abstract. 2.Data on file, Amgen, Thousand Oaks, Calif.
6%
*P = 0.0002 vs placebo‡P < 0.0001 vs placebo
‡
‡
‡
*
the problemthe problem
• Is there a correlation between the „objective“ clinical course and QOL?
• Answer– The DLQI „…demonstrated the ability
to detect small but meaningful changes in clinical status over time…“ Mazzotti et al., BJD 2003, 149: 318
– „DLQI and PASI improve together initially and during retreatment with etanercept“ Leonardi et al., AAD and EADV posters 2005
the „but“the „but“
• All it takes to „earn“ >105 € worth of treatment is to know where to put your marks on a questionnaire!!!
a solution?a solution?