Effects of Biologics on Mental Health and Health-Related Quality of Life in Patients With Psoriasis: A Repeated Cross-Sectional Survey in Chinese Population

Abstract

Objective: Psoriasis is a chronic inflammatory systemic disease that severely impacts patients’ quality of life (QoL) and psychological health. While biologics have been shown to be effective in treating psoriatic lesions, thus improving QoL, real-life data regarding such effects remain scant. We administered a repeated cross-sectional survey to assess the effects of 8 weeks of biologics treatment on the QoL and mental health status of patients with moderate-to-severe plaque psoriasis. Methods: From March to May 2022, patients with moderate-to-severe plaque psoriasis were enrolled and treated with biologics in the outpatient clinic at the Dermatology Hospital of Southern Medical University. Assessments were performed before treatment and after 4 and 8 weeks of treatment with biologics. Psoriasis severity, QoL, and mental health status were evaluated using the Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), 36-Item Short-form Health Survey (SF-36), and Hospital Anxiety and Depression Scale (HADS). A multivariate generalized estimating equations (GEE) analysis was used to account for repeated measures and to determine the effects of treatment duration and type of biological agent on relevant indicators. Results: Among the 78 enrolled patients, the ranges of pretreatment scores were 4.6 to 46.8 for the PASI, 1 to 30 for the DLQI, 31.5 to 100.0 for the physical component score (PCS) of the SF-36, 16.6 to 100.0 for the mental component score (MCS) of the SF-36, 0 to 15 for the HADS-A, and 0 to 17 for the HADS-D. After 8 weeks of biologics treatment, 98.7% (77/78) of patients had obtained PASI 75. All assessed scores changed over time (GEE, P < 0.001). Moreover, there were group-by-time interaction effects for the DLQI score (GEE, P = 0.023) and PCS (GEE, P = 0.029). The HADS-A and HADS-D scores were both decreased at week 8 compared with pretreatment values. Correlation analyses revealed that higher DLQI scores were associated with lower levels of QoL and higher levels of anxiety or depression. Conclusion: Biologics are not only effective in the treatment of skin lesions but also exert beneficial effects upon the QoL and mental health of patients with psoriasis as determined in the short-term assessments conducted in this study.