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?