Patient-Reported Outcomes by Baseline Body Surface Area Involvement Among Individuals Initiating Biologic Therapy: Results from the CorEvitas Psoriasis Registry

Abstract Introduction Psoriasis body surface area (BSA) of 10% or more has been a major criterion for determining systemic therapy eligibility. However, patients with BSA < 10% and even ≤ 3% may have high disease burden and difficulties accessing biologics. To assess psoriasis burden among patien...

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Main Authors: April W. Armstrong, Steven R. Feldman, Timothy Fitzgerald, Theodore Alkousakis, Adam Sima, Alvin Li, Hyung-Joo Kang, Sandra I. Main, Saakshi Khattri, Linda Stein Gold
Format: Article
Language:English
Published: Adis, Springer Healthcare 2025-06-01
Series:Dermatology and Therapy
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Online Access:https://doi.org/10.1007/s13555-025-01456-5
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author April W. Armstrong
Steven R. Feldman
Timothy Fitzgerald
Theodore Alkousakis
Adam Sima
Alvin Li
Hyung-Joo Kang
Sandra I. Main
Saakshi Khattri
Linda Stein Gold
author_facet April W. Armstrong
Steven R. Feldman
Timothy Fitzgerald
Theodore Alkousakis
Adam Sima
Alvin Li
Hyung-Joo Kang
Sandra I. Main
Saakshi Khattri
Linda Stein Gold
author_sort April W. Armstrong
collection DOAJ
description Abstract Introduction Psoriasis body surface area (BSA) of 10% or more has been a major criterion for determining systemic therapy eligibility. However, patients with BSA < 10% and even ≤ 3% may have high disease burden and difficulties accessing biologics. To assess psoriasis burden among patients with BSA ≤ 10%, this study characterized patient-reported outcomes (PROs) across BSA categories among systemic treatment-naïve patients initiating biologic therapy. Methods Patients from the CorEvitas Psoriasis Registry initiating biologics between April 2015 and September 2023 were categorized according to low (< 3%), medium (3–10%), or high (> 10%) BSA involvement. Measures assessed at initiation of biologic therapy included health-related quality of life, itch, pain, fatigue, psoriatic arthritis, psoriasis disease characteristics, and medical history. Overlap between BSA groups for each outcome was calculated via non-parametric Mann–Whitney statistic transformation (range 0.0–1.0; 0.5 indicates complete similarity [i.e., for a comparison between low and high BSA groups, overlap of 0.5 means there is 50% probability that a randomly selected patient with low BSA would have the same or greater PRO burden as one with high BSA]; 0 or 1 indicates complete dissimilarity) to determine whether each measure differed in randomly selected patients with low or medium versus high BSA. Results Of 1640 patients who initiated biologics, 7.0% had low BSA, 46.9% had medium BSA, and 46.2% had high BSA involvement. PRO overlap statistics ranged from 0.52 to 0.59 and from 0.60 to 0.70 for randomly selected patients with high versus medium and low BSA, respectively, indicating patients with high and medium BSA are likely to have similar levels of disease burden, and patients with high BSA are slightly more likely to have higher disease burden than those with low BSA. Near complete overlap (range 0.44–0.58) was observed for psoriasis disease characteristics and medical history in the low versus high and medium BSA groups. Conclusion Observed overlap in PROs across BSA categories shows that patients with low BSA can experience similarly poor quality of life and high symptom burden to those with higher BSA. These findings support the appropriateness of considering biologic therapies for patients with low BSA and indicators of high disease burden. Trial Registration ClinicalTrials.gov: NCT02707341.
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spelling doaj-art-8a14d3013f5f44d3ba4172274bf8a8db2025-08-20T03:04:10ZengAdis, Springer HealthcareDermatology and Therapy2193-82102190-91722025-06-011582117213010.1007/s13555-025-01456-5Patient-Reported Outcomes by Baseline Body Surface Area Involvement Among Individuals Initiating Biologic Therapy: Results from the CorEvitas Psoriasis RegistryApril W. Armstrong0Steven R. Feldman1Timothy Fitzgerald2Theodore Alkousakis3Adam Sima4Alvin Li5Hyung-Joo Kang6Sandra I. Main7Saakshi Khattri8Linda Stein Gold9University of California Los AngelesWake Forest University School of MedicineJohnson & JohnsonJohnson & JohnsonCorEvitas, LLCCorEvitas, LLCCorEvitas, LLCCorEvitas, LLCMount Sinai Medical CenterHenry Ford Health SystemAbstract Introduction Psoriasis body surface area (BSA) of 10% or more has been a major criterion for determining systemic therapy eligibility. However, patients with BSA < 10% and even ≤ 3% may have high disease burden and difficulties accessing biologics. To assess psoriasis burden among patients with BSA ≤ 10%, this study characterized patient-reported outcomes (PROs) across BSA categories among systemic treatment-naïve patients initiating biologic therapy. Methods Patients from the CorEvitas Psoriasis Registry initiating biologics between April 2015 and September 2023 were categorized according to low (< 3%), medium (3–10%), or high (> 10%) BSA involvement. Measures assessed at initiation of biologic therapy included health-related quality of life, itch, pain, fatigue, psoriatic arthritis, psoriasis disease characteristics, and medical history. Overlap between BSA groups for each outcome was calculated via non-parametric Mann–Whitney statistic transformation (range 0.0–1.0; 0.5 indicates complete similarity [i.e., for a comparison between low and high BSA groups, overlap of 0.5 means there is 50% probability that a randomly selected patient with low BSA would have the same or greater PRO burden as one with high BSA]; 0 or 1 indicates complete dissimilarity) to determine whether each measure differed in randomly selected patients with low or medium versus high BSA. Results Of 1640 patients who initiated biologics, 7.0% had low BSA, 46.9% had medium BSA, and 46.2% had high BSA involvement. PRO overlap statistics ranged from 0.52 to 0.59 and from 0.60 to 0.70 for randomly selected patients with high versus medium and low BSA, respectively, indicating patients with high and medium BSA are likely to have similar levels of disease burden, and patients with high BSA are slightly more likely to have higher disease burden than those with low BSA. Near complete overlap (range 0.44–0.58) was observed for psoriasis disease characteristics and medical history in the low versus high and medium BSA groups. Conclusion Observed overlap in PROs across BSA categories shows that patients with low BSA can experience similarly poor quality of life and high symptom burden to those with higher BSA. These findings support the appropriateness of considering biologic therapies for patients with low BSA and indicators of high disease burden. Trial Registration ClinicalTrials.gov: NCT02707341.https://doi.org/10.1007/s13555-025-01456-5BiologicsBody surface areaPatient-reported outcomesPsoriasis
spellingShingle April W. Armstrong
Steven R. Feldman
Timothy Fitzgerald
Theodore Alkousakis
Adam Sima
Alvin Li
Hyung-Joo Kang
Sandra I. Main
Saakshi Khattri
Linda Stein Gold
Patient-Reported Outcomes by Baseline Body Surface Area Involvement Among Individuals Initiating Biologic Therapy: Results from the CorEvitas Psoriasis Registry
Dermatology and Therapy
Biologics
Body surface area
Patient-reported outcomes
Psoriasis
title Patient-Reported Outcomes by Baseline Body Surface Area Involvement Among Individuals Initiating Biologic Therapy: Results from the CorEvitas Psoriasis Registry
title_full Patient-Reported Outcomes by Baseline Body Surface Area Involvement Among Individuals Initiating Biologic Therapy: Results from the CorEvitas Psoriasis Registry
title_fullStr Patient-Reported Outcomes by Baseline Body Surface Area Involvement Among Individuals Initiating Biologic Therapy: Results from the CorEvitas Psoriasis Registry
title_full_unstemmed Patient-Reported Outcomes by Baseline Body Surface Area Involvement Among Individuals Initiating Biologic Therapy: Results from the CorEvitas Psoriasis Registry
title_short Patient-Reported Outcomes by Baseline Body Surface Area Involvement Among Individuals Initiating Biologic Therapy: Results from the CorEvitas Psoriasis Registry
title_sort patient reported outcomes by baseline body surface area involvement among individuals initiating biologic therapy results from the corevitas psoriasis registry
topic Biologics
Body surface area
Patient-reported outcomes
Psoriasis
url https://doi.org/10.1007/s13555-025-01456-5
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