In addition to managing the clinical manifestations of psoriasis, clinical practices should implement an overall and holistic assessment of the wellbeing of each patient, says a panel of scientists speaking at a symposium during the European Association of Dermatology and Venereology (EADV) 30th Congress. 

Psoriasis affects the overall emotional wellbeing of 88 perent of affected patients, and at least 20 percent of them have considered suicide, Almirall reports. According to the World Psoriasis Happiness Report 2018, only 27 percent report that their doctor talked to them about mental health. Additionally, almost 50 percent of psoriasis patients feel that their health care professionals don’t understand the impact that the disease has on their mental health.

In the symposium titled “Are you wasting your time getting to PASI100?”, Prof. Piaserico (Italy) together with Prof. Mrowietz (Germany) and happiness scientist Prof. Quoidbach (Spain), addressed questions on psoriasis patients’ true needs and wellbeing. The experts pointed out that, in addition to managing the disease’s clinical manifestations, the clinical practice should implement an overall and holistic assessment of the wellbeing of each patient. “The endpoints that are currently being used, such as PASI and DLQI, do not capture correctly the full impact of psoriasis on patients’ life,” stated Prof. Stefano Piaserico, Associate Professor at the University of Padua, Italy and Head of the Regional Centre for Psoriasis.

As a first step to measure the value of a treatment on the overall wellbeing of the patient, Prof. Quoidbach shared some practical tips that dermatologists could implement in their clinical practice, including asking questions like “How do you feel? Do you feel okay? Do you feel happy?”

The overall wellbeing of a patient and the holistic approach of people-centered healthcare has never been measured in a robust prospective psoriasis study, says Almirall. To assess patient wellbeing, the POSITIVE study will apply the 5-item WHO Well-being Index (WHO-5), a widely used questionnaire assessing the subjective psychological health-related wellbeing in a variety of chronic diseases such as diabetes, cardiovascular disease, cancer, and depression. This is the first time the WHO-5 will be tested as a primary endpoint in patients with psoriasis to capture the effect that tildrakizumab can have on patients’ wellbeing in a real-world setting. Moreover, the long-term response on physicians' satisfaction and psoriasis patients' partners' lives will also be evaluated. 

Prof. Mrowietz, Head of the Psoriasis-Center at the University Medical Center Schleswig-Holstein, presented the design of the POSITIVE study. Tildrakizumab was chosen for this study as a representative of the anti-IL-23 class biologics, that block the key master cytokine in the pathogenesis of plaque psoriasis. 

"Providing patients with real solutions that improve their health and wellbeing is at the core of everything we do at Almirall. The symposium has explored outcomes that truly matter to patients and their wellbeing in the context of commonly used regulatory endpoints. With advanced modern therapies now widely available to HCPs, Almirall believes that it is important to also advance our understanding of truly meaningful and ambitious outcomes for our patients," states Volker Koscielny, Chief Medical Officer at Almirall.