The visible signs of psoriasis may only scratch the surface of what matters most to patients. A recent study found that getting rid of itch might improve the lives of people with psoriasis even more than getting clearer skin.
Previous research has found that when patients’ psoriasis improves, their quality of life goes up as well. For many patients, when symptoms start to go away, the disease stops interfering in daily life, and makes less of an impact on activities like work or school. But recent studies have shown that improvements in quality of life don’t always match up to clinical improvements in psoriasis. Even though their skin looks better, some patients still don’t feel better.
A study published in the November 2014 issue of the British Journal of Dermatology helps explain why, reporting that the severity of a patient’s itch can be a bigger indicator of quality of life than the severity of their skin plaques. Researchers analyzed data from a Phase II clinical trial for ixekizumab, a drug currently in development, looking at the correlation between clinical severity, itch severity and quality of life.
The trial assessed clinical severity using the Psoriasis Area and Severity Index (PASI), which measures redness, thickness and scaling of skin. Itching was evaluated through a visual analogue scale that asked patients to rate the severity of their itch from one to 100, and the Dermatology Life Quality Index (DLQI) assessed the impact of the disease on patients’ daily life.
Researchers compared scores taken four months into the trial. They found a significant correlation between PASI and DLQI when they looked at those two scores together. But when they factored in itch, they reported, the correlation between PASI and DLQI was no longer as significant. Instead, they found a more significant correlation between itching and quality of life.
In other words, skin appearance is a key factor in determining a patient’s quality of life. But getting relief from itch alongside clearer skin may lead to even stronger quality-of-life improvements.
About 84 percent of people with psoriasis experience itch, the researchers noted, and most patients — as many as 77 percent — deal with itch on a daily basis. Based on the results of their study, itching could be another important factor in deciding whether a patient’s treatment is working, the researchers concluded.
Editor's note: Ixekizumab won FDA approval in March 2016.
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