New Study Suggests Patient Benefit Index Complements Traditional Psoriasis Outcome Measures

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A new study published in Scientific Reports suggests that the Patient Benefit Index (PBI) may serve as a valuable complement to the Dermatology Life Quality Index (DLQI) in assessing treatment outcomes for patients with psoriasis (PSO) and atopic dermatitis (AD).

Findings from the longitudinal cohort study showed that improved skin clearance, reduced anxiety and depression, and the initiation of biologic therapy significantly influenced perceived patient benefit.

The management of chronic skin conditions such as PSO and AD poses significant challenges for both patients and health care providers. Traditional measures of treatment success, such as DLQI, may not fully capture the patient’s experience, according to researchers. The current study was designed to assess the effectiveness of the PBI as a complementary tool in understanding patient-relevant treatment outcomes.

Researchers assessed 82 patients with PSO and 61 with AD before and up to 16 weeks after initiating a new treatment regimen. They evaluated the impact of clinical, demographic, and psychological factors on patient-reported outcomes using the PBI.

Results indicated that 84.1% of patients with PSO and 77.0% with AD achieved at least a minimal benefit (PBI ≥ 1) from treatment. The most valued treatment goals among individuals with PSO were achieving rapid skin improvement (84.1%), complete skin clearance (81.7%), and obtaining a clear diagnosis and therapy (78.0%). According to the authors, "the findings suggest a low correlation between disease severity and impact on health-related quality of life," emphasizing the need for additional outcome measures beyond the DLQI.

Multivariate regression analyses demonstrated that male gender, biologic therapy, better skin clearance (as measured by Body Surface Area reduction), and improved DLQI scores were associated with higher PBI. Anxiety and depression reduction also contributed positively to patient-reported benefit, with evidence of a mediating effect on treatment success.

Interestingly, while skin clearance was a primary goal for many patients, health-related quality of life improvements had a greater impact on perceived benefit than disease severity alone. As investigators noted, “patients with clinically relevant anxiety/depression and inadequate coping should be offered adjuvant psychosomatic treatment." This finding highlights the importance of addressing both physical and psychological aspects in dermatologic care.

The results support the use of the PBI alongside the DLQI to capture individual treatment goals and perceived benefits more effectively. Given the high prevalence of anxiety and depression among PSO patients, the authors recommend integrating psychosomatic support into dermatologic treatment plans.

“Patients with PSO, as with other chronic inflammatory skin diseases, should be well educated and trained to use appropriate problem and emotion-focused strategies to better live with and manage the disease in their daily lives,” researchers wrote. “For example, complementary psychological interventions and educational techniques should aim to proactively manage social discrimination and stigma, help reassess chronic health problems and reduce social withdrawal.”

Source: Wintermann GB, Abraham S, Peters EMJ, Beissert S, Weidner K. Determinants of perceived patient benefit in a longitudinal cohort study of patients with psoriasis and atopic dermatitis. Sci Rep. Published online January 10, 2025. doi:10.1038/s41598-024-84794-2