Disease severity in moderate‐to‐severe plaque psoriasis: Results from the Belgian REDISCOVER study

• Published in: JEADV clinical practice 2024-12, Vol.3 (5), p.1487-1498
• Main Authors: Hillary, Tom, Ghys, Liesbeth F. E., Willaert, Fabienne, Swimberghe, Sandra, Lecuyer, Myriam, Ghislain, Pierre‐Dominique, Morrens, Joachim, Lambert, Jo
• Format: Article
• Language: English
• Subjects: biologicals; health related quality of life; patient reported outcomes; psoriasis treatment; real world evidence; treatment goals
• ISSN: 2768-6566; 2768-6566
• DOI: 10.1002/jvc2.488

Background In the Belgian DISCOVER study, conducted in 2011–2012 before the advent of the IL‐17 and IL‐23 Inhibitors, significant undertreatment of patients with plaque psoriasis was reported. Objectives The present study aimed to re‐evaluate the real‐world clinical management and quality of care of moderate‐to‐severe plaque psoriasis patients treated with systemic treatment for at least 24 weeks in clinical practice in Belgium. Methods This cross‐sectional and retrospective chart review (REDISCOVER) was conducted in 2021–2022 in private practices and hospitals in Belgium. Patient data were collected during one single visit and included assessments of psoriasis severity (Psoriasis Area Severity Index [PASI], Body Surface Area [BSA], Pruritus VAS scale) and Health‐Related Quality of Life (Dermatology Life Quality Index [DLQI]) and other selected criteria of the Belgian treat‐to‐target (T2T) outcome set. Results Of the 306 patients included in the study, 81.4% received treatment with biologicals and 18.6% with traditional systemics, that is, methotrexate or apremilast. IL‐23 Inhibitors (33.7%) and methotrexate (10.8%) were the most prescribed biologicals and traditional systemic, respectively. Between the time of treatment initiation and enrolment, the average PASI and BSA scores decreased, indicating treatment benefits. PASI scores were lower in patients treated with biologicals versus patients treated with traditional systemics. Full achievement of the two Belgian T2T guidelines dimensions was observed in 51% of the patients. Nonetheless, patients were generally satisfied with their treatment (96.1%) and physicians evaluated the treatment as adequate for most patients (87.3%). Conclusions Compared to 10 years ago, a demonstrable improvement in care of moderate‐to‐severe psoriasis patients was observed in Belgium. This was reflected by substantial achievement of the current treatment goals and high treatment satisfaction by both patients and physicians. While one out of five patients is not achieving targeted goals, and is not treated with a biological, it seems there is still room for improvement. The REDISCOVER study evaluated moderate‐to‐severe plaque psoriasis care of 306 Belgian patients between 2021 and 2022. Compared to 10 years ago, T2T outcomes and patient satisfaction improved, especially with biologicals. At initiation, DLQI was evaluated only in 4% of the patients, underscoring the need for better QoL monitoring. For patients with PASI >10, 75%