Longer PASI90 Duration Associated With Better PROs for Patients With Psoriasis

May 1, 2021
AJMC Staff

Each month of duration of 90% or more improvement in Psoriasis Are and Severity Index significantly impacted patient-reported outcomes in patients with psoriasis.

Patients with moderate-to-severe psoriasis who had high levels of skin clearance experienced significant improvements in patient-reported outcomes (PROs) for each month of duration of the outcome, according to a poster presented at the American Academy of Dermatology.

The researchers assessed the impact of duration of 90% or more improvement in Psoriasis Are and Severity Index (PASI90) for 1-year post-baseline on patients from 4 randomized phase 3 trials of risankizumab. The analysis included 2101 patients.

“Novel therapies for psoriasis have allowed patients to achieve high levels of skin clearance,” the authors noted. They added that previous studies have shown high reductions in moderate-to-severe plaque psoriasis are associated with favorable health-related quality of life measures. “However, the impact of durable skin clearance (i.e. duration of PASI90) on patient reported outcomes (PROs) has not been previously assessed,” they explained.

The average PASI90 duration over the first year was 206 days. The researchers adjusted for select baseline characteristics including age, gender, race, ethnicity, body mass index, PASI, psoriasis duration, and value of respective outcome being assessed. Once adjusting, they found that each additional month of PASI90 was associated with –0.46 point in the Dermatology Life Quality Index (DLQI) and –0.40 point in the Psoriasis Symptoms Scale (PSS). Higher numbers on these scales indicate the disease has an extremely large impact on the patient’s life or severe symptoms, respectively.

In addition, for each month of PASI90, the odds of patients achieving DLQI 0/1, which is that the condition has no impact on the patient’s life, increased by 31% and of patients achieving PSS 0, which is no symptoms, by 37%.

Other PROs that showed significant improvements with each additional month of PASI90 duration were the patient global assessment visual analog scale (–2.436), the pain visual analog scale (–2.106), and the Work Limitations Questionnaire (–0.159).

The authors noted that the results of the study may not be generalizable to a real-world population given the inclusion and exclusion criteria, as well as the controlled conditions of the trials. While this was a limitation, there was a benefit of using clinical trial population to longitudinally measure PASI90.

“Use of clinical trial data ensures patients were closely monitored and followed for a significant period of time, and that the PASI scores and PROs were well measured,” the researchers explained.


Pinter A, Soliman AM, Yang H, et al. The impact of PASI90 duration on patient reported outcomes among patients with psoriasis. Presented at: American Academy of Dermatology Virtual Meeting Experience; April 23-26. Poster 25574.