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Research Article
23 March 2026

Health utility by Psoriasis Area and Severity Index response status after biologic induction therapy in Chinese patients with moderate to severe psoriasis

Authors: Lu Jian, Liang Zhang, Guo Zhou, Xingzhi Wang, Kun Hu, Yongfang Duan, Mi Zhang, Liang Tan, Wendong Chen, Bingfa Li [email protected], and Yehong Kuang [email protected]Author Info & Affiliations
Volume 15, Number 4
https://doi.org/10.57264/cer-2025-0122
PDFFormats

Abstract

Aim: Psoriasis severely affects quality of life, particularly in patients with moderate to severe psoriasis. This study aims to estimate health utility by Psoriasis Area and Severity Index (PASI) response after biologic induction therapy in Chinese patients with moderate to severe psoriasis. Materials & methods: Based on an established mapping algorithm between the Dermatology Life Quality Index and EuroQol 5 Dimension 5 Level utility score, the retrospective Dermatology Life Quality Index total scores before and after biologic induction therapy in 512 patients were converted into health utility scores to assess the associations between PASI response and post-induction utility using a multivariate generalized linear regression model. The constructed regression model was further applied to estimate post-induction utility by PASI response for a representative patient cohort, including 300 moderate to severe psoriasis patients from five tertiary hospitals. Results: When compared with baseline utility, the post-induction utility increased significantly irrespective of PASI response status. The multivariate regression analysis indicated that higher PASI response status was significantly correlated with higher utility score when compared with PASI <50 (coefficient: 0.050–0.124, p < 0.001). Relative to the baseline utility before treatment (0.653) in the representative patient cohort, the estimated post-induction utility increased by 0.174 for PASI <50, 0.224 for PASI 50–74, 0.275 for PASI 75–89, 0.280 for PASI 90–99 and 0.298 for PASI 100, respectively. Conclusion: As the extent of PASI improvement increases in Chinese patients with moderate to severe psoriasis, their health utility values rise significantly. However, the improvement in quality of life above PASI 75 is relatively limited when compared with PASI 75.

Plain language summary: How biologic treatments improve quality of life in Chinese patients with moderate to severe psoriasis

What is this article about?

This article looks at how different levels of skin improvement from biologic treatments affect the quality of life in Chinese patients with moderate to severe psoriasis. The study uses a tool called the PASI score to measure skin improvement, and it translates patients’ skin condition improvements into a measure of overall health and wellbeing called health utility.

What were the results?

The study found that all patients experienced better quality of life after treatment, but those who had more visible improvements in their skin (especially full or near-full clearance) reported greater benefits. However, once a patient reached about 75% skin improvement, further gains in utility became smaller.

What do the results mean?

This means that while biologic treatments can significantly improve both skin symptoms and overall wellbeing, the biggest improvement in quality of life comes from reaching around 75% skin clearance. Going beyond that may offer only limited extra benefit. These findings are important for doctors and policymakers when deciding which treatments to recommend or fund, helping them balance the costs and benefits of advanced psoriasis therapies.

Shareable abstract

Better PASI response after biologics leads to greater quality-of-life gains, but improvements are limited beyond PASI 75. Post-treatment utility is strongly linked to both PASI status and baseline health. #Psoriasis #Biologics #QoL #Dermatology

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Supplementary Material

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References

Papers of special note have been highlighted as: • of interest; •• of considerable interest
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