Patient Characteristics, Disease Profile and Treatment Patterns in Mild and Moderate Psoriasis Patients: Results From Real‐World Clinical Practices in Five European Countries (PROSPECT Study)

ABSTRACT Background Categorisation of psoriasis (PsO) disease severity in patients varies, although body surface area (BSA) affected is commonly used (< 3% ‘mild’, 3%–10% ‘moderate’ and > 10% ‘severe’). While moderate‐severe PsO has been well‐studied, more limited information regarding mild‐to‐moderate PsO is available. Objectives To assess diagnosis, treatment patterns and disease progression for patients diagnosed with mild‐to‐moderate PsO. Methods Data were drawn from the Adelphi Real World PsO Disease Specific Programme, a cross‐sectional survey with retrospective data collection from dermatologists and their consulting adult PsO patients in France, Germany, Italy, Spain and the United Kingdom, conducted December 2021 to March 2022. Dermatologists reported on patient demographics and clinical characteristics at survey, diagnosis and treatment initiation. Patients self‐reported the impact of PsO on their quality of life. Results Overall, 209 dermatologists provided data for 875 patients, with 356 (40.7%) providing self‐reported data. At initial presentation, 35.3% of patients were diagnosed with mild PsO, despite 79.7% of these patients having a BSA of 3%–10%. Further, 64.7% of patients were diagnosed with moderate PsO, although 62.8% had a BSA > 10%. Between diagnosis and current treatment initiation, patients diagnosed with mild PsO showed greater deterioration than those diagnosed with moderate PsO (mean relative BSA increase of 113.2 ± 307.2% compared to 17.7 ± 93.6%; p < 0.001). Most patients received topical therapy and/or phototherapy at diagnosis (mild: 94.9%, moderate: 85.5%; p < 0.001). Those diagnosed with moderate PsO were more likely to receive systemic treatments at diagnosis ( p < 0.001) and biologics at diagnosis and time of survey ( p = 0.029 and p < 0.001, respectively). Patients diagnosed with moderate PsO showed greater quality‐of‐life impact in the DLQI ( p = 0.006) and WPAI ( p = 0.002 and p = 0.006, respectively). Conclusions Dermatologists may underestimate severity and treatment requirements in patients diagnosed with mild‐moderate PsO. Further research into PsO underdiagnosis and advanced treatment use in cases of mild PsO may provide better optimised treatment strategies.