Health state utility values derived from EQ-5D in psoriatic patients: a systematic review and meta-analysis

Background: To determine pooled EQ-5D utility scores for psoriasis as a general condition, plaque psoriasis, and psoriatic arthritis. Methods: A systematic review and meta-analysis of EQ-5D utility scores for psoriatic patients was conducted. Univariate meta-regression was used to explore the degree of heterogeneity. Results: Seventy-five studies were included in the systematic review. The EQ-5D in psoriatic patients demonstrated decent convergent, known-groups validity, and a degree of responsiveness with a ceiling effect. Among the five EQ-5D dimensions, ‘self-care’ showed the lowest and ‘pain/discomfort’ showed the highest percentages of reporting any problems. For meta-analysis, we identified 70 utility scores from 59 studies: 22 for plaque psoriasis, 26 for psoriasis as a general condition, and 22 for psoriatic arthritis. The mean (95% CIs; I²) of the EQ-5D utility scores for psoriasis as a general condition, plaque psoriasis, and psoriatic arthritis was 0.748 (0.718, 0.777; 98.8%), 0.755 (0.727, 0.783; 98.6%), and 0.585 (0.538, 0.632; 98.2%), respectively. For psoriasis as a general condition and plaque psoriasis, factors such as country, psoriasis area and severity index (PASI), dermatology life quality index (DLQI) and questionnaire version (EQ-5D-3L or EQ-5D-5L) all significantly influenced the utility scores. Conclusion: Psoriasis imposes a substantial impairment on patients’ quality of life, especially the pain/discomfort dimension. Heterogeneity exists among different EQ-5D utility values found in the literature.