A cross-sectional study using the Children’s Dermatology Life Quality Index (CDLQI) in childhood psoriasis: negative effect on quality of life and moderate correlation of CDLQI with severity scores

Jager, M.E.A. de; Kerkhof, P.C.M. van de; Jong, E.M.G.J. de; Seyger, M.M.B.

doi:10.1111/j.1365-2133.2010.09993.x

Cited by 74 publications

(71 citation statements)

References 16 publications

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“…The CDLQI has been used in multiple studies that include adolescents with psoriasis [11,14,24,[32][33][34][35][36] . The first prospective observational study, completed by Oostveen et al [37] , used the Child-CAPTURE patient registry to examine 85 patients with mild psoriasis (PASI 7.0 ± 5.8) from 3 to 17 years old who were grouped into 3 treatment clusters.…”

Section: Dermatology-specific Hrql Measurement Toolsmentioning

confidence: 99%

Systematic Review of Health-Related Quality of Life in Adolescents with Psoriasis

et al. 2016

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Background: Many cases of psoriasis begin in adolescence. The affected adolescents face the combined physical and psychosocial challenges of their disease-free peers with the added complexity of a visible disease. Objective: To review the impact of psoriasis on the health-related quality of life (HRQL) in adolescents as compared to their peers with other chronic diseases and to determine the best tools to measure HRQL in this population. Methods: A systematic literature review was completed using PubMed. Results: 256 publications were screened for inclusion, 37 were relevant to objectives and included in the systematic review. Most studies are pediatric psoriasis studies with an adolescent subgroup, very few are dedicated to solely addressing HRQL in adolescents with psoriasis. Adolescents with psoriasis face both the challenges similar to an adult psoriasis population in addition to the complexities inherent to healthy adolescents. Studies often use a general pediatric HRQL measure, PedsQL 4.0, or a dermatology-specific measure adapted from an adult questionnaire. Only one psoriasis-specific measurement tool exists, and it is specifically for scalp psoriasis. Conclusion: Both dermatologists and primary care physicians should treat the visible cutaneous lesions and disease comorbidities and address the psychosocial impact of psoriasis in their adolescent patients. Use of both a general and dermatology-specific HRQL questionnaire may allow physicians to better identify the impact of the disease and recognize improvement or impairment over time.

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Section: Dermatology-specific Hrql Measurement Toolsmentioning

confidence: 99%

Systematic Review of Health-Related Quality of Life in Adolescents with Psoriasis

et al. 2016

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“…Presence of psoriatic arthritis, psychiatric disorders, and other co-morbidities may further worsen QoL and should be taken into account. The association between symptom severity and QoL, though observed by some studies [98,116], is not always strong, and other studies found no significant association at all [48,95]. Symptom severity has been shown to have a greater direct impact on the physical rather than the mental components of QoL, while the effects of stigmatization on QoL are more strongly mental [67].…”

Section: Conclusion and Recommendations For Clinical Practicementioning

confidence: 96%

“…Data on QoL in juvenile psoriasis are limited, however some studies demonstrated the negative influence of psoriasis on the QoL of children by means of the Children's Dermatology Life Quality Index (CDLQI) [96][97][98][99][100].The social development domain, which is one of the developmental milestones in a child, is particularly impaired [101]. Moreover, psoriasis in childhood causes a high degree of limitations on recreational activities in at least 15-30% of patients [101].…”

Section: Qol In Children With Psoriasismentioning

confidence: 99%

Quality of Life in Psoriasis

Colombo¹,

Perego²

2013

Psoriasis - Types, Causes and Medication

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“…24,25 Usually, children, either alone or with the help of their parents, choose one of the four possible replies (scored from 0 to 3), with a maximum overall score of 30 and with a high score corresponding to low quality of life and vice versa. 25 Children's Dermatology Life Quality Index scores can be divided into scoring bands -band 0 (score of 0-1), band 1 (score of 2-6), band 2 (score of [7][8][9][10][11][12], band 3 (score of [13][14][15][16][17][18] and band 4 (score of [19][20][21][22][23][24][25][26][27][28][29][30] -that respectively correspond to no, small, moderate, very large or extremely large effects on the child's quality of life. 25 However, the CDLQI is not considered appropriate for use as a health-related quality-of-life (HRQoL) assessment tool beyond the age of 16 years.…”

Section: Children's Dermatology Life Quality Indexmentioning

confidence: 99%

“…In the case of younger children, proxy measurements may more accurately reflect parental perception or concern. There is only moderate correlation between PASI/PGA response measures and the CDLQI; 27 some children with relatively mild disease can have very poor HRQoL scores, whereas others with more severe disease can have acceptable HRQoL. As well as disease symptoms and consequences, the frequency of injections can be an important quality-of-life consideration in children.…”

Section: Teenager's Quality Of Life Indexmentioning

confidence: 99%

Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people: systematic review and economic evaluation

Duarte

Mebrahtu

Gonçalves

et al. 2017

Health Technol Assess

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Background Psoriasis is a chronic inflammatory disease that predominantly affects the skin. Adalimumab (HUMIRA®, AbbVie, Maidenhead, UK), etanercept (Enbrel®, Pfizer, New York, NY, USA) and ustekinumab (STELARA®, Janssen Biotech, Inc., Titusville, NJ, USA) are the three biological treatments currently licensed for psoriasis in children. Objective To determine the clinical effectiveness and cost-effectiveness of adalimumab, etanercept and ustekinumab within their respective licensed indications for the treatment of plaque psoriasis in children and young people. Data sources Searches of the literature and regulatory sources, contact with European psoriasis registries, company submissions and clinical study reports from manufacturers, and previous National Institute for Health and Care Excellence (NICE) technology appraisal documentation. Review methods Included studies were summarised and subjected to detailed critical appraisal. A network meta-analysis incorporating adult data was developed to connect the effectiveness data in children and young people and populate a de novo decision-analytic model. The model estimated the cost-effectiveness of adalimumab, etanercept and ustekinumab compared with each other and with either methotrexate or best supportive care (BSC), depending on the position of the intervention in the management pathway. Results Of the 2386 non-duplicate records identified, nine studies (one randomised controlled trial for each drug plus six observational studies) were included in the review of clinical effectiveness and safety. Etanercept and ustekinumab resulted in significantly greater improvements in psoriasis symptoms than placebo at 12 weeks’ follow-up. The magnitude and persistence of the effects beyond 12 weeks is less certain. Adalimumab resulted in significantly greater improvements in psoriasis symptoms than methotrexate for some but not all measures at 16 weeks. Quality-of-life benefits were inconsistent across different measures. There was limited evidence of excess short-term adverse events; however, the possibility of rare events cannot be excluded. The majority of the incremental cost-effectiveness ratios for the use of biologics in children and young people exceeded NICE’s usual threshold for cost-effectiveness and were reduced significantly only when combined assumptions that align with those made in the management of psoriasis in adults were adopted. Limitations The clinical evidence base for short- and long-term outcomes was limited in terms of total participant numbers, length of follow-up and the absence of young children. Conclusions The paucity of clinical and economic evidence to inform the cost-effectiveness of biological treatments in children and young people imposed a number of strong assumptions and uncertainties. Health-related quality-of-life (HRQoL) gains associated with treatment and the number of hospitalisations in children and young people are areas of considerable uncertainty. The findings suggest that biological treatments may not be cost-effective for the management of psoriasis in children and young people at a willingness-to-pay threshold of £30,000 per quality-adjusted life-year, unless a number of strong assumptions about HRQoL and the costs of BSC are combined. Registry data on biological treatments would help determine safety, patterns of treatment switching, impact on comorbidities and long-term withdrawal rates. Further research is also needed into the resource use and costs associated with BSC. Adequately powered randomised controlled trials (including comparisons against placebo) could substantially reduce the uncertainty surrounding the effectiveness of biological treatments in biologic-experienced populations of children and young people, particularly in younger children. Such trials should establish the impact of biological therapies on HRQoL in this population, ideally by collecting direct estimates of EuroQol-5 Dimensions for Youth (EQ-5D-Y) utilities. Study registration This study is registered as PROSPERO CRD42016039494. Funding The National Institute for Health Research Health Technology Assessment programme.

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A cross-sectional study using the Children’s Dermatology Life Quality Index (CDLQI) in childhood psoriasis: negative effect on quality of life and moderate correlation of CDLQI with severity scores

Cited by 74 publications

References 16 publications

Systematic Review of Health-Related Quality of Life in Adolescents with Psoriasis

Systematic Review of Health-Related Quality of Life in Adolescents with Psoriasis

Quality of Life in Psoriasis

Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people: systematic review and economic evaluation

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