Depression Symptoms Predict Worse Clinical Response to Etanercept Treatment in Psoriasis Patients

Abstract

Background/Aims: This study aimed to investigate the predicting values of depression and anxiety symptoms for clinical response to etanercept treatment in psoriasis patients. Methods: A total of 85 psoriasis patients who received 6 months of etanercept treatment were consecutively enrolled in this prospective cohort study. The Psoriasis Area and Severity Index (PASI) score was evaluated at month 0 (M0), M1, M3, and M6, and the corresponding PASI 75/90 response at each visit was assessed. Also, anxiety and depression symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS) at M0, M1, M3, and M6. Results: Depression symptoms were observed to correlate with female gender (p = 0.004), longer disease duration (p = 0.018), and higher PASI score (p < 0.001), and anxiety symptoms were seen to be associated with female gender (p = 0.017), larger psoriasis-affected body surface area (p = 0.049), and higher PASI score (p = 0.017) in psoriasis patients. After etanercept treatment, HADS-Depression (HADS-D) and HADS-Anxiety (HADS-A) scores were both decreased at M1, M3, and M6 (all p < 0.001) compared with M0. Most importantly, baseline depressed patients presented with a lower PASI 75 response rate at M3 (p = 0.014) and M6 (p = 0.005), and a reduced PASI 90 response rate at M6 (p = 0.045) compared with baseline non-depressed patients. Furthermore, multivariate logistic regression analyses revealed that depression symptoms at baseline were an independent predictive factor for the lower possibility of both PASI 75 response (p = 0.048) and PASI 90 response (p = 0.048) achievements at M6 in psoriasis patients. However, no correlation of baseline anxiety symptoms with PASI 75/90 responses was observed. Conclusion: Depression symptoms at baseline independently predict a worse clinical response to etanercept treatment in psoriasis patients.

Psychological burden of psoriatic patients in a German university hospital dermatology department

“…This is in line with data from the published work indicating that depending on the screening methodology, depressive symptoms are present in 9–55% of psoriatic patients 55 . Depressive symptoms at baseline may predict a worse clinical response to antipsoriatic treatment 56 . Furthermore, therapeutic options for psoriatic patients with comorbid depression are more limited compared with patients without depression.…”

“…55 Depressive symptoms at baseline may predict a worse clinical response to antipsoriatic treatment. 56 Furthermore, therapeutic options for psoriatic patients with comorbid depression are more limited compared with patients without depression. In most of the cases, depression and suicidal ideation behavior represent an exclusion criterion for participation in clinical trials with new compounds.…”

Prevalence and factors associated with depression and anxiety in patients with psoriasis

“…Such psychiatric comorbidities can aggravate the condition, delay recovery, impair treatment or even accelerate the recurrence of psoriasis. Also, they contribute to increased consumption of alcohol and tobacco, with potential worsening to the disease (Jin et al, 2019; Koo et al, 2017).…”

Effect of Disease Severity on the Quality of Life and Sense of Stigmatization in Psoriatics

“…In another study, carried out by Bronikowska-Kolasa et al 43 in a group of 110 patients, PASI scores ranged from 1 to 27.3 pts, with the mean value of 12.7 ±5.6 pts corresponding to moderate to severe psoriasis. Jin et al 44 followed 85 patients with psoriasis for six months of etanercept treatment, assessing their PASI 75/90 response at each visit. The study demonstrated that depression symptoms at the baseline were associated with worse clinical response to etanercept, as shown by reduced PASI 75/90 response rates.…”