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CRYSTAL-Greece: Disease severity and QoL with systemic treatments in psoriasis

By Ella Dixon

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Feb 7, 2025

Learning objective: After reading this article, learners will be able to cite a new clinical development in plaque psoriasis.



Systemic therapies are commonly used in patients with moderate-to-severe psoriasis, or in those who have not responded to topical treatment. However, there are limited real-world data on rates of complete skin clearance and disease burden in patients with psoriasis.

CRYSTAL-Greece was a multicenter, single-country retrospective chart study which analyzed data from 280 Greek patients with moderate-to-severe plaque psoriasis. Enrolled patients had been on continuous treatment with a systemic therapy for ≥24 weeks. Their PASI score was evaluated at the study visit and used to confirm current disease severity. Results from the study were published by Rigopoulos et al. in the Journal of Dermatological Treatment.

At diagnosis, the median patient age was 29.9 years, and baseline physician-reported psoriasis severity was mild in 38.5%, moderate in 35.2%, and severe in 26.3% of cases.


Key learnings
The median absolute PASI score was reduced from 14.7 to 1.8 from time of current systemic therapy initiation to study visit. PASI scores of ≤1, ≤3, and ≤5 were achieved by 36.8%, 64.6%, and 83.9% of patients, respectively, indicating persistent disease.
At the study visit, 18.9% of patients had a DLQI score >5 with 58.6% of patients reporting anxiety/depression and 28.6% experiencing pain/discomfort​ after treatment with systemic therapy for ≥24 weeks.
Absolute PASI >5 rates were 13.7% in the biologic and 28.9% in the nonbiologic monotherapy subgroups, respectively. More patients receiving biologic treatments were completely satisfied with the treatment (49.3%) compared with patients receiving nonbiologics (17.8% ).
Complete skin clearance remains an unmet need in many patients with psoriasis. Biologic therapies, including those targeting TNF, IL-17, and IL-12/23 pathways show promise for improving outcomes in moderate-to-severe disease.

Abbreviations: DLQI, Dermatology Life Quality Index; IL, interleukin; PASI, Psoriasis Area and Severity Index; TNF, tumor necrosis factor.

References

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