Health-related quality of life in patients with psoriasis eligible for biologic therapy in southern Iran via the EQ-5D-5 L and DLQI

Abstract

Abstract Psoriasis is a chronic inflammatory skin disease that can substantially impair health-related quality of life (HRQoL). While biologic therapies are widely used in patients with psoriasis, their real-world impact on HRQoL within biologic-eligible patient populations remains insufficiently explored, particularly in resource-constrained settings. This cross-sectional study assessed HRQoL in adult patients with psoriasis in Iran who were considered clinically eligible for biologic therapy according to Iranian treatment guideline criteria. HRQoL was assessed via the EQ-5D-5 L, EQ-VAS, and Dermatology Life Quality Index (DLQI). Multiple linear and logistic regression analyses were conducted to identify sociodemographic and clinical factors associated with HRQoL. The mean scores were 0.51 (EQ-5D-5 L), 59.7 (EQ-VAS), and 11.9 (DLQI). A lower HRQoL was significantly associated with greater disease severity, infliximab use, less than six years of education, lack of supplementary insurance, disease duration ≤ 5 years, and being married. Multivariate analysis confirmed the independent effects of these variables. The most commonly reported issues were pain/discomfort (78.5%) and anxiety/depression (75.9%). Patients with psoriasis eligible for biologic therapy in southern Iran experienced poor HRQoL. These real-world findings highlight the need for patient-centered approaches and policy reforms that enhance insurance coverage, improve health literacy, and ensure equitable access to psoriasis care in resource-constrained settings.