Patient-reported outcomes of adalimumab, phototherapy, and placebo in the Vascular Inflammation in Psoriasis Trial: A randomized controlled study

J Am Acad Dermatol. 2019 Oct;81(4):923-930. doi: 10.1016/j.jaad.2019.05.080. Epub 2019 Jun 1.


Background: There are limited data about the impact of narrowband ultraviolet B phototherapy on patient-reported measures of health-related quality of life.

Objective: To evaluate the impact of adalimumab and phototherapy on health-related quality of life.

Methods: We examined patient-reported outcomes from a multicenter, randomized, placebo-controlled trial ( no. NCT01553058). The Dermatology Life Quality Index and EQ-5D-3L were evaluated every 4 weeks.

Results: We enrolled 97 patients: 30.9% were female, mean age was 43.5 years (standard deviation, 14.0), and median Psoriasis Area and Severity Index score was 16.7 (interquartile range, 13.9-21.6). At week 12, patients being treated with adalimumab (odds ratio [OR], 2.88; 95% confidence interval [CI], 1.02-8.17) and phototherapy (OR, 8.83; 95% CI, 2.47-31.57) were more likely to achieve the minimal clinically important difference in the Dermatology Life Quality Index compared with those receiving placebo. There were higher odds of achieving the minimal clinically important difference for the EQ-5D-3L Index score when comparing phototherapy versus placebo (OR, 9.78; 95% CI, 2.99-31.95) and phototherapy versus adalimumab (OR, 4.07; 95% CI, 1.42-11.70).

Limitations: Small sample size, secondary analysis, generalizability.

Conclusion: Phototherapy and adalimumab both improve skin-related quality of life and overall health-related quality of life compared with placebo in patients with psoriasis; however, patients treated with phototherapy achieved more improvement in overall health-related quality of life compared with patients treated with adalimumab.

Keywords: DLQI; EQ5D; adalimumab; patient-reported outcomes; phototherapy; psoriasis; randomized controlled trials.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adalimumab / therapeutic use*
  • Adult
  • Anti-Inflammatory Agents / therapeutic use*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Minimal Clinically Important Difference
  • Patient Reported Outcome Measures
  • Psoriasis / therapy*
  • Quality of Life*
  • Severity of Illness Index
  • Ultraviolet Therapy*


  • Anti-Inflammatory Agents
  • Adalimumab

Associated data