Purpose: To evaluate the efficacy of etanercept (ETN) compared with placebo for moderate-to-severe psoriasis regarding patient-reported outcomes (PROs).
Methods: Systematic review of studies retrieved by a sensitive search strategy in Medline, Embase, Cochrane Library.
Selection criteria: (population) studies had to include patients with for moderate-to-severe psoriasis; (intervention and control) studies had to test ETN vs. placebo; and (outcomes), studies had to report PROs including quality of life, pain, pruritus, or sleep. Only randomized controlled trials (RCT) were included. Two reviewers independently selected the articles and collected data. Studies quality was assessed using the Jadad score. For the meta-analysis, a random effects model was followed and statistical heterogeneity was tested with statistic I2.
Results: We finally included 12 RCT. Compared with placebo, ETN significantly improved quality of life, patient global assessment, pruritus and pain in the short and medium term, fatigue in the short term (although the effect size and differences with placebo are unclear). ETN also produces a high patient's satisfaction, which increases over time and is higher compared with placebo and might improve depressive symptoms in the long term.
Conclusions: ETN is an effective option for improving PROs in patients with moderate-to-severe psoriasis.
Keywords: Psoriasis; etanercept; meta-analysis; systematic review.