Supplementary Material for: Depression Symptoms Predict Worse Clinical Response to Etanercept Treatment in Psoriasis Patients

2018-11-08T15:22:48Z (GMT) by Jin W. Zhang S. Duan Y.
<b><i>Background/Aims:</i></b> This study aimed to investigate the predicting values of depression and anxiety symptoms for clinical response to etanercept treatment in psoriasis patients. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> Depression symptoms were observed to correlate with female gender (<i>p</i> = 0.004), longer disease duration (<i>p</i> = 0.018), and higher PASI score (<i>p</i> < 0.001), and anxiety symptoms were seen to be associated with female gender (<i>p</i> = 0.017), larger psoriasis-affected body surface area (<i>p</i> = 0.049), and higher PASI score (<i>p</i> = 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 <i>p</i> < 0.001) compared with M0. Most importantly, baseline depressed patients presented with a lower PASI 75 response rate at M3 (<i>p</i> = 0.014) and M6 (<i>p</i> = 0.005), and a reduced PASI 90 response rate at M6 (<i>p</i> = 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 (<i>p</i> = 0.048) and PASI 90 response (<i>p</i> = 0.048) achievements at M6 in psoriasis patients. However, no correlation of baseline anxiety symptoms with PASI 75/90 responses was observed. <b><i>Conclusion:</i></b> Depression symptoms at baseline independently predict a worse clinical response to etanercept treatment in psoriasis patients.