{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T06:02:04Z","timestamp":1789884124164,"version":"4.0.1"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,7,15]],"date-time":"2013-07-15T00:00:00Z","timestamp":1373846400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004342","name":"Wyeth","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004342","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Pfizer Inc"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Impaired sleep in patients with moderate\u2010to\u2010severe psoriasis and improvement on therapy has not been widely studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Quantify baseline aspects of sleep and improvement in patients with psoriasis receiving etanercept (ETN) when allowed concomitant topical medications (<jats:styled-content style=\"fixed-case\">PRISTINE<\/jats:styled-content> study).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with moderate\u2010to\u2010severe psoriasis were randomized to 50\u00a0mg <jats:styled-content style=\"fixed-case\">ETN<\/jats:styled-content> once weekly (<jats:styled-content style=\"fixed-case\">QW<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">QW<\/jats:styled-content>) or 50\u00a0mg <jats:styled-content style=\"fixed-case\">ETN<\/jats:styled-content> twice weekly (BIW\/QW) for weeks 1\u201312, followed by 50\u00a0mg <jats:styled-content style=\"fixed-case\">QW<\/jats:styled-content> for weeks 13\u201324; a broad range of topical therapies were permitted during weeks 13\u201324. Sleep impairment was measured by the Medical Outcomes Study (<jats:styled-content style=\"fixed-case\">MOS<\/jats:styled-content>) sleep questionnaire Index II (population norm\u00a0=\u00a025.8; minimum clinically important difference\u00a0=\u00a05.1); quality of life (QoL) measures included Dermatology Life Quality Index (<jats:styled-content style=\"fixed-case\">DLQI<\/jats:styled-content>), EuroQoL 5 Dimension (<jats:styled-content style=\"fixed-case\">EQ<\/jats:styled-content>\u20105D) Utility Index and Visual Analogue Scale (<jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content>) and Functional Activity in Chronic Therapy\u2010Fatigue (<jats:styled-content style=\"fixed-case\">FACIT<\/jats:styled-content>\u2010Fatigue). <jats:sc>ancova<\/jats:sc> and Fisher's exact test or chi\u2010squared tests were used for between\u2010group testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean baseline <jats:styled-content style=\"fixed-case\">MOS<\/jats:styled-content>\u2010Sleep scores were 34.0 for both groups indicating impairment (<jats:italic>N<\/jats:italic>\u00a0=\u00a0270; <jats:styled-content style=\"fixed-case\">QW<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">QW <\/jats:styled-content><jats:italic>n<\/jats:italic>\u00a0=\u00a0137; <jats:styled-content style=\"fixed-case\">BIW<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">QW <\/jats:styled-content><jats:italic>n<\/jats:italic>\u00a0=\u00a0133, approximately 64% had impaired sleep). At week 12 of treatment, <jats:styled-content style=\"fixed-case\">MOS<\/jats:styled-content>\u2010Sleep scores improved to 30.8 and 30.1, and at week 24, to 28.4 and 28.2 respectively. Poor sleep was significantly associated with clinically important problems in <jats:styled-content style=\"fixed-case\">EQ<\/jats:styled-content>\u20105D utility, <jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">FACIT<\/jats:styled-content>\u2010Fatigue; sleep improvement was associated with improved <jats:styled-content style=\"fixed-case\">EQ<\/jats:styled-content>\u20105D utility and <jats:styled-content style=\"fixed-case\">FACIT<\/jats:styled-content>\u2010Fatigue (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study confirms that most patients with moderate\u2010to\u2010severe psoriasis have impaired sleep which is associated with impaired QoL. Treatment with etanercept significantly improved sleep, with most improvement occurring before a broad range of topicals were allowed. 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