Health-related quality of life in patients with psoriasis in Asian countries: a systematic review and meta-analysis of EQ-5D utility scores

Health utility estimates are important for cost-utility analyses, treatment prioritization, and health technology assessment in psoriasis. Region-specific estimates may be particularly valuable for informing these decisions in Asian settings. This systematic review and meta-analysis synthesized EQ-5D utility scores reported in Asian psoriasis populations and explored variation by country of study, psoriasis type, EQ-5D version, value set, and disease severity. A systematic search of PubMed, EMBASE, Scopus, the Cochrane Library, and Google Scholar from inception to July 2025 identified studies reporting EQ-5D index or EQ-VAS scores in Asian adults with psoriasis. Cross-sectional, cohort, case-control, and randomized controlled studies were included. Two reviewers independently screened studies and extracted data. Risk of bias was assessed using AXIS, NOS, and RoB-2. Random-effects meta-analyses, subgroup analyses, sensitivity analyses, and domain-wise proportion analyses were conducted. Fourteen studies comprising 2,322 patients with psoriasis were included. The pooled EQ-5D utility index was 0.84 (95% CI: 0.78–0.89; I² = 95.00%) across 10 studies with 1,453 participants. Subgroup analyses suggested variation by country of study, psoriasis type, EQ-5D version, and value set. The pooled EQ-5D VAS score was 70.73 (95% CI: 67.01–74.46; I² = 87.10%) from eight studies with 1,227 participants. In moderate-to-severe psoriasis, the pooled EQ-5D utility estimate was 0.80 (95% CI: -0.14 to 1.75) and the pooled EQ-VAS score was 63.08 (95% CI: 38.71–87.45). Domain-wise analysis indicated that pain/discomfort was the most commonly reported problem domain (22%), followed by mobility (20%), whereas self-care was least frequently reported. Funnel plot asymmetry and Egger’s test suggested possible small-study effects for EQ-5D utility scores, although trim-and-fill adjustment did not materially change the pooled estimate. Interpretation of these findings should take into account substantial unexplained heterogeneity, variation in EQ-5D versions and value sets, limited severity-stratified data, and uneven geographic coverage across Asia. The pooled estimates may provide preliminary, context-informed utility values for Asian psoriasis populations and could be useful as indicative inputs for economic evaluations and health technology assessments where country-specific data are limited. Registration: This review was registered in PROSPERO (CRD420251062372).