Dermatologist and Patient Preferences in Choosing Treatments for Moderate to Severe Psoriasis

Alcusky, Matthew; Lee, Seina; Lau, Gordon; Chiu, Gretchen R.; Hadker, Nandini; Deshpande, Aparna; Fleming, Stephen E.; Vance, Nicola; Fakharzadeh, Steve

doi:10.1007/s13555-017-0205-2

Cited by 33 publications

(36 citation statements)

References 19 publications

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“…This finding compares with a recent study from the US in which risk of adverse events was more important than efficacy among moderate psoriasis patients, but results were the other way round for severe psoriasis patients [ 21 ]. In a German patient population, participants with moderate-to-severe psoriasis were most interested in safety of biologicals, followed by efficacy, but preferences varied with socio-demographic characteristics and working status [ 29 ].…”

Section: Discussioncontrasting

confidence: 51%

“…This study involves eliciting both patient and physician preferences for such treatment attributes by means of a DCE. Previous DCEs in psoriasis have evaluated either physician [ 19 ] or patient [ 20 ] preferences for treatment attributes, with few studies comparing the concordance of the preferences between stakeholders [ 21 , 22 ]. For Japan, to the best of our knowledge, this would be the first attempt to compare physician and patient preferences in psoriasis.…”

Section: Introductionmentioning

confidence: 99%

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Patient and Physician Preferences for Therapy Characteristics for Psoriasis: A Discrete Choice Experiment in Japan

Bolt

Kobayashi²,

Mahlich

2018

PharmacoEconomics Open

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Background With progress being made in the treatment of psoriasis, a variety of clinical research and treatment options are being pursued. This study used a discrete choice experiment (DCE) to estimate treatment characteristic preferences for both patients and physicians in Japan. Subgroup analysis was also applied in order to examine differences within the range of patients and within the range of physicians. Methods The DCE was developed with the input of clinical experts in the treatment of psoriasis to ensure inclusion of the most relevant attributes at appropriate levels in a way that is understandable to both physicians and patients. The study was conducted on parallel samples of Japanese physicians ( n = 161) and Japanese psoriasis patients ( n = 306) through an online panel. For each sample, a conditional logit statistical model and subgroup analysis were then performed to estimate respondent preferences for treatment attributes. Results The overall findings are that better treatment efficacy as measured by proportion of patients achieving 90% reduction in the Psoriasis Area and Severity Index score (PASI 90), lower risk of adverse events and the availability of a bio-holiday are important decision factors for both patients and physicians. Low injection frequency is less of a priority for both samples. Also, while both groups demonstrate a preference to receive the treatment injections at a clinic by a healthcare professional rather than self-injection at home, this is more pronounced for the patient sample. The physician sample shows considerably more emphasis on the type of injection, though both samples prefer subcutaneous injections to intravenous injections. Implications This study reveals the importance of addressing both clinical effectiveness and process factors in systemic, non-topical psoriasis treatments to gain acceptance by both physicians and patients. As well as efficacy (as measured by PASI 90), which remains a consistent priority in treatment, administration and development of new treatments should also consider process factors such as the mode of administration and possibility for a bio-holiday. Electronic supplementary material The online version of this article (10.1007/s41669-018-0104-1) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 51%

Section: Introductionmentioning

confidence: 99%

Patient and Physician Preferences for Therapy Characteristics for Psoriasis: A Discrete Choice Experiment in Japan

Bolt

Kobayashi²,

Mahlich

2018

PharmacoEconomics Open

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“…Long-lasting improvement in disease is an important treatment goal for both clinicians and patients [44,45], and long-term data from clinical trials provide valuable information to clinicians on benefit-risk profiles. In previously reported findings, ixekizumab was well tolerated and provided a persistent and long-term clinical response through 4 years of treatment in patients with moderate-to-severe plaque psoriasis [37].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Ixekizumab Through 5 Years in Moderate-to-Severe Psoriasis: Long-Term Results from the UNCOVER-1 and UNCOVER-2 Phase-3 Randomized Controlled Trials

Reich

Foley

Torii

et al. 2020

Dermatol Ther (Heidelb)

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Introduction: Ixekizumab, a high-affinity monoclonal antibody that selectively targets interleukin-17A, is approved for treatment of moderate-to-severe plaque psoriasis. Our objective was to evaluate the long-term efficacy and safety of ixekizumab in moderate-to-severe plaque psoriasis through 5 years. Methods: Data were integrated from the UNCOVER-1 and UNCOVER-2, randomized, double-blinded, phase-3 trials. Patients who continuously received the labeled ixekizumab dose, were static Physician's Global Assessment (sPGA) (0,1) responders at Week 12 and completed 60 weeks of treatment could enter the long-term extension (LTE) period. Patients could escalate to every-2-week dosing per investigator opinion. Efficacy and health outcomes included proportion of patients achieving Psoriasis Area and Severity Index (PASI) 75/90/100, sPGA (0,1) and (0), absolute PASI B 5/ B 3/ B 2/ B 1 and Dermatology Life Quality Index (DLQI) (0,1). Results exclude patients who escalated to every-2-week dosing. A Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/m9.figshare. 11925636.

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“…The impacts of safety and dosing frequency were also assessed, given their demonstrated relevance to treatment choice in previous studies. 29,30…”

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confidence: 99%

Patient-reported outcomes are important elements of psoriasis treatment decision making: A discrete choice experiment survey of dermatologists in the United States

Feldman

Régnier

Chirilov

et al. 2019

Journal of the American Academy of Dermatology

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and Chicago, IllinoisBackground: Psoriasis Area and Severity Index (PASI) response rates have been the benchmark for evaluating treatment efficacy in trials involving moderate-to-severe psoriasis.Objective: To understand how dermatologists assess biologics and which trade-off rules they apply when planning psoriasis treatment.Methods: Two online surveys of 130 and 129 US dermatologists (surveys 1 and 2, respectively) were conducted with use of direct and indirect elicitation via discrete choice experiment. Respondents were asked to choose hypothetical biologics on the basis of 6 attributes (a $75% reduction from baseline in PASI score or a $90% reduction from baseline in PASI score, infection risk, dosing frequency, and 3 patientreported outcomes [PROs] [relief of depression, relief of itching, and impact on usual activities]).Results: Most dermatologists (74% in survey 1 and 76% in survey 2) reported using both PASI and PROs when selecting a biologic. PASI response rate was the most important attribute (35%-38% of overall decision weight), whereas combined PRO attributes had similar importance (36% of decision weight). Infection risk and dosing frequency influenced the decision to a lesser extent.Limitations: Potential bias in considering 3 PROs versus 1 PASI rate and 1 safety attribute.Conclusion: PASI is most important for dermatologists selecting biologics, but PROs are also considered, especially when PASI response rate is similar between treatments. PRO data should be collected in trials involving moderate-to-severe psoriasis. ( J Am Acad Dermatol 2019;80:1650-7.)

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Dermatologist and Patient Preferences in Choosing Treatments for Moderate to Severe Psoriasis

Cited by 33 publications

References 19 publications

Patient and Physician Preferences for Therapy Characteristics for Psoriasis: A Discrete Choice Experiment in Japan

Patient and Physician Preferences for Therapy Characteristics for Psoriasis: A Discrete Choice Experiment in Japan

Efficacy and Safety of Ixekizumab Through 5 Years in Moderate-to-Severe Psoriasis: Long-Term Results from the UNCOVER-1 and UNCOVER-2 Phase-3 Randomized Controlled Trials

Patient-reported outcomes are important elements of psoriasis treatment decision making: A discrete choice experiment survey of dermatologists in the United States

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