Evaluation of adherence predictors for the treatment of moderate to severe psoriasis with biologics: the importance of physician–patient interaction and communication

Zschocke, I.; Ortland, C.; Reich, Kristian

doi:10.1111/jdv.14178

Cited by 18 publications

(13 citation statements)

References 28 publications

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“…34 In patients with acne, the adherence to oral retinoids was 57%, whereas to topical retinoids only 2%. 54 Biologic agents have shown relatively good adherence rates, ranging from 58% to 100%, 52,[58][59][60] which is higher than the adherence rates reported for oral therapy. 61 In two trials including only psoriasis patients, ustekinumab showed the best overall adherence rate among systemic therapies studied (acitretin, methotrexate, adalimumab, etanercept, infliximab).…”

Section: Treatment-relatedmentioning

confidence: 87%

A systematic review of factors influencing treatment adherence in chronic inflammatory skin disease – strategies for optimizing treatment outcome

Eicher

Knop

Aszodi

et al. 2019

Acad Dermatol Venereol

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Adherence describes how a patient follows a medical regime recommended by a healthcare provider. Poor treatment adherence represents a complex and challenging problem of international healthcare systems, as it has a substantial impact on clinical outcomes and patient safety and constitutes an important financial burden. Since it is one of the most common causes of treatment failure, it is extremely important for physicians to reliably distinguish between non‐adherence and non‐response. This systematic review aims to summarize the current literature on treatment adherence in dermatology, focusing on chronic inflammatory skin diseases such as psoriasis, atopic dermatitis and acne. A systematic literature search was performed using the PubMed Database, including articles from 2008 to 2018. Low treatment adherence is a multidimensional phenomenon defined by the interplay of numerous factors and should under no circumstances be considered as the patient's fault alone. Factors influencing treatment adherence in dermatology include patient characteristics and beliefs, treatment efficacy and duration, administration routes, disease chronicity and the disease itself. Moreover, the quality of the physician‐patient relationship including physician‐time available for the patient plays an important role. Understanding patients’ adherence patterns and the main drivers of non‐adherence creates opportunities to improve adherence in the future. Strategies to increase treatment adherence range from reminder programs to simplifying prescriptions or educational interventions. Absolute adherence to treatment may not be realistically achievable, but efforts need to be made to raise awareness in order to maximize adherence as far as possible.

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Section: Treatment-relatedmentioning

confidence: 87%

A systematic review of factors influencing treatment adherence in chronic inflammatory skin disease – strategies for optimizing treatment outcome

Eicher

Knop

Aszodi

et al. 2019

Acad Dermatol Venereol

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“…Discouraged patients with recalcitrant disease may lose confidence about treatment if they do not observe efficient improvement of their skin symptoms, which can lead to poor medication adherence. 35 Thus, it is important to treat these patients early with rapid-acting biologic therapies, a niche that IL-17 inhibitors fill well.…”

Section: Discussionmentioning

confidence: 99%

Secukinumab in the treatment of psoriasis: patient selection and perspectives

Yang¹,

Beck²,

Liao³

2018

PTT

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Secukinumab is a human monoclonal antibody targeting IL-17A that has been approved for three indications: moderate-to-severe plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis. In Phase III clinical trials for each of these three indications, secukinumab has proven to be both highly efficacious and well-tolerated. However, several biologic medications are currently approved for the treatment of moderate-to-severe plaque psoriasis, and many demonstrate excellent efficacy and safety. Due to this wide selection, it is often unclear how to choose biologics for specific patients. Important considerations in biologic selection include clinical efficacy, safety, cost, convenience, onset of action, and management of comorbid disease. This article aims to outline the key considerations in patient selection for the treatment of plaque psoriasis with secukinumab.

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“…The adhesion of patients with psoriasis to anti-TNFα therapy is an essential condition for obtaining and maintaining the expected therapeutic outcome, but also a long-term indicator of patient satisfaction. The risk of reactivating the disease in the context of cessation of treatment confers a key role in maintaining the favorable clinical effects to the notion of adherence to therapy (17,18).…”

Section: Discussionmentioning

confidence: 99%

Aspects concerning patient adherence to anti‑TNFα therapy in psoriasis: A decade of clinical experience

et al. 2019

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Non-adherence to psoriasis treatment has an important impact in controlling chronic disease evolution and the occurrence of systemic comorbidities. Biologic therapy represents a revolutionary treatment, many of the undesirable psychological and socio-economical consequences of conventional topical or systemic therapies being avoided. Nevertheless, the discontinuation of biological therapy may occur due to facts related to the patient, to the lack of good communication between the patient and the physician or to the adverse or paradoxical reactions. We studied the non-adherence reasons to anti-TNFα agents (Infliximab, Adalimumab, Etanercept) used for treating 84 cases with moderate-severe psoriasis. The results of our study over the past 10 years showed a 76.2% adherence rate, lowest in patients treated with Etanercept (70.9%). Relative to the anti-TNF agent used, the highest adherence rate was recorded in Adalimumab (80.8%), followed by Infliximab (76.5%) and Etanercept (70.9%). We have noticed differences between the rates of adhesion to therapy with different anti-TNFα agents, but with no statistical significance. The main adverse effects that occurred during anti-TNFα therapy were: local reaction to the drug, mild infectious events, allergic reactions, cardiotoxicity, alopecia areata, pancreatitis, eosinophilia, thrombocytopenia. Anti-TNF therapy was discontinued in one case of endocarditis, one case with tuberculous laryngitis and another one with polydiscitis (Adalimumab), a case of colon cancer and one of pregnancy (Etanercept) and one paradoxical reaction (Infliximab).

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Evaluation of adherence predictors for the treatment of moderate to severe psoriasis with biologics: the importance of physician–patient interaction and communication

Abstract: The data reported here underline the importance of patient education and information delivery to optimize patient adherence and thereby treatment outcomes. Treating physicians should be aware that soft aspects of their interaction with the patient might influence treatment adherence.

Cited by 18 publications

References 28 publications

A systematic review of factors influencing treatment adherence in chronic inflammatory skin disease – strategies for optimizing treatment outcome

A systematic review of factors influencing treatment adherence in chronic inflammatory skin disease – strategies for optimizing treatment outcome

Secukinumab in the treatment of psoriasis: patient selection and perspectives

Aspects concerning patient adherence to anti‑TNFα therapy in psoriasis: A decade of clinical experience

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