Patient preference for biologic treatments of psoriasis in Japan

Abstract

Psoriasis is a chronic autoimmune disease affecting skin which may also manifest in nails and joints. Several biologic treatments have been approved in Japan for psoriasis. Each biologic has a different profile for efficacy and safety, including different dosing regimens and co‐payment considerations which may complicate treatment decisions made by patients and physicians during short consultations. Elucidating patient preference is expected to contribute to shared decision‐making between patients and physicians to optimize treatment satisfaction and outcomes. However, the number of studies investigating this in Japan is very limited. The study used a discrete choice experiment methodology to elicit patient preferences for hypothetical options in an experimental framework. Participants were asked to choose their preferred treatment option from two hypothetical choices, defined by different levels of six attributes (i.e. early onset of efficacy, long‐term efficacy, sustained efficacy after drug withdrawal, dosing convenience, co‐payment and risk of serious infection). The survey included 16 treatment choice scenarios and was completed by 395 participants. Across all participants, the attribute regarded as most important was sustained efficacy after drug withdrawal, followed by dosing convenience, co‐payment, long‐term efficacy, early onset of efficacy and risk of serious infection. The study found that patients prefer treatments which have durable efficacy and lower treatment burden characterized as fewer injection frequency and lower co‐payment. These results may be helpful to understand patient preference for biologic treatments used for psoriasis in Japan and contribute to shared decision‐making between patients and physicians to improve patient satisfaction and treatment outcomes.

Pathogenic implication of epidermal scratch injury in psoriasis and atopic dermatitis

“…30,43 The excellent therapeutic efficacy of anti-TNF-a, anti-IL-23 and anti-IL-17A biologics for treatment of psoriasis highlights the central roles of the TNF-a and IL-23/IL-17A axes in its pathogenesis. [44][45][46][47] In accordance with this, IL-17A-producing immune cells and IL-17A signatures are predominantly detected in the lesional skin of patients with psoriasis. [48][49][50][51][52] Some IL-17A-producing T cells are known to recognize autoantigens.…”

Aryl Hydrocarbon Receptor in Atopic Dermatitis and Psoriasis

“…Psoriasis is also comorbid with cardiovascular diseases, metabolic diseases, and renal disorders, which represent a condition called inflammatory skin march [111,125,126,127,128,129]. The excellent therapeutic efficacy of anti-TNF-α/IL-23/IL-17A biologics for psoriasis point to the central role of the TNF-α/IL-23/IL-17A axis in its pathogenesis [18,19,130,131,132,133,134] Additionally, genetic and environmental factors are known to be involved in its pathogenesis [135,136].…”

Interleukin-17A and Keratinocytes in Psoriasis

“…That the tumor necrosis factor-α (TNF-α) and IL-23/IL-17A axes appear to be major drivers in the pathogenesis of psoriasis is underscored by the excellent response of psoriasis to biologics targeting TNF-α, IL-23, and IL-17A, although a difference exists in their efficacy [46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61]. Anti-TNF-α/IL-23/IL-17A biologics successfully improve psoriatic arthritis [18,56,[62][63][64].…”