Patient-reported treatment satisfaction and choice of dosing frequency with biologic treatment for moderate to severe plaque psoriasis

Abstract

BackgroundModerate to severe plaque psoriasis has a serious effect on health-related quality of life. Patients treated with biologic medications place importance on satisfaction and treatment frequency options. We assessed patient-reported treatment satisfaction and dosing frequency choice with biologics.MethodsWe used a health care claims database to identify patients with moderate to severe plaque psoriasis. Participants completed the Treatment Satisfaction Questionnaire for Medication. Results were compared between patients experienced with biologics (adalimumab, etanercept, or ustekinumab) or not (cyclosporine or methotrexate). Participants were asked for their choices of dosing options of once every 1–2 weeks, 3–4 weeks, 1–2 months, or 2–3 months. Participants were also asked for their choices of dosing options of every 1, 2, 3, and so on up to every 12+ weeks.ResultsA total of 426 patients completed the survey (263 biologic-experienced and 163 biologic-naïve patients). Patient satisfaction with psoriasis treatment was significantly higher in the biologic-experienced cohort. The most frequently chosen option (38.8% of all participating patients) was every 2–3 months; 37.3% chose once every 1–2 weeks. Significant differences were found in the percentage of biologic-naïve patients choosing 2–3-month (49.7%) over 1–2-week (20.9%) dosing (P<0.001). Among biologic-experienced patients, the difference between the percentage of patients choosing the 2–3-month (35.7%) and 1–2-week (41.8%) options was not significant (P=0.264). The two most often week-specific intervals chosen by biologic-naïve patients were 12+ weeks (42.3%) and 4 weeks (15.6%). The biologic-experienced patients most often chose 12+ weeks (31.2%) and 1 week (25.9%).ConclusionPatients using biologics reported satisfaction with their treatment, which may positively affect outcomes. Longer dosing intervals were chosen most frequently among all patients combined. Reports of patient satisfaction with prior treatments and choices regarding dosing frequency, among all other considerations, should be evaluated in determining an appropriate biologic medication for psoriasis.

Use of dose–exposure–response relationships in Phase 2 and Phase 3 guselkumab studies to optimize dose selection in psoriasis

“…Appropriate dose selection is a critical issue during drug development and must balance key considerations including efficacy, safety and convenience . If the dose is inadequate, dose escalation may be necessary .…”

“…16,21 Appropriate dose selection is a critical issue during drug development and must balance key considerations including efficacy, safety and convenience. 22,23 If the dose is inadequate, dose escalation may be necessary. 24,25 With the data presented here, and additional population PK modelling and exposure-response modelling analyses outlined above, as well as the comprehensive efficacy and safety assessments in Phase 3, the method for dose selection in the guselkumab psoriasis programme was robust and yielded the optimal, convenient dosing regimen of 100 mg at weeks 0, 4, then q8w for the broader population of moderate-to-severe psoriasis patients.…”

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

“…Although dermatologists involved into this study think that a good formulation as well as an easy‐to‐apply regimen add to adherence, they primarily focus on patient's individual clinical aspects when selecting the medication to be prescribed (i.e. significant findings on the skin, presence of lesions in visible body areas, presence of joint pain, presence of disturbing pruritus) as well as on the expected efficacy of the medication as discontinuation of biologics seems often to be linked to treatment inefficacy .…”

Patient Adherence to Biologic Agents in Psoriasis

“…We speculate that the shorter interval between injections of etanercept (once or twice weekly) than for adalimumab (every 4th week) or ustekinumab (every 12th week) is of importance. It has been shown that longer intervals (every 2nd or 3rd month) are more preferable to the patients than more frequent injections [26]. Indeed, in the MARS questionnaire surveying the attitudes to treatment, the significant difference between etanercept and the other two biologics was captured by questions Q2, Q4, and Q6, which are related to the ease of administration of the medicine (fig.…”