Psoriasis patient preferences for topical drugs: a systematic review

Svendsen, Mathias Tiedemann; Feldman, Steven R.; Tiedemann, Sylvia Naiga; Sørensen, Anne Sofie Stochholm; Rivas, Cecilie Marie Ringgaard; Andersen, Klaus Ejner

doi:10.1080/09546634.2019.1675855

Cited by 30 publications

(31 citation statements)

References 23 publications

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“…These efficacy data align with patient-reported outcomes, in which individuals with clear skin are more likely to report no impact of psoriasis on quality of life than those with almost clear skin (17). Moreover, drug efficacy can have a strong impact on patients' preferences for and satisfaction with topical psoriasis therapies (19), which in turn can profoundly affect adherence to treatment and overall treatment success. Thus, treating to clear skin and increasing the posttreatment duration of therapeutic effects may improve patient satisfaction and quality of life.…”

Section: Discussionsupporting

confidence: 55%

Posttreatment maintenance of therapeutic effect with fixed-combination halobetasol propionate 0.01%/tazarotene 0.045% lotion for moderate-to-severe plaque psoriasis

Lebwohl

Gold

Rosso³

et al. 2021

Journal of Dermatological Treatment

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Background: The topical corticosteroid halobetasol propionate (HP) and retinoid tazarotene (TAZ) are effective in psoriasis treatment. Fixed-combination HP 0.01%/TAZ 0.045% lotion has demonstrated efficacy and safety in moderate-to-severe plaque psoriasis. Objective: To investigate the maintenance of therapeutic effects after cessation of once-daily HP/ TAZ treatment. Methods: In two phase 3 studies (NCT02462070; NCT02462122), adults with moderate-to-severe psoriasis received HP/TAZ for 8 weeks. Data at week 12 were analyzed post hoc to evaluate posttreatment maintenance of treatment success (clear/almost clear skin), improvements in signs of psoriasis (erythema, plaque elevation, scaling), and reductions in affected body surface area (BSA). In a 52-week open-label study (NCT02462083), participants stopped HP/TAZ treatment after achievement of treatment success; data were analyzed post hoc to assess time to retreatment. Results: Across all studies, most participants who achieved treatment success maintained this effect for at least one month posttreatment. Treatment effects were similarly maintained for improvements in signs of psoriasis and reductions in BSA. Some participants continued to improve after cessation of treatment. Maintenance of treatment success and time to retreatment were greater for participants who achieved clear skin. Conclusion: HP/TAZ lotion provides therapeutic effects that persist after treatment cessation, supporting its use in long-term management of plaque psoriasis.

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Section: Discussionsupporting

confidence: 55%

Posttreatment maintenance of therapeutic effect with fixed-combination halobetasol propionate 0.01%/tazarotene 0.045% lotion for moderate-to-severe plaque psoriasis

Lebwohl

Gold

Rosso³

et al. 2021

Journal of Dermatological Treatment

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“…It is important to realise that, especially in topical therapy of psoriasis, patients must be motivated regularly and re-encouraged on the correct way of application and frequency to ensure adherence over time and to achieve an optimal result. Patients’ expectations need to be understood and managed individually in parallel [10, 11].…”

Section: The Goal Of Treatment: Satisfaction With Treatment and Outcomementioning

confidence: 99%

Topical Treatment of Psoriasis Vulgaris: The Swiss Treatment Pathway

Maul

Anzengruber

Conrad³

et al. 2021

Dermatology

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Topical treatment is crucial for the successful management of plaque psoriasis. Topicals are used either as a stand-alone therapy for mild psoriasis or else in combination with UV or systemic treatment for moderate-to-severe disease. For the choice of a suitable topical treatment, the formulation matters and not just the active substances. This expert opinion paper was developed via a non-structured consensus process by Swiss dermatologists in hospitals and private practices to illustrate the current treatment options to general practitioners and dermatologists in Switzerland. Defining treatment goals together with the patient is crucial and increases treatment adherence. Patients’ personal preferences and pre-existing experiences should be considered and their satisfaction with treatment and outcome regularly assessed. During the induction phase of “classical” mild-to-moderate psoriasis, the fixed combination of topical calcipotriol (Cal) 50 μg/g and betamethasone dipropionate (BD) 0.5 mg/g once daily is frequently used for 4–8 weeks. During the maintenance phase, a twice weekly (proactive) management has proved to reduce the risk of relapse. Of the fixed combinations, Cal/BD aerosol foam is the most effective formulation. However, the individual choice of formulation should be based on a patient’s preference and the location of the psoriatic plaques. Tailored recommendations are given for the topical management of specific areas (scalp, facial, intertriginous/genital, or palmoplantar lesions), certain symptoms (hyperkeratotic or hyperinflammatory forms) as well as during pregnancy or a period of breastfeeding. As concomitant basic therapy, several emollients are recommended. If topical treatment alone does not appear to be sufficient, the regimen should be escalated according to the Swiss S1-guideline for the systemic treatment of psoriasis.

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“…In both groups, the participants will be prescribed topical drugs based on a shared decision between the prescriber and patient, since preferences for topical drugs differ between patients and there is no single topical drug that is suitable for all psoriasis patients [ 26 ]. For both groups, one of the topical drugs containing corticosteroids or calcipotriol registered in Denmark for psoriasis patients will be prescribed (Table 2 ), since these drugs are the most frequently prescribed topical drugs in Denmark [ 27 ] and have a clear dose recommendation [ 28 ].…”

Section: Interventionsmentioning

confidence: 99%

Long-term improvement of psoriasis patients’ adherence to topical drugs: testing a patient-supporting intervention delivered by healthcare professionals

Svendsen

Feldman

Möller

et al. 2021

Trials

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Background Psoriasis affects 2–4% of the Western adult population and is a socio-economic burden for patients and society. Topical drugs are recommended as first-line treatment for mild-to-moderate psoriasis, but low adherence is a barrier to treatment success. Psoriasis patients require support, in order to improve their long-term use of topical drugs. The project aims to test whether a patient-supporting intervention delivered by dermatology nurses can reduce the severity of psoriasis, improve the use of topical drugs, and is cost-effective compared to standard procedure. Methods The intervention consists of improved support delivered to patients by three experienced dermatology nurses, who will support patients on a regular basis by consultations with a focus on providing reminder systems, accountability, reinforcement, and building trust in the treatment. Each patient will be supported by the same dermatology nurse throughout the entire study period. The effect will be compared with standard procedure. The intervention will be tested in a randomized controlled trial during a 48-week period. A group of patients with moderate-to-severe psoriasis (psoriasis affecting ≥ 4% of the total body surface area) and 18–85 years of age who are prescribed topical treatment will be randomized to a non-intervention (n ≈ 57) or intervention group (n ≈ 57). Participants in both arms will be prescribed topical preparations containing corticosteroid and/or calcipotriol. The primary outcome will be a change in the severity of psoriasis, measured as reduction in the Lattice-System Physician’s Global Assessment. Secondary outcomes will include changes in health-related quality of life (measured by disease specific and generic questionnaires), primary adherence (i.e., proportion of filled prescriptions), and secondary adherence by objective measure (rate of topical drug consumption (obtained by weighing medication packages) compared to estimated recommended consumption). A health economic evaluation is planned to run alongside the trial. Participants’ total health costs will be estimated on the basis of health costs reported to the national health registries and costs spent on the intervention, after which a cost-utility and cost-effectiveness analysis will be carried out. Discussion If the intervention can reduce the severity of psoriasis in a significant manner and is economically favorable compared to standard treatment, there is potential for implementing the intervention in dermatology clinics. Trial registration Clinicaltrials.govNCT04220554. Registered on January 7, 2020. Study results, either positive, negative, or inconclusive, will be published on www.clinicaltrials.gov. Trial registration no. with the Danish Regional Committee on Health Research Ethics, registration no. 72613.

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Psoriasis patient preferences for topical drugs: a systematic review

Abstract: results 1 exp COMPLIANCE/ 2 exp Treatment Compliance/ 3 exp PERSISTENCE/ 3382 4 exp Treatment Refusal/ 730 5 exp Drug Withdrawal/ 7615 6 exp Client Attitudes/ 7 exp Treatment Dropouts/ 2371 8 exp Health Behavior/ 9

Cited by 30 publications

References 23 publications

Posttreatment maintenance of therapeutic effect with fixed-combination halobetasol propionate 0.01%/tazarotene 0.045% lotion for moderate-to-severe plaque psoriasis

Posttreatment maintenance of therapeutic effect with fixed-combination halobetasol propionate 0.01%/tazarotene 0.045% lotion for moderate-to-severe plaque psoriasis

Topical Treatment of Psoriasis Vulgaris: The Swiss Treatment Pathway

Long-term improvement of psoriasis patients’ adherence to topical drugs: testing a patient-supporting intervention delivered by healthcare professionals

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