Abstract
Background: Previously, our cross-sectional observational study in Japan revealed high (68%) discordance within treatment goals between psoriasis patients and their physicians. Objective: This secondary analysis aimed to determine whether patient and physician users of biologics have higher treatment goals than users of non-biologics. Methods: A survey for both patients and physicians on background characteristics, disease severity, treatment goals, treatment satisfaction, and health-related quality of life was conducted at 54 sites. Association between treatment goals and biologic/non-biologic users was assessed using ordinal logistic regression models. Results: In total, 449 patient-physician pairs agreed to participate; 425 completed the survey and were analyzed. More biologic users than non-biologic users reported complete clearance (Psoriasis Area and Severity Index 100) as a treatment goal (patient-reported: 23.6% vs. 16.1%; physician-reported: 26.9% vs. 2.2%). Biologic users were significantly associated with higher treatment goals than non-biologic users (patient-reported: 1.8 (1.15–2.87) (odds ratio (9 5% CI)), p = 0.01; physician-reported: 11.0 (5.72–21.01), p < 0.01). Among biologic users, higher treatment goals were associated with higher treatment satisfaction (patient- and physician-rated); lower treatment goals were associated with back lesions and increasing patient age (patient-rated) and higher disease severity (physician-rated). Conclusion: Use of biologics among patients with psoriasis was associated with higher treatment goals. Further use of biologics contributed to treatment satisfaction. Appropriate treatment goals that are shared among patients and their physicians may improve treatment outcomes.
Highlights
Psoriasis is an immune-mediated skin condition that commonly manifests as inflamed, scaly skin lesions [1,2]
Biological therapies have emerged as an effective class of treatment for patients with psoriasis that have a significant effect on disease severity [7,8] and are associated with higher levels of treatment satisfaction compared with other therapies [7]
The variables included in the physicianreported analyses included lesion site—symptom on “upper limb”, physician’s specialty—psoriasis, physician’s workplace, physician’s experience with biologics, physician’s perspective on the patient’s understanding of their disease and treatment choice, PGA disease severity
Summary
Psoriasis is an immune-mediated skin condition that commonly manifests as inflamed, scaly skin lesions [1,2]. Severe symptoms associated with psoriasis are a major contributor to patients’ health-related quality of life (HRQOL) [3,4,5,6]. Biological therapies have emerged as an effective class of treatment for patients with psoriasis that have a significant effect on disease severity [7,8] and are associated with higher levels of treatment satisfaction compared with other therapies [7]. In Japan, the use of biologics is recommended for patients with poor Health Related Quality of Life, HRQOL The treatment goals currently recommended in treatment guidelines for psoriasis focus on clinical measures of disease severity and do not take into account other factors such as treatment satisfaction and HRQOL [10,11]. Treatment goals for psoriasis appear to vary widely between patients and their physicians [13,14]
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