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J Am Acad Dermatol. 2019 Jan 28. pii: S0190-9622(19)30146-X. doi: 10.1016/j.jaad.2019.01.039. [Epub ahead of print]

Patient-Reported Outcomes are Important Elements of Psoriasis Treatment Decision Making: A Discrete Choice Experiment Survey of Dermatologists in the United States.

Author information

1
Department of Dermatology, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA.
2
Novartis AG, Basel, Switzerland. Electronic address: stephane.regnier@novartis.com.
3
GfK SE, Nuremberg, Germany.
4
Ipsos SA, Nuremberg, Germany.
5
Novartis AG, Basel, Switzerland.
6
Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA.

Abstract

BACKGROUND:

Psoriasis Area and Severity Index (PASI) response rates have been the benchmark for evaluating treatment efficacy in moderate-to-severe psoriasis trials.

OBJECTIVE:

Understand how dermatologists assess biologics and what trade-off rules they apply when planning psoriasis treatment.

METHODS:

Two online surveys of 130 and 129 U.S. dermatologists (Survey 1 and 2, respectively) were conducted using direct and indirect elicitation via discrete-choice experiment. Respondents were asked to choose hypothetical biologics based on six attributes (PASI 75 or 90 response rate, infection risk, dosing frequency, and three patient-reported outcomes [PROs] [relief of depression and itching, impact on usual activities]).

RESULTS:

Most dermatologists (Survey 1: 74%, Survey 2: 76%) reported using both PASI and PROs when selecting a biologic. PASI response rate was the most important attribute (35-38% of overall decision weight), while combined PRO attributes had similar importance (36% of decision weight). Infection risk and dosing frequency influenced the decision to a lesser extent.

LIMITATIONS:

Potential bias in considering three PROs versus one PASI rate and one safety attribute.

CONCLUSION:

PASI is most important for dermatologists selecting biologics, but PROs are also considered, especially when PASI response rate is similar between treatments. PRO data should be collected in moderate-to severe-psoriasis trials.

KEYWORDS:

Psoriasis Area Severity Index; biologics; patient-reported outcomes; psoriasis; treatment decision-making

PMID:
30703461
DOI:
10.1016/j.jaad.2019.01.039
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