Dermatologist preferences for first-line therapy of moderate to severe psoriasis in healthy adult patients - 18/02/12
Reprint requests: Joel M. Gelfand, MD, MSCE, Department of Dermatology, University of Pennsylvania School of Medicine 1471 Penn Tower, One Convention Ave, Philadelphia, PA 19104.Abstract |
Background |
Despite increasing therapies for moderate to severe psoriasis, dermatologists’ treatment preferences are unknown.
Objective |
We sought to assess dermatologists’ preferences for first-line treatments and their selection determinants.
Methods |
We surveyed 1000 US dermatologists (500 National Psoriasis Foundation and 500 American Academy of Dermatology members who treat psoriasis) about their preferences for first-line treatment of moderate to severe psoriasis in healthy adults of childbearing age using standardized patient vignettes.
Results |
The response rate was 39% (N = 387). Preferred therapies for male and female patients were: ultraviolet (UV) B (40% and 56%, respectively), etanercept (15% and 19%), methotrexate (16% and 4%), and adalimumab (12% and 10%). Of respondents, 66% administered phototherapy in their practice. After adjusting for all physician characteristics, those preferring first-line UVB for male or female patients were significantly more likely to have phototherapy in their practice (odds ratio [OR] 3.4, 95% confidence interval [CI] 1.8-6.6 and OR 2.8, 95% CI 1.5-5.3, respectively) and to have used UVB in more than 10 patients in the last 3 months (OR 8.0, 95% CI 3.9-16.4; OR 9.6, 95% CI 4.3-21.6). Dermatologists in the Midwest were more likely than those in the Northeast to prefer adalimumab first line for male and female patients.
Limitations |
We surveyed only dermatologists with interest in treating psoriasis and elicited their treatment preferences for a single base case scenario. Treatment preferences may differ between survey respondents and nonrespondents.
Conclusion |
UVB is most commonly preferred as a first-line treatment for moderate to severe psoriasis in healthy adults, and preferences vary based on region, phototherapy availability, and prior treatment use.
Le texte complet de cet article est disponible en PDF.Key words : biologic, comparative effectiveness, methotrexate, phototherapy, psoriasis, treatment preference, tumor necrosis factor inhibitor
Abbreviations used : AAD, CI, NPF, OR, UV
Plan
| Supported by grants from the National Institute of Arthritis and Musculoskeletal and Skin Diseases RC1-AR058204 (Dr Gelfand), the Doris Duke Clinical Research Fellowship (Dr Abuabara), and National Institutes of Health Training Grant T32-AR07465 (Ms Wan and Mr Shin). |
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| Disclosure: Dr Van Voorhees served on the advisory board of and was an investigator and speaker for Amgen and Genentech, receiving honoraria and grants; was a consultant for Incyte, Leo, VGX, and Xtrac, receiving honoraria; served on the advisory board and was a speaker for Abbott, Centocor, and Connetics, receiving honoraria; served on the advisory board and was an investigator for Bristol Myers Squibb and Warner Chilcott, receiving honoraria and grants; was an investigator for Astellas, IDEC, and Roche, receiving grants; served as a consultant for Amgen; and received honoraria from Synta. Dr Bebo has had relationships with Abbott, Amgen, Astellas, Centocor, Galderma, Genentech, PhotoMedix, Stiefel/GSK, Warner Chilcott, and Wyeth, receiving other financial benefits. Dr. Krueger served on the steering committees for Centocor/Phoenix 2 and Golimumab/psoriatic arthritis, receiving no compensation; served on the steering committee for PSOLAR, receiving other financial benefit; served on the data monitoring board for Novartis and as chair of the data monitoring safety board for Pfizer, receiving other financial benefit; was a consultant and/or advisory board member for Abbott, Almirall, Amgen, Anacor, Astellas, Boehringer Ingleheim, Bristol Myers Squibb, Centocor, CombinatoRx, Genzyme, Isis, Lilly, L’Oreal, Lupin Limited, MedaCorp, Medicis, Novartis, Nova Nordisk, Pfizer, Schering Plough, Somagenics, theDerm.org, Synvista, Warner Chilcot, UCB, Vascular Biogenics Limited, and ZARS, receiving honoraria or other financial benefit; was a stockholder in ZARS, receiving stock options; was a speaker for Abbott, Amgen, Astellas, Centocor, and the National Psoriasis Foundation, receiving honoraria; and was an investigator for Abbott, Amgen, and Centocor, receiving grants. Dr Callis Duffin was an investigator, consultant, and speaker for Abbott, Amgen, and Centocor, receiving honoraria and salary; served on the advisory board of Amgen; and received residency/fellowship program funding from Abbott and Amgen. Dr Gelfand served as consultant and investigator with Abbott, Amgen, Centocor, Genentech, Novartis, and Pfizer, receiving grants and honoraria; was a consultant with Celgene, Covance, Galderma, Shire Pharmaceuticals, and Wyeth, receiving honoraria; and was an investigator with Shionogi, receiving grants. Drs Abuabara and Troxel, Mr Shin, and Ms Wan have no conflicts of interest to declare. |
Vol 66 - N° 3
P. 376-386 - mars 2012 Retour au numéro
Article précédent
- Physician Global Assessment (PGA) and Psoriasis Area and Severity Index (PASI): Why do both? A systematic analysis of randomized controlled trials of biologic agents for moderate to severe plaque psoriasis
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