Variation in dermatologist beliefs about the safety and effectiveness of treatments for moderate to severe psoriasis - 13/01/13
Abstract |
Background |
Multiple systemic treatments are available for moderate to severe psoriasis, but dermatologists' perceptions of these treatments are unknown. Physician perceptions can influence prescribing patterns and patient outcomes, and may help to explain variations in clinical practice.
Objective |
We sought to describe the variation in dermatologist's beliefs about the safety and effectiveness of psoriasis treatments and evaluate how these relate to dermatologist characteristics and treatment preferences.
Methods |
We conducted a cross-sectional mail survey of a random sample of 500 National Psoriasis Foundation (NPF) members and 500 American Academy of Dermatology (AAD) members who treat psoriasis.
Results |
Of 989 clinicians who could be contacted, 246 NPF members and 141 AAD members returned the survey (39% response rate). Respondents perceived infliximab, ustekinumab, cyclosporine, and adalimumab to have the highest likelihood of skin clearance in 3 months (67%-75%). Etanercept, adalimumab, ultraviolet B, and ustekinumab had the lowest perceived likelihood of side effects requiring treatment discontinuation (9%-11%). Up to 49% of respondents “didn't know” the effectiveness or likelihood of side effects; calculated coefficients of variation were higher for perceived likelihood of side effects than perceived effectiveness. There were few significant associations between safety and effectiveness perceptions and respondent characteristics, and treatment preferences were not consistently predictive of perceptions.
Limitations |
Only dermatologists with interest in treating psoriasis were surveyed and general perceptions were elicited via survey format. Perceptions may differ between survey respondents and nonrespondents.
Conclusions |
Psoriasis providers demonstrate wide variation in their perception of the effectiveness and especially safety of systemic treatments.
Le texte complet de cet article est disponible en PDF.Key words : biologics, comparative effectiveness, pharmacoepidemiology, phototherapy, psoriasis, systemic therapies
Abbreviations used : AAD, CER, NPF, 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), National Institutes of Health (NIH) Training Grant T32-AR07465 (Dr Wan and Mr Shin), and an NIH Mentored Scholars Grant 1KM1CA156723 (Dr Callis Duffin). |
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| Disclosure: Dr. Van Voorhees served on an advisory board of and was an investigator, speaker, and consultant for Amgen, receiving honoraria and grants; was an advisory board member and a speaker for Abbott and Centocor, receiving honoraria; was an advisory board member and investigator for Genentech receiving honoraria and grants; was an advisory board member for Leo and Warner Chilcott, receiving honoraria; and received an honorarium from Synta for other work. In addition she has owned stock and stock options in Merck. Dr Bebo has had relationships with Abbott, Amgen, Janssen, Galderma, Stiefel/GSK, and Wyeth, receiving other 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, Novo 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, advisory board member, and speaker for Abbott and Amgen receiving honoraria, salary, and residency or fellowship funding; was an investigator, consultant, advisory board member, and speaker for Janssen/Centocor, receiving honoraria and salary; was an investigator and consultant for Pfizer/Wyeth receiving honoraria and salary; was a consultant for Eli Lilly receiving honoraria; was a consultant and investigator for Genzyme and Incyte receiving honoraria and salary; was an investigator for Celgene receiving salary; and was an investigator and consultant for Novo Nordisk, ApoPharma, and VBL, receiving honoraria and salary. 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 Dr Wan have no conflicts of interest to declare. |
Vol 68 - N° 2
P. 262-269 - février 2013 Retour au numéro
Article précédent
- An open-label pilot study of apremilast for the treatment of moderate to severe lichen planus: A case series
- Joan Paul, Clare E. Foss, Stefanie A. Hirano, Tina D. Cunningham, David M. Pariser
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- Enes Hajdarbegovic, Tamar Nijsten, Anton Westgeest, Fred Habraken, Loes Hollestein, Bing Thio
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