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Dermatologists reported varied perceptions on safety, effectiveness of psoriasis therapy
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Dermatologists who treat patients with moderate to severe psoriasis reported wide variations in their perceptions of the efficacy and particularly the safety of systemic therapies in a recent study.
Researchers conducted a cross-sectional mail survey of 387 dermatologists with expertise on psoriasis who completed four-page questionnaires between May 2010 and August 2010. The cohort included randomly selected members of the National Psoriasis Foundation (n=246) and American Academy of Dermatology (n=141). Average length of practice was 23.1 years and 72% of respondents were men. Ten systemic therapies were assessed, and questions focusing on effectiveness and safety included:
- What percent of patients treated with each of the following therapies will have clear or almost clear skin after 3 months?
- What percent of patients will have to discontinue each of the following therapies due to side effects (ie, laboratory abnormalities, adverse effects or general tolerability issues)?
Respondents perceived infliximab (75%) to have the greatest mean effectiveness, followed by ustekinumab (72%), cyclosporine (69%) and adalimumab (67%). Treatments perceived to have the least likelihood of side effects resulting in discontinuation were etanercept (9%), adalimumab (10%), ultraviolet B (11%) and ustekinumab (11%).
Of 56 tested associations, researchers found only two significant correlations for safety and effectiveness perceptions involving prescription preferences for UVB phototherapy as a first-line treatment choice and as a heavily used treatment.
“Physician beliefs [regarding the safety and effectiveness of psoriasis medications] may impact patient outcomes, and could help to explain variations in clinical practice, a topic central to health care reform,” the researchers concluded. “Our data indicate that there is variation among psoriasis providers’ perceptions of treatments. Additional work is needed to contextualize the amount of variation in beliefs and to understand the causes of this variation.”
Disclosure: See the study for a full list of relevant disclosures.
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