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Psoriasis, psoriatic arthritis patients reported nontreatment, dissatisfaction

A significant portion of patients with psoriasis and psoriatic arthritis reported nontreatment or undertreatment, and about half reported treatment dissatisfaction, according to recent study results.

April W. Armstrong, MD, MPH, of the department of dermatology, University of California-Davis, and colleagues used data collected by the National Psoriasis Foundation from surveys conducted from 2003 to 2011 of 5,604 patients with psoriasis or psoriatic arthritis. Use of prescription medications (topical, phototherapeutic, oral systemic and biologic) determined the main outcome measures of nontreatment, undertreatment and treatment trends, plus treatment satisfaction and reasons for discontinuing medication.

 

April W. Armstrong

Untreated patients with mild psoriasis ranged from 36.6% to 49.2% compared with 23.6% to 35.5% of patients with moderate psoriasis and 9.4% to 29.7% of those with severe psoriasis. Of patients receiving treatment, topical medications alone were used by 41.9% of patients with mild psoriasis, 29.5% with moderate psoriasis and 21.5% with severe psoriasis in 2011.

UV-B was the most frequently used phototherapy modality, while methotrexate was the most commonly used oral therapy. Although patients cited ineffectiveness and adverse effects as primary reasons for discontinuing biologics, their inability to acquire adequate insurance was among the top reasons for discontinuation.

Treatment dissatisfaction was reported by 52.3% of psoriasis patients and 45.5% of patients with psoriatic arthritis.

“With an expanding array of therapeutic options for treatment of psoriasis and psoriatic arthritis, it is imperative to determine treatment trends and undertreatment patterns among patients with these conditions in the last decade,” the researchers reported. “While various treatment modalities are available … widespread treatment dissatisfaction exists. Efforts in advocacy and education are necessary to ensure that effective treatments are accessible to this patient population.”

Disclosure: Dr. Armstrong has received research grants or consultant honoraria from Abbott, Amgen and Janssen.