Patients, clinicians support use of as-needed biologic therapy for psoriasis

Key takeaways:

• The majority of patients and clinicians agreed with the use of as-needed biologic therapy for psoriasis.
• Benefits of this approach may include reducing health care burdens and empowering patients.

Patients and clinicians agree that as-needed use of biologic therapy has benefits over continuous long-term biologic use for the treatment of psoriasis, according to a study.

“Continuous use of biologic therapy contributes to an increased risk of infections, drug adverse events, injection burden and cost,” David Gleeson, BA, BM BCh, of St. John’s Institute of Dermatology, Guy’s and St. Thomas’ NHS Foundation Trust and King’s College London, and colleagues wrote. “‘As-needed’ biologic therapy, in which an individual takes their biologic at the first sign of psoriasis recurrence (rather than continuously at fixed dose intervals), may help to address these problems.”

According to the study, there is a knowledge gap in clinicians’ and patients’ perceptions toward as-needed biologic therapy. Additionally, concerns regarding this strategy have been raised, including the loss of disease control and the need for close clinician oversight.

To explore clinicians’ and patients’ views on as-needed biologic therapy for psoriasis, the authors sent an online survey to 27 clinicians and 67 patients in the United Kingdom. Results showed that 67% of patients and 78% of clinicians supported the use of as-needed biologic therapy for psoriasis.

Sixty-two percent of patients were concerned about side effects of continuous long-term use of biologic therapy, as well as the impact on the immune system (61%), the impact on other health conditions (48%) and the risk of infections (36%).

All clinicians agreed that an advantage of as-needed biologic therapy was a reduction in health care burdens including drug costs, follow-up visits and monitoring; 81% of clinicians also highlighted patient empowerment to have more control over their health as a benefit of as-needed biologic therapy.

On the other hand, 78% of clinicians expressed concern over the potential risk of losing disease control with as-needed therapy, with 67% citing potential risks of drug immunogenicity and 37% voicing concerns about the complexities of prescribing medication.

Despite the hesitations, both patients and clinicians agreed that the benefits of as-needed biologic therapy for psoriasis outweigh the risks given that certain protocols are followed.

“This approach is acceptable from both a patient and clinician perspective, provided an individualized patient assessment is undertaken, with adequate monitoring, appropriate ease of reaccess to medication and a motivated patient/clinician dynamic,” the authors wrote.