An expert panel of dermatologists and hospital pharmacists have developed a list of agreed-upon items detailing the definitions, measurements, and factors affecting treatment persistence in patients with moderate to severe psoriasis. The full list can be found in their paper published in the Journal of the European Academy of Dermatology and Venereology.
A panel composed of 90 dermatologists and 34 hospital pharmacists in Spain convened to develop a questionnaire regarding the treatment of psoriasis. The questionnaire consisted of 70 items and was developed to determine definitions and measures in psoriasis therapy, treatment persistence, factors affecting treatment persistence, effect of treatment persistence, and treatment-related costs. Online surveys were sent to panel experts, and the panel analyzed and discussed the results to corroborate on the current clinical landscape of biologic treatment of psoriasis.
The dermatologists and hospital pharmacists reached a consensus on 77.1% and 71.4% of items proposed, respectively. Standardized measures for the assessment of treatment maintenance over time was agreed on by both groups. Treatment survival, treatment persistence, and treatment retention were considered synonymous by dermatologists, whereas hospital pharmacists deemed only treatment persistence as its own valid term.
Drug persistence and patient satisfaction were considered indicators of treatment success in psoriasis that may be influenced by the efficacy and safety profile of a drug, according to agreement by queried panelists. The panel also agreed that the order of treatment and the different causes of treatment discontinuation, including treatment failure, adverse events, and remission, should be included in a Kaplan-Meier analysis of treatment persistence.
Limitations of the study include the use of questionnaire data, lack of a randomization design, and the limited sample size of clinicians.
The conclusions reached by the panel may “facilitate treatment optimization for patients with psoriasis and promote long-term effectiveness of biological therapies.”
de la Cueva Dobao P, Notario J, Ferrándiz C, et al. Expert consensus on the persistence of biological treatments in moderate-to-severe psoriasis [published online April 29, 2019]. J Eur Acad Dermatol Venereol. doi:10.1111/jdv.15600