Patient Preference for Psoriasis Biologic Treatment Changed Following the COVID-19 Pandemic

A study of patient preferences following the COVID-19 pandemic indicated that patients with psoriasis preferred biologics with less frequent injection schedules and a lower risk of serious infection requiring hospitalization, according to findings published in The Journal of Dermatology. This reflects a change from prior to the pandemic, at which time patients placed the highest importance on psoriasis treatment efficacy.

Investigators from Teikyo University School of Medicine in Japan and Novartis Pharma KK conducted this patient preference, web-based survey study in October 2021. Patients (N=448) with psoriasis who were registered in the INTAGE Healthcare Inc database, which is a marketing research company in Japan, received a questionnaire that used a discrete choice approach to query about biologic treatment preferences and potential factors influencing those preferences.

Among the survey respondents, 357 had consistent answers across repeated questions and were included in this analysis.

The mean age of study participants was 55.9 (standard deviation [SD], 10.3) years, 75.35% were men, 33.61% had psoriasis for at least 21 years, the most common affected areas were the scalp (54.06%) and lower extremities (52.105), 19.61% reported joint pain, 92.72% were using topical medications, and 7.84% were using biologics.

The most important factor for preferring a biologic treatment was administration route and visit schedule (relative importance [RI], 24.21%), followed by risk for serious infection leading to hospitalization (RI, 23.10%), 1-year efficacy (RI, 16.63%), incidence of injection site reactions (RI, 14.43%), and cost (RI, 14.22%). The least important factors were treatment efficacy in addressing skin manifestations (RI, 3.54%) and indication (RI, 3.87%).

In the subgroup analyses, women weighed risk for serious infection higher (RI, 29.23%) and 1-year efficacy lower (RI, 11.36%), patients 65 years of age and older indicated that the incidence of injection site reactions was less important (RI, 10.65%), those with no lesions in difficult-to-treat areas indicated that 1-year efficacy was less important (RI, 14.22%), and those without joint pain were less concerned with efficacy in addressing skin manifestations (RI, 15.75%) compared with the entire study population.

In general, preferences relating to risk for serious infection requiring hospitalization and visits for medication administration differed on the basis of location, likely due to the fact that biologic treatment for psoriasis is only permitted at institutions approved by the Japan Dermatological Association and varies by geography.

The results of this study may have been limited by recruiting patients regardless of symptom severity or current treatment.

Study authors concluded, “A more important factor in patient preference for biologics in the present study was risk of serious infections requiring hospitalization, which differs from the patient preferences observed in the previous study and appears to have been influenced by the change in awareness of infectious diseases among psoriasis patients since the COVID-19 outbreak. This study also highlighted differential patterns of preference in various attributes by subgroup analyses.”

Disclosure: This research was supported by Maruho Co., Ltd., and Novartis Pharma K.K.  Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.