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Armstrong AW, Jaleel T, Merola JF, Gottlieb AB, Khattri S, Helt CC, Malatestinic WN, Ross SE, Ngantcha ME, de Vlam K. Ixekizumab Demonstrates Rapid and Consistent Efficacy for Patients with Psoriatic Arthritis, Regardless of Psoriasis Severity. Dermatol Ther (Heidelb) 2024; 14:1615-1631. [PMID: 38814433 PMCID: PMC11169211 DOI: 10.1007/s13555-024-01188-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/16/2024] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION Skin involvement in patients with psoriatic arthritis (PsA) worsens the severity and burden of disease. Ixekizumab (IXE), a selective interleukin (IL)-17A antagonist, was compared to placebo (PBO) in the SPIRIT-P1 (NCT01695239) and SPIRIT-P2 (NCT02349295) studies in patients with PsA and evidence of plaque psoriasis. This post hoc analysis reports musculoskeletal, skin, and nail outcomes through week 24 in patients from SPIRIT-P1 and SPIRIT-P2, stratified by mild, moderate, or psoriasis at baseline. METHODS This post hoc analysis pooled patients from SPIRIT-P1 and SPIRIT-P2 who were randomly assigned to PBO or IXE 80 mg every 4 weeks (Q4W) or every 2 weeks (Q2W). Efficacy outcomes were analyzed through week 24 by baseline psoriasis severity, defined by percent body surface area (BSA) affected; mild = BSA < 3%, moderate = 3% ≤ BSA ≤ 10%, severe = BSA > 10%. The primary outcomes assessed were the proportion of patients achieving American College of Rheumatology (ACR)20, ACR50, and ACR70 responses. Secondary outcomes included musculoskeletal, disease activity, skin and nail, and health-related quality-of-life measures. RESULTS Similar proportions of patients achieved ACR20/ACR50/ACR70 over time across all severity subgroups and treatment arms. More than one-third of IXE-treated patients achieved ACR20 at week 4, or ACR50 at week 24, with no significant differences according to psoriasis severity at baseline. Disease activity outcomes were similar through week 24 with both IXEQ4W and IXEQ2W, regardless of psoriasis severity at baseline. There were no significant differences over 24 weeks in the proportions of IXE-treated patients with mild, moderate, or severe baseline psoriasis who achieved Minimal Disease Activity (MDA). Across all severity subgroups, IXE demonstrated Psoriasis Area Severity Index 100 response as early as week 4, and approximately one-third of IXE-treated patients achieved total skin clearance at week 24. CONCLUSION IXE demonstrated rapid and consistent efficacy in joint, skin, and nail for patients with PsA, regardless of baseline psoriasis severity. TRIAL REGISTRATION SPIRIT-P1 (NCT01695239), SPIRIT-P2 (NCT02349295).
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Affiliation(s)
| | - Tarannum Jaleel
- Department of Dermatology, Duke University School of Medicine, Durham, NC, USA
| | - Joseph F Merola
- Department of Dermatology and Department of Medicine, Division of Rheumatology, UT Southwestern, Dallas, TX, USA
| | - Alice B Gottlieb
- Department of Dermatology, Icahn School of Medicine, New York, NY, USA
| | - Saakshi Khattri
- Department of Dermatology, Icahn School of Medicine, New York, NY, USA
| | - Cameron C Helt
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA.
| | | | - Sarah E Ross
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA
| | - Marcus E Ngantcha
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA
| | - Kurt de Vlam
- Department of Rheumatology, University Hospitals Leuven, Louvain, Belgium
- Skeletal Biology and Engineering Research Centre, Department Development and Regeneration, KU Leuven, Louvain, Belgium
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Armstrong A, González-Cantero A, Khattri S, Muzy G, Malatestinic WN, Lampropoulou A, Feely M, See SK, Mert C, Blauvelt A. Comparing Achievement of National Psoriasis Foundation Treatment Targets among Patients with Plaque Psoriasis Treated with Ixekizumab versus Other Biologics in Clinical and Real-World Studies. Dermatol Ther (Heidelb) 2024; 14:933-952. [PMID: 38521874 PMCID: PMC11052751 DOI: 10.1007/s13555-024-01136-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 02/29/2024] [Indexed: 03/25/2024] Open
Abstract
INTRODUCTION The National Psoriasis Foundation (NPF) recommends evaluating patient response to treatment at week 12, with a target response of ≤ 1% body surface area (BSA) affected by plaque psoriasis and an acceptable response of BSA ≤ 3% or ≥ 75% improvement. This post hoc analysis compared the achievement of NPF target and acceptable responses for ixekizumab (IXE) versus other biologics. METHODS Outcomes were evaluated at week 12 for patients with moderate-to-severe plaque psoriasis from four head-to-head randomized clinical trials (RCTs; UNCOVER-2, UNCOVER-3, IXORA-R, and IXORA-S) and one real-world prospective observational study (Psoriasis Study of Health Outcomes; PSoHO). RCT patients were treated with IXE or etanercept (ETN; UNCOVER-2/3), guselkumab (GUS; IXORA-R), or ustekinumab (UST; IXORA-S). PSoHO patients were treated with anti-interleukin (IL)-17A biologics (IXE, secukinumab, SEC) and other approved biologics for the treatment of plaque psoriasis. Patients with missing outcomes were imputed as non-responder imputation. For RCT data, statistical comparisons between treatment groups were performed using Fisher's exact test with no multiplicity adjustments. For real-world data, adjusted comparative analyses were performed using frequentist model averaging (FMA) and reported as odds ratio (OR). RESULTS Across the four head-to-head clinical trials analyzed, significantly higher proportions of patients achieved target and acceptable responses at week 12 with IXE versus ETN, GUS, or UST. Likewise, the proportion of PSoHO patients achieving target and acceptable response at week 12 was higher with IXE compared with other individual biologics. Adjusted comparative analyses showed that IXE had significantly greater odds of target and acceptable response at week 12 versus SEC, GUS, risankizumab (RIS), adalimumab (ADA), UST, and tildrakizumab (TILD) and numerically greater odds of target and acceptable response at week 12 versus brodalumab (BROD). CONCLUSION Across both clinical studies and real-world settings, more patients treated with IXE achieved NPF target and acceptable responses at week 12 compared with those treated with other biologics. TRIAL REGISTRATION UNCOVER-2 (NCT01597245); UNCOVER-3 (NCT01646177); IXORA-R (NCT03573323); IXORA-S (NCT02561806); PSoHO (EUPAS24207).
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Affiliation(s)
| | - Alvaro González-Cantero
- Ramón y Cajal University Hospital, Madrid, Spain
- Faculty of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | | | | | | | | | - Meghan Feely
- Mount Sinai Hospital, New York, NY, USA
- Eli Lilly and Company, Indianapolis, IN, USA
| | | | - Can Mert
- HaaPACS GmbH, Schriesheim, Germany
| | - Andrew Blauvelt
- Oregon Medical Research Center, 9495 SW Locust St., Suite G, Portland, OR, 97223, USA.
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van Ee I, Deprez E, Egeberg A, Conrad C, Corazza V, Donati L, Lambert J, Lăpădatu R, Meyer A, Paul C, Penzer-Hick R, Stephen K, van der Zon J, Bewley A. Freedom from disease in plaque psoriasis: Comparing the perceived importance of voting round 2 statements from a Delphi consensus of patients, physicians and nurses. J Eur Acad Dermatol Venereol 2024; 38:e16-e19. [PMID: 37556673 DOI: 10.1111/jdv.19397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 08/03/2023] [Indexed: 08/11/2023]
Affiliation(s)
- Ilse van Ee
- Psoriasispatiënten Nederland, Nijkerk, The Netherlands
| | | | - Alexander Egeberg
- Department of Dermatology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Curdin Conrad
- Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - Valeria Corazza
- Fondazione Natalino Corazza Onlus Psoriasis & Co, Bologna, Italy
| | - Ludovica Donati
- Fondazione Natalino Corazza Onlus Psoriasis & Co, Bologna, Italy
| | - Jo Lambert
- Ghent University Hospital, Ghent, Belgium
| | | | | | - Carle Paul
- Paul Sabatier University, Toulouse, France
- Centre Hospitalier Universitaire, Toulouse, France
| | | | | | | | - Anthony Bewley
- Barts Health NHS Trust & Queen Mary University, London, UK
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Reich A, Pinter A, Maul JT, Vender RB, Torres T, Brnabic A, Haustrup N, Reed C, Schuster C, Riedl E. Speed of clinical improvement in the real-world setting from patient-reported Psoriasis Symptoms and Signs Diary: Secondary outcomes from the Psoriasis Study of Health Outcomes through 12 weeks. J Eur Acad Dermatol Venereol 2023; 37:1825-1840. [PMID: 37147855 DOI: 10.1111/jdv.19161] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/24/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Rapid skin improvement is a key treatment goal of patients with moderate-to-severe psoriasis (PsO). OBJECTIVES To compare the speed of clinical improvement of approved biologics on the symptoms and signs of psoriasis assessed by patients using the validated Psoriasis Symptoms and Signs Diary (PSSD) through 12 weeks. METHODS Psoriasis Study of Health Outcomes (PSoHO) is an international, prospective, non-interventional study that compares the effectiveness of anti-interleukin (IL)-17A biologics versus other biologics, together with pairwise comparisons of ixekizumab versus five individual biologics in patients with PsO. Using the PSSD 7-day recall period, patients assessed the symptoms (itch, skin tightness, burning, stinging and pain) and signs (dryness, cracking, scaling, shedding/flaking, redness and bleeding) of their psoriasis (0-10). Symptom and sign summary scores (0-100) are derived from the average of individual scores. Percentage change in summary scores and proportion of patients with clinically meaningful improvements (CMI) in PSSD summary and individual scores are evaluated weekly. Longitudinal PSSD data are reported as observed with treatment comparisons analysed using mixed model for repeated measures (MMRM) and generalized linear mixed models (GLMM). RESULTS Across cohorts and treatments, eligible patients (n = 1654) had comparable baseline PSSD scores. From Week 1, the anti-IL-17A cohort achieved significantly larger score improvements in PSSD summary scores and a higher proportion of patients showed CMIs compared to the other biologics cohort through 12 weeks. Lower PSSD scores were associated with a greater proportion of patients reporting their psoriasis as no longer impacting their quality-of-life (DLQI 0,1) and a high level of clinical response (PASI100). Results also indicate a relationship between an early CMI in PSSD score at Week 2 and PASI100 score at Week 12. CONCLUSIONS Treatment with anti-IL-17A biologics, particularly ixekizumab, resulted in rapid and sustained patient-reported improvements in psoriasis symptoms and signs compared with other biologics in a real-world setting.
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Affiliation(s)
- A Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | - A Pinter
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - J-T Maul
- Department of Dermatology and Venereology, University Hospital of Zürich and Faculty of Medicine, University of Zürich, Zürich, Switzerland
| | - R B Vender
- Dermatrials Research Inc. and Venderm Consulting, Hamilton, Ontario, Canada
| | - T Torres
- Department of Dermatology and Dermatology Research Unit, Centro Hospitalar Universitário do Porto, University of Porto, Porto, Portugal
| | - A Brnabic
- Eli Lilly and Company, Indiana, Indianapolis, USA
| | - N Haustrup
- Eli Lilly and Company, Indiana, Indianapolis, USA
| | - C Reed
- Eli Lilly and Company, Indiana, Indianapolis, USA
| | - C Schuster
- Eli Lilly and Company, Indiana, Indianapolis, USA
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - E Riedl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
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Balieva FN, Catton L, Claréus BW, Danielsen K, Fierens F, Iversen L, Koulu L, Osmanecevic A, Pasternack R, Skov L. Treatment Preferences in Young Adults with Moderate to Severe Psoriasis: A Qualitative Study from the Nordic Countries. Dermatol Ther (Heidelb) 2023:10.1007/s13555-023-00973-5. [PMID: 37452929 PMCID: PMC10366034 DOI: 10.1007/s13555-023-00973-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION The purpose of this study is to explore treatment preferences and identify patient characteristics in young bio-naive adults with moderate to severe psoriasis in the Nordic countries (Norway, Finland, Sweden, and Denmark). METHODS Patients were 18-45 years old and bio-naive but referred for biologic treatment of moderate to severe psoriasis. Patients were included at eight Nordic dermatology clinics. Patients with significant comorbidity or psoriatic arthritis were excluded. The Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) were assessed along with basic patient information. A semistructured interview guide was used in individual qualitative interviews, asking patients about their treatment preferences and reasons, disease journey, and disease management. The interviews were analyzed using thematic content analysis. Twenty-four patients sufficed to reach saturation in this qualitative study. RESULTS The patient sample characteristics represented a qualitative variation in age, sex, symptoms, duration of disease, and country. We included a total of 12 male and 12 female patients. The mean age was 34 years (range 18-45 years), the mean age at diagnosis was 20 years (range 6-34 years), the mean ± standard deviation (SD) time since diagnosis was 13 ± 8 years, PASI was 9.5 ± 4.7, and DLQI was 15.2 ± 6.4. Interviews suggested that both the burden of disease as well as the burden of treatment influenced patient preferences regarding treatment attributes, hence getting alleviation from symptoms did not alone influence patient preferences. Time, effort, and inconvenience related to psoriasis treatments also influenced patient preferences. CONCLUSIONS This first in-depth, qualitative study in young bio-naive adults with psoriasis suggests that patient preferences are focusing not only on symptom relief but also on alleviating the burden of psoriasis treatment. Understanding the reasons for patient preferences and the perspectives of young adults is needed to guide individual shared decision-making in psoriasis management.
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Affiliation(s)
- Flora Nicol Balieva
- Department of Dermatology, Stavanger University Hospital, Cort Adelersgate 12, Pb. 8100, 4068, Stavanger, Norway.
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
| | | | | | - Kjersti Danielsen
- Department of Community Medicine, UiT, The Arctic University of Norway, Tromsø, Norway
| | | | - Lars Iversen
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Leena Koulu
- Department of Dermatology, Turku University Hospital and University of Turku, Turku, Finland
| | - Amra Osmanecevic
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Rafael Pasternack
- Department of Dermatology, Tampere University Hospital, Tampere, Finland
| | - Lone Skov
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
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Schots L, Soenen R, Blanquart B, Thomas D, Lambert J. Blocking interleukin-17 in psoriasis: Real-world experience from the PsoPlus cohort. J Eur Acad Dermatol Venereol 2023; 37:698-710. [PMID: 36562700 DOI: 10.1111/jdv.18827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 11/21/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Real-world studies on the use of biologics in psoriasis (Pso) are increasing, but still scarce. Trough concentrations (Ct s) of interleukin-17 inhibitors (IL-17i) seem promising for clinical decision-making, but their value in daily practice has yet to be proven. OBJECTIVES To report on IL-17i effectiveness, treatment modifications and Ct use in our clinic. METHODS Data were collected from IL-17i-treated Pso patients followed up in the PsoPlus clinic at the Dermatology department, Ghent University Hospital, Belgium. Descriptive statistics and Kaplan-Meier analysis were performed. RESULTS A total of 111 patients were included, counting for 134 IL-17i courses (secukinumab, ixekizumab, and brodalumab). Fifty-five per cent of the patients were bio-naive prior to IL-17i initiation. During maintenance, merely 97.0% and 77% achieved near-complete and complete skin clearance, respectively. Major reasons for treatment modification were suboptimal response (63.0%) and safety issues (9.3%). Reported modifications were switch (25.4%), dose escalation (11.9%), dose de-escalation (6.7%), treatment association (6.0%) and IL-17i stop (3.0%). Overall drug survival was 69.0 months, without difference between the different IL-17i (p = 0.078). Ixekizumab tended to have the highest survival. Drug survival was higher in bio-naive subjects compared to bio-experienced subjects (p = 0.011). Ct was measured in 20 patients and interpreted post hoc. In 85%, the clinical decision was in accordance with the Ct (e.g. substantiated need for dose escalation). For the other cases, the Ct would have led to another clinical decision if known at that time. CONCLUSIONS This real-world study showed that IL-17i are very effective drugs for Pso, with ixekizumab as leading biologic. Prior bio-experience seemed to impact IL-17i drug survival. Treatment modifications were mainly performed in case of insufficient response, primarily via switch and dose escalation, and least frequently in ixekizumab patients. Ct might rationalize clinical decision-making; however, there is need for standardized algorithms to corroborate its use.
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Affiliation(s)
- Lisa Schots
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - Rani Soenen
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | | | - Debby Thomas
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Jo Lambert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
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Thaçi D, Piaserico S, Gaarn Du Jardin K, Warren RB. Long-term stability of PASI <3 response to tildrakizumab: Pooled analyses from reSURFACE 1 and reSURFACE 2 phase 3 trials through 5 years. J Eur Acad Dermatol Venereol 2023; 37:e501-e504. [PMID: 36433779 DOI: 10.1111/jdv.18783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Diamant Thaçi
- Institute and Comprehensive Centre for Inflammation Medicine, University of Lübeck, Lübeck, Germany
| | - Stefano Piaserico
- Unit of Dermatology, Department of Medicine, University of Padova, Padova, Italy
| | | | - Richard B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, The University of Manchester, Manchester, UK
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Hoelker S, Ninosu N, Buettner S, Peitsch WK, Schaarschmidt ML. Patient preferences for topical psoriasis treatments: a discrete choice experiment. J DERMATOL TREAT 2022; 33:2595-2604. [DOI: 10.1080/09546634.2022.2059052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Suna Hoelker
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Nadia Ninosu
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Sylvia Buettner
- Department for Biomathematics and Medical Statistics, Faculty of Medicine Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Wiebke K. Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Marthe-Lisa Schaarschmidt
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
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Lang Y, Wu B, Sun Z, Ye E, Dou G, Guan X. Patient Preference for Biologic Treatments of Psoriasis in the Chinese Setting. Patient Prefer Adherence 2022; 16:1071-1084. [PMID: 35479654 PMCID: PMC9038155 DOI: 10.2147/ppa.s357795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/09/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Assessments of patients' preferences can support in clinical decision-making regarding biologic therapies for psoriasis. Our objective was to investigate patient preference for biologic treatments in patients with psoriasis in China. METHODS From October 2020 to January 2021, psoriasis patients were recruited for a survey that included demographic and disease-related questions, as well as a discrete choice experiment to measure their preferences for biologic therapy. A discrete-choice experiment was used in which respondents selected psoriasis treatments based on benefits (ie, early onset of efficacy, long-term efficacy, sustained efficacy) and treatment costs. We analyzed choice data using conditional logit model. RESULTS This study included 236 patients with moderate-to-severe psoriasis. The relative importance of the cost of biologic treatments, probability of keeping PASI100 at 5 years, probability of achieving PASI100 at 3 months and time to achieve PASI50 after initiation the biologic treatment were 0.593, 0.137, 0.185 and 0.085. Over 50% of patients regarded the cost of biologic treatments as the most important attribute. High-income and low-income subgroups had higher preference weight in probability of achieving PASI100 at 3-month and monthly cost. CONCLUSION The cost of biologic treatments was found as the most important attribute for Chinese patients with psoriasis. Among efficacy attributes, the probability of achieving PASI100 at 3 months showed most sensitive. These results may be helpful to understand patient preference for biologic treatments used for psoriasis in China.
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Affiliation(s)
- Yitian Lang
- Department of Pharmacy, Huangpu Branch, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People’s Republic of China
| | - Bin Wu
- Medical Decision and Economic Group, Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 201100, People’s Republic of China
| | - Zhilin Sun
- Department of Dermatology, Peking University Third Hospital, Peking University, Haidian District, Beijing, People’s Republic of China
| | - Erjia Ye
- Lilly China Drug Development and Medical Affairs Center, Eli Lilly and Company, Shanghai, People’s Republic of China
| | - Guanshen Dou
- Lilly China Drug Development and Medical Affairs Center, Eli Lilly and Company, Shanghai, People’s Republic of China
| | - Xin Guan
- Department of Dermatology, Peking University Third Hospital, Peking University, Haidian District, Beijing, People’s Republic of China
- Correspondence: Xin Guan, Department of Dermatology, Peking University Third Hospital, Peking University, No. 49, Huayuan North Road, Haidian District, Beijing, People’s Republic of China, Email
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Boeri M, Saure D, Schuster C, Hill J, Guerreiro M, Klein K, Hauber B. Impact of clinical and demographic characteristics on patient preferences for psoriasis treatment features: Results from a discrete-choice experiment in a multicountry study. J DERMATOL TREAT 2021; 33:1598-1605. [PMID: 33406942 DOI: 10.1080/09546634.2020.1869145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVES This study aimed to elicit preferences for psoriasis treatment features and to test for preference heterogeneity across groups of respondents. MATERIALS AND METHODS A discrete-choice experiment was employed to elicit preferences of patients with plaque psoriasis in multiple countries. The survey instrument included a series of choice questions between three hypothetical treatments, each characterized by varying levels of six attributes (namely, lesion reduction, risk of impairing side effects, time to reach results, mode and frequency of administration, itching reduction, and side effects). Random parameters logit was used to model the data. Results were compared across a total of 18 subgroup sets. RESULTS The data analysis from 1,123 respondents showed that, on average, respondents receive more utility gain from higher levels of lesion reduction and lower risks of impairing side effects than changes in other attributes included in the study. Systematic differences were detected for 13 sets; the most pronounced differences were observed based on disease severity, nail psoriasis, biologic experience, and quality-of-life scores. CONCLUSION These many sources of preference heterogeneity identified by our analysis suggest that to improve patient satisfaction and, probably, adherence and persistence, clinicians should discuss options with patients when prescribing their treatment.
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Affiliation(s)
- Marco Boeri
- RTI Health Solutions, Health Preference Assessment, Belfast, UK
| | | | - Christopher Schuster
- Eli Lilly and Company, Vienna, Austria.,Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | | | | | - Kathleen Klein
- RTI Health Solutions, Health Preference Assessment, Research Triangle Park, NC, USA
| | - Brett Hauber
- RTI Health Solutions, Health Preference Assessment, Research Triangle Park, NC, USA
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Sain N, Willems D, Charokopou M, Hiligsmann M. The importance of understanding patient and physician preferences for psoriasis treatment characteristics: a systematic review of discrete-choice experiments. Curr Med Res Opin 2020; 36:1257-1275. [PMID: 32468865 DOI: 10.1080/03007995.2020.1776233] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Introduction: Treatment adherence continues to be a major challenge in psoriasis. Patient preference studies, especially discrete-choice experiments, are gaining popularity to gather insights into patient reported treatment outcomes. This systematic literature review aimed to critically assess all discrete choice experiments exploring patients' and physicians' preferences for psoriasis treatment characteristics.Methods: PubMed and EMBASE databases were searched using keywords "psoriasis" and "preferences" to identify relevant literature. Discrete-choice experiments conducted in French or English from the year 2000 onwards, that focused on evaluating psoriasis treatment preferences in patients and/or physicians, were included. The relative importance of treatment attributes was assessed and studies were critically appraised using validated checklists.Results: Out of 987 articles identified, 25 articles fulfilled the inclusion criteria. Overall, patients and physicians prioritize efficacy-specific outcomes. Patients are shown to place greater importance to process attributes when compared to physicians, especially route and location of administration. Physicians focus primarily of efficacy attributes, however when the top two attributes are considered, safety outcomes increasingly become considered important. Of the studies, 60% conducted subgroup analysis, of which many reported associations between specific patient characteristics and preferences. Factors such as age, disease severity, and duration of condition significantly affected preferences for treatment attributes.Conclusions: This review provides insight into the types of attributes that patients and physicians value most, and therefore can help improve shared decision-making. The findings of this study also encourage regulatory agencies to continue integrating patient preferences in their decision-making.
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Affiliation(s)
- Noem Sain
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Damon Willems
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- UCB Pharma, Brussels, Belgium
| | | | - Mickaël Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
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Veysey E. Choosing a biologic for psoriasis: is it a sprint or a marathon? Br J Dermatol 2020; 182:1321-1322. [DOI: 10.1111/bjd.19038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- E. Veysey
- Dermatology St Vincent's Hospital, Melbourne Pty Ltd Fitzroy Vic Australia
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Hagelund LM, Elkjær Stallknecht S, Jensen HH. Quality of life and patient preferences among Danish patients with ulcerative colitis - results from a survey study. Curr Med Res Opin 2020; 36:771-779. [PMID: 31944145 DOI: 10.1080/03007995.2020.1716704] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective: To explore health-related quality of life (HRQoL) and assess preferences for medical treatment attributes to obtain information of the relative importance of the different attributes in a Danish population with ulcerative colitis (UC).Methods: We used data from an online survey collected in March 2018 among people with self-reported UC. A total of 302 eligible respondents answered the HRQoL questionnaires (EuroQol-5 Dimensions (EQ-5D-5L) and the Short Inflammatory Bowel Disease Questionnaire (SIBDQ)), and 212 also completed the discrete choice experiment (DCE). The probability of choosing an alternative from a number of choices in the DCE was estimated using a conditional logit model.Results: The respondents had an average SIBDQ score of 4.5 and an HRQoL score of 0.77, applying the EQ-5D-5L questionnaire. HRQoL correlated with disease severity, and the respondents had lower HRQoL than did a gender- and age-matched subset of the Danish population. The most important medical treatment attribute was efficacy within eight weeks. Additionally, respondents stated a preference for avoiding taking steroids, for fast onset of effect and for oral formulations.Conclusions: HRQoL correlates with disease severity, and patients with UC have lower HRQoL than the general population. The most important treatment attribute was efficacy, but patients also would like to avoid steroids, value fast onset of effect and prefer oral formulations.
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Leonardi C, Reich K, Foley P, Torii H, Gerdes S, Guenther L, Gooderham M, Ferris LK, Griffiths CEM, ElMaraghy H, Crane H, Patel H, Burge R, Gallo G, Shrom D, Leung A, Lin CY, Papp K. Efficacy and Safety of Ixekizumab Through 5 Years in Moderate-to-Severe Psoriasis: Long-Term Results from the UNCOVER-1 and UNCOVER-2 Phase-3 Randomized Controlled Trials. Dermatol Ther (Heidelb) 2020; 10:431-447. [PMID: 32200512 PMCID: PMC7211779 DOI: 10.1007/s13555-020-00367-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Indexed: 01/09/2023] Open
Abstract
Introduction Ixekizumab, a high-affinity monoclonal antibody that selectively targets interleukin-17A, is approved for treatment of moderate-to-severe plaque psoriasis. Our objective was to evaluate the long-term efficacy and safety of ixekizumab in moderate-to-severe plaque psoriasis through 5 years. Methods Data were integrated from the UNCOVER-1 and UNCOVER-2, randomized, double-blinded, phase-3 trials. Patients who continuously received the labeled ixekizumab dose, were static Physician’s Global Assessment (sPGA) (0,1) responders at Week 12 and completed 60 weeks of treatment could enter the long-term extension (LTE) period. Patients could escalate to every-2-week dosing per investigator opinion. Efficacy and health outcomes included proportion of patients achieving Psoriasis Area and Severity Index (PASI) 75/90/100, sPGA (0,1) and (0), absolute PASI ≤ 5/ ≤ 3/ ≤ 2/ ≤ 1 and Dermatology Life Quality Index (DLQI) (0,1). Results exclude patients who escalated to every-2-week dosing. A modified non-responder imputation method was used to account for missing data. Supplemental analyses include patients who escalated to every-2-week dosing and observed and multiple imputation results. Exposure-adjusted safety outcomes are also reported. Results Of 206 patients who entered the LTE periods, 172 completed treatment. At Week 60, PASI 75/90/100 responses were 94.7%, 85.0% and 62.1%, respectively, and at year 5 were 90.3%, 71.3% and 46.3%, respectively. Similarly, meaningful responses were achieved for the other efficacy and health measures. Among patients with PASI 100 through 5 years, 92% achieved DLQI (0,1), indicating no impact of skin disease on quality of life. During the LTE period, exposure-adjusted incidence rates were 31.4 per 100 patient-years for treatment-emergent adverse events and 6.8 per 100 patient-years for serious adverse events. No deaths were reported. No new or unexpected safety findings were noted. Conclusions The results demonstrate 80 mg ixekizumab maintains long-term efficacy and a safety profile consistent with previous data in patients with moderate-to-severe plaque psoriasis through 5 years of treatment. Trial Registration ClinicalTrials.gov identifier, UNCOVER-1: NCT01474512, UNCOVER-2: NCT01597245. Electronic Supplementary Material The online version of this article (10.1007/s13555-020-00367-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Kristian Reich
- Center for Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Skinflammation® Center, Hamburg, Germany
| | - Peter Foley
- St. Vincent's Hospital Melbourne and Probity Medical Research, Skin Health Institute, The University of Melbourne, Melbourne, VIC, Australia
| | - Hideshi Torii
- Division of Dermatology, Tokyo Yamate Medical Center, Tokyo, Japan
| | - Sascha Gerdes
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Lyn Guenther
- Guenther Dermatology Research Centre, London, ON, Canada
| | - Melinda Gooderham
- SkiN Centre for Dermatology and Probity Medical Research, Peterborough, ON, Canada
| | - Laura K Ferris
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Hany ElMaraghy
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - Heidi Crane
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - Himanshu Patel
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - Russel Burge
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - Gaia Gallo
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - David Shrom
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA.
| | | | - Chen-Yen Lin
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - Kim Papp
- K. Papp Clinical Research and Probity Medical Research Inc., Waterloo, ON, Canada
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Warren RB, See K, Burge R, Zhang Y, Brnabic A, Gallo G, Garrelts A, Egeberg A. Rapid Response of Biologic Treatments of Moderate-to-Severe Plaque Psoriasis: A Comprehensive Investigation Using Bayesian and Frequentist Network Meta-analyses. Dermatol Ther (Heidelb) 2020; 10:73-86. [PMID: 31686337 PMCID: PMC6994587 DOI: 10.1007/s13555-019-00337-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Rapid improvement of psoriasis is valued by patients and should be considered to be an important factor in treatment selection. We investigated Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) response rates within the first 12 weeks of treatment to compare the rapid response of 11 biologic therapies for moderate-to-severe psoriasis using Bayesian and Frequentist network meta-analyses (NMA). METHODS A systematic literature review was conducted to identify phase 3, double-blind, randomized, controlled trials for adult patients with moderate-to-severe psoriasis treated with interleukin (IL)-17 (brodalumab, ixekizumab, secukinumab), IL-12/-23 (ustekinumab), IL-23 (guselkumab, risankizumab, tildrakizumab), or tumor necrosis factor inhibitors (adalimumab, certolizumab pegol, etanercept, infliximab). Outcome measures extracted from 32 publications were ≥ 75, ≥ 90, or 100% improvement in PASI score (PASI 75, PASI 90, or PASI 100, respectively) at weeks 2, 4, 8, and 12 and DLQI (0,1), where score (0,1) indicates no effect on patient's life, at week 12. Bayesian NMA (BNMA) used fixed-treatment effect and random-baseline effect, normal independent models. Frequentist NMA (fNMA) was conducted as sensitivity analyses to test the robustness of the findings. RESULTS Based on BNMA and fNMA, brodalumab and ixekizumab showed the most rapid treatment effects on PASI 75 at weeks 2, 4, and 8 and on PASI 90 and PASI 100 at weeks 2, 4, 8, and 12; ixekizumab overlapped with risankizumab on PASI 75 at week 12. Brodalumab, ixekizumab, and secukinumab yielded higher DLQI (0,1) gains at week 12 compared to all of the other biologics studied. Additional measures of quality of life were not assessed in this report. CONCLUSIONS Ixekizumab and brodalumab provide the most rapid response and earliest clinical benefit at week 2 among all of the biologics studied, including other biologic treatments such as secukinumab, ustekinumab, guselkumab, adalimumab, and etanercept. BNMA and fNMA results showed similar relative effect estimates and treatment rankings. FUNDING Eli Lilly and Company.
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Affiliation(s)
- Richard B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, University of Manchester, Manchester, UK
| | - Kyoungah See
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - Russel Burge
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA.
- College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA.
| | - Ying Zhang
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - Alan Brnabic
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - Gaia Gallo
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - Alyssa Garrelts
- Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
| | - Alexander Egeberg
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
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Wu B, Muser E, Teeple A, Pericone CD, Feldman SR. Treatment adherence and persistence of five commonly prescribed medications for moderate to severe psoriasis in a U.S. commercially insured population. J DERMATOL TREAT 2019; 32:595-602. [PMID: 31714168 DOI: 10.1080/09546634.2019.1687828] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To evaluate medication discontinuation, persistence, and adherence of moderate to severe psoriasis patients treated with adalimumab, apremilast, etanercept, secukinumab, and ustekinumab. METHODS Adult patients diagnosed with psoriasis and ≥1 psoriasis pharmacy or medical claim of any of the five psoriasis medications (index date) and continuous insurance enrollment were included from the Optum Clinformatics database during the intake period (7/1/2014-9/30/2017). Medication discontinuation, persistence, medication possession ratio (MPR), and proportion of days covered (PDC) were evaluated during a 12-month post-index follow-up period, using three gap definitions. RESULTS Among the study population (n = 8524), 34.4% initiated adalimumab, 25.7% apremilast, 9.0% etanercept, 7.1% secukinumab, and 23.7% ustekinumab. Mean age ranged from 48.7 to 52.2 years. For all three gap definitions, discontinuation was lowest and persistence greatest among ustekinumab treated patients (48.4% and 59.8%, respectively using the default definition). A greater proportion of ustekinumab patients had an MPR ≥80% (81.8%) than adalimumab (67.9%), apremilast (54.9%), etanercept (56.4%), and secukinumab (68.0%) patients. Also, 50.6% of ustekinumab patients had a PDC ≥80% versus 35.6%, 23.9%, 19.5%, and 41.7% of adalimumab, apremilast, etanercept, and secukinumab patients, respectively. CONCLUSIONS Although heterogeneity across cohorts may explain some medication utilization differences, ustekinumab was associated with lower discontinuation and greater persistence and adherence.
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Affiliation(s)
- Bingcao Wu
- Janssen Scientific Affairs, LLC, Titusville, NJ, USA
| | - Erik Muser
- Janssen Scientific Affairs, LLC, Titusville, NJ, USA
| | - Amanda Teeple
- Janssen Scientific Affairs, LLC, Titusville, NJ, USA
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Soekhai V, de Bekker-Grob EW, Ellis AR, Vass CM. Discrete Choice Experiments in Health Economics: Past, Present and Future. PHARMACOECONOMICS 2019; 37:201-226. [PMID: 30392040 PMCID: PMC6386055 DOI: 10.1007/s40273-018-0734-2] [Citation(s) in RCA: 387] [Impact Index Per Article: 77.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVES Discrete choice experiments (DCEs) are increasingly advocated as a way to quantify preferences for health. However, increasing support does not necessarily result in increasing quality. Although specific reviews have been conducted in certain contexts, there exists no recent description of the general state of the science of health-related DCEs. The aim of this paper was to update prior reviews (1990-2012), to identify all health-related DCEs and to provide a description of trends, current practice and future challenges. METHODS A systematic literature review was conducted to identify health-related empirical DCEs published between 2013 and 2017. The search strategy and data extraction replicated prior reviews to allow the reporting of trends, although additional extraction fields were incorporated. RESULTS Of the 7877 abstracts generated, 301 studies met the inclusion criteria and underwent data extraction. In general, the total number of DCEs per year continued to increase, with broader areas of application and increased geographic scope. Studies reported using more sophisticated designs (e.g. D-efficient) with associated software (e.g. Ngene). The trend towards using more sophisticated econometric models also continued. However, many studies presented sophisticated methods with insufficient detail. Qualitative research methods continued to be a popular approach for identifying attributes and levels. CONCLUSIONS The use of empirical DCEs in health economics continues to grow. However, inadequate reporting of methodological details inhibits quality assessment. This may reduce decision-makers' confidence in results and their ability to act on the findings. How and when to integrate health-related DCE outcomes into decision-making remains an important area for future research.
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Affiliation(s)
- Vikas Soekhai
- Section of Health Technology Assessment (HTA) and Erasmus Choice Modelling Centre (ECMC), Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam (EUR), P.O. Box 1738, Rotterdam, 3000 DR The Netherlands
- Department of Public Health, Erasmus MC, University Medical Center, P.O. Box 2040, Rotterdam, 3000 CA The Netherlands
| | - Esther W. de Bekker-Grob
- Section of Health Technology Assessment (HTA) and Erasmus Choice Modelling Centre (ECMC), Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam (EUR), P.O. Box 1738, Rotterdam, 3000 DR The Netherlands
| | - Alan R. Ellis
- Department of Social Work, North Carolina State University, Raleigh, NC USA
| | - Caroline M. Vass
- Manchester Centre for Health Economics, The University of Manchester, Manchester, UK
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Florek AG, Wang CJ, Armstrong AW. Treatment preferences and treatment satisfaction among psoriasis patients: a systematic review. Arch Dermatol Res 2018; 310:271-319. [DOI: 10.1007/s00403-018-1808-x] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 12/21/2017] [Accepted: 01/12/2018] [Indexed: 12/01/2022]
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Rigopoulos D, Ioannides D, Chaidemenos G, Kallidis P, Voultsidou A, Matekovits A, Soura E. Patient preference study for different characteristics of systemic psoriasis treatments (Protimisis). Dermatol Ther 2018; 31:e12592. [DOI: 10.1111/dth.12592] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 11/19/2017] [Accepted: 12/22/2017] [Indexed: 10/18/2022]
Affiliation(s)
- D. Rigopoulos
- 1st Department of Dermatology‐VenereologyMedical School, National and Kapodistrian University of Athens, Andreas Sygros HospitalAthens Greece
| | - D. Ioannides
- 1st Department of DermatologyAristotle UniversityThessaloniki Greece
| | | | | | | | | | - E. Soura
- 1st Department of Dermatology‐VenereologyMedical School, National and Kapodistrian University of Athens, Andreas Sygros HospitalAthens Greece
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Gonzalez JM. Evaluating Risk Tolerance from a Systematic Review of Preferences: The Case of Patients with Psoriasis. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2018; 11:285-300. [DOI: 10.1007/s40271-017-0295-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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De Abreu Lourenco R, Haas M, Hall J, Viney R. Valuing Meta-Health Effects for Use in Economic Evaluations to Inform Reimbursement Decisions: A Review of the Evidence. PHARMACOECONOMICS 2017; 35:347-362. [PMID: 27858368 DOI: 10.1007/s40273-016-0470-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE This review explores the evidence from the literature regarding how meta-health effects (effects other than health resulting from the consumption of health care) are valued for use in economic evaluations. METHODS A systematic review of the published literature (the EMBASE, MEDLINE, PsycINFO, CINAHL, EconLit and SocINDEX databases were searched for publications in March 2016, plus manual searching) investigated the associations between study methods and the resulting values for meta-health effects estimated for use in economic evaluations. The review considered which meta-health effects were being valued and how this differed by evaluation approach, intervention investigated, source of funds and year of publication. Detailed reasons for differences observed between values for comparable meta-health effects were explored, accounting for the method of valuation. RESULTS The search of the literature revealed 71 studies of interest; 35% involved drug interventions, with convenience, information and process of care the three meta-health effects most often investigated. Key associations with the meta-health effects were the evaluation method, the intervention, and the source of funds. Relative values for meta-health effects ranged from 0.9% to 68% of the overall value reported in a study. For a given meta-health effect, the magnitude of the effect evaluated and how the meta-health effect was described and framed relative to overall health explained the differences in relative values. CONCLUSIONS Evidence from the literature shows variability in how meta-health effects are being measured for use in economic evaluations. Understanding the sources of that variability is important if decision makers are to have confidence in how meta-health effects are valued.
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Affiliation(s)
- Richard De Abreu Lourenco
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Level 2, Block 5D, Quay St, Haymarket, Sydney, NSW, Australia.
| | - Marion Haas
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Level 2, Block 5D, Quay St, Haymarket, Sydney, NSW, Australia
| | - Jane Hall
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Level 2, Block 5D, Quay St, Haymarket, Sydney, NSW, Australia
| | - Rosalie Viney
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Level 2, Block 5D, Quay St, Haymarket, Sydney, NSW, Australia
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Gonzalez JM, Johnson FR, McAteer H, Posner J, Mughal F. Comparing preferences for outcomes of psoriasis treatments among patients and dermatologists in the U.K.: results from a discrete-choice experiment. Br J Dermatol 2016; 176:777-785. [PMID: 27292093 DOI: 10.1111/bjd.14798] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Plaque psoriasis can have a significant negative effect on patients' quality of life, and treatments can result in serious toxicities. Although there have been several studies of patients' and physicians' relative preferences for the benefits and risks of psoriasis treatments, it is unclear how and whether patients' and physicians' preferences for the outcomes of psoriasis treatments differ. OBJECTIVES To quantify patient and dermatologist preferences for improvements in psoriasis symptoms and for increases in the risk of treatment-related serious adverse events. METHODS Members of the U.K. Psoriasis Association and U.K. dermatologists with experience prescribing biologics completed a web-enabled discrete-choice experiment survey in which they evaluated efficacy and safety features of biological treatments for psoriasis. Choices between hypothetical treatment options were used to estimate preference weights indicating respondents' relative trade-off preferences among treatment outcomes. These outcomes included improvements in the severity and coverage of psoriatic plaques and treatment-related risks of tuberculosis, serious infections and lymphoma. Preference estimates were used to derive the maximum level of side-effect risks that respondents would accept for improvements in psoriasis symptoms. RESULTS Respondents' tolerance for side-effect risks varied with side-effect severity and location of plaques, and risk tolerance for serious side-effects was greater for patients than for dermatologists. CONCLUSIONS Estimates of patients' risk tolerance for serious side-effects indicate that patients valued psoriasis symptom control highly and suggest that psoriasis symptoms have a significant effect on patients' quality of life. In light of research showing increased treatment satisfaction and improved treatment adherence among patients who receive therapies that are consistent with their preferences, our findings suggest that greater communication between dermatologists and patients about risk tolerance could help improve patient care.
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Affiliation(s)
- J M Gonzalez
- RTI Health Solutions, Research Triangle Park, NC, U.S.A
| | - F R Johnson
- Duke Clinical Research Institute, Duke University, Durham, NC, U.S.A
| | - H McAteer
- Psoriasis Association, Northampton, U.K
| | - J Posner
- RTI Health Solutions, Research Triangle Park, NC, U.S.A
| | - F Mughal
- RTI Health Solutions, Research Triangle Park, NC, U.S.A
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Feldman SR, Holmen Moeller A, Erntoft Idemyr ST, González JM. Relative Importance of Mode of Administration in Treatment Preferences among Plaque Psoriasis Patients in the United States. JOURNAL OF HEALTH ECONOMICS AND OUTCOMES RESEARCH 2016; 4:141-157. [PMID: 37661952 PMCID: PMC10471409 DOI: 10.36469/9817] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Background: Some aspects of psoriasis treatments can negatively influence patients' quality of life. There is evidence from previous preference-elicitation research in psoriasis that administration characteristics are at least as important as treatment outcomes to patients. Objectives: Our objective was to test the hypothesis that patients' preferences for reduced disease and treatment burden are as important as preferences around treatment efficacy. We evaluated patient preferences for attributes of psoriasis treatments, including efficacy, tolerability, and mode and frequency of administration. Methods: Adult patients in the United States with a self-reported physician diagnosis of psoriasis completed an online discrete-choice experiment survey. The survey included eight choice questions, each asking respondents to choose between pairs of hypothetical psoriasis medications defined by attributes including efficacy, adverse reactions, and mode and frequency of administration. A random-parameters logit regression model was used to model the preference data. Results from this model were used to calculate respondents' willingness to trade efficacy for reduced treatment burden. Results: A total of 397 respondents, with a mean self-assessed Psoriasis Activity and Severity Index score of 8.2 (SD, 9.8), provided data for analysis. Improvements in treatment efficacy were more important than improvements in speed of onset and were more important than most increases in the chance of treatment side effects. The maximum possible improvement in treatment efficacy offered in the study was not enough to match the improvements in well being associated with some changes in mode of administration. For example, respondents were willing to accept a reduction in the percentage of patients who achieve clear or almost-clear skin after treatment from approximately 70% to 40% to avoid injections at home and use a topical treatment. Topical treatments were the most preferred option of administration followed by oral agents and intravenous infusion. Conclusions: Psoriasis patients had well-defined preferences for changes in the treatment attributes considered. Avoiding injections in favor of oral or topical treatment was more important to patients than some improvements in efficacy. These findings support previous research regarding the importance of treatment burden relative to outcomes in psoriasis and emphasize the importance of individual patient preferences in determining treatment strategy.
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Affiliation(s)
- Steven R Feldman
- Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, United States
| | | | | | - Juan Marcos González
- RTI Health Solutions, 200 Park Offices Drive, Research Triangle Park, NC, 27709, United States
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Gutknecht M, Schaarschmidt ML, Herrlein O, Augustin M. A systematic review on methods used to evaluate patient preferences in psoriasis treatments. J Eur Acad Dermatol Venereol 2016; 30:1454-64. [DOI: 10.1111/jdv.13749] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 12/22/2015] [Indexed: 11/30/2022]
Affiliation(s)
- M. Gutknecht
- Institute for Health Services Research in Dermatology and Nursing (IVDP); German Center for Health Services Research in Dermatology (CVderm); University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - M.-L. Schaarschmidt
- Institute for Health Services Research in Dermatology and Nursing (IVDP); German Center for Health Services Research in Dermatology (CVderm); University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - O. Herrlein
- Institute for Health Services Research in Dermatology and Nursing (IVDP); German Center for Health Services Research in Dermatology (CVderm); University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP); German Center for Health Services Research in Dermatology (CVderm); University Medical Center Hamburg-Eppendorf; Hamburg Germany
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Kim J, Kim DJ, Ortenzio FS, Dare L, Frank C, Kost RG, Lowes MA. Patients With Psoriasis and Personalized Trade-offs in Treatment Decisions-Lessons Learned From Focus Groups. JAMA Dermatol 2016; 152:720-2. [PMID: 27028481 DOI: 10.1001/jamadermatol.2016.0501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jaehwan Kim
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, New York
| | - Dong Joo Kim
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, New York
| | - Francesca S Ortenzio
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, New York
| | - Lynn Dare
- Christine Frank and Associates: Research and Evaluation, Barrie, Ontario, Canada
| | - Christine Frank
- Christine Frank and Associates: Research and Evaluation, Barrie, Ontario, Canada
| | - Rhonda G Kost
- Center for Clinical and Translational Science, The Rockefeller University, New York, New York
| | - Michelle A Lowes
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, New York
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Belinchón I, Rivera R, Blanch C, Comellas M, Lizán L. Adherence, satisfaction and preferences for treatment in patients with psoriasis in the European Union: a systematic review of the literature. Patient Prefer Adherence 2016; 10:2357-2367. [PMID: 27895471 PMCID: PMC5118025 DOI: 10.2147/ppa.s117006] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Adherence to treatment in patients with psoriasis is often poor. An investigation of patient preferences and satisfaction with treatment may be important, based on the expected correlation with therapy compliance. This paper aims to examine and describe the current literature on patient preferences, satisfaction and adherence to treatment for psoriasis in the European Union (EU). METHODS Electronic searches were conducted using PubMed, ISI Web of Knowledge, Scopus, Spanish databases and Google Scholar. European studies published in English or Spanish between January 1, 2009 and December 31, 2014 regarding patient-reported outcomes in psoriatic patients were included. Studies conducted in non-EU countries, letters to the editor, editorials, experts' opinions, case studies, congress proceedings, publications that did not differentiate between patients with psoriasis and psoriatic arthritis or studies related to specific treatment were excluded. RESULTS A total of 1,769 titles were identified, of which 1,636 were excluded as they were duplicates or did not provide any relevant information. After a full-text reading and application of the inclusion/exclusion criteria, 46 publications were included. This paper will describe publications on adherence (n=4), preferences (n=5) and satisfaction with treatment (n=7). Results related to health-related quality of life articles (n=30) have been published elsewhere. Adherence rates are generally low in psoriasis patients regardless of the type of treatment, severity of disease or methods used to measure adherence. Biologic therapy is associated with greater clinical improvement. There is a direct association between physician recommendations, patient preferences and several domains of treatment satisfaction. CONCLUSION The results of this review support the conclusion that adherence rates in patients with psoriasis are suboptimal and highlight the need to improve patient compliance and satisfaction with treatment. Patients' preferences should be taken into account in the treatment decision-making process in order to improve patients' clinical outcomes by ensuring satisfaction and adherence.
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Affiliation(s)
- I Belinchón
- Department of Dermatology, Hospital General Universitario de Alicante, Alicante
| | - R Rivera
- Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid
| | - C Blanch
- Novartis Farmacéutica S.A., Barcelona
| | | | - L Lizán
- Outcomes’10, Castellón, Spain
- Medical Department, University Jaime I, Castellón, Spain
- Correspondence: L Lizán, Outcomes’10, Espaitec 2, Universitat Jaume I, Castellón de la Plana, Castellón, Spain, Tel +34 964 83 19 98, Email
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Zhang M, Goren A, Lee S, DiBonaventura MD, Olson WH. Characterizing patients with psoriasis on injectable biologics adalimumab, etanercept, and ustekinumab: A chart review study. J DERMATOL TREAT 2015; 27:339-45. [PMID: 26558924 DOI: 10.3109/09546634.2015.1118427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study examined plaque psoriasis (PsO) patient characteristics across injectable biologics. METHODS Data were collected from 400 US dermatologists randomly selecting five charts each for patients with PsO (patient n = 2000): adalimumab (ADA; n = 447), etanercept (ETA; 539), ustekinumab (UST) 45 mg (511) and UST 90 mg (503). Physicians had to have been in practice 2-30 years, managing 10+ patients (5 + with biologics for PsO). Generalized estimating equation models, weighted according to inverse probability of patient selection and accounting for patient correlation within physicians, examined patient measures as a function of treatment (UST 90 mg = reference). RESULTS Patients on UST 90 mg had higher odds of weighing >100 kg (adjusted mean = 34.4%) vs. ADA (10.9%), ETA (5.5%) or UST 45 mg (6.8%), greater body surface affected and higher odds of severe PsO prior to treatment and higher odds of prior biologics use. Mean prior biologics used was higher with UST 90 mg versus ADA or ETA. Number of comorbidities was higher with UST 90 mg versus ETA or UST 45 mg. CONCLUSIONS Among biologics-treated patients with PsO, UST 90 mg appears to be used in patients with greater weight, baseline severity and prior biologics experience than ADA, ETA or UST 45 mg. UST 90 mg is used in patients with more comorbidities than other treatments except ADA.
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Affiliation(s)
| | - Amir Goren
- b Kantar Health , New York , NY , USA , and
| | - Seina Lee
- a Janssen Scientific Affairs, LLC , Horsham , PA , USA
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Hess JN, Moustafa FA, Kindley KJ, Huang KE, Feldman SR. Is Safety Psoriasis Patients’ Overriding Concern? J Cutan Med Surg 2015; 19:201-2. [DOI: 10.1177/1203475415576427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Erdem S, Campbell D, Thompson C. Elimination and selection by aspects in health choice experiments: prioritising health service innovations. JOURNAL OF HEALTH ECONOMICS 2014; 38:10-22. [PMID: 25281524 DOI: 10.1016/j.jhealeco.2014.06.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 05/03/2014] [Accepted: 06/13/2014] [Indexed: 05/15/2023]
Abstract
Priorities for public health innovations are typically not considered equally by all members of the public. When faced with a choice between various innovation options, it is, therefore, possible that some respondents eliminate and/or select innovations based on certain characteristics. This paper proposes a flexible method for exploring and accommodating situations where respondents exhibit such behaviours, whilst addressing preference heterogeneity. We present an empirical case study on the public's preferences for health service innovations. We show that allowing for elimination-by-aspects and/or selection-by-aspects behavioural rules leads to substantial improvements in model fit and, importantly, has implications for willingness to pay estimates and scenario analysis.
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Affiliation(s)
- Seda Erdem
- Economics Division, Stirling Management School, University of Stirling, UK.
| | - Danny Campbell
- Economics Division, Stirling Management School, University of Stirling, UK.
| | - Carl Thompson
- Department of Health Sciences, University of York, UK.
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