Patient-relevant treatment goals in psoriasis
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Patient-oriented care requires therapeutic decisions to agree with the patients’ treatment needs and goals. This study addressed the following questions: What is important to psoriasis patients starting systemic treatment? How stable are these preferences within the first year of treatment? Are treatment goals associated with age, gender, or treatment success? The importance of treatment goals was assessed for patients with moderate-to-severe psoriasis in the German Psoriasis Registry (PsoBest) at baseline (onset of a systemic treatment; n = 3066) and at a 1-year follow-up (n = 1444) using the Patient Benefit Index (PBI). Treatment success was measured with PBI global score and Psoriasis Area Severity Index (PASI). Patients with moderate-to-severe psoriasis pursued a wide range of different goals. The most general treatment goals were rated most relevant, including skin healing and quick skin improvement (94.8/94.5 % “quite” or “very” important), confidence in the therapy (93.0 %), control over the disease (92.3 %), and a clear diagnosis and therapy (89.6 %). Further important goals related to not being in fear of the disease getting worse (84.8 %), reduction in itching (83.9 %), burning (70.6 %), and pain (60.6 %) as well as attaining a normal everyday life (78.4 %) and low treatment burden (64.2–77.9 %). Goals were mostly not associated with sex and gender. Goal importance slightly increased with treatment success. In a substantial proportion of patients (30.3–54.7 %) goal importance changed within 1 year after onset of systemic treatment. We conclude that treatment goal importance should be assessed in clinical practice on a regular basis.
KeywordsPsoriasis Patient preferences Treatment goals Patient Benefit Index Health-related quality of life
Compliance with ethical standards
The study was supported by the German Federal Ministry of Education and Research (BMBF) within the context of the Hamburg Centre for Health Economics (HCHE), Grant No. 01EH1101B. The German Psoriasis Registry PsoBest is commissioned by the Professional Society of German Dermatologists (BVDD) and the German Society of Dermatology (DDG). It is also funded by changing pharmaceutic companies.
Conflict of interest
Blome C has received speaker honoraria, research grants, awards, and/or travel grants from Janssen-Cilag, Kreussler, Lilly, and medi. Gosau R has no conflicts of interest to declare. Radtke MA has received honoraria and travel expenses from Biogen, Pfizer, Abbvie, Celgene, Janssen, MSD, Amgen, Mundipharma, Leo, Almirall and Galderma. Reich K has served as consultant and paid speaker for and participated in clinical trials sponsored by companies that manufacture drugs used for the treatment of psoriasis including Abbvie, Amgen, Biogen, Elgene, Entocor, Ovagen, Forward Pharma, GSK, Janssen- ilag, Leo, Lilly, Medac, MSD, Novartis, Pfizer, Vertex, Takeda. Rustenbach SJ is an employee at the University Medical Center Hamburg-Eppendorf (UKE). Spehr C is an employee at the University Medical Center Hamburg-Eppendorf (UKE). Thaçi D has served as a consultant, investigator, and speaker, and has participated in advisory boards for AbbVie, Amgen, Biogen, Celgene, Eli Lilly, Janssen, Leo Pharma, MSD, Novartis, and Pfizer Inc; and has received research/educational Grants from Abbvie and Pfizer Inc. Augustin M has received honoraria and travel expenses from Abbott, Almirall, Amgen, Biogen, Celgene, Centocor, Janssen-Cilag, Leo, Medac, MSD (formerly Essex, Schering-Plough), Novartis, Pfizer (formerly Wyeth).
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- 3.Blome C, Costanzo A, Dauden E, Ferrandiz C, Girolomoni G et al (2015) Patient-relevant needs and treatment goals in nail psoriasis. Qual Life Res (epub ahead of print) Google Scholar
- 7.Gisondi P, Cazzaniga S, Chimenti S, Giannetti A, Maccarone M, Picardo M, Girolomoni G, Naldi L, Psocare Study Group (2013) Metabolic abnormalities associated with initiation of systemic treatment for psoriasis: evidence from the Italian Psocare Registry. J Eur Acad Dermatol Venereol 27:e30–e41CrossRefPubMedGoogle Scholar
- 9.Menter A, Gottlieb A, Feldman SR, Van Voorhees AS, Leonardi CL et al (2008) Guidelines of care for the management of psoriasis and psoriatic arthritis: section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol 58(5):826–850CrossRefPubMedGoogle Scholar
- 10.Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM et al (2011) Guidelines of care for the management of psoriasis and psoriatic arthritis: section 6. Guidelines of care for the treatment of psoriasis and psoriatic arthritis: case-based presentations and evidence-based conclusions. J Am Acad Dermatol 65(1):137–174CrossRefPubMedGoogle Scholar
- 13.Papp KA, Strober B, Augustin M, Calabro S, Londhe A, Chevrier M, PSOLAR investigators and Steering Committee (2012) PSOLAR: design, utility, and preliminary results of a prospective, international, disease-based registry of patients with psoriasis who are receiving, or are candidates for, conventional systemic treatments or biologic agents. J Drugs Dermatol 11:1210–1217PubMedGoogle Scholar
- 21.Warren RB, Smith CH, Yiu ZZ, Ashcroft DM, Barker JN et al (2015) Differential drug survival of biologic therapies for the treatment of psoriasis: a prospective observational cohort study from the British Association of Dermatologists Biologic Interventions Register (BADBIR). J Invest Dermatol 135(11):2632–2640CrossRefPubMedGoogle Scholar