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. 2024 Nov 28:14:167-174.
doi: 10.2147/PTT.S478352. eCollection 2024.

The Association Between Patient-Reported Disease Burden and Treatment Switching in Patients with Plaque Psoriasis Treated with Nonbiologic Systemic Therapy

Vardhaman Patel  1 , Sang Hee Park  1 , Yichen Zhong  1 , Adam P Sima  2 , Joe Zhuo  1 , Carla Roberts-Toler  2 , Brandon Becker  1 , Sara Hovland  1 , Bruce Strober  3   4
Affiliations

The Association Between Patient-Reported Disease Burden and Treatment Switching in Patients with Plaque Psoriasis Treated with Nonbiologic Systemic Therapy

Vardhaman Patel et al. Psoriasis (Auckl). .

Abstract

Purpose: This real-world study investigated the impact of patient-reported disease burden and health-related quality of life (HRQoL) on switching from systemic nonbiologic to biologic therapy in patients with plaque psoriasis.

Patients and methods: Biologic therapy-naive (biologic-naive) patients aged ≥18 years who were using systemic nonbiologic treatment and who enrolled in the CorEvitas Psoriasis Registry between April 2015 and August 2022 were included. Measures of patient-reported disease burden and HRQoL were collected at Registry enrollment. The primary outcome of interest was initiation of biologic therapy within 45 days of enrollment. Multivariable logistic regression models were fitted separately for each patient-reported measure, adjusting for patient, disease, and treatment characteristics, including physician-rated disease severity. Adjusted odds ratios of switching to biologic therapy were estimated for greater versus lesser burden for each measure.

Results: Of 848 included patients, 323 (38.1%) switched to biologic treatment. Greater patient-reported burden was independently associated with switching, with significantly higher adjusted odds ratios (95% confidence interval) for greater versus lesser burden as measured by the Dermatology Life Quality Index (1.55 [1.08-2.23], P=0.017), visual analog scale (VAS) for itch (2.14 [1.49-3.08], P<0.001), VAS for skin pain (2.18 [1.45-3.29], P<0.001), VAS for fatigue (1.66 [1.15-2.40], P=0.007), Patient Global Assessment-VAS (3.09 [1.94-4.91], P<0.001), and with activities impairment on the Work Productivity and Activity Impairment questionnaire (2.51 [1.72-3.65], P<0.001).

Conclusion: In addition to clinically assessed disease severity, patient-reported disease burden and quality of life may drive the switch to biologic treatment in real-world patients with plaque psoriasis.

Keywords: biological products; health-related quality of life; patient-reported outcome measures; registries; surveys and questionnaires.

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Conflict of interest statement

Ms Park, Dr Zhong, and Dr Becker are employees of and may own stock options in Bristol Myers Squibb. Dr Sima is an employee of CorEvitas, LLC (formerly Corrona). Ms Roberts-Toler was an employee of CorEvitas at the time of the study. Dr Patel and Dr Hovland were employees of Bristol Myers Squibb at the time of the study and may be shareholders in the company. Dr Hovland is currently affiliated with Chiesi USA, Inc., Boston, MA. Dr Strober has served as a consultant with honoraria for AbbVie, Acelyrin, Alamar, Almirall, Alumis, Amgen, Arcutis, Arena Pharmaceuticals, Aristea, Asana, Boehringer Ingelheim, Bristol Myers Squibb, Capital One, Celltrion, CorEvitas, Dermavant, Inmagene, Janssen/J&J Innovative Medicine, Kangpu Biopharmaceuticals, Leo Pharma, Lilly, Maruho, Meiji Seika Pharma, Monte Rosa Therapeutics, Novartis, Pfizer, Protagonist, RAPT Therapeutics, Regeneron, Sanofi, Sun Pharma, Takeda, TD Cowen, UCB, Union Therapeutics, Ventyx Biosciences, and vTv Therapeutics; as a speaker for AbbVie, Arcutis, Dermavant, Incyte, Janssen/J&J Innovative Medicine, Lilly, Regeneron, and Sanofi; as a co-scientific director (consulting fee) and investigator for the CorEvitas Psoriasis Registry; as editor-in-chief with an honorarium for the Journal of Psoriasis and Psoriatic Arthritis; he holds stock options in Connect Biopharma and Mindera Health. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Adjusted associations (aOR and 95% CI) for patient-reported outcome measures and switching to biologic treatment (N=848), estimated with models specific to each measure or subscale.a aVariables adjusted for included age, sex, race, ethnicity, work status, body mass index, psoriasis duration, psoriatic arthritis, number of nonbiologic systemics used before the study period began, history of psoriasis in difficult-to-treat areas, and disease severity as measured by body surface area involvement, Psoriasis Area and Severity Index score, and Investigator’s Global Assessment score. bMeasured by the EQ-5D-3L.
See this image and copyright information in PMC

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