Report
Are patients with psoriasis undertreated? Results of National Psoriasis Foundation survey

https://doi.org/10.1016/j.jaad.2007.06.042Get rights and content

Objective

We sought to assess whether patients with psoriasis with moderate or severe disease are being treated with systemic therapy.

Methods

Participants were identified from a random sample of the National Psoriasis Foundation contact database who were 18 years and older, with severe psoriasis (>10% body surface area) and moderate psoriasis (3%-10% body surface area); respondents with psoriatic arthritis were excluded.

Results

In all, 1657 respondents with psoriasis completed the survey (28% severe, 41% moderate). A total of 39% of respondents with severe psoriasis and 37% with moderate psoriasis were not currently receiving any treatment. Among respondents currently receiving therapy, only 43% of respondents with severe psoriasis received either traditional systemic therapy, biologic therapy, or phototherapy.

Limitations

Respondents were from the National Psoriasis Foundation contact database and reported their current severity, which may be affected by their treatment. Body surface area as a measure of patient-reported severity has not been validated but has been used in several published studies.

Conclusions

Almost 40% of respondents with psoriasis were currently not receiving treatment. For respondents with severe psoriasis, 26% were treated with systemic therapy, phototherapy, or both; 39% were not in treatment; and 35% were treated with topical therapy alone.

Section snippets

Methods

The National Psoriasis Foundation conducts semiannual surveys to collect information about disease burden, treatment patterns, treatment satisfaction, and quality of life among patients with psoriasis and psoriatic arthritis. Participants were identified from a random sample of the National Psoriasis Foundation contact database, which lists more than 32,500 individuals. Through stratified sampling, approximately 400 surveys, balanced for age, sex, and disease severity (weighed to capture more

Results

There were a total of 1657 respondents who completed one of the 6 National Psoriasis Foundation surveys: 505 in 2003, 655 in 2004, and 497 in 2005. Of respondents, 28% (n = 459) reported their psoriasis as severe and 41% reported moderate psoriasis (n = 683).

Discussion

Many respondents with severe and moderate psoriasis were not being treated with systemic therapy as recommended in published reports. Nearly 40% of respondents, including those with severe and moderate disease, reported no current treatment at the time of their interview. In addition, less than 50% of respondents with severe psoriasis currently in treatment received traditional systemic or biologic therapy or phototherapy, which is recommended by the guidelines and consensus statements. The

Cited by (0)

The National Psoriasis Foundation funded, designed, and conducted the surveys. Amgen and National Psoriasis Foundation collaborated for the analysis of treatment patterns in individuals with psoriasis. Strategic Healthcare Solutions, an independent consultant, was funded by Amgen for project design, statistical analysis, interpretation of data, drafting the article, and project management.

Disclosure: At the time of this work, Dr Horn was an employee of the National Psoriasis Foundation. The National Psoriasis Foundation receives unrestricted funding from Abbott Immunology, Amgen, Wyeth, Barrier Therapeutics, Biogen Idec, Centocor, Connetics Corporation, Daavlin, Galderma Laboratories, Genentech, National Biologic Corporation, Photomedex, UVBiotek, Valeant Pharmaceuticals, and Warner Chilcott. Dr Fox is a paid consultant to Amgen. Drs Patel, Chiou, and Dann are employees of Amgen. Dr Lebwohl has been a consultant and/or speaker for Amgen, Abbott, Astellas, Centocor, Genentech, Connetics, Pharmaderm, Novartis, Warner Chilcott, and Galderma Laboratories.

Presented in abstract and poster form at the Annual Meeting of the American Academy of Dermatology in Washington, DC, on February 3, 2007.

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