A Survey of Community Dermatologists Reveals the Unnecessary Impact of Trial-and-Error Behavior on the Psoriasis Biologic Treatment Paradigm

Dermatology and Therapy - Tập 11 - Trang 1851-1860 - 2021
Bruce Strober1,2, David Pariser3, Ann Deren-Lewis4, Tobin J. Dickerson4, Mark Lebwohl5, Alan Menter6
1Yale University School of Medicine, New Haven, USA
2Central Connecticut Dermatology, Cromwell, USA
3Eastern Virginia Medical School and Virginia Clinical Research, Inc., Norfolk, USA
4Mindera Corporation, San Diego, USA
5Icahn School of Medicine at Mt. Sinai, New York, USA
6Baylor University Medical Center, Dallas, USA

Tóm tắt

In the USA, psoriasis affects approximately 3% of the population and costs more than $110 billion annually. The development of targeted biologics has revolutionized psoriasis management, but at an increasing cost. According to Joint AAD/NPF guidelines, an important need exists to identify biomarkers that can predict the appropriate biologic agent for patients. A survey of community dermatologists was developed to address (1) significant factors influencing biologic therapy utilization in psoriasis; (2) the clinical utility of a test stratifying biologic response. Respondents confirmed that trial and error leads to frequent biologic switching. The survey indicated that 82% of dermatologists switch 10–30% of their patients in the first year and 98% switch intra-class for at least 50% of non-responding patients. The trial and error is due, in part, to formularies influencing the physician 77% of the time, with only 14% reporting that their first choice and the formulary alignment is greater than 75%. Compounding trial and error, 93% of the physicians report that they wait at least 12 weeks before determining non-response, in alignment with AAD/NPF guidelines. The lack of precision medicine and this trial-and-error approach result in unnecessary wasted spending and suboptimal patient outcomes. After being given an overview of Mind.Px, a dermal biomarker patch used to predict therapeutic response to a biologic class, survey participants expressed that: Surveyed dermatologists believe a test that predicts psoriasis treatment response to a class of biologic drugs would lessen trial and error, provide a tool for physicians to make more informed decisions about drug selection, improve patient outcomes, and significantly reduce wasted spending.

Tài liệu tham khảo

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