Dermatologist preferences for first-line therapy of moderate to severe psoriasis in healthy adult patients

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

卷:66

Article

Wan, Joy¹  Abuabara, Katrina¹  Troxel, Andrea B.^2,3  Shin, Daniel B.^1,3  Van Voorhees, Abby S.¹  Bebo, Bruce F., Jr.⁴  Krueger, Gerald G.⁵  Duffin, Kristina Callis⁵  Gelfand, Joel M.^1,2,3 

[1] Univ Penn, Dept Dermatol, Perelman Sch Med, Philadelphia, PA 19104 USA

[2] Univ Penn, Ctr Clin Epidemiol & Biostat, Perelman Sch Med, Philadelphia, PA 19104 USA

[3] Univ Penn, Dept Epidemiol & Biostat, Perelman Sch Med, Philadelphia, PA 19104 USA

[4] Natl Psoriasis Fdn, Portland, OR USA

[5] Univ Utah, Dept Dermatol, Sch Med, Salt Lake City, UT 84112 USA

关键词: biologic;    comparative effectiveness;    methotrexate;    phototherapy;    psoriasis;    treatment preference;    tumor necrosis factor inhibitor;   

DOI  :  10.1016/j.jaad.2011.03.012

来源: Elsevier

【 摘 要 】

Background: Despite increasing therapies for moderate to severe psoriasis, dermatologists' treatment preferences are unknown. Objective: We sought to assess dermatologists' preferences for first-line treatments and their selection determinants. Methods: We surveyed 1000 US dermatologists (500 National Psoriasis Foundation and 500 American Academy of Dermatology members who treat psoriasis) about their preferences for first-line treatment of moderate to severe psoriasis in healthy adults of childbearing age using standardized patient vignettes. Results: The response rate was 39% (N = 387). Preferred therapies for male and female patients were: ultraviolet (UV) B (40% and 56%, respectively), etanercept (15% and 19%), methotrexate (16% and 4%), and adalimumab (12% and 10%). Of respondents, 66% administered phototherapy in their practice. After adjusting for all physician characteristics, those preferring first-line UVB for male or female patients were significantly more likely to have phototherapy in their practice (odds ratio [OR] 3.4, 95% confidence interval [CI] 1.8-6.6 and OR 2.8, 95% CI 1.5-5.3, respectively) and to have used UVB in more than 10 patients in the last 3 months (OR 8.0, 95% CI 3.9-16.4; OR 9.6, 95% CI 4.3-21.6). Dermatologists in the Midwest were more likely than those in the Northeast to prefer adalimumab first line for male and female patients. Limitations: We surveyed only dermatologists with interest in treating psoriasis and elicited their treatment preferences for a single base case scenario. Treatment preferences may differ between survey respondents and nonrespondents. Conclusion: UVB is most commonly preferred as a first-line treatment for moderate to severe psoriasis in healthy adults, and preferences vary based on region, phototherapy availability, and prior treatment use. (J Am Acad Dermatol 2012;66:376-86.)

【 授权许可】

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