Factors Influencing Biologic Therapy Switching in Psoriasis and Psoriatic Arthritis

Announcer:

You're listening to On the Frontlines of Psoriasis on ReachMD. On this episode, we’ll hear from Dr. Philip J. Mease, who’s the Director of Rheumatology Research at Providence Swedish Medical Center in Seattle and a Clinical Professor at the University of Washington. Dr. Mease is the lead author of a recent study examining factors that influence biologic therapy switching in patients with psoriasis and psoriatic arthritis. Let’s hear from him now.

Dr. Mease: 

So what we were trying to do in this analysis was to sort out what really contributes to a patient’s feeling that their disease is not being adequately controlled with whatever medication they’re on and then making a decision along with their physician to switch from one immunomodulatory medication to another.

We used the CorEvitas Psoriasis Registry to understand these factors. What we then did was look at their various outcome measures, what’s known as the PASI score—that stands for Psoriasis Area and Severity Index—and it’s a way of quantifying how much psoriasis is in that person. The other measures that were used were the DLQI, or Dermatology Life Quality Index, which is a measure of quality of life and function. In those patients who had psoriatic arthritis, we analyzed their pain score on a visual analog scale, and those patients who had greater than 40 were considered to have significant pain. 

What we found—and this is perhaps intuitive—is that the patients who had both a very impaired quality of life and a very high PASI score—i.e. they really hadn’t changed significantly during the first six months of their treatment, or in some cases, we were able to track the patients out for a much longer period of time—and we found that both high skin score and poor quality of life or high skin score and high amount of joint pain led to the decision in most instances to switch medications. And about 20 percent of the patients at the six-month mark were making the decision to make such a switch. They weren’t satisfied with their current treatments. On the other hand, the patients who had low skin scores and good quality of life changes felt satisfied and did not feel that they needed to make a change. And then we also looked at some intermediate patients—so for example, those that had high skin score but still pretty good quality of life and so on—and found that they were not as driven to want to make a switch. So it really appeared that it wasn’t just the skin, but it was also the other factors like the impact of the disease on quality of life and the high amount of pain in those with psoriatic arthritis. 

Announcer:

That was Dr. Philip J. Mease discussing the factors influencing biologic therapy switching in patients with psoriasis and psoriatic arthritis. To access this and other episodes in our series, visit On the Frontlines of Psoriasis on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!