Survey: Psoriasis/Psoriatic Arthritis Undertreated

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Key clinical point: Psoriasis and psoriatic arthritis treatment algorithms are underused, and patients are often undertreated.

Major finding: Among survey respondents, 22% were on no treatment, and 23% reported ever discussing conventional oral or biologic therapies with a health care provider.

Data source: A telephone survey (MAPP) of 735 psoriasis and 270 psoriatic arthritis patients.

Disclosures: The survey was sponsored by Celgene, which markets apremilast (Otezla). Dr. Lebwohl disclosed ties to numerous pharmaceutical companies, including several that market drugs for psoriasis and psoriatic arthritis.




ORLANDO – Patients with psoriasis and psoriatic arthritis have a high level of dissatisfaction with current treatment options and have numerous unmet health care needs, according to the U.S. findings from the Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) survey.

Of 1,005 U.S. adults who participated in the population-based telephone survey, 735 had psoriasis diagnosed by a health care provider, and 270 had psoriatic arthritis diagnosed – with or without a diagnosis of psoriasis. Half of those surveyed reported dissatisfaction with available oral and biologic therapies, Dr. Mark Lebwohl of Mount Sinai Hospital, New York, and his colleagues reported in a poster at the Orlando Dermatology Aesthetic and Clinical Conference.

Most respondents with psoriasis reported moderate symptoms (40%), with about 30% each reporting mild or severe symptoms. Itching was the most bothersome symptom, occurring in about 42% of patients, followed by flaking (26%) and scales (22%). Itching was the greatest contributor to estimates of disease severity.

Psoriatic arthritis patients were more likely to report severe symptoms (56%), while 12% reported mild symptoms, and about a third reported moderate symptoms. Itching was the most bothersome symptom among these patients, followed by pain (21%) and flaking (19%). Pain and joint swelling were the greatest contributors to estimates of disease severity in this group, the investigators said.

The majority of respondents (57%) had seen a doctor in the past year. For psoriasis patients, that doctor was most often a dermatologist (57%), while psoriatic arthritis patients most often saw a rheumatologist (38%).

A third of patients most often saw a primary care physician.

The main reasons cited for not having seen a doctor in the past year were having mild or no symptoms, and a feeling that a health care provider would be unable to help.

Of concern, patterns reported by the patients indicated widespread undertreatment of psoriasis and psoriatic arthritis, they said.

More than one in five psoriasis patients (22%) reported no treatment at the time of the survey, and although most described their disease as moderate or severe, only 23% reported ever discussing the use of conventional oral or biologic therapies with their health care providers, and only 9% were currently receiving systemic therapy; most were using prescription topical therapy.

Psoriatic arthritis patients were much more likely than were psoriasis patients to have ever used a conventional oral or biologic therapy, but only 50% were receiving systemic therapy, while 26% reported use of biologic therapy and 24% reported use of an oral therapy.

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