Feldman S, Poulos C, Gilloteau I, Mange B, Germino B, Boehm K, Gutknecht M, Augustin M. Patient preferences for treatment of moderate-to-severe psoriasis: a U.S. discrete-choice experiment survey. Poster presented at the 2019 American Academy of Dermatology (AAD) Annual Meeting; March 2, 2019. Washington, DC.

INTRODUCTION: Psoriasis patients’ preferences for the attributes of biologics may vary. We sought to characterize psoriasis patients’ preferences for selected attributes that may differentiate biologic treatments.

METHODS: Discrete-choice experiment (DCE) survey data were analyzed using mixed logit to quantify treatment preferences among U.S. adults with a self-reported physician diagnosis of moderate-to-severe psoriasis. The attributes were: chance of clear or almost clear skin after 1 year, risk of serious infection in the first year, risk of mild to moderate injection site reaction (ISR), number of treatments in the first year, and number of years of proven efficacy and safety in large clinical trials. The strength of preference for each attribute level (i.e., relative preference weights) was estimated and used to calculate the importance of attributes relative to each other (i.e., conditional relative importance scores). Levels of attributes were based on existing clinical information. In addition, patients ranked the importance of these five attributes plus five additional attributes: getting clear or almost clear skin more quickly, the treatment’s ability to treat all manifestations of psoriasis and psoriatic arthritis, complete relief of psoriasis symptoms, risk of anti-drug antibodies, and the number of injections required each time the medicine is taken.

RESULTS: The average age was 46 years, 39% were male, 79% had moderate to severe symptoms in the previous week, 49% self-reported PsA, and 50% had experience with biologics. The conditional relative importance scores indicated that clear skin was more important than other treatment attributes (P < 0.05). The remaining attributes were similarly important (not statistically significantly different; P < 0.05) except that the risk of ISR was more important than the risk of serious side effects. From the ranking exercise, the attributes most frequently chosen as the most important were serious side effects, clear skin, time to achieve clear skin and the ability of the treatment to treat all manifestations of psoriasis and psoriatic arthritis. The number of injections per dose and injection frequency were ranked least important.

CONCLUSION: Attributes beyond clear skin and novel in preference studies, such as number of years of proven efficacy, safety and ISR, are also important to patients. Patients’ perspectives regarding psoriasis treatment options may be considered in treatment selection.

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