%0 Journal Article
%T Treatment Changes in Patients With Moderate to Severe Psoriasis: A Retrospective Chart Review
%A Brooke Wehausen
%A Irma Richardson
%A Jaclyn A. Smith
%A Steven R. Feldman
%A Vivian Herrera
%A Yang Zhao
%A Yunfeng Li
%J Journal of Cutaneous Medicine and Surgery
%@ 1615-7109
%D 2018
%R 10.1177/1203475417724438
%X Psoriasis treatment involves topical medications, oral medications, phototherapy, and/or biologics. The treatments used depend on a myriad of factors that change over time. To characterise the frequency of and reasons for treatment changes in patients with moderate to severe psoriasis. A chart review examined treatment changes at 902 visits by 116 patients seen between January 1, 2010, and June 30, 2015, for moderate to severe psoriasis and the physicians¡¯ justifications for those changes. ¡®Treatment change¡¯ was defined as switching between, adding, or removing medication classes or switching within the oral or biologic class. There were 221 visits with treatment changes identified, and a change occurred every 4.1 visits. On average, there were 1.2 treatment changes per year. Patients treated for at least 1 year averaged 1 treatment change every 16 months. The most common type of change was from one biologic to another biologic (24.9%), followed by adding a nonbiologic to a biologic (18.6%). The most common reason for switching was poor control or flare of psoriasis. Affordability was a more common problem for biologics than for nonbiologic treatments. Biologic treatment options provide a major improvement over older systemic treatments, but patients still undergo frequent treatment changes to help control their disease
%K health care delivery
%K pharmacoeconomics
%K effectiveness
%K biologics
%K adalimumab
%K ustekinumab
%K etanercept
%U https://journals.sagepub.com/doi/full/10.1177/1203475417724438