Comparing treatment goals for psoriasis to treatment decisions

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This study published in The British Journal of Dermatology looks at treatment goals that have been developed to optimize daily clinical practice psoriasis care for patients using biologics.

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Background:
Treatment goals have been developed to optimize daily clinical practice psoriasis care, but have not yet been studied in real life.

Objectives:
To investigate to what extent treatment decisions made by dermatologists for psoriasis patients on biologics in daily clinical practice are already in accordance with the treatment goals without the active application of the treatment goals algorithm.

Methods:
Data were extracted from a prospective daily practice cohort of psoriasis patients on biologics. Analysis was done on effectiveness (Psoriasis Area and Severity Index score) and quality of life (Dermatology Life Quality Index questionnaire). Treatment decisions such as dosage adjustments, combination treatments, or switching therapy were compared to the treatment goals algorithm.

Results:
In 64% (253 of 395) of visits, physicians followed treatment goals algorithm. There were 162 (41%) visits in which there should have been a treatment modification according to treatment goals (group Modify) and a modification was indeed made in 59 of these 162 visits (36%). In 233 (59%) visits no treatment modification was necessary (group Continue) and therapy was indeed not modified in 194 of 233 visits (83%).

Conclusions:
Physicians acted in accordance with treatment goals in the majority of patient visits. In the patient group not achieving these goals, physicians should have modified therapy according to treatment goals but continued the same therapeutic regimen in the majority of visits. Optimizing therapy and defining barriers in the latter group might increase treatment results in daily practice psoriasis care.

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