UK Psoriasis patients being let down with Bio treatments.

[Fred]

Psoriasis patients in the UK are being let down when going onto the bio treatments according to a new study which shows 54 percent of patients who failed to achieve effective control with a bio had no treatment change six months later, and almost all (92 percent) of patients who lost effective control had no treatment change six months later.

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New UK data from the PICTURE study released at the European Academy of Dermatology and Venereology (EADV) annual congress in Amsterdam show that two thirds of UK moderate to severe psoriasis patients treated with biologic therapies are failing to reach or maintain effective control of their symptoms. These data show one third failed to reach a 75 percent reduction in symptoms, (known as PASI 75), and an additional one third failed to maintain this response.

Additionally, the PICTURE study demonstrated that 54 percent of patients who failed to achieve effective control had no treatment change six months later. Furthermore, almost all (92 percent) of patients who lost effective control had no treatment change six months later. These data suggest UK clinicians may be maintaining patients on initial biologic treatment even though a response has not been achieved, or is not sustained.

Commenting on the results, chief investigator Dr Anthony Bewley, Whipps Cross University Hospital, London said, "These results demonstrate that many patients are failing to achieve optimal treatment for their psoriasis and remain on inadequate therapies. We must be aware of patients who are failing to respond and work with them to ensure they are on the most appropriate treatment so we can make the most of our resources."

In the UK, approximately 1.8 million people live with psoriasis and 20 percent are thought to have moderate to severe psoriasis. Poorly controlled moderate to severe psoriasis patients could cost the NHS up to approximately £6million per year. In addition to the cost burden, psoriasis has been shown to be associated with depression, anxiety and tendency to suicide (350 cases per year) as well as reduced levels of employment and income.

Obvious symptoms of psoriasis include red, itchy skin with scaly patches (plaques). People with moderate to severe psoriasis may have an increased risk of comorbidities, including psoriatic arthritis, obesity, metabolic syndrome, cardiovascular disease, psychiatric illness and cancer.

About the PICTURE study:
The PICTURE study primarily aimed to describe current treatment pathways with biologic therapies used in the management of psoriasis in UK NHS clinical practice.

PICTURE was a retrospective observational study of 221 UK patients with chronic plaque psoriasis aged >18 years at initiation of first biologic therapy. Data were collected from 10 NHS Trust sites across the UK (England, Wales and Scotland).

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[jiml]

These are frightening figures.........It's a shame that patients aren't monitored more closely at the start of treatments, so if one doesn't work it can be easily modified or changed Although I have never been on biological treatments I can't understand why a hospital dermatology department would continue with an ineffective treatment...... It's costing a lot of money, and may as well be stopped and another tried fairly quickly. I don't know if the hospitals are to blame or the patients for not demanding more monitoring.... A simple phone call from the patient to say it's ineffective should warrant a recall



I have no complaints about the treatment I have received over the years. I don't know if I have been lucky. But each time I have presented for treatment I have always had a dermatologist that listens to my concerns and offers what seems to me to be the best treatment they have available at the time....

[Fred]

I don't know if the hospitals are to blame or the patients for not demanding more monitoring.... A simple phone call from the patient to say it's ineffective should warrant a recall

In my opinion the hospitals, specialists, ARE to blame. It's not up to us the patient to keep doing their job for them, they shouldn't be letting people down like this.

After all we go to them because they are trained professionals and we put our trust in them that they will help us and they know what they are doing, these figures show that they just don't care or don't understand the workings of the bio treatments.

We are just people, we don't understand the workings, we just want something that works and a simple piece of monitoring the patient properly and suggesting a move to another bio is all it takes.

I like Jim have a very good relationship with my dermatologist, and she works very hard with me as I'm sure she does with all her patients. She keeps a good eye on me, and it was her who worked with my to find what was best for me.

Most of the Bio treatments recommend stopping after 3-4 months if there is no significant improvement, so it's not rocket science. Switch to another one and give it a try, but in the meantime the patient after 6 months has had enough and just gives up.