Nontreatment, Undertreatment of Psoriatic Disease Quantified
(HealthDay News) – Nontreatment and undertreatment of psoriasis and psoriatic arthritis, including severe disease, is widespread in the United States, according to research published online Aug. 14 in JAMA Dermatology.
April W. Armstrong, MD, MPH, from the University of California-Davis in Sacramento, and colleagues used national survey data collected by the National Psoriasis Foundation from biannual surveys conducted from 2003–2011 to examine nontreatment, undertreatment, and treatment trends. Data were collected from 5,604 respondents with psoriasis or psoriatic arthritis, identified from a database of >76,000 patients.
The researchers found that 36.6–49.2% of patients with mild psoriasis, 23.6–35.5% with moderate psoriasis, and 9.4–29.7% with severe psoriasis were untreated. Of those who were treated, topical agents alone were received by 29.5% and 21.5% of patients with moderate and severe psoriasis, respectively. Ultraviolet-B was the most frequently used phototherapy modality, while methotrexate was the most frequently used oral agent. The main reasons for discontinuing biological agents were adverse effects and lack of effectiveness, with the inability to obtain adequate insurance coverage also cited as a reason for discontinuation. Dissatisfaction with treatment was reported by about half of patients (52.3% of those with psoriasis and 45.5% of those with psoriatic arthritis).
"Nontreatment and undertreatment of patients with psoriasis and psoriatic arthritis remain a significant problem in the United States," the authors write. "Efforts in advocacy and education are necessary to ensure that effective treatments are accessible to this patient population."
One author disclosed financial ties to the pharmaceutical industry.