The journey of adult psoriasis patients towards biologics: past and present. Results from the BioCAPTURE registry

Abstract

Background

A considerable disease period often precedes initiation of a biologic in patients with psoriasis. Little is known about this important period in patients' lives. Evaluation of this 'journey' can reveal important insights and opportunities for physicians and health care decision makers.

Objectives

(1) To describe patient and treatment characteristics until the start of biologic treatment in patients with severe psoriasis, (2) to assess shifts in early (2005-2009) versus established (2010-2015) biologics prescription periods, (3) to assess changes in hospital/day care admissions before vs. after starting biologics.

Methods

Explorative, retrospective study on the treatment characteristics of the period until first biologic presented with descriptive statistics of patients included in the BioCAPTURE registry. Journeys of 2005-2009 and 2010-2015 were compared with statistical tests to identify important shifts.

Results

Median TUS (time until conventional systemic) was 11.0 years and median TUB (time until biologic) was 18.9 years for all patients treated from 2005-2015. Most patients received 3 different conventional antipsoriatic systemic therapies. We noticed a small trend towards a shorter journey (TUB) with only 2 conventional systemic agents instead of 3 before initiating a biologic in later years (2010-2015, vs. 2005-2009). We also noticed a significant decrease of (day care) admissions comparing the two years before, versus the two first years after starting biologic treatment (17.7 versus 8.6 admissions/100 follow-up years, p<0.001). Cyclosporine, intensive topical treatment (dithranol), retinoids and PUVA therapy lost popularity in recent years.

Conclusion

The 'journey' of patients with psoriasis towards a biologic is still long and characterized by many different treatments. Shifts towards fewer conventional drugs before biologic initiation and a clear decrease of hospital and day care admissions before vs. after a biologic are seen. Improvement of this journey, especially in young or recently diagnosed patients can decrease negative influences on patients' lives and reduce societal impact.

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