Management of Moderate to Severe Psoriasis in Routine Clinical Practice in Spanish Hospitals

Actas Dermosifiliogr (Engl Ed). 2018 Sep;109(7):631-642. doi: 10.1016/j.ad.2018.02.015. Epub 2018 Jun 8.
[Article in English, Spanish]

Abstract

Background: There is currently little information available on the management of patients with psoriasis in the daily clinical practice of dermatologists in Spain.

Objective: The aim of this study was to survey a group of Spanish dermatologists with particular expertise in the management of psoriasis to determine their opinions on the protocols used in routine clinical practice.

Material and methods: A cross-sectional study based on an online survey about the management of psoriasis sent to 75 dermatologists. The survey, which was specifically designed for the study, included 12questions on different aspects of clinical practice in the treatment of moderate to severe psoriasis.

Results: The response rate was 96% (n=72). Biologics were the most widely used monotherapy option. In total, 64.3% of respondents reported that their patients used conventional systemic therapies for 1 to 2years before switching to a biologic drug and that the main reason for the switch was unstable control of disease activity. Overall, 85.7% assigned a "high" or "very high" importance to the use of a Psoriasis Area Severity Index score of <3 as a treatment goal. The drugs of choice among the respondents were etanercept for pediatric patients (78.6%), adalimumab and etanercept for patients with psoriatic arthritis (64.3%), and ustekinumab in patients frequently away from home (78.6%) and patients with a history of multiple sclerosis, demyelinating diseases (64.3%), or poor adherence to treatment (71.4%).

Conclusion: This study provides a unique overview of the opinions of a representative sample of expert dermatologists on the current use of biologics for the treatment of psoriasis in Spain.

Keywords: Agentes biológicos; Biologic agents; Dermatologists; Dermatólogos; Encuesta; Psoriasis; Survey; Tratamiento; Treatment.

MeSH terms

  • Adult
  • Anti-Inflammatory Agents / therapeutic use
  • Biological Products / therapeutic use
  • Child
  • Contraindications, Drug
  • Cross-Sectional Studies
  • Disease Management
  • Drug Substitution
  • Female
  • Health Care Surveys
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Patient Selection
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Psoriasis / drug therapy*
  • Psoriasis / epidemiology
  • Severity of Illness Index
  • Spain / epidemiology

Substances

  • Anti-Inflammatory Agents
  • Biological Products
  • Immunosuppressive Agents