Poll Suggests Patients with Psoriasis Prefer Topicals to Injectable, Oral Medications

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US patients with psoriasis prefer topical medications to injections or pills, according to recent online survey results, and most are interested in implementing a new topical drug.¹

These data are the result of a Harris Poll conducted to improve understanding among clinicians of the preferences of patients with psoriasis associated with topicals. The overall goal was improving adherence to treatment as well as satisfaction levels, resulting in improved outcomes among such patients.

This survey research was led by April W. Armstrong, MD, MPH, professor and chief of dermatology at UCLA and Chair Emeritus of the Medical Board of the National Psoriasis Foundation. The investigators noted the challenges of adherence to topicals, citing a previously-reported rate of 50% for adherence to such drugs.²

“The aim of this study was to determine treatment pattern, patient preferences on medication delivery method (topical, oral, versus injectable medications), patient satisfaction, and perspectives on topical therapies,” Armstrong et al. wrote. “This manuscript presents results related to patient treatment preferences and treatment patterns.”¹

Background and Design

The research team involved 507 US adult respondents in their survey between October - November 2021, with these respondents having had prior psoriasis diagnosis diagnosed by a healthcare professional. To participate, these individuals had to be using a prescription topical treatment during the polling period and could not be implementing a prescription injectable psoriasis therapy.

The team carried out their survey in the English language only. They weighted the collected data as needed, reflecting the actual population proportions using a multistep weighting system.

At first, the investigators noted that their total opt-in online sample of American adults in the age range of 18 years and older had been weighted according to benchmarks from the March 2020 Current Population Survey. As a result, there was a natural sample termed the "Gen Pop" or general population sample in which 247 qualified polling respondents with psoriasis were identified among 9,584 US adults.

During the research team’s next step, their Gen Pop sample combined with another group into a total sample of 507 individuals with psoriasis was further weighted. This was to match the demographic distributions which had been estimated in the team’s initial opt-in sample.

The investigators looked at demographics such as gender, education, age, race/ethnicity, size of household, census area, and marital status. They also included a propensity score variable in order to account for the possibility of polling respondents being online.

They added that the data resulting from their survey was reported as percentages, noting that this may not sum to 100% given rounding and the inclusion of several different options for polling responses.

Findings

The investigators reported that among the 507 patients with psoriasis using topical options, most individuals reported that they had mild disease symptoms (31%) or moderate symptoms (59%). They also concluded that the most-impacted bodily regions were shown to be subjects’ elbows, scalps, intertriginous areas, legs, arms, and knees.

The research team further noted that the greatest effect on respondents quality of life was shown to be among those affected on the elbows (20%), scalp (39%), and legs (excluding knees; 19%). They also found that 76% of the participants noted a preference for topical options for psoriasis therapy.

The team added that 20% of those polled expressed a preference for oral treatments and 4% expressed a preference for injectable options. The investigators found that the most common product attributes which were desired among respondents in a topical therapy, which would thereby help them with adherence, was plaque improvement among 68%, pruritus improvements among 68%, and application ease among 63% of those polled.

“A limitation is that the present study only addresses people with psoriasis currently using topical therapies, which excludes the many patients with mild-to-moderate psoriasis who are not using any therapy or who are using topical treatments in combination with an injectable,” they noted. “Therefore, the results of this survey may not reflect treatment preferences for those patients and could have resulted in a biased preference against other treatment methods.”

References

1. ^{Armstrong A, Young M, Seal MS, Higham RC, Greiling T. Treatment burden and the perspectives of patients with psoriasis using topical treatments: results from a national survey of adults with psoriasis in the United States. J Dermatolog Treat. 2024 Dec;35(1):2389174. doi: 10.1080/09546634.2024.2389174. Epub 2024 Aug 11. PMID: 39128848.}
2. ^{Nasimi M, Abedini R, Ghandi N, et al. Topical treatment adherence and associated factors in patients with psoriasis: a single center, cross-sectional study. Dermatol Ther. 2022;35(7):e15547. doi: 10.1111/dth.15547.}