Unmet Needs in Psoriasis

The concept of unmet needs in psoriasis is not new. We are aware that both patients and physicians feel there are gaps in the management and treatment of the condition. Lebwohl et al (J Am Acad Dermatol. 2014;70:871-881) performed an extensive survey to further the understanding of the unmet needs of psoriasis and psoriatic arthritis (PsA) patients. The survey was a large, multinational, population-based analysis of psoriasis and/or PsA patients in North America and Europe. In terms of methodology, surveyed individuals were selected by list-assisted random digit dialing and did not have to currently be under the care of a health care provider, a patient organization member, or receiving treatment. Overall, the survey screened 139,948 households, and 3426 patients completed the survey.

The population prevalence of psoriasis and/or PsA ranged from 1.4% in Spain to 3.3% in Canada, with an overall prevalence of 1.9%. Seventy-nine percent of patients had psoriasis alone, while 21% experienced PsA with or without psoriasis.

When rating disease severity at its worst, 27% of those with psoriasis and 53% with psoriasis and/or PsA rated it as severe. Itching (43%), scales (23%), and flaking (20%) were considered the most bothersome signs or symptoms by psoriasis patients, and 45% of them had not seen a physician in 1 year. More than 80% of psoriasis patients with at least 4 palms body surface area and 59% of the PsA cohort were receiving no treatment or only topical treatment. Of patients who had received oral or biologic therapy, 57% and 45%, respectively, discontinued therapy, most often for safety or tolerability reasons and a lack or loss of efficacy.

The authors concluded that the following identified unmet needs warrant additional attention and action: improved severity assessment, PsA screening, patient awareness, and treatment options. They noted that their findings suggest there is a high rate of undertreatment of both psoriasis and PsA and a mismatch between patient and physician assessment of severity.

What’s the issue?

Again we are faced with data suggesting that our patients perceive deficiencies in their psoriasis care. Therefore, it is important that we continue to educate our patients and ourselves so that we can narrow these gaps. How will you react to these findings in your management of psoriasis?

We want to know your views! Tell us what you think.