Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan.
AbbVie GK, Tokyo, Japan.
J Dermatol. 2019 Jun;46(6):466-477. doi: 10.1111/1346-8138.14870. Epub 2019 Apr 15.
Psoriasis is a chronic autoimmune disease affecting skin which may also manifest in nails and joints. Several biologic treatments have been approved in Japan for psoriasis. Each biologic has a different profile for efficacy and safety, including different dosing regimens and co-payment considerations which may complicate treatment decisions made by patients and physicians during short consultations. Elucidating patient preference is expected to contribute to shared decision-making between patients and physicians to optimize treatment satisfaction and outcomes. However, the number of studies investigating this in Japan is very limited. The study used a discrete choice experiment methodology to elicit patient preferences for hypothetical options in an experimental framework. Participants were asked to choose their preferred treatment option from two hypothetical choices, defined by different levels of six attributes (i.e. early onset of efficacy, long-term efficacy, sustained efficacy after drug withdrawal, dosing convenience, co-payment and risk of serious infection). The survey included 16 treatment choice scenarios and was completed by 395 participants. Across all participants, the attribute regarded as most important was sustained efficacy after drug withdrawal, followed by dosing convenience, co-payment, long-term efficacy, early onset of efficacy and risk of serious infection. The study found that patients prefer treatments which have durable efficacy and lower treatment burden characterized as fewer injection frequency and lower co-payment. These results may be helpful to understand patient preference for biologic treatments used for psoriasis in Japan and contribute to shared decision-making between patients and physicians to improve patient satisfaction and treatment outcomes.
银屑病是一种慢性自身免疫性疾病，影响皮肤，也可能在指甲和关节上表现出来。在日本，已有几种生物制剂被批准用于银屑病。每种生物制剂在疗效和安全性方面都有不同的特点，包括不同的剂量方案和共付考虑因素，这可能会使患者和医生在短时间的咨询中做出治疗决策变得复杂。阐明患者的偏好有望促进患者和医生之间的共同决策，以优化治疗满意度和结果。然而，在日本，研究这方面的数量非常有限。本研究使用离散选择实验方法在实验框架中引出患者对假设选项的偏好。参与者被要求从两个假设的选择中选择他们喜欢的治疗选择，这两个选择由六个属性（即疗效早期出现、长期疗效、停药后持续疗效、给药方便性、共付和严重感染风险）的不同水平定义。该调查包括 16 种治疗选择方案，由 395 名参与者完成。在所有参与者中，被认为最重要的属性是停药后的持续疗效，其次是给药方便性、共付、长期疗效、疗效早期出现和严重感染风险。研究发现，患者更喜欢具有持久疗效和较低治疗负担的治疗方法，其特征是注射频率较低和共付较低。这些结果可能有助于了解日本银屑病生物治疗的患者偏好，并有助于患者和医生之间的共同决策，以提高患者满意度和治疗结果。
