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一项关于日本中重度银屑病患者对口服和注射治疗偏好的离散选择实验。

A discrete choice experiment on oral and injection treatment preferences among moderate-to-severe psoriasis patients in Japan.

机构信息

Jichi Medical University Hospital, Tochigi, Shimotsuke, Japan.

Bristol Myers Squibb, Tokyo, Japan.

出版信息

J Dermatol. 2023 Jun;50(6):766-777. doi: 10.1111/1346-8138.16746. Epub 2023 Feb 20.

Abstract

Long-term psoriasis (PsO) management remains challenging. With growing variation in treatment efficacy, cost, and modes of administration, patient preferences for different treatment characteristics are not well understood. A discrete choice experiment (DCE), informed by qualitative patient interviews, was conducted to assess patient preferences for different attributes of PsO treatments; 222 adult patients with moderate-to-severe PsO receiving systemic therapy participated in the DCE web survey. Better long-term efficacy and lower cost were preferred (preference weights p < 0.05). Long-term efficacy had the highest relative importance (RI) and mode of administration was as important as the outcome attributes (efficacy and safety). Patients also preferred oral to injectable administration. In subgroup analyses by disease severity, residence, psoriatic arthritis as a comorbidity, and gender, the trends for each subgroup were the same as the overall population although the extent of RI for administration mode varied. Mode of administration was more important for patients with moderate versus severe disease, or rural versus urban residence. This DCE utilized attributes related to both oral and injectable treatment as well as a broad study population of systemic treatment users. Preferences were further stratified by patient characteristics to explore trends in different subgroups. Understanding the RI of treatment attributes and the attribute trade-offs acceptable to patients helps inform moderate-to-severe PsO systemic treatments decisions.

摘要

长期银屑病(PsO)管理仍然具有挑战性。随着治疗效果、成本和管理模式的不断变化,患者对不同治疗特点的偏好尚不清楚。通过定性患者访谈,进行了一项离散选择实验(DCE),以评估患者对不同银屑病治疗特征的偏好;222 名接受系统治疗的中重度银屑病成年患者参与了 DCE 网络调查。更好的长期疗效和更低的成本更受青睐(偏好权重 p < 0.05)。长期疗效的相对重要性最高(RI),给药方式与疗效和安全性等结果属性同样重要。患者也更喜欢口服给药而非注射给药。在按疾病严重程度、居住地、银屑病关节炎合并症和性别进行的亚组分析中,尽管给药方式的 RI 程度有所不同,但每个亚组的趋势与总体人群相同。对于疾病严重程度中度与重度、或居住地为农村与城市的患者,给药方式更为重要。这项 DCE 既利用了与口服和注射治疗相关的属性,又涵盖了广泛的系统治疗使用者的研究人群。还根据患者特征进一步分层,以探索不同亚组中的趋势。了解治疗属性的 RI 和患者可接受的属性权衡有助于为中重度银屑病的系统治疗决策提供信息。

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