Nontreatment and undertreatment of patients with psoriasis and psoriatic arthritis appears to still be a significant problem in the United States, according to a study by April W. Armstrong, M.D., M.P.H., of University of California-Davis, Sacramento, and colleagues.
A total of 5,604 patients with psoriasis or psoriatic arthritis completed surveys collected by the National Psoriasis Foundation from January 2003 through December 2011.
From 2003 through 2011, patients who were untreated ranged from 36.6 percent to 49.2 percent of patients with mild psoriasis, 23.6 percent to 35.5 percent of patients with moderate psoriasis, and 9.4 percent to 29.7 percent of patients with severe psoriasis. Among those receiving treatment, 29.5 percent of patients with moderate psoriasis and 21.5 percent of patients with severe psoriasis were treated with topical agents alone. Although adverse effects and a lack of effectiveness were primary reasons for discontinuing biological agents, the inability to obtain adequate insurance coverage was among the top reasons for discontinuation. Overall, 52.3 percent of patients with psoriasis and 45.5 percent of patients with psoriatic arthritis were dissatisfied with their treatment, according to study results.
“While various treatment modalities are available for psoriasis and psoriatic arthritis, widespread treatment dissatisfaction exists. Efforts in advocacy and education are necessary to ensure that effective treatments are accessible to this patient population,” the authors conclude.
(JAMA Dermatol. Published August 14, 2013. doi:10.1001/jamadermatol.2013.5264.