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Dermatologists Cite Unmet Needs in Psoriasis Treatment

Emerging therapies have potential to improve psoriatic plaques

Decision Resources Group, a health care research firm located in Burlington, Mass., finds that, according to surveyed U.S. and European dermatologists, short- and long-term effects on the clearance of psoriatic plaques are two of the attributes that most strongly influence their prescribing decisions for patients with moderate-to-severe psoriasis.

Emerging therapies that offer improved effects in these attributes over current treatments would be well received, the experts indicated.

Based on the thought leaders’ opinions and on clinical trial data, emerging therapies, especially interleukein (IL)-17 inhibitors, such as secukinumab (Novartis), brodalumab (Amgen/AstraZeneca), and ixekizumab (Eli Lilly), have potential because of their improved efficacy compared with that of current treatments in improving psoriatic plaques. However, based on physicians’ opinions and current data, emerging therapies lack the efficacy, safety, tolerability, and/or delivery features that would allow them to offer a better overall clinical profile than that of ustekinumab (Stelara, Janssen).

“Emerging IL-17 inhibitors have a potential to fulfill some of the unmet efficacy needs highlighted by dermatologists,” said analyst Alexandra Makarova, MD, PhD. “However, safety and tolerability are very important for the dermatologists’ prescribing decisions, and many physicians will likely require several years of post-marketing data before prescribing novel therapies.”

Both U.S. and European experts indicated that a greater sustained long-term response with continuous therapy and a greater effect on quality of life are key areas of unmet need for therapies aimed at moderate-to-severe psoriasis; European clinicians also indicated an unmet need for treatments with a lower risk of malignancies.

Among safety and tolerability attributes, surveyed U.S. and European dermatologists selected the risks of malignancies, serious infections, and organ toxicities as the most important factors to consider when making prescribing decisions.

Surveyed U.S. managed care organization pharmacy directors agreed that improvements in the rate of serious infections and organ toxicities are the driving force behind their decisions to grant an agent favorable formulary status.

“Although dermatologists indicated a relatively high unmet need for agents with more convenient formulation, an improved delivery alone will not be enough for a novel therapy to enjoy a strong uptake,” Makarova said. “When physicians are prescribing therapies to their moderate-to-severe psoriasis patients, efficacy and safety considerations usually carry more weight than delivery convenience, and new therapies must demonstrate very strong efficacy and safety data.”

Source: Decision Resources Group; July 24, 2014.

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