Poster abstracts
analyses. For robust data on recently authorised therapeutics, more
observation time is needed, especially with a constantly changing
spectrum of treatments.
P074
THE IMPACT OF PATIENT REQUESTS ON PSORIATIC
ARTHRITIS TREATMENT
Lynn Price, Jennifer Robinson, Gianna Melendez
Spherix Global Insights
Introduction: As a result of direct to consumer advertising, pa-
tients frequently request well-known brands for the treatment of
psoriatic arthritis, and these patients tend to be highly involved
in their therapy decisions. Patient requests commonly relate to
formulation preferences, and in an indication dominated by bio-
logics administered either subcutaneously or intravenously, oral
small molecules are in high demand.
Objectives: One of the objectives of this study was to gain further
insight into patient requests as a main driver for switching to and
from biologics/apremilast.
Methods: An independent market analytics firm collaborated
with US rheumatologists (n = 200) to conduct a retrospective
chart review of patients diagnosed with psoriatic arthritis (PsA)
(n = 1,008), who had switched from one biologic therapy or
apremilast to another in the prior twelve weeks. Rheumatologists
were able to submit up to seven PsA patient charts. Data were col-
lected in April 2017 and included clinical and non-clinical patient
demographics, as well as physician demographics and attitudinal
survey responses.
Results: PsA patients tend to be very involved when it comes to
treatment decisions as 60 percent of patients had significant input
or were the primary driver behind the recent decision to switch
agents. Of those patient driven switches, only 36 percent of treating
rheumatologists felt there was strong clinical rationale behind the
switch; despite this, nearly half of rheumatologists state they tend
to approve specific patient requests.
Two-thirds of collaborating rheumatologists believe patients would
choose an oral agent over one that administered subcutaneously,
thus switching to apremilast is particularly common when patients
are involved in the decision. Patient requests were the primary
driver behind 24 percent of all switches to apremilast, compared
to just 12 percent when switching to a biologic. Furthermore, for
rheumatologists who are not in favor of an “apremilast before
biologics” treatment approach, patient requests are significantly
more of a driver for the brand than those who have adopted an
“apremilast before biologics” approach.
Conclusion: PsA patients are highly involved in the decision to
initiate and switch biologic/apremilast therapies, and treating rheu-
matologists tend to be open to granting such requests, regardless
of clinical rationale. When patient requests are a primary driver
for switching, apremilast benefits the most; largely due to the oral
formulation. With the new approval of the first JAK inhibitor and
second oral option in the PsA market, tofacitinib will likely fill a
gap for both physicians and patients by introducing a high efficacy
oral option, warranting follow-up analysis on the evolution and
impact of patient requests in PsA.
P075
THE RISK OF KC IN PSORIASIS PATIENTS RECEIVING
BIOLOGICS COMPARED TO CONVENTIONAL
SYSTEMIC THERAPIES
Kayleigh Mason
The University of Manchester, Manchester, UK
Introduction: Whether psoriasis patients exposed to biologic
therapies have an elevated risk of keratinocyte carcinoma (KC),
including basal cell carcinoma (BCC) or cutaneous squamous cell
carcinoma (cSCC) remains uncertain.
33
Objective:The aim of the present study was to determine whether
such patients were at higher risk of developing a KC compared to
those on conventional therapy.
Methods: The British Association of Dermatologists Biologic
Interventions Register (BADBIR), a pharmacovigilance register
of psoriasis patients, explores the long-term safety of systemic
therapies. Patients with chronic plaque psoriasis registering to
BADBIR on their first biologic or a conventional therapy, who had
at least one follow-up completed were included in analyses if they
were of white ethnicity, Fitzpatrick skin types 1–4 and reported
no previous cancers. Confounding factors included: age; sex;
smoking; and previous exposure to acitretin, psoralen ultraviolet-
A (PUVA), ciclosporin, and/or PUVA and ciclosporin. Propensity
score-weighted Cox-proportional hazard models estimated the
hazard ratio (HR) for developing a first KC or separately, first
BCC or cSCC.
Results: In total, 5672 patients initiating biologic therapy and 3188
patients on conventional therapy who met the entry criteria were
identified with 20558 and 7829 person-years of follow-up, respec-
tively. Durin