Patients' demographic and socioeconomic characteristics influence the therapeutic decision-making process in psoriasis.

BACKGROUND

Knowledge regarding differences in care for psoriatic patients is limited. The aim of this study was to investigate factors influencing prescription of systemic treatments for patients with psoriasis with a special focus on socioeconomic factors.

METHODS AND FINDINGS

This was a non-interventional, cross-sectional study, conducted in 18 Italian University and/or hospital centers with psoriasis-specialized units. Questionnaires evaluating demographic and socioeconomic characteristics were administered to participants. Overall, 1880 consecutive patients affected by mild-to-severe psoriasis were recruited. Univariate and multivariable logistic regression analyses of systemic therapy prescription, with a special focus on biologics, accounting for the above mentioned characteristics were performed. Our analysis showed that all analyzed patients' characteristics were significantly associated with biological therapy compared to non-biological systemic one. Particularly, women were less likely to receive biologics than men (OR = 0.66; 95% CI, 0.57-0.77). Elderly patients (≥65 years) and subjects with a BMI ≥30 had lower odds to receive biologics respect to adults (≥35-64 years) (OR = 0.33; 95% CI, 0.25-0.40), and subjects with BMI≥25<30 (OR = 0.64; 95% CI, 0.53-0.77), respectively. Northern and Southern patients were both less likely to receive biologics than Central patients (OR = 0.75; 95% CI, 0.63-0.89, and OR = 0.56; 95% CI,0.47-0.68, respectively). Lower economic profile and never reading books were both associated with decreased odds of receiving biological therapy.

CONCLUSIONS

This study shows that sex, age, comorbidities, and socioeconomic characteristics influence the prescription of systemic treatments in psoriasis, highlighting that there are still unmet needs influencing the therapeutic decision-making process that have to be addressed.

Déclaration de conflit d'intérêts

P. Amerio has been a scientific consultant for Abbvie, Eli-Lilly, Jannsen, Celgene, Galderma, LEO-Pharma, Sanofi Genzyme and Alfa Wasserman. F. Bardazzi has been a scientific consultant/speaker/clinical study investigator for AbbVie, Celgene, Janssen, LEOPharma, Eli-Lilly, MSD, Novartis and Pfizer. L. Bianchi has been a scientific consultant/speaker for Abbvie, Janssen, Celgene, Pfizer, UCB, Novartis, Sanofi Genzyme and LEO-Pharma. A. Campanati has been a scientific consultant/speaker/clinical study investigator for AbbVie, Celgene, Janssen, LEO-Pharma, Eli-Lilly, MSD, Novartis, Pfizer and Sanofi. S.P. Cannavò has been a scientific consultant/speaker for AbbVie, Celgene, Eli-Lilly, Janssen, LEO-Pharma, Novartis and Sanofi. A. Chiricozzi has been a scientific consultant/speaker/clinical study investigator for Abbvie, Biogen, Fresenius Kabi, LEO-Pharma, Eli-Lilly, Novartis, UCB, Sanofi and Janssen. A. Conti has been a scientific consultant for Abbvie, Eli-Lilly, Janssen Cilag, LEO-Pharma, UCB and Sandoz. P. Dapavo has been a scientific consultant/speaker for Novartis, Abbvie, Eli-Lilly, Celgene, LEOpharma and Janssen. C. De Simone has been a scientific consultant/speaker/clinical study investigator for AbbVie, Almirall, Amgen, Celgene, Janssen, LEO-Pharma, Eli-Lilly, MSD, Novartis, Pfizer, Sanofi and Sun Pharma. M. Esposito has been a scientific consultant/speaker for Abbvie, Novartis, Eli-Lilly, Biogen, LEO-Pharma. M.C. Fargnoli has been a scientific consultant/speaker/clinical study investigator for AbbVie, Celgene, Janssen, LEO-Pharma, Eli- Lilly, Novartis, Pfizer, Sanofi, Galderma, Almirall, Mylan, UCB and Regeneron. C. Guarneri has been a scientific consultant/speaker/clinical study investigator for Wyeth-Pfizer, Abbott Immunology-Abbvie, Janssen-Cilag, Novartis, LEO-Pharma, Eli-Lilly, Celgene and Merck-Serono. K. Hansel has been a scientific consultant/speaker/clinical study investigator for AbbVie, Eli- Lilly, Novartis, Sanofi and Admiral. P. Malagoli has been a scientific consultant/speaker/clinical study investigator for AbbVie, Amgen, Biogen, Celgene, Janssen, LEO-Pharma, Eli-Lilly, Novartis. G. Micali has been a scientific consultant/clinical study investigator for Abbvie, Eli-Lilly, Janssen- Cilag, LEO-Pharma and Novartis. C. Mugheddu has been a speaker/clinical study investigator for Abbvie, Celgene, Boehringer Ingelheim, Janseen, Novartis and LEO-Pharma. A. Offidani has been a scientific consultant/speaker/clinical study investigator for AbbVie, Celgene, Janssen, LEOPharma, Eli-Lilly, MSD, Novartis, Pfizer, Sanofi, Alfasigma and Almirall. F. Prignano has been a scientific consultant/adviser/clinical study investigator for Eli-Lilly, Abbvie, Novartis, LEOPharma, Abiogen-Pharma, Celgene and Janssen-Cilag. F. Rongioletti has been a scientific consultant/speaker/clinical study investigator for AbbVie, Boehringer, Celgene, Janssen, LEOPharma, Eli-Lilly, Novartis and Sanofi. L. Stingeni has been a scientific consultant/speaker/clinical study investigator for AbbVie, Celgene, Eli-Lilly, Novartis, Almirall and Sanofi. A. Balato has been a scientific consultant/speaker/clinical study investigator for AbbVie, Celgene, Janssen, Eli-Lilly, Novartis, Pfizer, Sanofi and UCB. The remaining authors declare no conflicts of interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials.