Biologic Use Increases In Psoriasis Treatment
BioTrends Research Group released its third annual TreatmentTrends : Psoriasis publication, providing insight into the management of psoriasis. This report is based on responses to an online survey completed by 102 US Dermatologists in April 2008.
According to the study, the majority of Dermatologists reported an increase in their use of biologics for the treatment of psoriasis in the past year, particularly in patients with moderate psoriasis. While the increased use of biologics was seen across the board, certain physician types, particularly those newer to practice, seem to be more aggressive in their use of these agents. Amgen/Wyeth's Enbrel continues to hold its position as market leader amongst the biologics, however, Abbott's Humira has increased its share significantly in the past year, and Dermatologists expect its growth to continue, primarily at the expense of Enbrel. Genentech/Xoma's Raptiva and Astellas' Amevive are rarely used with a collective share of less than 10%.
Despite the increased use of biologics, topical agents remain the most commonly prescribed therapy for psoriasis. Warner Chilcott's Taclonex, continues to hold its position as market leader among topical agents, although Galderma's Clobex is perceived to have significant advantages on certain attributes, most notably around its formulation. While the use of oral agents to treat psoriasis increases with disease severity, less than one-third of patients with severe psoriasis are on oral therapies. Methotrexate and Stiefel's Soriatane are the most commonly prescribed oral agents to treat psoriasis, and each is perceived to have unique advantages and disadvantages. Similar to oral agents, the use of phototherapy to treat psoriasis increases with disease severity, although only about one-fifth of patients with severe psoriasis are receiving phototherapy treatment.
For all treatment types (topicals, orals, biologics), long-term safety is the most important attribute. While all products fall short on this attribute compared to its importance, Dermatologists do perceive there to be significant safety differences between products in each product class, and perceived safety seems to be an important factor in brand preference. Moreover, in a ranking exercise of twelve attributes, "safe when used long term" was the attribute of greatest needs for new products in development to treat psoriasis. Time will tell whether the new IL-12 agents, such as Centocor's ustekinumab and Abbott's ABT-874 will be able to penetrate the TNF alpha inhibitor dominance in the Dermatology setting although interest in these agents is high.