Related Experiment Video
Updated: Apr 4, 2026

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Predictors of Topical Use in Psoriasis Patients in the REFINE Study
Melinda J Gooderham1, Melanie Poulin-Costello2, Jennifer Shelton2
1Skin Centre for Dermatology, Peterborough, Ontario, Canada mjgooderham@gmail.com.
Background:
The factors influencing the use of topical agents in combination with biologic therapies for the treatment of plaque psoriasis (PsO) are not well understood.
Objective:
To examine potential predictors of topical use in patients with moderate to severe plaque PsO receiving etanercept (ETN).
Methods:
Post hoc descriptive analyses and a multinomial regression of the REFINE study data were used to examine associations between topical agent potency and covariates, including Psoriasis Area and Severity Index (PASI) score, study site, and province.
Results:
Not achieving PASI 90 at week 12 predicted topical use, with a lower PASI 90 rate in patients who used high-potency topical agents post randomization (P = .003). Additionally, statistically significant differences were found in patterns of topical use among Canadian provinces (P = .007), with the use of high-potency topical agents being greater in Ontario and Quebec than the rest of Canada.
Conclusion:
This analysis revealed that region and PASI 90 status at week 12 predict topical use.
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