Improving systemic therapy selection for inflammatory skin diseases: A clinical need survey

Area of Science:

• Dermatology
• Pharmacogenomics
• Clinical Trial Design

Background:

• Empirical treatment selection for psoriasis (PSO) and atopic dermatitis (AD) can delay disease control and increase healthcare costs.
• Current clinical practice lacks routine molecular testing for guiding systemic therapy choices in PSO and AD.
• The study addresses the need for improved, personalized treatment strategies in these common dermatological conditions.

Purpose of the Study:

• To investigate how clinicians select systemic therapies for PSO and AD patients without molecular diagnostic tools.
• To assess the frequency of medication switching necessitated by the current empirical treatment approach.
• To gauge clinician interest in molecular testing for optimizing therapeutic decisions.

Main Methods:

• A 20-question survey was administered to dermatology conference attendees in 2022.
• The survey assessed clinician strategies for systemic treatment of AD and PSO.
• A 64% response rate (265/414) was achieved, providing data on treatment decision-making.

Main Results:

• "Reported efficacy" was the primary factor influencing treatment choice (P < .001).
• 62% of clinicians reported needing 2 or more systemic medications for efficacy.
• Over 90% of respondents expressed strong interest in molecular tests for guiding therapy selection.

Conclusions:

• Clinicians currently rely on empirical methods for selecting PSO and AD therapies, often requiring multiple medication trials.
• There is a significant unmet need and strong demand for molecular tests to personalize and optimize systemic treatment selection.
• Implementing molecular diagnostics could improve treatment outcomes and reduce healthcare costs associated with suboptimal therapy choices.