Predictors of Topical Use in Psoriasis Patients in the REFINE Study

J Cutan Med Surg. 2016 Mar-Apr;20(2):106-12. doi: 10.1177/1203475415604322. Epub 2015 Sep 1.

Abstract

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.

Keywords: combination therapy; etanercept; plaque psoriasis; predictor; topical agent; topical corticosteroid; topical steroid.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Topical
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Etanercept / administration & dosage*
  • Female
  • Follow-Up Studies
  • Glucocorticoids / administration & dosage*
  • Humans
  • Male
  • Middle Aged
  • Psoriasis / diagnosis
  • Psoriasis / drug therapy*
  • Retrospective Studies
  • Severity of Illness Index
  • Skin / pathology*
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Glucocorticoids
  • Etanercept