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

by Emanuele Scala, Matteo Megna, Paolo Amerio, Giuseppe Argenziano, Graziella Babino, Federico Bardazzi, Luca Bianchi, Giacomo Caldarola, Anna Campanati, Serafinella Patrizia Cannavò, Andrea Chiricozzi, Andrea Conti, Giovanni Damiani, Paolo Dapavo, Clara De Simone, Maria Esposito, Gabriella Fabbrocini, Maria Concetta Fargnoli, Francesca Ferrara, Rosaria Fidanza, Giulio Gualdi, Claudio Guarneri, Katharina Hansel, Piergiorgio Malagoli, Giovanna Malara, Giuseppe Micali, Cristina Mugheddu, Maria Letizia Musumeci, Giulia Odorici, Annamaria Offidani, Leonardo Pescitelli, Francesca Prignano, Annunziata Raimondo, Simone Ribero, Franco Rongioletti, Luca Stingeni, Caterina Trifirò, Salvatore Zanframundo, Anna Balato

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.

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.

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.