About half of all patients with psoriasis and psoriatic arthritis (PsA) are dissatisfied with the treatment they are getting, according to a new study published online in August in JAMA Dermatology. Moreover, the study found a large percentage of study participants are either undertreated or not getting any treatment at all.

Psoriasis – an autoimmune, inflammatory skin disease – causes patients to develop painful red, scaly rashes. Up to 30 percent of patients with psoriasis have or will develop psoriatic arthritis, in which the joints are also affected, causing pain, swelling and potential damage. Treatment for both PsA and psoriasis includes topical creams (applied to the skin), phototherapy (light therapy), oral drugs such as methotrexate, and/or biologics such as etanercept (Enbrel) and adalimumab (Humira).

“I think the numbers are significant especially for the psoriatic arthritis population,” says lead author April W. Armstrong, MD, assistant clinical professor of dermatology and director of the Clinical Research Unit at the University of California – Davis in Sacramento. “For people suffering from psoriatic arthritis, if they are unsatisfied with their treatments it’s often because they have noticeable symptoms. And that is something that is concerning because the symptoms they have often correlate with X-ray findings for joint destruction. And once joint destruction occurs that is irreversible.”

For the study, researchers analyzed data from 13 surveys – conducted by the National Psoriasis Foundation between 2003 and 2011 – of 5,604 patients with psoriasis or PsA. The researchers found:

  • Depending on the year the survey was taken, 23 to 49 percent of patients with mild and moderate psoriasis said they were untreated, and 9 and 30 percent of those with severe psoriasis said they were untreated.
  • Among those who were treated, 29.5 percent of patients with moderate psoriasis and 21.5 percent with severe psoriasis were only using topical treatments. Among the top three reasons, according to respondents: Topicals have fewer side effects than other medications, their “disease is not serious enough” for other medications, and their doctor would not prescribe other treatments.
  • Overall, 45.5 percent of PsA patients and 52.3 percent of psoriasis patients reported they weren’t satisfied with their treatment.