title: Psoriasis patients' willingness to accept side-effect risks for improved treatment efficacy.
abstract: BACKGROUND
  Previous studies suggest that efficacy is more important than side-effect risks to psoriasis patients. However, those studies did not consider potentially fatal risks of biologic treatments.
  
  
  OBJECTIVE
  To quantify the risks patients are willing to accept for improvements in psoriasis symptoms.
  
  
  METHODS
  Adults with a self-reported physician diagnosis of psoriasis were recruited through the National Psoriasis Foundation. Using a discrete-choice experiment, patients completed a series of nine choice questions, each including a pair of hypothetical treatments. Treatments were defined by severity of plaques, body surface area (BSA), and 10-year risks of tuberculosis, serious infection and lymphoma.
  
  
  RESULTS
  For complete clearance of 25% BSA with mild plaques, respondents (n = 1608) were willing to accept a 20% (95% confidence interval: 9-26%) risk of serious infection, 10% (5-15%) risk of tuberculosis and 2% (1-3%) risk of lymphoma. For complete clearance of 25% BSA with severe plaques, respondents were willing to accept a 54% (48-62%) risk of serious infection, 36% (28-49%) risk of tuberculosis and 8% (7-9%) risk of lymphoma.
  
  
  CONCLUSIONS
  Respondents were asked to evaluate hypothetical scenarios. Actual treatment choices may differ.
  
  
  CONCLUSIONS
  Respondents were willing to accept risks above likely clinical exposures for improvements in psoriasis symptoms. Individual risk tolerances may vary.
authors.affiliation: a Cubist Pharmaceuticals , Lexington , MA , USA .
authors.forename: Teresa L
authors.initials: TL
authors.lastname: Kauf
authors.affiliation: b Pacific Economics Research, LLC , Bellevue , WA , USA .
authors.forename: Jui-Chen
authors.initials: JC
authors.lastname: Yang
authors.affiliation: c Massachusetts General Hospital , Boston , MA , USA .
authors.forename: Alexa B
authors.initials: AB
authors.lastname: Kimball
authors.affiliation: d AbbVie Inc . , North Chicago , IL , USA .
authors.forename: Murali
authors.initials: M
authors.lastname: Sundaram
authors.affiliation: d AbbVie Inc . , North Chicago , IL , USA .
authors.forename: Yanjun
authors.initials: Y
authors.lastname: Bao
authors.affiliation: d AbbVie Inc . , North Chicago , IL , USA .
authors.forename: Martin
authors.initials: M
authors.lastname: Okun
authors.affiliation: d AbbVie Inc . , North Chicago , IL , USA .
authors.forename: Parvez
authors.initials: P
authors.lastname: Mulani
authors.affiliation: e RTI Health Solutions, Research Triangle Park , NC , USA , and.
authors.forename: A Brett
authors.initials: AB
authors.lastname: Hauber
authors.affiliation: f Center for Clinical and Genetic Economics, Duke Clinical Research Institute , Durham , NC , USA.
authors.forename: F Reed
authors.initials: FR
authors.lastname: Johnson
mesh_terms: D000328:Adult; D001691:Biological Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy*; D012306:Risk; D016896:Treatment Outcome
keywords: Benefit-risk; discrete-choice experiment; maximum acceptable risk; psoriasis; risk tolerance; tumor necrosis factor blocker