Predictors of Topical Use in Psoriasis Patients in the REFINE Study.
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.


CONCLUSIONS
This analysis revealed that region and PASI 90 status at week 12 predict topical use.
Skin Centre for Dermatology, Peterborough, Ontario, Canada mjgooderham@gmail.com.
Melinda J
MJ
Gooderham
Amgen Canada Inc, Mississauga, Ontario, Canada.
Melanie
M
Poulin-Costello
Amgen Canada Inc, Mississauga, Ontario, Canada.
Jennifer
J
Shelton
Amgen Canada Inc, Mississauga, Ontario, Canada.
Nabil
N
Bayan
K Papp Clinical Research and Probity Medical Research, Waterloo, Ontario, Canada.
Kim A
KA
Papp
D000287:Administration, Topical; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D000068800:Etanercept / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology*; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D000068800:Etanercept
combination therapy; etanercept; plaque psoriasis; predictor; topical agent; topical corticosteroid; topical steroid