title: Identification of factors that may influence the selection of first-line biological therapy for people with psoriasis: a prospective, multicentre cohort study.
abstract: BACKGROUND
  The Psoriasis Stratification to Optimise Relevant Therapy (PSORT) consortium has a collective aim to develop a prescribing algorithm to help stratify eligible patients with psoriasis to the most appropriate biological treatment. To facilitate the adoption of a stratified approach, it is necessary to first understand the factors driving the choice of first-line biological therapy.
  
  
  OBJECTIVE
  To identify and quantify factors that influence the selection of the first-line biological therapy for people with psoriasis.
  
  
  METHODS
  Multinomial logistic regression was used to determine the factors that influenced the probability of treatment selection, using data from the British Association of Dermatologists Biologic Interventions Register from January 2012 to December 2015. Sensitivity analyses were performed to assess the robustness of the findings to key assumptions.
  
  
  RESULTS
  The main analysis was based on a dataset comprising 3040 people with psoriasis. The identified factors affecting first-line biological selection within the available therapies were: presence of psoriatic arthritis; patient weight; employment status; country of registration; and baseline disease severity. Importantly, the analysis showed a general shift in prescribing behaviour over time. These results were robust to sensitivity analysis.
  
  
  CONCLUSIONS
  This study offers important insights into the factors influencing current prescribing practice for first-line biological therapies for people with psoriasis. It provides baseline data to inform the evaluation of future potential changes that may affect prescribing behaviour, such as stratified medicine.
authors.affiliation: Manchester Centre for Health Economics, The University of Manchester, Manchester, U.K.|BADBIR (on behalf of the PSORT consortium), The University of Manchester, Manchester, U.K.
authors.forename: N J
authors.identifier: http://orcid.org/0000-0002-9447-0825
authors.initials: NJ
authors.lastname: Davison
authors.affiliation: The Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.
authors.forename: R B
authors.initials: RB
authors.lastname: Warren
authors.affiliation: BADBIR (on behalf of the PSORT consortium), The University of Manchester, Manchester, U.K.
authors.forename: K J
authors.initials: KJ
authors.lastname: Mason
authors.affiliation: BADBIR (on behalf of the PSORT consortium), The University of Manchester, Manchester, U.K.
authors.forename: K
authors.initials: K
authors.lastname: McElhone
authors.affiliation: Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland.
authors.forename: B
authors.initials: B
authors.lastname: Kirby
authors.affiliation: Department of Dermatology, Western Infirmary, Glasgow, U.K.
authors.forename: A D
authors.initials: AD
authors.lastname: Burden
authors.affiliation: St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, U.K.
authors.forename: C H
authors.initials: CH
authors.lastname: Smith
authors.affiliation: Manchester Centre for Health Economics, The University of Manchester, Manchester, U.K.
authors.forename: K
authors.initials: K
authors.lastname: Payne
authors.affiliation: The Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Manchester, U.K.
authors.forename: C E M
authors.initials: CEM
authors.lastname: Griffiths
mesh_terms: D000328:Adult; D000465:Algorithms; D001685:Biological Factors / Q000627:therapeutic use*; D001691:Biological Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007378:Interleukins / Q000037:antagonists & inhibitors; D008297:Male; D010818:Practice Patterns, Physicians'; D055553:Prescription Drugs / Q000627:therapeutic use; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D001685:Biological Factors; D007378:Interleukins; D055553:Prescription Drugs; D014409:Tumor Necrosis Factor-alpha