Epidemiology and Proactive Care in Psoriasis

Kicking off Spring Dermatology Week 2023, Joel M. Gelfand, MD MSCE, and Steven R. Feldman, MD, PhD, discussed the clinical epidemiology of psoriasis and the need for analytical studies to enhance clinical practices during their session, “Better Care for Psoriasis Patients.”

To start, Dr Gelfand presented a study that showcased the use of biologics and systemic therapies for psoriasis where it peaks significantly in the spring. “We had this idea that psoriasis gets worse in the spring, and here's large scale analytic data now to show, in fact, the hypothesis is probably true,” he stated.

He also reminded attendees that these kinds of findings highlight the need for good analytical studies with control groups, which are often placebo groups, for physicians to understand how well their therapies work. Additionally, he presented a more historical overview on the science of clinical epidemiology showing how it has evolved over the years. For modern epidemiology, he noted that there are already studies looking at the distribution and determinants of health and disease in patient populations. He also noted that clinical epidemiology takes these techniques and extends them to the critical evaluation of diagnostic and therapeutic modalities in clinical practice. He added that this is the underlying basic science that informs public health, preventive medicine, and individual patient care decisions with discipline.

Dr Feldman bounced off this by agreeing with Dr Gelfand and adding that understanding the data presented in these studies is crucial. He focused on studies with long-term responses, noting that these are often presented as observed data. However, they do not include the patients who have dropped out, which can skew the data, making it appear more positive.

He reviewed one study where 424 out of 463 people participated for 2 years, comparing it with another study in which it appeared that the drug improved patient outcomes over time. However, when looking at the fine print, Dr Feldman pointed out how only 63% of the participants in that study were left. “And so, 66% having success out of 63%, it doesn't look really all that good,” he concluded.

For more meeting coverage, visit the Spring Dermatology Week 2023 newsroom.

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Reference
Feldman S Gelfand J. Better care for psoriasis patients. Presented at: Dermatology Week 2023; May 3–6, 2023; Virtual.