The “True” Heartbreak of Psoriasis — Undertreatment or No Treatment

Patients with psoriasis and psoriatic arthritis have a higher risk for comorbid medical conditions. Evidence suggests that systemic therapy might prevent some of these conditions, particularly cardiovascular, cerebrovascular, and peripheral vascular disease. If so, more-aggressive treatment might improve not only quality of life but also longevity.

Researchers analyzed responses to surveys conducted by the National Psoriasis Foundation from January 1, 2003, through December 31, 2011, in the U.S. of 5604 patients with psoriasis and psoriatic arthritis to determine the extent of nontreatment and undertreatment and to explore the issues underlying inadequate treatment. They found that 37% to 49% of patients with mild psoriasis, 24% to 36% of patients with moderate psoriasis, and 9% to 30% of patients with severe psoriasis were untreated. Of treatment recipients, approximately 30% with moderate psoriasis and more than 20% with severe psoriasis received topical medication alone. Methotrexate was the most frequently used systemic therapy, and ultraviolet B was the most frequent phototherapy. Many patients ceased therapy with biologic agents due to insurance and cost issues. About half of psoriasis patients and a third with psoriatic arthritis were dissatisfied with their therapy.