. New patient preference survey confirms that patients value clear skin the most, but expect additional benefits from their treatment, such as proven long-term efficacy and safety data and no injection site reactions[1]
?A separate ranking incorporating additional characteristics showed that effectiveness in treating multiple manifestations of psoriatic disease was also important[1]
?The number of injections per dose and injection frequency were least important to patients according to the ranking analysis[1]

Basel, September 12, 2018 - Novartis, a leader in immuno-dermatology, announced today new data from a patient preference survey showing psoriasis patients want their treatment to go beyond just clear skin and safety. This study of 300 psoriasis patients is being presented during a poster session at the 27th European Academy of Dermatology and Venereology (EADV) Congress in Paris, France.

Results confirmed that clear skin is the most preferred treatment attribute, which is consistent with previous patient preference surveys in psoriasis[2]-[5]. Results also show patients expect additional benefits from their treatment that are not traditionally assessed in patient surveys, including the number of years of proven efficacy and safety data in large clinical trials and no injection site reactions[1].

In a separate ranking incorporating additional characteristics, patients ranked the effectiveness in treating multiple manifestations of psoriatic disease (including PsA, nail, palmoplantar and scalp), and complete symptom relief, as being important, after risk of side effects and clear skin (including time to achieve clear skin)[1]. Least important were the number of injections per dose and injection frequency[1].

"It's relevant to understand from psoriasis patients which additional benefits from their treatment they want besides clear skin and safety," said Professor Matthias Augustin, Director Institute of Health Care Research in Dermatology and Nursing, University of Hamburg. "From the findings of this survey, consistent and sustained long term efficacy and safety from large clinical studies, no pain at injection site or efficacy in all manifestations of psoriatic disease could be influential when choosing a treatment for moderate-to-severe psoriasis."

"The survey will help Novartis and dermatologists better understand patient preference in selecting psoriatic disease treatment options," stated Sam Khalil, PhD, Head Worldwide Medical Affairs, Immunology, Hepatology and Dermatology. "It supports Novartis goal of leadership in immuno-dermatology and our commitment to improving patient care. Reimagining medicine for patients, starts by listening to what patients truly want and need."

Psoriatic disease is complex and multifaceted. Up to 40% of psoriasis patients may develop PsA[6]. In the long term, up to 90% of psoriasis patients may also develop nail psoriasis, palmoplantar psoriasis (of the palms of the hands and soles of the feet), or scalp psoriasis[8]-[10]. These manifestations are associated with a greater burden on patients' life.

According to the American Academy of Dermatology's guidelines, psoriasis treatments should be tailored to the patient's situation and preference[11]. A greater understanding of patients' preferences for moderate-to-severe psoriasis treatment is central to improving models of shared patient-doctor decision making. These results provide additional insight into the patients' perspective of the psoriasis treatment options available.

About the patient preference study[1]
The aim of the patient preference study was to quantify the relative patient preferences for five selected attributes that may differentiate among biologic treatments for moderate-to-severe plaque psoriasis. The data was collated from an online discrete choice experiment (DCE) survey from 300 US respondents with a self-reported physician diagnosis of moderate-to-severe psoriasis. Levels of attributes were based on existing clinical information for current biologic treatments of moderate-to-severe plaque psoriasis.

In addition, patients ranked the importance of an expanded list of treatment attributes, which included the five DCE attributes plus five additional psoriasis-relevant treatment attributes, in a separate and exploratory series of direct questions.

About psoriasis
Psoriasis is a distressing and painful autoimmune disease that affects more than 125 million people worldwide[7]. It is a debilitating condition associated with a significant emotional and physical daily burden. In the long-term, psoriasis can also lead to other conditions, such as diabetes, heart disease, depression and psoriatic arthritis (PsA) - which up to 40% of patients with psoriasis may develop[6].

Plaque psoriasis is the most common form of the disease and appears as raised, red skin patches covered with a silvery white build-up of dead cells. Most patients with psoriasis will also develop difficult-to-treat forms of the disease which appear on the scalp, nails, palms of the hands or soles of the feet and are associated with further pain, decreased mobility and functional impairment[8]-[10],[12].

About Novartis Immunology & Dermatology
Novartis is a global leader in Immunology & Dermatology. We are dedicated to transforming the lives of people living with immunologic diseases, focusing on immunodermatology, rheumatology and specialty liver diseases. Our Immunology & Dermatology pipeline includes multiple compounds in liver disease and other immunological areas where high unmet medical needs exist.

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References
[1] Feldman S, et al. Exploring Patient Preferences for the Treatment of Moderate to Severe Psoriasis: a Discrete Choice Experiment Study in the US, Abstract presented at EADV, 2018
[2] Niedhardt K. Patient-Relevant Endpoints In Psoriasis - A Literature Review Of Patient Preference Studies. Value Health. 2016;19(7):a571
[3] Kauf T L , et al. Psoriasis patients' willingness to accept side-effect risks for improved treatment efficacy. Journal of Dermatological Treatment. 2015;26(6):507-513
[4] Feldman S, et al. Journal of Health Economics and Outcomes Research. 2016;4(2):141-15
[5] Gonzalez J M, et al. Comparing preferences for outcomes of psoriasis treatments among patients and dermatologists in the UK: results from a discrete-choice experiment. British Journal of Dermatology. 2017;176(3) 777-785
[6] Mease P J, et al. Managing patients with psoriatic disease: the diagnosis and pharmacologic treatment of psoriatic arthritis in patients with psoriasis. Drugs 2014;74:423-41.
[7] International Federation of Psoriasis Associations (IFPA) World Psoriasis Day website. "About Psoriasis." Available at: http://www.worldpsoriasisday.com/web/page.aspx?refid=114?. Last accessed January 2018.
[8] Baran R. The burden of nail psoriasis: an introduction. Dermatol. 2010:221 Suppl 1:1-5.
[9] Kumar B, et al. Palmoplantar lesions in psoriasis: a study of 3065 patients. Acta Dermatol Venereol. 2002;82:192-5.
[10] Zampieron A, et al. Quality of life in patients with scalp psoriasis. G Ital Dermatol Venereol. 2015 Jun;150(3):309-16
[11] Menter, et al. Journal of the American Academy of Dermatology. 2008; 58(5):826-50
[12] Chung J, et al. Palmoplantar psoriasis is associated with greater impairment of health-related quality of life compared with moderate to severe plaque psoriasis. J Am Acad Dermatol. 2014;71(4):623-32.

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