TARGETED LITERATURE REVIEW OF THE BENEFITS AND LIMITATIONS OF CURRENT MODERATE-TO-SEVERE PSORIASIS (PSO) ROUTES OF ADMINISTRATION
Author(s)
Karen Chiang, MBiotech1, Radia Kamal, MSc1, Joshua Gauci, MSc1, Imtiaz Samjoo, BSc, MSc, PhD1, Nan Li, PhD2, Lara Feghelm, MSc2.
1EVERSANA, Victoria, BC, Canada, 2J&J Innovative Medicine, Horsham, PA, USA.
1EVERSANA, Victoria, BC, Canada, 2J&J Innovative Medicine, Horsham, PA, USA.
OBJECTIVES: Advanced systemic treatments for moderate-to-severe PsO include injectable biologics (inhibiting tumor necrosis factor alpha, interleukin [IL]-17, or IL-12 and/or IL-23) and oral small molecules (OSM; inhibiting phosphodiesterase-4 or tyrosine kinase 2). Biologics deliver high efficacy, but real-world treatment pattern evidence indicates restricted long-term persistence of biologicals. Conversely, OSMs offer improved accessibility and ease of use, but lower efficacy. This targeted literature review (TLR) aims to understand the impact of route of administration (RoA) on outcomes in PsO.
METHODS: A PRISMA-informed TLR was conducted to identify English-language citations published between January 2015 and November 2025 in Ovid MEDLINE® and Embase. Eligible studies evaluated approved biologics or OSMs in moderate-to-severe PsO and reported outcomes for preferences, accessibility, adherence, safety or economic burden that were attributed to the RoA.
RESULTS: A total of 3,134 citations were captured. Fifty-four were included for qualitative synthesis. Discrete-choice experiments consistently showed that patients prefer oral therapies and were willing to trade approximately 25%-50% of anticipated efficacy to avoid needles. Injection-related anxiety, reported in up to 50% of adolescents and 30% of young adults from RW studies, was a potential barrier to biologic access. Compared to OSMs, biologics were associated with additional administration or monitoring laboratory costs and substantial injection burden (pain, burning, irritation). The most common reasons for discontinuation varied between RoAs; for biologics, discontinuation was more likely due to adverse reactions (43%) than efficacy (39%), whereas for OSMs, discontinuation was more likely due to efficacy (57%) than adverse reactions (36%).
CONCLUSIONS: The current treatment landscape demonstrates unrealized potential for innovative options that can deliver the efficacy benefits of biologics with the improved accessibility and preference of OSMs. As few studies reported the proportion of patients who are unable to or have delays in accessing biologics due to supply considerations, needle fear, or other considerations, additional research is needed.
METHODS: A PRISMA-informed TLR was conducted to identify English-language citations published between January 2015 and November 2025 in Ovid MEDLINE® and Embase. Eligible studies evaluated approved biologics or OSMs in moderate-to-severe PsO and reported outcomes for preferences, accessibility, adherence, safety or economic burden that were attributed to the RoA.
RESULTS: A total of 3,134 citations were captured. Fifty-four were included for qualitative synthesis. Discrete-choice experiments consistently showed that patients prefer oral therapies and were willing to trade approximately 25%-50% of anticipated efficacy to avoid needles. Injection-related anxiety, reported in up to 50% of adolescents and 30% of young adults from RW studies, was a potential barrier to biologic access. Compared to OSMs, biologics were associated with additional administration or monitoring laboratory costs and substantial injection burden (pain, burning, irritation). The most common reasons for discontinuation varied between RoAs; for biologics, discontinuation was more likely due to adverse reactions (43%) than efficacy (39%), whereas for OSMs, discontinuation was more likely due to efficacy (57%) than adverse reactions (36%).
CONCLUSIONS: The current treatment landscape demonstrates unrealized potential for innovative options that can deliver the efficacy benefits of biologics with the improved accessibility and preference of OSMs. As few studies reported the proportion of patients who are unable to or have delays in accessing biologics due to supply considerations, needle fear, or other considerations, additional research is needed.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
PCR93
Topic
Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance, Patient Behavior and Incentives
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)