Dissatisfaction with the results and unwanted side effects are two of the biggest reasons why a large number of psoriasis and psoriatic arthritis patients go untreated, according to a new study in the journal JAMA Dermatology.

More than 52 percent of psoriasis patients say they aren’t happy with their current treatments, and nearly 46 percent of patients with psoriatic arthritis reported they, too, were dissatisfied with the results.

Dr. April W. Armstrong of the University of California, Davis and her colleagues used survey data from 5,604 patients with psoriasis or psoriatic arthritis collected by the National Psoriasis Foundation (NPF).

The results highlight the challenges and frustrations of treating these common autoimmune disorders.

According to the NPF, psoriasis is the most prevalent autoimmune disease in the U.S., affecting as many as 7.5 million Americans. Between 10 and 30 percent of people with psoriasis will develop psoriatic arthritis, involving severe joint pain and swelling.

Treatments & Side Effects

About 30 percent of people with mild psoriasis surveyed said they used topical treatments alone. They reported that these products had the fewest adverse side effects, that their disease wasn’t severe enough to warrant more therapy, or that their doctor wouldn’t prescribe any other treatments.

Phototherapy, including UV-B treatments, was used by 33 percent of those surveyed. Researchers said UV-B is the preferred phototherapy technique among patients.

Methotrexate, sold under the brand names Rheumatrex and Trexall, was the most frequently used oral systemic drug for psoriasis until 2011, when nearly 23 percent of patients reported using acitretin, a retinoid drug sold under the brand name Soriatane.

Biological agents, such as immunosuppressant therapy, have increased in popularity since 2003, but their use remains low compared to other therapies. At one point, as many as 25 percent of patients used entanercept (Embrel), but those numbers have dropped to about 10 percent in recent years.

The primary reasons patients said they stopped taking biological agents was because the drugs didn’t work well or there were adverse side effects, including an increased risk of infections.

The Importance of Quality Treatments

Ensuring that people with psoriasis and psoriatic arthritis receive proper treatment for their conditions is vital. These decrease quality-of-life and can lead to a higher risk of diabetes, mild liver disease, and heart attack.

Prior studies have linked psoriasis to self-esteem issues, depression, suicide, and more. Psoriatic arthritis carries these risks as well, but can also create severe mobility issues as it progresses.

“Collaborative efforts from the various stakeholders, including patients, physicians, payers, regulatory agencies, and advocacy organizations, are necessary to improve the lives of those affected by psoriasis and psoriatic arthritis,” the study authors wrote.

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