3 Ways Amgen Uses Real-World Evidence to Advance Understanding of Plaque Psoriasis

Big data is on everyone’s minds these days as advances in human data science and analytics, including the use of real-world evidence, transform healthcare for patients.

As my Amgen colleague Brian Bradbury, vice president and head of our Center for Observational Research (CfOR), says, real-world evidence has the potential to revolutionize every stage of clinical research, including trial design, regulatory requirements and outcomes measurement to contribute meaningfully to public health. This is exactly what we are beginning to see in plaque psoriasis, where patients’ and clinicians’ experiences in the real world can shed light far beyond what is recorded in clinical trials.

Thanks to groups like CfOR, Amgen has been collecting real-world data on plaque psoriasis for over a decade – including research examining systemic therapy adoption and patient/physician treatment disconnects – to better understand this common, misunderstood condition. Plaque psoriasis is a lifelong inflammatory skin disease that affects millions of people worldwide (1). It typically results in scaly patches or plaques on the skin, often in high-impact areas that can profoundly impact patients, such as the scalp, palms, soles, nails, genitals, and visible areas (1,2). Plaques can limit function of hands and feet and symptoms frequently cause physical discomfort (1,3).

We know there’s more that can be done to help improve outcomes for patients (4), and as the field evolves, it’s crucial to identify ways to help both patients and clinicians manage this complex, sometimes debilitating disease.

At Amgen, we harness data science to track and predict how a disease like plaque psoriasis progresses and how patients can potentially benefit from treatment. Keep reading to better understand three ways Amgen is using real-world evidence to unlock insights to advance the understanding of plaque psoriasis.

1. Provide a Closer Look at the Disease Burden of Plaque Psoriasis

Real-word evidence obtained through disease registries and patient and clinician surveys allows us to better understand the attitudes and behaviors of people living with this disease and their providers as well as how perceptions evolve over time. It can uncover deep insights about the patient journey, leading to better disease management.

Plaque psoriasis and symptoms occurring in highly visible, sensitive and high-impact areas, along with persistent itch, are highly burdensome (5,6). People living with it may be embarrassed by or self-conscious about their disease (7,8). Disease burden can extend to family members and partners as a result of disruptions due to plaque psoriasis symptoms (7,8). Often, the full burden of plaque psoriasis is underappreciated by clinicians, especially since patients don’t always communicate the full impact of their symptoms (2,8).

2. Bridge the Gap Between Randomized Trials and Everyday Clinical Practice

Real-world evidence complements clinical trial data, providing a more integrated view of patient care in everyday practice settings. Populations in real-world studies are more representative of patients seen in dermatology practices compared to clinical trials performed in controlled settings. Real-world data extends knowledge about diseases and therapies by including extensive datasets from electronic health records, insurance claims data, disease registries and other sources.

Real-world evidence can help uncover insights about how plaque psoriasis is managed in practice, evaluate how treatment can make a difference in a broad and diverse range of patients, and identify barriers to treatment adherence. These insights can help providers make more informed clinical decisions.

We can also uncover disparities in care, such as underdiagnosis and undertreatment of plaque psoriasis in people with darker skin tones and social determinants of health that can impact patient care.

Amgen is committed to assessing our therapies within the context of real-world treatment patterns. This gives us a better understanding of the value of our therapies so we can continue innovating and refining how we help patients.

3. Advance Understanding of Treatment Needs for Every Patient

In January, Amgen presented new data at the Maui Derm conference on the effects of early initiation of an oral systemic treatment of plaque psoriasis compared to late initiation of systemic treatment among patients with mild to moderate disease.

The findings showed that patients who initiated systemic treatment later in their treatment cycled through more topical treatments than those who received systemic therapy earlier (9). And importantly, those who initiated systemic therapy later had skin area affected by psoriasis worsen, suggesting that disease burden and exacerbations may be increasing while patients are waiting to receive systemic treatment (9). Based on these findings, there may be patients who are not receiving systemic treatment early enough that could help reduce symptoms.

Previous real-world studies we conducted showed that patients with limited skin affected may perceive their disease as more severe based on the location of symptoms or itch, reinforcing the importance of timely treatment (5). Other factors contributing to the reported high burden of disease may include long-standing disease duration and prior systemic therapy failure (10).

Patients may have different treatment goals from their dermatologists, and these disconnects could impact their care. Understanding how plaque psoriasis affects every patient is critical, as there is no one-size-fits-all approach to treatment.

References

1.     Armstrong AW, Read C. Pathophysiology, Clinical Presentation, and Treatment of Psoriasis: A Review. JAMA. 2020 May 19;323(19):1945-1960. doi: 10.1001/jama.2020.4006. 

2.     Gupta S, Garbarini S, Nazareth T, Khilfeh I, Costantino H, Kaplan D. Characterizing Outcomes and Unmet Needs Among Patients in the United States with Mild-to-Moderate Plaque Psoriasis Using Prescription Topicals. Dermatol Ther (Heidelb). 2021 Dec;11(6):2057-2075. doi: 10.1007/s13555-021-00620-x. Epub 2021 Oct 14. 

3.     Taliercio VL, Snyder AM, Webber LB, et al. The Disruptiveness of Itchiness from Psoriasis: A Qualitative Study of the Impact of a Single Symptom on Quality of Life. J Clin Aesthet Dermatol. 2021 Jun;14(6):42-48. Epub 2021 Jun 1.

4.     Drakos A, Vender R. A Review of the Clinical Trial Landscape in Psoriasis: An Update for Clinicians. Dermatol Ther (Heidelb). 2022 Dec;12(12):2715-2730. doi: 10.1007/s13555-022-00840-9. Epub 2022 Nov 1.

5.     Lebwohl M, Langley RG, Paul C, et al. Evolution of Patient Perceptions of Psoriatic Disease: Results from the Understanding Psoriatic Disease Leveraging Insights for Treatment (UPLIFT) Survey. Dermatol Ther (Heidelb). 2022 Jan;12(1):61-78. doi: 10.1007/s13555-021-00635-4. 

6.     Korman NJ, Zhao Y, Pike J, Roberts J. Relationship between psoriasis severity, clinical symptoms, quality of life and work productivity among patients in the USA. Clin Exp Dermatol. 2016 Jul;41(5):514-21. doi: 10.1111/ced.12841. Epub 2016 Apr 8. 

7.     Pariser D, Schenkel B, Carter C, et al; Psoriasis Patient Interview Study Group. A multicenter, non-interventional study to evaluate patient-reported experiences of living with psoriasis. J Dermatolog Treat. 2016;27(1):19-26. doi: 10.3109/09546634.2015.1044492. Epub 2015 Jul 3.

8.     Strober BE, van der Walt JM, Armstrong AW, et al. Clinical Goals and Barriers to Effective Psoriasis Care. Dermatol Ther (Heidelb). 2019 Mar;9(1):5-18. doi: 10.1007/s13555-018-0279-5. Epub 2018 Dec 21. 

9.     Strober B, Stein Gold L, Gisondi P. Poster presented at Maui Derm, January 22-26, Maui, Hawaii.

10.  Augustin M, Kleyn CE, Conrad C, et al. J Eur Acad Dermatol Venereol. 2021 Jan;35(1):123-134. doi: 10.1111/jdv.16431. Epub 2020 Jul 30.