• A recent study found that people with psoriasis would like their health care providers to use a “biologic calculator” when prescribing biologics.
• The study authors developed a biologic calculator that takes into account response, non-reponse, risk of infections, and more.
• The respondents preferred the calculator for predicting who would respond to a biologic, who wouldn’t, and what the risk of infections would be.

People with psoriasis prefer their physician to use a biologic calculator — a type of algorithmic tool — to predict whether or not they would be a candidate for treatment, according to a recent study from the United Kingdom. Researchers believe this “stratified medicine” approach can help clinicians select which treatments would work best for an individual, based on individuals’ particular disease risks and responses to therapies.

“Researchers are looking for new approaches to help doctors prescribe biologics,” the authors wrote. “These new approaches use lots of information about the patient, including their genetics, to decide whether to use a biologic and, if so, which biologic is best for that individual.”

Biologics are human-made proteins that are used to treat a variety of inflammatory conditions, including psoriasis. They work by dampening the immune system, which helps control inflammation. However, some biologics have been found to increase a person’s risk of developing serious infections.

A successful psoriasis treatment approach balances the benefits against the risks. If the therapeutic benefits outweigh the risks of harmful side effects, then the medication will be recommended. A biologic calculator uses algorithms to determine risks and benefits of biologics for people, based on a number of factors that influence their particular diagnosis and response to treatment. These factors could include body mass index, sex, smoking status, the location of their psoriasis, and even genetics.

The authors sent the internet-based survey to people in the UK with psoriasis to understand how they feel about a biologic calculator. The 212 respondents chose between two different biologic calculators, or the conventional approach that is currently used for prescribing biologics. They considered five different factors when making their selections:

• Delaying the start of treatment in order to wait for results
• The calculator’s capability of predicting who would respond well to a certain biologic
• The calculator’s capability of predicting who would not respond well to a certain biologic
• The probability of developing a serious infection after treatment with a certain biologic
• The cost of savings to the UK’s National Health Services

Overall, the respondents most wanted the biologic calculator to accurately predict who would respond well to the treatment versus who would not. Respondents also wanted to know the risk of infection if they take a certain biologic.

The authors wrote, “These findings have important implications for the implementation of stratified medicine in psoriasis, and suggest that tools should be designed with the goal of reaching a sufficient level of predictive accuracy given the cost of implementing these into clinical practice.”

In the study, the authors also note that using an internet-based survey may have limited the people surveyed, and other methods such as telephone interviews or postal surveys may also be used in the future.