Clinical Utility Findings of a Transcriptomic Psoriasis Biologic Test Demonstrate Altered Physician Prescribing Behavior and Improved Patient Outcomes.
Bruce E Strober, Michael Bukhalo, April W Armstrong, David Pariser, Leon Kircik, Brian Johnson, Paul Montgomery, Tobin J Dickerson
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Abstract
Introduction: This randomized, prospective study (MATCH) was designed to assess the clinical utility of a machine learning-based tool (Mind.Px) that predicts patient response to the biologic drug classes used in the management of psoriasis.
Methods: Patients with psoriasis who were biologic naïve or approaching a medication change owing to nonresponse were enrolled into the study (N = 210). At baseline, a dermal biomarker patch was applied to lesional skin, and Mind.Px test results were provided to physicians for patients in the informed arm of the study prior to biologic selection. The choice of biologic was recorded, and, in the case of physician nonconcordance with Mind.Px test results, a questionnaire was completed to determine the reason for nonconcordance. Patients were evaluated at weeks 4 and 12 after baseline using Psoriasis Area and Severity Index (PASI). Statistical analysis between groups was performed using Fisher's exact test.
Results: Physician prescribing behavior was measured with and without the inclusion of Mind.Px test results in the decision-making process (N = 205). Additional comparisons were made to a previously collected data set identical to the Mind.Px-uninformed arm (N = 429). Statistical analysis of concordance between the Mind.Px-informed and Mind.Px-uninformed groups (92.3% versus 62.9%, respectively) showed that when given access to Mind.Px results, physician behavior was significantly altered (p = 8.08 × 10-7). Furthermore, analysis of patients whose physicians followed Mind.Px results showed that not only did more patients reach the clinical endpoint (PASI75) at 12 weeks (p = 5.4 × 10-4), but also more patients reached this endpoint by week 4 than those in the treatment-as-usual arm (p = 0.01).
Conclusions: These results provide evidence of the clinical utility of Mind.Px by showing that physicians utilize test results in psoriasis biologic decision-making, leading to improved patient outcomes. These improved patient outcomes can also potentially translate into cost savings for healthcare systems. Mind.Px can minimize the trial-and-error approach to psoriasis treatment, and provide physicians, patients, and payers with an effective tool for re-envisioning the management of patients with psoriasis.
期刊介绍：
Dermatology and Therapy is an international, open access, peer-reviewed, rapid publication journal (peer review in 2 weeks, published 3–4 weeks from acceptance). The journal is dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of dermatological therapies. Studies relating to diagnosis, pharmacoeconomics, public health and epidemiology, quality of life, and patient care, management, and education are also encouraged.
Areas of focus include, but are not limited to all clinical aspects of dermatology, such as skin pharmacology; skin development and aging; prevention, diagnosis, and management of skin disorders and melanomas; research into dermal structures and pathology; and all areas of aesthetic dermatology, including skin maintenance, dermatological surgery, and lasers.
The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols, and short communications. Dermatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an International and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. The journal appeals to a global audience and receives submissions from all over the world.
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