A Survey of Nurse Practitioner and Physician Assistant Advanced Practice Providers Uncovers a Need for Precision Medicine in Psoriasis Management

The arrival of biologics has considerably improved the treatment of psoriasis and psoriatic arthritis; however, it can be difficult to identify which biologic(s) a patient will respond to without undergoing a trial-and-error approach. The current survey was designed to investigate biologic switching in the clinic and whether a biomarker test would assist in selecting the appropriate treatment for patients and improve psoriasis management. A survey of 157 nurse practitioner and physician assistant (NP/PA) advanced practice providers was conducted to assess (1) the frequency of biologic switching and (2) the perceived clinical utility of a biomarker test that stratifies psoriasis patients to predict biologic response. More than half of advanced practice providers (55%) indicated that psoriasis patients require at least two different biologics to achieve an adequate response to treatment, with 59% of respondents specifying that 10% to 30% of their patients switch biologics the first year of treatment. Ninety-six percent of respondents indicated that a biomarker test would likely improve their practice, with the majority of participants (84%) suggesting a biomarker test could improve their ability to determine the most appropriate therapy for their patients. Ninety-one percent indicated they would use a biomarker test (Mind.Px, Mindera Health, San Diego, California), and 63% said they would perform the test in their office. A biomarker test may help shift psoriasis management from a trial-and-error approach to precision care, thereby reducing the time to effective treatment and improving patient outcomes.