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Patient Viewpoints: Quantitave Research


Peter Lio, MD, shares findings and takeaways from a quantitative study designed to spotlight patient perceptions of current atopic dermatitis treatments and willingness to try new therapies.

Peter Lio, MD: Hello, and welcome back to this Partner Perspectives video series. I'm Dr. Peter Lio, a clinical assistant professor of dermatology and pediatrics at Northwestern University, Feinberg School of Medicine, and the founding director of the Chicago Integrative Eczema Center, as well as a founding partner of Medical Dermatology Associates of Chicago.

This video is sponsored by ASLAN Pharmaceuticals and its content was developed for, directed by, and presented on behalf of ASLAN Pharmaceuticals. In our first video in this series, we explored patient feedback from a series of interviews conducted by ASLAN Pharmaceuticals. Today, we're going to take a look at the design, methodology, and findings of a quantitative/conjoint study that ASLAN conducted as part of the same research.

In June and July of 2023, ASLAN conducted 83 online surveys with patients diagnosed with moderate to severe AD. Patients were arranged into 3 cohorts based on current or past treatments, which were those currently on biologic therapy, those who have lapsed on a biologic, and those who were biologic and oral JAK inhibitor naive. The purpose of this research was to understand the impact of AD on patients' quality of life while identifying unmet needs for patients with moderate to severe disease. The research was designed to uncover the perception patients have of current advanced systemic treatments and understand their expectations when it comes to future therapies. A further objective of this research was to gain a deeper understanding of a patient's willingness to switch therapies.

A conjoint analysis was also performed, along with a general survey to discern if small changes to drug attributes made a significant difference to preference, which allowed statistical comparison of attributes and benefits.

Before we dive into the findings, let's quickly review patient disease characteristics. It's worth noting the higher proportion of males in this quantitative study compared to the previously reviewed qualitative data. 62% of the patients had moderate disease when first diagnosed, while 29% had severe disease when first diagnosed. At their most recent visit, 69% had moderate disease and 27% had severe disease. Nearly half of patients had some comorbidities. Among patients with comorbid conditions, asthma was the most common at about 30%, followed by allergic rhinitis at 18%, and other allergies at 18%.

Itch is one of the most debilitating symptoms of AD and we know that it can affect all areas of a patient's life. As you can see here, the quantitative data further validates this with almost 90% of patients citing itch as the most burdensome symptom. As far as flare-ups go, more than 30% of these patients experience flares greater than 5 times a month, with some over 8 times a month.

One of the key takeaways I wanted to highlight was that approximately 30% of patients noted sleep loss as a significant symptom of AD, and this is likely due to that constant itch. Regarding patient satisfaction, about half of lapsed biologic patients were shown to switch treatment. These patients noted being only somewhat satisfied with their treatments and became less satisfied before the switch.

Some of the key takeaways included, on average, lapsed patients were only somewhat satisfied with marketed advanced systemic treatments when first prescribed and became slightly less satisfied before deciding to switch. This suggests current available systemic treatment may not be fully addressing patient needs and lapsed patients are willing to try new treatments until satisfied.

About 50% of lapsed biologic patients report using it for less than 6 months before switching to a new treatment, and all of the lapsed biologic patients from one of the medications studied stopped before 12 months. In terms of why patients were relapsing, a decrease in efficacy was the most popular reason why patients stopped use, while other reasons included delayed onset of action, adverse reactions, and cost among others.

Among patients who were biologic or oral JAK inhibitor naive, more than half mentioned that the lack of a recommendation from their doctor prevented them from trying something different. Another thing to highlight here is that about half of these patients reported that they did not like to administer the injections every 2 weeks, indicating that the root and frequency of administration may be influencing factors when it comes to deciding which treatment a patient with AD chooses.

Among the different cohorts, roughly half showed a willingness to switch to a new treatment that offered better efficacy and durability. When asked about attributes desired in a new treatment, the top attribute was better efficacy at reducing itch, followed by better durability and better efficacy in clearing skin.

Looking specifically at patients with comorbidities, we see similar numbers. In this study, 53% of patients were noted to have comorbidities and, in my experience, I've typically seen that number or even higher percentage of patients who present with atopic comorbidities in my own practice. But what's interesting here is that roughly 40% of these patients consider potential efficacy in other atopic conditions a TOP-2 attribute of importance, and a key driver for switching treatments. This makes sense, considering that 96% of all patients with other atopic conditions showed a moderate to high willingness to switch to a new treatment if it could help with those conditions.

And here, we see how a conjoint study is done, with product A, representing a base biologic, and product B, representing that same profile, but with 2 injections in one sitting every month. Beyond the safety and efficacy attributes of the drugs, delivery is also an important factor for patients. Roughly 40% of overall patients and current biologic users would prefer an analogous product with injections every 4 weeks, rather than every 2 weeks.

A couple of key take home points: First, given the same therapeutic profile and benefits of a leading biologic, nearly 40% of patients would prefer once monthly 2-injection dosing versus 1 injection every two weeks. Number 2, comparing the therapeutic profile of a biologic versus a hypothetical new biologic with once monthly two-injection dosing and less conjunctivitis, less than 5%, more patients or about 55% preferred the hypothetical new biologic. Number 3, other key differentiators of a hypothetical new biologic were proven to be no refrigeration requirement, reduction in topical use and improvement in sleep quality. And finally, number four, 90% of patients prefer to hypothetical new biologic product profile with 20 to 25% higher efficacy thresholds and once monthly to injections dosing.

With that, I'd like to conclude the second video in our series. On behalf of Aslan Pharmaceuticals, thank you for watching.

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