Identifying Systemic-Ready Phenotype(S) to Estimate Systemic Treatment Needs with Predictive Analytics and Ehr Data among Us Topical-Initiating Psoriasis Patients
Recommended Citation
Stein Gold L, Cameron M, De Cassia Castro R, Deignan C, Chen K, Orroth K, Tran K, Armstrong A. Identifying Systemic-Ready Phenotype(S) to Estimate Systemic Treatment Needs with Predictive Analytics and Ehr Data among Us Topical-Initiating Psoriasis Patients. J Am Acad Dermatol 2026; 95(1):AB250.
Document Type
Conference Proceeding
Publication Date
7-1-2026
Publication Title
J Am Acad Dermatol
Keywords
Dermatology
Abstract
Despite availability of effective systemic therapies, undertreatment of PsO remains prevalent. The International Psoriasis Council recommends initiating systemic therapy for PsO patients with BSA>10%, high-impact site involvement, or topical failure (Strober et al., 2025) since 2020; adoption of these guidelines in clinical practice is not known. We aim to identify systemic-ready patient phenotypes and estimate unmet treatment needs with a data-driven approach using real-world data. This retrospective cohort study includes adults ( ≥ 18 years-old) with plaque PsO from the OM1 PremiOM™ database, ≥ 1 topical therapy (index), baseline BSA, and no prior systemic use. Cluster analysis will be implemented to distinguish clusters of known systemic-initiators, topical patients suspected of being systemic-ready or topical-sufficient. We hypothesize similarities between the first two groups. These clusters will inform a predictive model estimating the volume of systemic-ready patients across the broader population. Among 18,865 systemic-naïve PsO patients, key potential predictors (t-/chi-square test p-value <0.05) of initiating systemic therapies include age, insurance, high-impact site involvement, PsA, baseline BSA, and topical treatment history. Compared with non-initiators (n=11,297), systemic-initiators (n=7,568) were more likely aged <65 (79.2% vs. 64.1%) and to have commercial insurance (41.7% vs. 34.2%), high-impact site involvement (40.3% vs. 33.5%), PsA (13.3% vs. 3%), higher baseline BSA (mean [SD]: 13.1 [16.1] vs. 7.3 [11.3]), and use more topicals (37.1% vs. 25.7% with ≥ 4 unique topicals ever). Cluster and predictive modeling results are forthcoming. This data-driven study using novel predictive analytics and real-world data may help accelerate identification of systemic-ready patients and systemic treatment initiation among undertreated PsO patients.
Volume
95
Issue
1
First Page
AB250
