Patel Vaishali, Horn Elizabeth J, Lobosco Steve J, Fox Kathleen M, Stevens Seth R, Lebwohl Mark
Amgen Inc, Thousand Oaks, California, USA.
J Am Acad Dermatol. 2008 Jun;58(6):964-9. doi: 10.1016/j.jaad.2008.02.048. Epub 2008 Apr 18.
The study evaluated community physician prescribing patterns for patients with psoriasis.
US dermatologists actively practicing general dermatology and treating 10 or more patients with psoriasis/mo were interviewed (n = 90) in April and June 2006 and they recruited 8 to 10 consecutive patients for record review (n = 895, mean age = 46 years, 51% men). Proportion of patients treated with systemic, biologic, or topical therapy as reported by the dermatologist and recorded in the records was assessed by psoriasis severity.
Among patients with severe psoriasis (body surface area affected > 10%), 56% to 63% received systemic therapy (including biologics) or phototherapy and 37% to 44% received topical therapy only. Dermatologists reported prescribing biologics to 41% of patients with severe disease compared with patient records where 27% to 34% of body surface area = 11% to 40% and 36% of body surface area greater than 40% patients received biologics.
Because of the small sample, eligibility criteria, and voluntary interview, selection bias may have occurred.
Some dermatologists are prescribing systemic therapy for the majority of their patients with severe psoriasis but a gap in treatment remains for about 40% who received topical therapy alone.
本研究评估社区医生对银屑病患者的处方模式。
2006年4月和6月，对积极从事普通皮肤科工作且每月治疗10名或更多银屑病患者的美国皮肤科医生进行了访谈（n = 90），他们招募了8至10名连续的患者进行记录审查（n = 895，平均年龄 = 46岁，51%为男性）。根据皮肤科医生报告并记录在案的情况，按银屑病严重程度评估接受全身治疗、生物治疗或局部治疗的患者比例。
在重度银屑病患者（体表面积受累>10%）中，56%至63%接受了全身治疗（包括生物治疗）或光疗，37%至44%仅接受了局部治疗。皮肤科医生报告称，41%的重症患者使用了生物制剂，而患者记录显示，体表面积为11%至40%的患者中有27%至34%、体表面积大于40%的患者中有36%接受了生物制剂治疗。
由于样本量小、纳入标准和自愿访谈，可能存在选择偏倚。
一些皮肤科医生为大多数重度银屑病患者开具全身治疗药物，但约40%仅接受局部治疗的患者仍存在治疗缺口。
