Moreno-Ramírez D, Fonseca E, Herranz P, Ara M
Servicio de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Virgen Macarena de Sevilla, Seville, Spain.
Actas Dermosifiliogr. 2010 Dec;101(10):858-65.
Various treatment options are available for use in moderate-to-severe psoriasis and election is dependent upon the clinical criteria applied by the attending physician. We undertook a survey among dermatologists to assess the treatment of moderate-to-severe psoriasis currently used in clinical practice in Spain.
A cross-sectional study was performed by sending a questionnaire to dermatologists in Spain who treat patients with moderate-to-severe psoriasis. The questionnaire comprised 33 items distributed in 6 sections: profile of the dermatologist, case load, patient profile, follow-up and management of the disease, treatment regimens, and assessment of pharmacological treatments.
According to the responses of the 164 dermatologists surveyed, 6.8% of patients seen in their clinics have moderate-to-severe psoriasis; of those, 45.8% receive systemic treatment and 22.9% are treated with biologic drugs. In many of those patients (50.2%), the dermatologist felt that a change in treatment was necessary; in 51.1% of cases, this change would be from systemic therapy to a biologic drug. The principal reason for the change (50.8%) would be lack of efficacy or the appearance of adverse effects. Efficacy and safety were considered essential criteria in the choice of an appropriate treatment (82.9% and 28.0% of dermatologists, respectively). Patient quality of life was also considered an essential consideration in choice of treatment by 28.0% of dermatologists.
Optimal treatment for moderate-to-severe psoriasis should be effective and safe, and improve patient quality of life. This makes it essential to use drugs with an excellent efficacy and safety profile.
中度至重度银屑病有多种治疗方案可供选择，具体选择取决于主治医生采用的临床标准。我们对皮肤科医生进行了一项调查，以评估西班牙临床实践中目前用于治疗中度至重度银屑病的方法。
通过向西班牙治疗中度至重度银屑病患者的皮肤科医生发送问卷进行横断面研究。问卷包括33个项目，分为6个部分：皮肤科医生简介、病例数量、患者概况、疾病的随访与管理、治疗方案以及药物治疗评估。
根据164名接受调查的皮肤科医生的回复，他们诊所中6.8%的患者患有中度至重度银屑病；其中，45.8%接受全身治疗，22.9%接受生物药物治疗。在许多这类患者中（50.2%），皮肤科医生认为有必要改变治疗方法；在51.1%的病例中，这种改变将是从全身治疗改为生物药物治疗。改变治疗方法的主要原因（50.8%）将是疗效不佳或出现不良反应。疗效和安全性被认为是选择合适治疗方法的重要标准（分别有82.9%和28.0%的皮肤科医生这样认为）。28.0%的皮肤科医生也认为患者的生活质量是选择治疗方法时的重要考虑因素。
中度至重度银屑病的最佳治疗方法应有效、安全，并能改善患者生活质量。这使得使用具有优异疗效和安全性的药物至关重要。
