Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 19104, USA.
J Am Acad Dermatol. 2013 Feb;68(2):262-9. doi: 10.1016/j.jaad.2012.07.007. Epub 2012 Aug 19.
Multiple systemic treatments are available for moderate to severe psoriasis, but dermatologists' perceptions of these treatments are unknown. Physician perceptions can influence prescribing patterns and patient outcomes, and may help to explain variations in clinical practice.
We sought to describe the variation in dermatologist's beliefs about the safety and effectiveness of psoriasis treatments and evaluate how these relate to dermatologist characteristics and treatment preferences.
We conducted a cross-sectional mail survey of a random sample of 500 National Psoriasis Foundation (NPF) members and 500 American Academy of Dermatology (AAD) members who treat psoriasis.
Of 989 clinicians who could be contacted, 246 NPF members and 141 AAD members returned the survey (39% response rate). Respondents perceived infliximab, ustekinumab, cyclosporine, and adalimumab to have the highest likelihood of skin clearance in 3 months (67%-75%). Etanercept, adalimumab, ultraviolet B, and ustekinumab had the lowest perceived likelihood of side effects requiring treatment discontinuation (9%-11%). Up to 49% of respondents "didn't know" the effectiveness or likelihood of side effects; calculated coefficients of variation were higher for perceived likelihood of side effects than perceived effectiveness. There were few significant associations between safety and effectiveness perceptions and respondent characteristics, and treatment preferences were not consistently predictive of perceptions.
Only dermatologists with interest in treating psoriasis were surveyed and general perceptions were elicited via survey format. Perceptions may differ between survey respondents and nonrespondents.
Psoriasis providers demonstrate wide variation in their perception of the effectiveness and especially safety of systemic treatments.
有多种全身性治疗方法可用于中重度银屑病，但皮肤科医生对这些治疗方法的看法尚不清楚。医生的看法会影响处方模式和患者的治疗结果，并且可能有助于解释临床实践中的差异。
我们旨在描述皮肤科医生对银屑病治疗安全性和有效性的看法的差异，并评估这些看法与皮肤科医生的特征和治疗偏好之间的关系。
我们对美国国家银屑病基金会（NPF）的 500 名成员和美国皮肤病学会（AAD）的 500 名治疗银屑病的成员进行了一项横断面邮寄调查。
在 989 名可联系到的临床医生中，有 246 名 NPF 成员和 141 名 AAD 成员返回了调查（39%的回复率）。受访者认为英夫利昔单抗、乌司奴单抗、环孢素和阿达木单抗在 3 个月内最有可能清除皮肤（67%-75%）。依那西普、阿达木单抗、紫外线 B 和乌司奴单抗被认为最不可能出现需要停药的副作用（9%-11%）。多达 49%的受访者“不知道”有效性或副作用的可能性；感知副作用的可能性的变异系数高于感知有效性的变异系数。安全性和有效性的看法与受访者特征之间几乎没有显著关联，并且治疗偏好并不能始终预测看法。
仅调查了对治疗银屑病有兴趣的皮肤科医生，并且通过调查格式得出了一般看法。调查结果可能因调查对象和非调查对象之间的差异而有所不同。
银屑病治疗者对全身性治疗的有效性，尤其是安全性的看法存在广泛差异。
