Takeshita Junko, Gelfand Joel M, Li Penxiang, Pinto Lionel, Yu Xinyan, Rao Preethi, Viswanathan Hema N, Doshi Jalpa A
Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA; Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA; Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
J Invest Dermatol. 2015 Dec;135(12):2955-2963. doi: 10.1038/jid.2015.296. Epub 2015 Jul 27.
Psoriasis is a common chronic inflammatory disorder, primarily of the skin. Despite an aging population, knowledge of the epidemiology of psoriasis and its treatments among the elderly is limited. We examined the prevalence of psoriasis and its treatments, with a focus on biologics and identification of factors associated with biologic use, using a nationally representative sample of Medicare beneficiaries in 2011. On the basis of several psoriasis identification algorithms, the claims-based prevalence for psoriasis in the United States ranged from 0.51 to 1.23%. Treatments used for moderate-to-severe psoriasis (phototherapy, oral systemic, or biologic therapies) were received by 27.3% of the total psoriasis sample, of whom 37.2% used biologics. Patients without a Medicare Part D low-income subsidy (LIS) had 70% lower odds of having received biologics than those with LIS (odds ratio 0.30; 95% confidence interval, 0.19-0.46). Similarly, the odds of having received biologics were 69% lower among black patients compared with white patients (0.31; 0.16-0.60). This analysis identified potential financial and racial barriers to receipt of biologic therapies and underscores the need for additional studies to further define the epidemiology and treatment of psoriasis among the elderly.
银屑病是一种常见的慢性炎症性疾病，主要累及皮肤。尽管人口老龄化，但关于老年人银屑病的流行病学及其治疗的知识仍有限。我们使用2011年医疗保险受益人的全国代表性样本，研究了银屑病的患病率及其治疗情况，重点关注生物制剂以及与生物制剂使用相关的因素。基于几种银屑病识别算法，美国基于索赔的银屑病患病率在0.51%至1.23%之间。在整个银屑病样本中，27.3%的患者接受了用于中重度银屑病的治疗（光疗、口服全身治疗或生物治疗），其中37.2%使用了生物制剂。没有医疗保险D部分低收入补贴（LIS）的患者接受生物制剂治疗的几率比有LIS的患者低70%（优势比0.30；95%置信区间，0.19 - 0.46）。同样，与白人患者相比，黑人患者接受生物制剂治疗的几率低69%（0.31；0.16 - 0.60）。该分析确定了接受生物治疗存在潜在的经济和种族障碍，并强调需要进一步研究以更明确老年人银屑病的流行病学和治疗情况。
