Trettel A, Spehr C, Körber A, Augustin M
Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Department of Dermatology, University Clinic Essen, Essen, Germany.
J Eur Acad Dermatol Venereol. 2017 May;31(5):870-875. doi: 10.1111/jdv.14115. Epub 2017 Mar 9.
Inequality between age groups has been demonstrated in the prescription of biologics, yet systematic real-world data about age-related differences in psoriasis care are missing.
To investigate disparities in psoriasis characteristics by age groups and to identify potential impact on psoriasis health care.
Data analysis included 3615 patients from the German psoriasis registry PsoBest, which observes adult patients with moderate-to-severe psoriasis or psoriatic arthritis (PsA) on systemic treatment over a time period of 10 years.
With 2376 participants (65.7%), the majority of patients was assigned to the age group 35-64, followed by 776 (21.4%) and 463 (12.8%) for the age groups 18-34 and 65+, respectively. Psoriasis vulgaris was the most frequent form of psoriasis with nearly 90% patients affected. Appearance of psoriasis forms did not differentiate significantly between the age groups except for erythrodermic psoriasis, which was more frequent in the elderly than in patients aged 35-64 (1.9%, P ≤ 0.048). Nail psoriasis appeared significantly more often in patients aged 35-64 (55.5%, P ≤ 0.001) and also showed the highest number of nails involved (6.9 ± 3.3). PsA was less frequent in the age group 18-34 (9.5%, P ≤ 0.001). This group showed the highest rate of scalp psoriasis (85.8%) compared to the elder age groups (P ≤ 0.001). Biologicals were used significantly less in younger patients (16.2%) compared to the age groups 35-64 (23.9%, P ≤ 0.001) and 65+ (21.8%, P ≤ 0.042).
Middle-aged patients show higher rates of PsA and nail psoriasis, which may explain age-dependent disparities in health care including the use of systemic treatment.
生物制剂处方在不同年龄组之间存在不平等现象，但缺乏关于银屑病治疗中年龄相关差异的系统性真实世界数据。
调查不同年龄组银屑病特征的差异，并确定对银屑病医疗保健的潜在影响。
数据分析纳入了来自德国银屑病登记处PsoBest的3615名患者，该登记处观察了10年间接受全身治疗的中度至重度银屑病或银屑病关节炎（PsA）成年患者。
2376名参与者（65.7%）被归入35 - 64岁年龄组，占大多数，其次是18 - 34岁年龄组的776人（21.4%）和65岁及以上年龄组的463人（12.8%）。寻常型银屑病是最常见的银屑病类型，近90%的患者受影响。除红皮病型银屑病外，各年龄组银屑病类型的出现情况无显著差异，红皮病型银屑病在老年人中比35 - 64岁患者更常见（1.9%，P≤0.048）。甲银屑病在35 - 64岁患者中出现的频率显著更高（55.5%，P≤0.001），且受累指甲数量也最多（6.9±3.3）。PsA在18 - 34岁年龄组中较少见（9.5%，P≤0.001）。与老年年龄组相比，该组头皮银屑病发生率最高（85.8%）（P≤0.001）。与35 - 64岁年龄组（23.9%，P≤0.001）和65岁及以上年龄组（21.8%，P≤0.042）相比，年轻患者使用生物制剂的比例显著较低（16.2%）。
中年患者PsA和甲银屑病的发生率较高，这可能解释了包括全身治疗使用在内的医疗保健中与年龄相关的差异。
