Department of Dermatology, University of Southern California, Los Angeles, CA, USA.
Kantar Insights, Wellington, New Zealand.
Clin Drug Investig. 2017 May;37(5):493-501. doi: 10.1007/s40261-017-0508-1.
Psoriasis patients frequently switch among multiple therapies while managing their psoriasis. Determining treatment transitions is fundamental to understanding how patients access and use treatments.
We aimed to identify patterns of treatment transitions of US patients with moderate to severe psoriasis over 5 years.
This was a retrospective, longitudinal cohort study in which US patients aged ≥18 years who had at least one psoriasis claim (International Classification of Diseases, Ninth Revision [ICD-9] diagnosis) were continuously enrolled in a health plan between October 2007 and September 2012. Data from eligible patients were projected to reflect the total US insured population with moderate to severe psoriasis, and the proportions of patients who started, stopped, switched, and restarted treatment at any time between September 2011 and September 2012 were analyzed. Treatment categories were biologics, traditional oral systemics, topicals, phototherapy, lapsed from treatment, and treatment-naive.
There were 8.9 million patients in the claims database, of whom 0.9 million (10.4%) had a psoriasis diagnosis and 46,369 (0.5%) met the inclusion criteria. When projected, 1.7 million insured patients had moderate to severe psoriasis. Of these, an estimated 807,000 patients had lapsed treatment, an additional 346,000 were receiving treatment, and 547,000 were defined as being treatment-naive. A total of 81,000 of 346,000 patients had switched treatment in the preceding year. In addition, many patients stopped (438,000) and restarted (384,000) treatment in the 12-month period.
Based on health claims data, undertreatment of moderate to severe psoriasis appeared to be common.
在治疗银屑病的过程中，银屑病患者经常在多种疗法之间转换。确定治疗的转变对于了解患者如何获得和使用治疗方法至关重要。
我们旨在确定 5 年内美国中重度银屑病患者的治疗转变模式。
这是一项回顾性、纵向队列研究，在 2007 年 10 月至 2012 年 9 月期间，连续纳入至少有一项银屑病（国际疾病分类，第九版[ICD-9]诊断）的医疗保险计划的年龄≥18 岁的美国患者。符合条件的患者的数据被预计反映了全美所有中重度银屑病保险患者，分析了 2011 年 9 月至 2012 年 9 月间任何时候开始、停止、转换和重新开始治疗的患者比例。治疗类别为生物制剂、传统口服全身药物、局部治疗、光疗、治疗中断和治疗初治。
在索赔数据库中，有 890 万患者，其中 90 万（10.4%）有银屑病诊断，46369 人（0.5%）符合纳入标准。预计有 170 万保险患者患有中重度银屑病。其中，估计有 807000 名患者治疗中断，另有 346000 名患者正在接受治疗，547000 名患者被定义为治疗初治。在过去一年中，346000 名患者中有 81000 名患者转换了治疗方法。此外，许多患者在 12 个月内停止（438000 人）和重新开始（384000 人）治疗。
基于健康索赔数据，中重度银屑病的治疗不足似乎很常见。
