Mazzuoccolo Luis Daniel, Luna Paula Carolina, Marciano Sebastián, Castro Perez Gimena Antonia, Marchesi Carolina, Nocito Mabel Jimena, Martin Koller Vanesa, Lorenzo Jimena, Koch Claudia, Echeverria Cristina Mariela
a Department of Dermatology, Hospital Eva Perón , Universidad de Buenos Aires , Gral San Martín , Argentina.
b Department of Dermatology , Hospital Alemán , Buenos Aires , Argentina.
J Dermatolog Treat. 2017 Nov;28(7):631-634. doi: 10.1080/09546634.2017.1329503. Epub 2017 May 30.
To describe dermatologists' methotrexate (MTX) prescription trends for the treatment of psoriasis, and to identify variables associated with suboptimal MTX use.
Cross-sectional study of dermatologists from Argentina who completed a pre-designed survey focussed on MTX prescription characteristics. A multiple logistic regression model was used to identify variables independently associated with suboptimal MTX use (when less than 12 weeks and less than 15 mg/week were administrated in patients with monotherapy before discontinuing or adding a second drug).
Two hundred and twenty-one dermatologists participated in the study. Median time of practice in dermatology: 10 (IQR 3-15) years. MTX initial dose: 2.5-7.5, 10-15 and 20-30 mg/week in 52%, 41% and 7% of the participants, respectively. Suboptimal MTX use was observed in 76% of the participants. Thirty per cent of the participants responded that they considered MTX to be an ineffective drug. The only variable that was independently associated with suboptimal MTX use was the prescriber's personal consideration of MTX to be an ineffective drug (OR 2.29; 95%CI 1.05-5.00).
A wide heterogeneity in the prescribing profile of MTX for the treatment of psoriasis was observed among Argentinean dermatologists. Suboptimal MTX use was identified in the majority of the prescribers.
描述皮肤科医生使用甲氨蝶呤(MTX)治疗银屑病的处方趋势,并确定与MTX使用欠佳相关的变量。
对来自阿根廷的皮肤科医生进行横断面研究,这些医生完成了一项针对MTX处方特征的预先设计的调查。采用多元逻辑回归模型来确定与MTX使用欠佳独立相关的变量(在单药治疗患者停药或加用第二种药物之前,给药时间少于12周且每周剂量少于15mg)。
221名皮肤科医生参与了该研究。皮肤科从业时间中位数:10(四分位间距3 - 15)年。MTX初始剂量:分别有52%、41%和7%的参与者使用2.5 - 7.5mg/周、10 - 15mg/周和20 - 30mg/周。76%的参与者存在MTX使用欠佳的情况。30%的参与者表示他们认为MTX是一种无效药物。与MTX使用欠佳独立相关的唯一变量是开处方者个人认为MTX是一种无效药物(比值比2.29;95%置信区间1.05 - 5.00)。
在阿根廷皮肤科医生中,观察到MTX治疗银屑病的处方情况存在广泛异质性。大多数开处方者存在MTX使用欠佳的情况。