Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Buenos Aires, Argentina.
Universidad Privada del Norte, Lima, Peru.
J Eur Acad Dermatol Venereol. 2017 Dec;31(12):1991-1998. doi: 10.1111/jdv.14393. Epub 2017 Jul 12.
Psoriasis is a chronic inflammatory disease that generally affects the skin, nails and joints. The burden of psoriatic disease in Latin America and the Caribbean (LAC) remains largely unknown. To estimate the burden of psoriasis in LAC. We conducted a systematic review following the MOOSE and PRISMA statements. We searched published studies in MEDLINE, EMBASE, LILACS and CENTRAL from 1st January 2000 to 5th August 2015. We included studies that reported incidence, prevalence, health resource use and health expenditures, treatment patterns, comparative effectiveness of different drugs, patients reported outcomes, adherence to treatment and patient preferences in LAC. Risk of bias was assessed evaluating selection of participants, control of cofounders, measurement of exposure and outcome and conflict of interest. Pairs of reviewers independently selected, extracted and assessed the bias risk of the studies. The systematic review was registered at PROSPERO (CRD42016038325). A total of 18 studies from 12 LAC countries were included. Most were observational studies, between which there was a large heterogeneity of outcomes. Population-based studies were not found and most data came from hospital registries. One study reported an incidence of psoriatic arthritis in 6.26 cases per 100 000 person-years. Another study found an incidence of psoriasis 1020 per 100 000 patient-year attending at a dermatology clinic. The prevalence reported in the Argentinean health service was 74 cases per 100 000. Further, psoriasis has been shown to have a substantial negative impact on quality of life. A number of studies also indicated that non-communicable disease burden increases with the presence and severity of psoriasis. With regard to treatment pattern, methotrexate was the dominant systemic therapy. In conclusion, there is an important lack of information from LAC concerning the burden of psoriasis. Further studies investigating the burden of psoriasis in representative LAC populations are needed.
银屑病是一种慢性炎症性疾病，通常会影响皮肤、指甲和关节。拉丁美洲和加勒比地区（LAC）的银屑病负担在很大程度上仍然未知。为了评估 LAC 地区银屑病的负担，我们按照 MOOSE 和 PRISMA 声明进行了系统评价。我们在 MEDLINE、EMBASE、LILACS 和 CENTRAL 中搜索了 2000 年 1 月 1 日至 2015 年 8 月 5 日发表的研究。我们纳入了报告发病率、患病率、卫生资源利用和卫生支出、治疗模式、不同药物的比较疗效、患者报告的结果、治疗依从性和患者偏好的研究。通过评估参与者的选择、混杂因素的控制、暴露和结果的测量以及利益冲突来评估偏倚风险。由两名评审员独立选择、提取和评估研究的偏倚风险。该系统评价已在 PROSPERO（CRD42016038325）上注册。共纳入了来自 12 个 LAC 国家的 18 项研究。这些研究大多是观察性研究，其结果存在很大的异质性。没有发现基于人群的研究，大多数数据来自医院登记处。一项研究报告了每 10 万人年 6.26 例银屑病关节炎的发病率。另一项研究发现，在皮肤科诊所就诊的患者中，银屑病的发病率为每 10 万人 1020 例。阿根廷卫生服务机构报告的患病率为每 10 万人 74 例。此外，银屑病已被证明对生活质量有重大负面影响。一些研究还表明，非传染性疾病负担随着银屑病的存在和严重程度而增加。关于治疗模式，甲氨蝶呤是主要的系统治疗药物。总之，LAC 地区关于银屑病负担的信息非常缺乏。需要进一步研究在有代表性的 LAC 人群中评估银屑病的负担。
