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银屑病和银屑病关节炎患者是否治疗不足?一项来自意大利南部的基于人群的研究。

Are Patients with Psoriasis and Psoriatic Arthritis Undertreated? A Population-Based Study from Southern Italy.

作者信息

Ingrasciotta Ylenia, Isgrò Valentina, Ientile Valentina, Tari Michele, Trifirò Gianluca, Guarneri Claudio

机构信息

Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy.

Department of Diagnostic and Public Health, University of Verona, 37134 Verona, Italy.

出版信息

J Clin Med. 2021 Jul 31;10(15):3431. doi: 10.3390/jcm10153431.

Abstract

This study aimed to explore the pattern of use of different treatment lines in psoriasis (PsO) and psoriatic arthritis (PsA) patients from Southern Italy. A retrospective cohort study was performed during the years 2010-2018 using data from the Caserta Local Health Unit (LHU) claims database. All of the PsO or PsA patients were identified. The proportion of PsO/PsA patients untreated or treated with ≥1 drug classes (i.e., non-disease-modifying antirheumatic drugs (non-DMARDs), conventional synthetic DMARDs (csDMARDs), biological drugs (bDMARDs) or targeted synthetic small molecules (tsDMARDs)) was calculated in the years 2016-2018. Among the bDMARD users, the median times from the first registered PsO/PsA diagnosis/from the first csDMARD to the first bDMARD were calculated. Overall, 10,296 (1.1%) and 1724 (0.2%) PsO and PsA patients were identified. More than half of the PsO patients ( = 5301; 51.6%) and 15% of the PsA patients ( = 251) were not treated with any drug. A very low proportion of PsO patients ( = 121; 1.2%) received csDMARDs/bDMARDs dispensing. Instead, 538 (32.2%) PsA patients were treated with bDMARDs. The median times from the first diagnosis to the first bDMARD dispensing were 54.0 (Q1-Q3: 30.5-72.2) and 13.3 (Q1-Q3: 3.1-43.9) months in the PsO and PsA patients, respectively. The median time from the first csDMARD to the first bDMARD dispensing was shorter in the PsO [9.2 months (Q1-Q3: 5.5-30.0)] than in the PsA [14.5 months (Q1-Q3: 8.6-33.5)] patients. A potential undertreatment of PsO (much less for PsA) in an LHU from Southern Italy, with a particularly low use of more recently marketed drugs, such as biological ones, was shown.

摘要

本研究旨在探究意大利南部银屑病(PsO)和银屑病关节炎(PsA)患者不同治疗线的使用模式。2010年至2018年期间,利用卡塞塔地方卫生部门(LHU)索赔数据库的数据进行了一项回顾性队列研究。识别出所有的PsO或PsA患者。计算了2016年至2018年未接受治疗或接受≥1类药物治疗(即非改善病情抗风湿药物(非DMARDs)、传统合成DMARDs(csDMARDs)、生物药物(bDMARDs)或靶向合成小分子(tsDMARDs))的PsO/PsA患者比例。在使用bDMARDs的患者中,计算从首次登记的PsO/PsA诊断起/从首次使用csDMARD到首次使用bDMARD的中位时间。总体而言,识别出10296名(1.1%)PsO患者和1724名(0.2%)PsA患者。超过一半的PsO患者(n = 5301;51.6%)和15%的PsA患者(n = 251)未接受任何药物治疗。极低比例的PsO患者(n = 121;1.2%)接受了csDMARDs/bDMARDs配药。相反,538名(32.2%)PsA患者接受了bDMARDs治疗。PsO和PsA患者从首次诊断到首次使用bDMARD配药的中位时间分别为54.0(第一四分位数-第三四分位数:30.5-72.2)个月和13.3(第一四分位数-第三四分位数:3.1-43.9)个月。PsO患者从首次使用csDMARD到首次使用bDMARD配药的中位时间[9.2个月(第一四分位数-第三四分位数:5.5-30.0)]比PsA患者[14.5个月(第一四分位数-第三四分位数:8.6-33.5)]短。结果显示,意大利南部一个地方卫生部门存在PsO(PsA的情况要少得多)治疗不足的情况,尤其是对生物制剂等近期上市药物的使用特别少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df6b/8348176/f2d9a86db166/jcm-10-03431-g001.jpg

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