School of Pharmacy, National Defense Medical Center, Taipei, Taiwan.
Department of Clinical Pharmacy, Tri-Service General Hospital Penghu Branch, Penghu, Taiwan.
Clin Exp Dermatol. 2024 Nov 22;49(12):1619-1626. doi: 10.1093/ced/llae260.
Psoriasis, an autoimmune skin condition, affects 2-4% of the global population, with significant prevalence among women of childbearing age. Pregnancy presents challenges in managing psoriasis because of hormonal changes and treatment safety concerns. Understanding treatment patterns in pregnant women is crucial, given limited real-world evidence.
To explore the utilization patterns of medications among pregnant women diagnosed with psoriasis within real-world data, utilizing data sourced from a nationwide database in Taiwan.
This nationwide study utilized Taiwan's National Health Insurance (NHI) database and birth certificate application records. It included registered pregnant women diagnosed with psoriasis from 2005 to 2014. Medication usage was tracked 3 years before conception to 3 years after delivery. Medications were categorized based on Anatomical Therapeutic Chemical codes, and statistical analyses were conducted using SAS software.
In total, 30 267 pregnant women with psoriasis were studied. In total, 11 651 (38.5%) mothers had received ≥ 1 prescription during follow-up (exposed group) and 61.5% (18 616) had never received medication (unexposed group). Demographics and comorbidities were similar between these two groups. Topical corticosteroids were the most prescribed treatment, followed by phototherapy, with systemic drugs and biologics less common. During the study period, 11 096 women with psoriasis had used topical corticosteroids, 3376 had used nonsteroidal topical agents, 218 had used systemic agents or biologics and 519 had received treatment with phototherapy. Medication usage declined during pregnancy, reaching its lowest in the third trimester but rebounded postpartum.
Psoriasis medications, systemic, biological or topical, were largely discontinued during pregnancy, sometimes up to 2 years before and extending postpartum. Research is needed to understand its impact on maternal and child health.
银屑病是一种自身免疫性皮肤疾病，影响全球 2-4%的人口，育龄妇女的患病率较高。由于激素变化和治疗安全性问题，妊娠期间管理银屑病具有挑战性。鉴于现实世界证据有限，了解孕妇的治疗模式至关重要。
利用来自台湾全国性数据库的数据，探索真实世界数据中诊断为银屑病的孕妇的药物使用模式。
这项全国性研究利用了台湾全民健康保险（NHI）数据库和出生证明申请记录。研究包括 2005 年至 2014 年期间确诊为银屑病的注册孕妇。在受孕前 3 年至分娩后 3 年内追踪药物使用情况。根据解剖治疗化学代码对药物进行分类，并使用 SAS 软件进行统计分析。
共研究了 30267 名患有银屑病的孕妇。在随访期间，共有 11651 名（38.5%）母亲至少接受了 1 次处方（暴露组），61.5%（18616 名）从未接受过药物治疗（未暴露组）。两组的人口统计学特征和合并症相似。最常开的治疗药物是局部皮质类固醇，其次是光疗，系统药物和生物制剂较少见。在研究期间，11096 名患有银屑病的女性使用了局部皮质类固醇，3376 名使用了非甾体类局部药物，218 名使用了系统药物或生物制剂，519 名接受了光疗。怀孕期间药物使用量下降，在第三个孕期达到最低水平，但产后又反弹。
银屑病药物治疗，包括系统、生物或局部治疗，在怀孕期间大多被停用，有时甚至在怀孕前 2 年就停止，并且持续到产后。需要研究其对母婴健康的影响。
