Yamaguchi Yukie, Spelman Lynda, Mizutani Yoko, Lukowski Bartosz, Lanzafame Alfred, Smith Annika
Department of Environmental Immuno-Dermatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Veracity Clinical Research and Probity Medical, Queensland, Australia.
Int J Womens Dermatol. 2025 Jan 2;11(1):e189. doi: 10.1097/JW9.0000000000000189. eCollection 2025 Mar.
A psoriasis (PSO) diagnosis may pose specific treatment challenges for women of childbearing age (WoCBA) who are considering pregnancy, are pregnant, or have just given birth.
To report perspectives of WoCBA with PSO regarding pregnancy and dermatologists about the disease management of these women in Australia and Japan.
Online surveys were completed by women aged 18 to 45 years who were pregnant within the past 5 years with moderate to severe PSO and dermatologists.
In Japan ( = 31) and Australia ( = 27), most WoCBA with PSO did not feel adequately informed about pregnancy planning and had concerns regarding the safety of tumor necrosis factor inhibitors (TNFi) when used during pregnancy. Dermatologists (Australia: = 40; Japan: = 97) also had safety concerns around prescribing TNFi during pregnancy, and most were impartial toward or not at all comfortable with prescribing TNFi to women who were pregnant or actively planning pregnancy. Dermatologists felt that more safety data on pregnancy, lactation, and pediatric outcomes 5 years postdelivery would increase their comfort with prescribing TNFi.
Limitations included small respondent size, a lack of formal validation for questionnaires, recall bias among participants, and generalizability of results to all WoCBA with PSO. Response rates of survey participants were also not collected.
Additional safety information can help address concerns about biologic use (including TNFi) in WoCBA, enabling dermatologists to make informed treatment recommendations in such patients.
对于正在考虑怀孕、已怀孕或刚分娩的育龄期女性银屑病（PSO）患者而言，银屑病的诊断可能带来特定的治疗挑战。
报告澳大利亚和日本患有银屑病的育龄期女性对于怀孕的看法，以及皮肤科医生对这些女性疾病管理的看法。
年龄在18至45岁之间、在过去5年内患有中度至重度银屑病且处于孕期的女性以及皮肤科医生完成了在线调查。
在日本（n = 31）和澳大利亚（n = 27），大多数患有银屑病的育龄期女性觉得在怀孕计划方面没有得到充分的信息，并且担心妊娠期间使用肿瘤坏死因子抑制剂（TNFi）的安全性。皮肤科医生（澳大利亚：n = 40；日本：n = 97）也对在孕期开具TNFi存在安全担忧，并且大多数人对于给怀孕或正在积极计划怀孕的女性开具TNFi持中立态度或极不放心。皮肤科医生认为，关于妊娠、哺乳以及产后5年儿童结局的更多安全数据会增加他们开具TNFi时的安心程度。
局限性包括受访者数量少、问卷缺乏正式验证、参与者存在回忆偏倚以及研究结果对所有患有银屑病的育龄期女性的可推广性。调查参与者的回复率也未收集。
更多的安全信息有助于解决育龄期女性对生物制剂（包括TNFi）使用的担忧，使皮肤科医生能够为这类患者做出明智的治疗建议。
