Sorbe Christina, Kargin Secilay, von Kiedrowski Ralph, Thaci Diamant, Weyergraf Ansgar, Blome Christine, Augustin Matthias, Stephan Brigitte
Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Medical Study & Service Selters GmbH, Selters (Westerwald), Germany.
Psoriasis (Auckl). 2025 May 30;15:197-207. doi: 10.2147/PTT.S524083. eCollection 2025.
Plaque-type psoriasis (PSO) is a chronic inflammatory systemic skin disease. Psoriatic arthritis (PsA) is a frequent component requiring early treatment to prevent joint damage. Guidelines recommend differentiated drug decisions for both conditions.
Descriptive analysis of drug choices for patients with PSO with or without additional PsA of the German Psoriasis registry PsoBest from 2007 to 2022.
The analysis comprises data of 17,310 patients with PSO: 18,6% with additional PsA (PSO+PsA), mean age 47.6 (± 14.8) years, 58.8% male, mean duration of PSO 16.4 years in patients without PsA (PSO-PsA; ± 14.3), 20.6 years in PSO+PsA (± 15.3, p < 0.001). PSO-PsA and PSO+PsA patients showed a marked burden of disease: PASI (15.7 (± 10.1) and 13.9 (± 10.6, p < 0.001)); DLQI (11.7 (± 7.2) and 12.3 (± 7.6; p < 0.001)). Before registry entry, 47.0% of patients received no systemic antipsoriatic treatment. Prior systemic medications were mainly non-biologics (40.4%), 12.6% were biologics, with a significantly higher rate in PSO+PsA patients (24.7% vs 9.8%). At registry baseline, the majority of the patients received non-biologic treatment (55.9%), with significantly higher rates for PSO-PsA patients (55.9% vs 34.8%). Biologics were used in 43.9% of all patients, with a significantly higher rate in PSO+PsA patients (65.9% vs 38.8%). Three hundred and three (9.4%) of PSO+PsA patients received treatments at baseline with approval for PSO, but not explicitly for PsA. Those patients had minor active joint involvement.
Early and effective treatment of PsA is crucial to prevent persistent damage of the joints. Although most patients received recommended systemic treatment for PSO+PsA, there is a small number of patients with prescriptions addressing mainly the inflammation of the skin and not explicitly PsA. To choose recommended medication for both entities we need to regard the entire systemic inflammation and interdisciplinary co-working should be implemented.
斑块型银屑病（PSO）是一种慢性炎症性全身性皮肤病。银屑病关节炎（PsA）是常见的伴随病症，需要早期治疗以防止关节损伤。指南建议针对这两种病症做出差异化的药物决策。
对2007年至2022年德国银屑病登记处PsoBest中伴有或不伴有额外PsA的PSO患者的药物选择进行描述性分析。
该分析涵盖了17310例PSO患者的数据：18.6%伴有额外的PsA（PSO+PsA），平均年龄47.6（±14.8）岁，58.8%为男性，无PsA的患者（PSO-PsA）的PSO平均病程为16.4年（±14.3），PSO+PsA患者为20.6年（±15.3，p<0.001）。PSO-PsA和PSO+PsA患者均表现出明显的疾病负担：银屑病面积和严重程度指数（PASI）分别为15.7（±10.1）和13.9（±10.6，p<0.001）；皮肤病生活质量指数（DLQI）分别为11.7（±7.2）和12.3（±7.6；p<0.001）。在登记入组前，47.0%的患者未接受过全身性抗银屑病治疗。先前使用的全身性药物主要是非生物制剂（40.4%），12.6%是生物制剂，PSO+PsA患者的比例显著更高（24.7%对9.8%）。在登记基线时，大多数患者接受非生物治疗（55.9%），PSO-PsA患者的比例显著更高（55.9%对34.8%）。43.9%的患者使用生物制剂，PSO+PsA患者的比例显著更高（65.9%对38.8%）。303例（9.4%）PSO+PsA患者在基线时接受的治疗获批用于PSO，但未明确用于PsA。这些患者的关节受累较轻。
早期有效治疗PsA对于预防关节持续性损伤至关重要。尽管大多数患者接受了针对PSO+PsA的推荐全身性治疗，但仍有少数患者的处方主要针对皮肤炎症，而未明确针对PsA。为这两种病症选择推荐药物时，我们需要考虑整体全身性炎症，并且应实施跨学科协作。
