von Kiedrowski Ralph, Metz Martin, Weisshaar Elke, Albrecht Inka, Schild Marie, Ständer Sonja
Company for Medical Study & Service Selters and Private Practice Dermatology, Selters/Westerwald, Germany.
Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
J Dtsch Dermatol Ges. 2025 Jul;23(7):844-855. doi: 10.1111/ddg.15721. Epub 2025 Jun 8.
Knowledge on patient care gaps of prurigo nodularis (PN) is limited. This retrospective chart review (ADVANCE PN) investigated unmet medical needs and gaps in diagnostics, treatment, and management of patients with PN in routine care in Germany.
Medical records for adults newly diagnosed with PN between January 2012 and December 2022 from dermatologic clinics and office-based dermatologists were analyzed. Baseline demographics, treatment patterns, diagnostics, symptoms, patient-reported outcomes (PROs), and disease-specific scores are reported.
Records of 363 patients from 42 sites were analyzed. Median age (range) was 67 (19-95) years; most patients were female (61.7%), Caucasian (73.4%), and retired (57.3%). Overall, 209 (62.2%) patients had comorbidities (most common: hypertension [28.3%]). Clinically, most patients had nodules (81.1%) or papules (66.7%). PROs, disease-specific scores, and laboratory assessments were performed for 32 (8.8%), 12 (3.3%), and 71 (19.7%) patients, respectively. Topical corticosteroids (TCS) were the most common overall (90.9%) and first-line therapy (84.9%); for second-line therapy, 'no further treatment' was most commonly documented (58.6%).
The findings of ADVANCE PN indicate a high unmet need in the current state of medical care, evidenced by shortcomings in PRO assessment, PN documentation, and adherence to guidelines on PN.
关于结节性痒疹（PN）患者护理差距的知识有限。这项回顾性图表审查（ADVANCE PN）调查了德国常规护理中PN患者未满足的医疗需求以及诊断、治疗和管理方面的差距。
分析了2012年1月至2022年12月期间皮肤科诊所和门诊皮肤科医生新诊断为PN的成年患者的病历。报告了基线人口统计学、治疗模式、诊断、症状、患者报告结局（PROs）和疾病特异性评分。
分析了来自42个地点的363例患者的记录。中位年龄（范围）为67（19 - 95）岁；大多数患者为女性（61.7%）、白种人（73.4%）且已退休（57.3%）。总体而言，209例（62.2%）患者有合并症（最常见的是高血压[28.3%]）。临床上，大多数患者有结节（81.1%）或丘疹（66.7%）。分别对32例（8.8%）、12例（3.3%）和71例（19.7%）患者进行了PROs、疾病特异性评分和实验室评估。外用糖皮质激素（TCS）是最常用的总体治疗方法（90.9%）和一线治疗方法（84.9%）；对于二线治疗，最常记录的是“不再进一步治疗”（58.6%）。
ADVANCE PN的研究结果表明，目前医疗护理状况存在高度未满足的需求，PRO评估、PN记录以及对PN指南的遵循方面的不足证明了这一点。
