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Increasing use of more potent treatments for psoriasis - 08/08/11

Doi : 10.1016/j.jaad.2008.10.055 
Lindsay C. Strowd, BS a, Brad A. Yentzer, MD a, Alan B. Fleischer, MD a, Steven R. Feldman, MD, PhD a, b, c,
a Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 
b Center for Dermatology Research, Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 
c Center for Dermatology Research, Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina 

Correspondence to: Steven R. Feldman, MD, PhD, Department of Dermatology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157-1071.

Abstract

Background

Psoriasis therapy has evolved during the past 25 years as newer and more effective medications become available. Furthermore, various combination regimens and approaches have been advocated.

Objective

We sought to describe patterns of psoriasis treatment from 1986 to 2005.

Methods

Visits to dermatologists for treatment of psoriasis were identified using National Ambulatory Medical Care Survey data, a representative survey of visits to physician offices in the United States. We focused on medications listed at these visits during the 1986-to-2005 interval to determine how treatment for psoriasis has changed.

Results

There were an estimated 23.9 million visits for psoriasis during the 20-year study period. As a category, the most common medications used for psoriasis were topical steroids. Dermatologists are prescribing more potent topical steroids compared with nondermatologists. The use of these potent drugs has increased from 1986 to 2005. There has been growing use of systemic treatments, with biologic therapies introduced in the 2001-to-2005 time period.

Limitations

National Ambulatory Medical Care Survey data represent national trends in psoriasis treatment and cannot be used to evaluate smaller subpopulations of patients with psoriasis. These data are used to speculate why certain trends in treatment are seen.

Conclusion

The primary treatment for psoriasis in the late 1980s and early 1990s was mid-potency corticosteroids. Since then, the primary therapies for psoriasis have evolved to include class I ultrapotent topical corticosteroids, vitamin-D analogs, and systemic medications such as methotrexate and biologic agents. These changes in psoriasis management are consistent with patient desire for better disease control.

Le texte complet de cet article est disponible en PDF.

Key words : biologic agents, calcipotriene, corticosteroids, methotrexate, psoriasis, NAMCS, treatment


Plan


 The Center for Dermatology Research is supported by an educational grant from Galderma Laboratories LP.
 Disclosure: Dr Feldman has received research, speaking, and/or consulting support from Galderma, Abbott Labs, Warner Chilcott, Aventis Pharmaceuticals, 3M, Connetics, Roche, Amgen, Biogen, and Genentech. Dr Fleischer has received research, speaking, and/or consulting support from Astellas, Centocor, Amgen, Abbott, Galderma, Stiefel, Medicis, and Intendis. Mrs Strowd and Dr Yentzer have no conflicts of interest to declare.
 Reprints not available from the authors.


© 2008  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 60 - N° 3

P. 478-481 - mars 2009 Retour au numéro
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