Real-world systemic treatment of patients with psoriasis: A retrospective study based on German claims data

J Dtsch Dermatol Ges. 2023 Jun;21(6):611-619. doi: 10.1111/ddg.15030. Epub 2023 Apr 19.

Abstract

Background and objectives: Psoriasis is a common skin disorder with a high physical and psychological burden for patients. Up to 30% of the patients are candidates for a systemic treatment. The aim of this study was to describe the characteristics and the real-world systemic treatment of psoriasis patients.

Patients and methods: This study was based on German medical claims data. A cross-sectional analysis observed all psoriasis patients in 2020. A longitudinal analysis was conducted, addressing psoriasis patients who newly started a systemic treatment.

Results: In total, 116,507 prevalent psoriasis patients and 13,449 newly treated patients were followed. Of all prevalent patients, 15.2% received systemic treatment in 2020 (8.7% systemic corticosteroids). Of the newly treated patients, 95.2% started with conventional treatment (79.2% systemic corticosteroids), 4.0% with biologics and 0.9% with apremilast. The rate of treatment discontinuation/switch after one year was highest for corticosteroids (91.3%) and lowest for biologics (23.1%).

Conclusions: Around 15% of psoriasis patients in Germany received a systemic treatment, with > 50% of these prescribed systemic corticosteroids. Therefore, we conclude that systemic treatment is not in line with guideline recommendations in a substantial number of observed patients. The lowest discontinuation/switch rates for biologics support their wider use.

Keywords: biologics; burden of disease; corticosteroids; psoriasis; systemic treatment; treatment pathways.

MeSH terms

  • Biological Factors
  • Biological Products* / therapeutic use
  • Cross-Sectional Studies
  • Humans
  • Psoriasis* / drug therapy
  • Psoriasis* / epidemiology
  • Retrospective Studies

Substances

  • Biological Factors
  • Biological Products