Psoriasis in the US Medicare Population: Prevalence, Treatment, and Factors Associated with Biologic Use.
Psoriasis in the US Medicare Population: Prevalence, Treatment, and Factors Associated with Biologic Use.
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DOI：
10.1038/jid.2015.296
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发表时间：
2015-12
期刊：
影响因子：
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通讯作者：
Doshi JA
中科院分区：
文献类型：
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作者：
Takeshita J;Gelfand JM;Li P;Pinto L;Yu X;Rao P;Viswanathan HN;Doshi JA
牛皮癣是一种常见的慢性炎性疾病，主要发生在皮肤上。尽管人口老龄化，银屑病的流行病学知识和治疗的老年人是有限的。我们研究了牛皮癣的患病率及其治疗方法，重点是生物制剂和确定与生物制剂使用相关的因素，使用了2011年全国代表性的医疗保险受益人样本。基于几种牛皮癣识别算法，美国基于索赔的牛皮癣患病率为0.51%至1.23%。27.3%的银屑病患者接受了中度至重度银屑病的治疗（光疗、口服全身或生物疗法），其中37.2%的患者使用了生物制剂。没有医疗保险D部分低收入补贴的患者比有低收入补贴的患者接受生物制剂的几率低70%（优势比0.30；95%可信区间0.19 - 0.46）。同样，黑人患者接受生物制剂的几率比白人患者低69%（0.31;0.16-0.60）。该分析确定了接受生物疗法的潜在经济和种族障碍，并强调需要进一步研究以进一步确定老年人牛皮癣的流行病学和治疗方法。
Psoriasis is a common chronic inflammatory disorder, primarily of the skin. Despite an aging population, knowledge of the epidemiology of psoriasis and its treatments among the elderly is limited. We examined the prevalence of psoriasis and its treatments, with a focus on biologics and identification of factors associated with biologic use, using a nationally representative sample of Medicare beneficiaries in 2011. Based on several psoriasis identification algorithms, the claims-based prevalence for psoriasis in the United States ranged from 0.51% to 1.23%. Treatments employed for moderate to severe psoriasis (phototherapy, oral systemic, or biologic therapies) were received by 27.3% of the total psoriasis sample, of whom 37.2% used biologics. Patients without Medicare Part D low-income subsidies had 70% lower odds of having received biologics than those with low-income subsidies (odds ratio 0.30; 95% confidence interval, 0.19– 0.46). Similarly, the odds of having received biologics was 69% lower among black patients than white patients (0.31; 0.16–0.60). This analysis identified potential financial and racial barriers to receipt of biologic therapies and underscores the need for additional studies to further define the epidemiology and treatment of psoriasis among the elderly.