The Impact of Age on Psoriasis Health Care in Germany

TY - JOUR

T1 - The Impact of Age on Psoriasis Health Care in Germany

AU - Trettel, A

AU - Spehr, C

AU - Körber, Andreas

AU - Augustin, M

N1 - © 2017 European Academy of Dermatology and Venereology.

PY - 2017/5

Y1 - 2017/5

N2 - INTRODUCTION: Inequality between age groups has been demonstrated in the prescription of biologics, yet systematic real-world data about age-related differences in psoriasis care are missing.OBJECTIVE: To investigate disparities in psoriasis characteristics by age groups and to identify potential impact on psoriasis health care.PATIENTS AND METHODS: Data analysis included 3615 patients from the German psoriasis registry PsoBest, which observes adult patients with moderate-to-severe psoriasis or psoriatic arthritis (PsA) on systemic treatment over a time period of 10 years.RESULTS: With 2376 participants (65.7%), the majority of patients was assigned to the age group 35-64, followed by 776 (21.4%) and 463 (12.8%) for the age groups 18-34 and 65+, respectively. Psoriasis vulgaris was the most frequent form of psoriasis with nearly 90% patients affected. Appearance of psoriasis forms did not differentiate significantly between the age groups except for erythrodermic psoriasis, which was more frequent in the elderly than in patients aged 35-64 (1.9%, P ≤ 0.048). Nail psoriasis appeared significantly more often in patients aged 35-64 (55.5%, P ≤ 0.001) and also showed the highest number of nails involved (6.9 ± 3.3). PsA was less frequent in the age group 18-34 (9.5%, P ≤ 0.001). This group showed the highest rate of scalp psoriasis (85.8%) compared to the elder age groups (P ≤ 0.001). Biologicals were used significantly less in younger patients (16.2%) compared to the age groups 35-64 (23.9%, P ≤ 0.001) and 65+ (21.8%, P ≤ 0.042).CONCLUSION: Middle-aged patients show higher rates of PsA and nail psoriasis, which may explain age-dependent disparities in health care including the use of systemic treatment.

AB - INTRODUCTION: Inequality between age groups has been demonstrated in the prescription of biologics, yet systematic real-world data about age-related differences in psoriasis care are missing.OBJECTIVE: To investigate disparities in psoriasis characteristics by age groups and to identify potential impact on psoriasis health care.PATIENTS AND METHODS: Data analysis included 3615 patients from the German psoriasis registry PsoBest, which observes adult patients with moderate-to-severe psoriasis or psoriatic arthritis (PsA) on systemic treatment over a time period of 10 years.RESULTS: With 2376 participants (65.7%), the majority of patients was assigned to the age group 35-64, followed by 776 (21.4%) and 463 (12.8%) for the age groups 18-34 and 65+, respectively. Psoriasis vulgaris was the most frequent form of psoriasis with nearly 90% patients affected. Appearance of psoriasis forms did not differentiate significantly between the age groups except for erythrodermic psoriasis, which was more frequent in the elderly than in patients aged 35-64 (1.9%, P ≤ 0.048). Nail psoriasis appeared significantly more often in patients aged 35-64 (55.5%, P ≤ 0.001) and also showed the highest number of nails involved (6.9 ± 3.3). PsA was less frequent in the age group 18-34 (9.5%, P ≤ 0.001). This group showed the highest rate of scalp psoriasis (85.8%) compared to the elder age groups (P ≤ 0.001). Biologicals were used significantly less in younger patients (16.2%) compared to the age groups 35-64 (23.9%, P ≤ 0.001) and 65+ (21.8%, P ≤ 0.042).CONCLUSION: Middle-aged patients show higher rates of PsA and nail psoriasis, which may explain age-dependent disparities in health care including the use of systemic treatment.

KW - Journal Article

U2 - 10.1111/jdv.14115

DO - 10.1111/jdv.14115

M3 - SCORING: Journal article

C2 - 28079929

VL - 31

SP - 870

EP - 875

JO - J EUR ACAD DERMATOL

JF - J EUR ACAD DERMATOL

SN - 0926-9959

IS - 5

ER -