United States systemic psoriasis treatments: increases in the use of biologic agents and plateau of methotrexate and oral small molecule inhibitors

Abstract

Objectives The systemic drug choices for psoriasis have been increasing due to a greater understanding of the pathophysiology of the disease. In this setting of increasing drug availability, it is unknown how the use of different agents in psoriasis is changing. This study examines changes in prescribing trends for systemic therapy in patients with psoriasis. Methods We analyzed the United States National Ambulatory Medical Care Survey data from 2007 to 2016 for visits in which psoriasis was the primary diagnosis and patients were treated with approved systemic medications. Weighting factors were used to provide nationally representative estimates. Results We found 20 (19, 21) million office visits during the 10-year study period. There was found to be no significant difference in the use of systemic agents by age (p = .3), race (p = .7) or sex (p = .2). The use of systemic agents (p = .002) and biologic agents (p = .003) had increased over time. There was no significant trend over time for the use of methotrexate (p = .5) or oral small molecule inhibitors (p = .3). Conclusions This study suggests that in the United States the use of biologic and systemic agents overall has increased. The use of methotrexate and oral small molecule inhibitors overall has not changed.