Abstract：
BACKGROUND: This study evaluated patient characteristics and treatment patterns according to weight in pediatric patients with psoriasis in a real-world setting.
METHODS: Primary care and specialist physicians treating pediatric patients with psoriasis aged 6-17 years in five European countries were surveyed in the 2019-2020 Adelphi Real World Pediatric Psoriasis Disease Specific Programme. At least two patients with current or previous biologic use were included per physician. Patient characteristics and treatment patterns were analyzed overall and for patients weighing 25-50 kg or more than 50 kg.
RESULTS: Data from 772 patients weighing 25-50 kg and 1147 weighing more than 50 kg were analyzed. Median age at diagnosis was significantly less in lighter than heavier patients (10.0 vs. 14.0 years; p < 0.001), as was median disease duration (2.2 vs. 3.0 years; p < 0.001). Topical treatments were prescribed in 59.0% of patients overall (70.3% of lighter and 51.4% of heavier patients; p < 0.001), and were used to treat mild rather than moderate-to-severe psoriasis. Conventional systemic use was low (10.8% of patients overall) and predominantly for moderate-to-severe psoriasis. In this biologic-enriched sample, most biologics (78.2%) were prescribed in older (> 13 years) patients. Biologic use increased with line of therapy (6.6% of first-line, 18.0% of second-line, 33.7% of third-line, 44.7% of fourth-line treatments).
CONCLUSIONS: Biologics are predominantly prescribed in older (> 13 years) and heavier (> 50 kg) patients, with little first- or second-line use. The low use of biologics in European pediatric patients with psoriasis may represent an unmet treatment need, as topical or conventional systemic agents remain the main treatment option for moderate or severe psoriasis in these patients through the treatment pathway.
This study looked into types of treatments according to body weight in children with psoriasis, since approved dosing regimens for some treatments are based on body weight. Primary care and specialist physicians treating children with psoriasis aged 6–17 years in five European countries completed a survey. Patient information for those receiving specific types of psoriasis treatments were collected. Of the children included, 772 weighed 25–50 kg and 1147 weighed more than 50 kg. Most children received treatments applied to the skin, such as creams and ointments; this occurred in 70% of lighter patients and in 51% of heavier patients. Conventional treatments taken via the mouth were prescribed in a few patients (11% [overall]), while newer biologic drugs were taken to a greater extent in heavier (30%) than lighter (16%) patients. Most biologics (78%) were prescribed in older (> 13 years) patients. Biologic use increased with the number of failed previous treatments, comprising 7%, 18%, 34%, and 45% of first, second, third, and fourth treatments, respectively. We conclude that children with psoriasis who are treated with biologic drugs are predominantly older and heavier, and have more severe psoriasis. Prescriptions for biologics are given after many other treatments have been tried.
METHODS: Primary care and specialist physicians treating pediatric patients with psoriasis aged 6-17 years in five European countries were surveyed in the 2019-2020 Adelphi Real World Pediatric Psoriasis Disease Specific Programme. At least two patients with current or previous biologic use were included per physician. Patient characteristics and treatment patterns were analyzed overall and for patients weighing 25-50 kg or more than 50 kg.
RESULTS: Data from 772 patients weighing 25-50 kg and 1147 weighing more than 50 kg were analyzed. Median age at diagnosis was significantly less in lighter than heavier patients (10.0 vs. 14.0 years; p < 0.001), as was median disease duration (2.2 vs. 3.0 years; p < 0.001). Topical treatments were prescribed in 59.0% of patients overall (70.3% of lighter and 51.4% of heavier patients; p < 0.001), and were used to treat mild rather than moderate-to-severe psoriasis. Conventional systemic use was low (10.8% of patients overall) and predominantly for moderate-to-severe psoriasis. In this biologic-enriched sample, most biologics (78.2%) were prescribed in older (> 13 years) patients. Biologic use increased with line of therapy (6.6% of first-line, 18.0% of second-line, 33.7% of third-line, 44.7% of fourth-line treatments).
CONCLUSIONS: Biologics are predominantly prescribed in older (> 13 years) and heavier (> 50 kg) patients, with little first- or second-line use. The low use of biologics in European pediatric patients with psoriasis may represent an unmet treatment need, as topical or conventional systemic agents remain the main treatment option for moderate or severe psoriasis in these patients through the treatment pathway.
This study looked into types of treatments according to body weight in children with psoriasis, since approved dosing regimens for some treatments are based on body weight. Primary care and specialist physicians treating children with psoriasis aged 6–17 years in five European countries completed a survey. Patient information for those receiving specific types of psoriasis treatments were collected. Of the children included, 772 weighed 25–50 kg and 1147 weighed more than 50 kg. Most children received treatments applied to the skin, such as creams and ointments; this occurred in 70% of lighter patients and in 51% of heavier patients. Conventional treatments taken via the mouth were prescribed in a few patients (11% [overall]), while newer biologic drugs were taken to a greater extent in heavier (30%) than lighter (16%) patients. Most biologics (78%) were prescribed in older (> 13 years) patients. Biologic use increased with the number of failed previous treatments, comprising 7%, 18%, 34%, and 45% of first, second, third, and fourth treatments, respectively. We conclude that children with psoriasis who are treated with biologic drugs are predominantly older and heavier, and have more severe psoriasis. Prescriptions for biologics are given after many other treatments have been tried.
摘要：
背景：这项研究评估了在真实世界环境中，根据体重评估小儿银屑病患者的特征和治疗模式。
方法：在2019-2020年AdelphiRealWorld儿科银屑病特定计划中，对五个欧洲国家的6-17岁小儿银屑病患者的初级保健和专科医师进行了调查。每位医师包括至少两名当前或先前使用生物制剂的患者。总体分析患者特征和治疗模式,并分析体重25-50kg或超过50kg的患者。
结果：分析了772名体重25-50公斤的患者和1147名体重超过50公斤的患者的数据。较轻的患者诊断时的中位年龄明显小于较重的患者（10.0vs.14.0年；p<0.001)，疾病持续时间中位数（2.2vs.3.0年；p<0.001)。59.0%的患者接受了局部治疗(70.3%的较轻患者和51.4%的较重患者;p<0.001)。用于治疗轻度而非中度至重度银屑病。常规的全身使用较低（占总体患者的10.8％），主要用于中重度银屑病。在这个富含生物的样本中，大多数生物制剂(78.2%)是在老年(>13岁)患者中开的.随着治疗线的增加，生物制剂的使用增加(一线的6.6%，二线的18.0%，三线的33.7%，四线治疗的44.7%）。
结论：生物制剂主要用于年龄较大（>13岁）和较重（>50公斤）的患者，很少使用一线或二线。欧洲小儿牛皮癣患者生物制剂的低使用可能代表未满足的治疗需求，因为局部或常规全身药物仍然是这些患者通过治疗途径治疗中度或重度银屑病的主要选择。
这项研究根据牛皮癣儿童的体重调查了治疗类型。因为某些治疗的批准给药方案是基于体重。在五个欧洲国家/地区治疗6-17岁牛皮癣儿童的初级保健和专科医生完成了一项调查。收集接受特定类型银屑病治疗的患者的患者信息。包括孩子们,772重25-50公斤，1147重50公斤以上。大多数儿童接受皮肤治疗，例如乳膏和软膏;这发生在70％的较轻患者和51％的较重患者中。少数患者(11%[总体])通过口腔进行常规治疗。而较重（30％）的患者比较轻（16％）的患者服用较新的生物药物的程度更高。大多数生物制剂（78％）是在老年（>13岁）患者中使用的。随着先前治疗失败的数量增加，生物使用增加，包括7%，18%,34%,45%的第一,第二,第三,第四种治疗方法，分别。我们得出的结论是，接受生物药物治疗的牛皮癣儿童主要年龄较大，体重较重，并有更严重的牛皮癣。在尝试了许多其他治疗方法之后，才给出了生物制剂的处方。
方法：在2019-2020年AdelphiRealWorld儿科银屑病特定计划中，对五个欧洲国家的6-17岁小儿银屑病患者的初级保健和专科医师进行了调查。每位医师包括至少两名当前或先前使用生物制剂的患者。总体分析患者特征和治疗模式,并分析体重25-50kg或超过50kg的患者。
结果：分析了772名体重25-50公斤的患者和1147名体重超过50公斤的患者的数据。较轻的患者诊断时的中位年龄明显小于较重的患者（10.0vs.14.0年；p<0.001)，疾病持续时间中位数（2.2vs.3.0年；p<0.001)。59.0%的患者接受了局部治疗(70.3%的较轻患者和51.4%的较重患者;p<0.001)。用于治疗轻度而非中度至重度银屑病。常规的全身使用较低（占总体患者的10.8％），主要用于中重度银屑病。在这个富含生物的样本中，大多数生物制剂(78.2%)是在老年(>13岁)患者中开的.随着治疗线的增加，生物制剂的使用增加(一线的6.6%，二线的18.0%，三线的33.7%，四线治疗的44.7%）。
结论：生物制剂主要用于年龄较大（>13岁）和较重（>50公斤）的患者，很少使用一线或二线。欧洲小儿牛皮癣患者生物制剂的低使用可能代表未满足的治疗需求，因为局部或常规全身药物仍然是这些患者通过治疗途径治疗中度或重度银屑病的主要选择。
这项研究根据牛皮癣儿童的体重调查了治疗类型。因为某些治疗的批准给药方案是基于体重。在五个欧洲国家/地区治疗6-17岁牛皮癣儿童的初级保健和专科医生完成了一项调查。收集接受特定类型银屑病治疗的患者的患者信息。包括孩子们,772重25-50公斤，1147重50公斤以上。大多数儿童接受皮肤治疗，例如乳膏和软膏;这发生在70％的较轻患者和51％的较重患者中。少数患者(11%[总体])通过口腔进行常规治疗。而较重（30％）的患者比较轻（16％）的患者服用较新的生物药物的程度更高。大多数生物制剂（78％）是在老年（>13岁）患者中使用的。随着先前治疗失败的数量增加，生物使用增加，包括7%，18%,34%,45%的第一,第二,第三,第四种治疗方法，分别。我们得出的结论是，接受生物药物治疗的牛皮癣儿童主要年龄较大，体重较重，并有更严重的牛皮癣。在尝试了许多其他治疗方法之后，才给出了生物制剂的处方。
