牛皮癣是一种慢性,与实质性身体和心理社会合并症相关的复发性炎性皮肤病。尽管生物制剂为那些对传统治疗无反应的人提供了变革性的治疗优势，最近文献的数据表明，某些人群的治疗严重不足，强调潜在的准入障碍。这篇综述旨在全面阐明生物治疗的障碍，解决当前文献中公认的差距。使用MEDLINE进行了搜索，Embase,和WebofScience调查了阻止未接受生物治疗的银屑病患者获得生物治疗的障碍和差异。然后将紧急主题系统地分为五个主要领域：患者级别，处方级别,医学层面,组织-，和外部环境层面的因素。我们的结果表明，包括年龄增长在内的明显障碍和差距，种族,社会经济地位,农村位置,成本和保险，知识不足，可能会阻碍银屑病患者获得生物治疗。需要进一步研究如何有效解决这些障碍，以优化治疗结果。
Psoriasis is a chronic, relapsing inflammatory skin disorder that is associated with substantial physical and psychosocial comorbidity. Although biologic agents have offered transformative therapeutic advantages to those unresponsive to traditional treatments, data from recent literature indicate significant undertreatment of certain populations, highlighting potential barriers to access. This review aims to comprehensively elucidate barriers to biological therapy, addressing a recognized gap in the current literature. A search was conducted using MEDLINE, Embase, and Web of Science to investigate the obstacles and disparities that prevent access to biologic treatments in biologic-naïve psoriatic patients. Emergent themes were then systematically categorized into five primary domains: patient-level, prescriber-level, medicine-level, organizational-, and external environment-level factors. Our results demonstrate pronounced barriers and disparities encompassing increased age, race, socioeconomic status, rural location, cost and insurance, and insufficient knowledge that may hinder access to biologic treatments among psoriatic patients. Further research on how these barriers can be effectively addressed is needed to optimize treatment outcomes.
