Does the treatment ladder for systemic therapy in moderate to severe psoriasis only go up? The percentage of patients with severe psoriasis on biologics increases over time

摘要: Abstract Background With the advent of biologic drugs in management moderate to severe psoriasis, there may have been a shift therapeutic approach from rotational strategies unidirectional progression topical treatments highest rung ladder. We studied frequency switching classic therapy and vice versa cohort patients with psoriasis over period up 5 years. Methods Patients are included BIOBADADERM prospective registry when they first prescribed any specific conventional or systemic treatment. The data for each patient refer follow-up time entered until October 2013. To describe pattern switches versa, we used on day every 365-day following date was cohort. Results In total, 47.3% (926/1956) were drug 52.7% (1030/1956) agent entry into study. Of 741 who accumulated years follow-up, 21.9% (155) receiving nonbiologic 78.1% (553) their 5th year follow-up. Conclusions proportion increased longer