Psoriatic arthritis is a frequent manifestation of psoriasis, and has a high level of impact on physical functioning, work ability and quality of life. However, there have been few studies of the ...epidemiology, development of and risk factors for concomitant psoriatic arthritis in patients with psoriasis. This study analysed data from a German public health insurance database of > 2 million individuals. Factors influencing the development of psoriatic arthritis were determined by descriptively analysing comorbidities and Cox regression modelling. The prevalences of psoriasis and psoriatic arthritis were 2.63% and 0.29% in adults (18+ years) and, respectively, 0.30% and 0.01% in children (0–17 years). The proportion of adult patients with incident psoriasis who developed concomitant psoriatic arthritis within five years after diagnosis of psoriasis (mean 2.3 years) was 2.6%. Cardiovascular diseases are the most frequent comorbidity in patients with psoriasis with or without concomitant psoriatic arthritis. Depression and neurosis/stress disorder were identified as indicators for the development of psoriatic arthritis.
Background: Information on the prevalence of atopic dermatitis (AD) varies greatly, and so far, only a few studies describe the healthcare of patients with AD in Germany. Objective: The aim of the ...study is to describe the prevalence and medications of people with AD in Germany. Methods: Health insurance data for the year 2019 were examined. Prevalence rates, the severity of disease, comorbidities and pharmaceutical supply were analyzed. Insured persons with AD were identified with at least one outpatient or inpatient International Classification Code of Diseases (L20). Results: In 2019, 4.21% 95% CI 4.21-4.22% of insured persons had AD (3.6 million). Women were affected slightly more frequently than men (4.74% 95% CI 4.73-4.74% and 3.64% 95% CI 3.64-3.65%). Adolescents and children under the age of 15 had the highest prevalence of AD compared to other age groups (9.44% 95% CI 9.42-9.46%). Majority of the insured persons with AD were affected by a mild to moderate form of the disease. The most common co-morbidity was infections of the skin (RR 5.00 95% CI 4.97-5.02%). Some patients were treated by a dermatologist, while others by a general practitioner, 39.10% and 36.74%, respectively. Of the anti-inflammatory drugs, systemic glucocorticosteroids preparations were used most frequently and were most frequently prescribed by the general practitioner. With a total of 42,841 prescriptions (1.53%), methotrexate (third-line treatment option) was prescribed more frequently than ciclosporin with 19,628 prescriptions (0.70%) or azathioprine with 25,696 prescriptions (0.92%). Ciclosporin (first-line treatment option) was prescribed much more frequently by a dermatologist (44.00% versus 14.32% by general practitioner). The biological dupilumab was prescribed 30,801 times (1,10%) and was also primarily prescribed by a dermatologist (66.67%). Conclusion: The present results reveal that a specialist treats approximately one-third of the patients with AD and that there is still a drug undersupply in some cases, especially concerning innovative drugs. Keywords: epidemiology, frequency of illness, pharmaceutical supply, neurodermatitis, statutory health insurance
Epidemiology of urticaria in German children Staubach, Petra; Mann, Caroline; Peveling‐ Oberhag, Adriane ...
Journal der Deutschen Dermatologischen Gesellschaft,
July 2021, Letnik:
19, Številka:
7
Journal Article
Recenzirano
Odprti dostop
Summary
Background
To date, robust epidemiological metrics as well as data on comorbidity in pediatric urticaria are lacking. They form the basis for the design of efficient healthcare.
Methods
...Retrospective study to analyze epidemiological data in pediatric urticaria. The analysis is based on routine data of a health insurance company operating throughout Germany (DAK‐Gesundheit). Insured people under 18 years of age who received at least one confirmed outpatient or inpatient urticaria diagnosis according to the ICD‐10 classification in the years 2010 to 2015 were included in the analysis and compared to children without a corresponding diagnosis.
Results
Of 2.3 million insured individuals, 313,581 (13.5 %) were under 18 years of age (153,214 female). Urticaria was diagnosed in 1.7 % of the 313,581 patients. The prevalence of urticaria decreased with age from 3.0 % in the 0–3‐year age group to 1.0 % in the 14–18‐year age group. Boys and girls were almost equally affected in all age groups. Atopic diseases as comorbidity occurred more frequently in children with urticaria than in the control group (16.0 % vs. 8.0 %). Autoimmune diseases, mental health problems, and obesity also occurred more frequently in children with urticaria than in the control group.
Conclusions
The increased prevalence of specific comorbidities in children with urticaria suggests an increased need for screening. Multimodal treatment strategies need to be developed and interdisciplinary collaboration promoted.
Psoriasis (PS) is a chronic inflammatory skin disease, and it increasingly appears also in the elderly population. There is a rising interest in drug therapy for PS, especially for people receiving ...care in nursing homes (NH). Which PS-related drugs are prescribed in the time before nursing home admission (NHA), and to what extent does the supply of drugs change after NHA? Which specialties prescribe PS-related drugs? Statutory health insurance data were examined for people with PS, aged ≥ 65 years, who were newly admitted to a NH in the period 2011–2014 and observed for one year before and after NHA. Changes in prescription prevalence (pre-post comparison) were examined for significant differences. Prescriptions of PS-relevant drugs were measured by defined daily dose and stratified according to the prescribing specialist group. The analysis included 718 insured persons with PS (76.2% female, mean age 83.3 years). Systemic therapeutics played a minor role (pre: 2.6% vs. post: 2.1%) in drug therapy. Topical steroids had a high share of about 40% in the pre–post comparison. Overall, the proportion of people with PS who received treatment remained at a comparable level before and after NHA. A structured assessment of the skin is crucial, specifically in people with cognitive impairment.
Abstract Background and objectives Systemic glucocorticosteroids (SGCs) are used in the short-term treatment of atopic dermatitis (AD), but are not recommended for long-term use since associated with ...severe side effects. This study aimed to characterize the utilization and potentially negative effects of SGC use for AD in German statutory health insurance (SHI) claims data. Patients and methods Cross-sectional and longitudinal analysis of a large nationwide SHI dataset. SGC drug prescriptions and incidences of predefined comorbidities after drug initiation known as potentially harmful side effects were analysed. The SGC use was quantified by 1) the number of quarters with at least one SGC prescription and 2) the defined daily doses (DDD). Adjustments in comparisons were made for age, gender and morbidity. Results The AD prevalence was 4.07% in 2020 (4.12% women, 3.71% men). During this period 9.91% of persons with AD were prescribed SGCs compared with 5.54% in persons without AD (p < 0.01). Prescribing of SGCs was significantly higher in women (10.20% vs.9.42% in men, p=<0.01) and the elderly. AD and sGC prevalence varied regionally. In a three-year follow-up period, 51% of persons with AD receiving a SGC were prescribed SGCs in > 1 quarter and 15% in > 6 quarters. The odds of developing osteoporosis (odds ratio 3.95 approach 1 and 1.80 approach 2) and diabetes (odds ratio 1.90 approach 1 and 1.38 approach 2) were significantly higher in people with AD on sGCS, especially in the frequently prescribed group compared with the rarely prescribed group, regardless of quantified use. Conclusion A considerable number of persons with AD in Germany are prescribed longterm SGCs. The onset of medical conditions known to be harmful effects from steroids was significantly more frequent in SGC “frequently prescribers”, indicating the need for optimized health care.
Alopecia areata (AA) is a chronic, immune-mediated disease characterized by acute-onset hair loss. The hair loss can range from small, circumscribed hairless areas on the scalp to complete loss of ...hair on the head and body hair. However, data on the epidemiology of AA are limited. Current evaluations are lacking in Germany. The aim of this study was to evaluate the epidemiology and comorbidity of AA in Germany based on claims data.
A representative 40% sample of all adults who were insured with a German statutory health insurance company (DAK-Gesundheit) between 2016 and 2020 was evaluated (n = 2.88 million). Based on at least one relevant outpatient or inpatient diagnosis of International Classification of Diseases (ICD)-10 L63, the annual AA prevalence and incidence (ICD-10 L63) were calculated for 2016 to 2020. Different case definitions were used for diagnosis validation. In addition, the occurrence of comorbidities in patients with AA was investigated.
In 2020, AA prevalence was 210 cases per 100 000 and incidence 72 cases per 100 000. Compared with persons without AA, those with AA significantly more often had atopic dermatitis rate ratio (RR) 2.9, pruritus (RR 2.7), lupus erythematosus (RR 2.4), urticaria (RR 2.3) and psoriasis (RR 2.2). Women were affected slightly more often than men (0.2% vs. 0.1%). On a regional level, higher prevalence and incidence rates were found in Brandenburg (prevalence 332 cases per 100 000; incidence 116 cases per 100 000), Hesse (prevalence 344 cases per 100 000; incidence 124 cases per 100 000) and Mecklenburg-Western Pomerania (prevalence 303 cases per 100 000; incidence 111 per 100 000).
AA is a common immune-mediated skin condition with marked regional variations in Germany. For a complete understanding of epidemiology, complementary population-based studies including clinical characteristics of AA are useful.
Zusammenfassung
Hintergrund und Zielsetzung
Es gibt nur wenige Studien zur Epidemiologie der Psoriasis und Psoriasis‐Arthritis in Deutschland. Ziel dieser Studie war es, diese Prävalenz anhand ...verschiedener Falldefinitionen zu schätzen.
Methoden
Es wurden Daten der Gesetzlichen Krankenversicherung (GKV) untersucht (2017 bis 2019). Die Prävalenz wurde anhand von drei verschiedenen Falldefinitionen analysiert und validiert:
(1)
mindestens eine stationäre oder ambulante Diagnose innerhalb eines Jahres
(2)
mindestens zwei ambulante Diagnosen innerhalb eines Jahres
(3)
zusätzlich innerhalb von drei Jahren.
Ergebnisse
Die administrative Prävalenz der Psoriasis inklusive Psoriasis‐Arthritis lag zwischen 1,90% und 2,51%. Bei allen Falldefinitionen nahm die Prävalenz mit dem Alter zu, wobei sie bei der Psoriasis ab einem Alter von 70 Jahren und bei der Psoriasis‐Arthritis ab einem Alter von 65 Jahren sank. Männer waren im höheren Alter häufiger betroffen (p <0,0001), während in der Altersgruppe der unter 20‐Jährigen mehr Mädchen betroffen waren (p = 0,04).
Schlussfolgerung
Die Psoriasis ist eine häufige Hauterkrankung in Deutschland. Die interne Diagnosenvalidierung hat gezeigt, dass in zukünftigen Studien mit GKV‐Routinedaten, je nach Fragestellung, die engen oder weiten Kriterien zur Identifizierung von Patienten mit Psoriasis verwendet werden sollten.
ZusammenfassungHintergrund und ZielsetzungEs gibt nur wenige Studien zur Epidemiologie der Psoriasis und Psoriasis‐Arthritis in Deutschland. Ziel dieser Studie war es, diese Prävalenz anhand ...verschiedener Falldefinitionen zu schätzen.MethodenEs wurden Daten der Gesetzlichen Krankenversicherung (GKV) untersucht (2017 bis 2019). Die Prävalenz wurde anhand von drei verschiedenen Falldefinitionen analysiert und validiert: (1) mindestens eine stationäre oder ambulante Diagnose innerhalb eines Jahres (2) mindestens zwei ambulante Diagnosen innerhalb eines Jahres (3) zusätzlich innerhalb von drei Jahren.ErgebnisseDie administrative Prävalenz der Psoriasis inklusive Psoriasis‐Arthritis lag zwischen 1,90% und 2,51%. Bei allen Falldefinitionen nahm die Prävalenz mit dem Alter zu, wobei sie bei der Psoriasis ab einem Alter von 70 Jahren und bei der Psoriasis‐Arthritis ab einem Alter von 65 Jahren sank. Männer waren im höheren Alter häufiger betroffen (p <0,0001), während in der Altersgruppe der unter 20‐Jährigen mehr Mädchen betroffen waren (p = 0,04).SchlussfolgerungDie Psoriasis ist eine häufige Hauterkrankung in Deutschland. Die interne Diagnosenvalidierung hat gezeigt, dass in zukünftigen Studien mit GKV‐Routinedaten, je nach Fragestellung, die engen oder weiten Kriterien zur Identifizierung von Patienten mit Psoriasis verwendet werden sollten.
Zusammenfassung
Hintergrund und Zielsetzung
Es gibt nur wenige Studien zur Epidemiologie der Psoriasis und Psoriasis‐Arthritis in Deutschland. Ziel dieser Studie war es, diese Prävalenz anhand ...verschiedener Falldefinitionen zu schätzen.
Methoden
Es wurden Daten der Gesetzlichen Krankenversicherung (GKV) untersucht (2017 bis 2019). Die Prävalenz wurde anhand von drei verschiedenen Falldefinitionen analysiert und validiert: (1) mindestens eine stationäre oder ambulante Diagnose innerhalb eines Jahres (2) mindestens zwei ambulante Diagnosen innerhalb eines Jahres (3) zusätzlich innerhalb von drei Jahren.
Ergebnisse
Die administrative Prävalenz der Psoriasis inklusive Psoriasis‐Arthritis lag zwischen 1,90% und 2,51%. Bei allen Falldefinitionen nahm die Prävalenz mit dem Alter zu, wobei sie bei der Psoriasis ab einem Alter von 70 Jahren und bei der Psoriasis‐Arthritis ab einem Alter von 65 Jahren sank. Männer waren im höheren Alter häufiger betroffen (p <0,0001), während in der Altersgruppe der unter 20‐Jährigen mehr Mädchen betroffen waren (p = 0,04).
Schlussfolgerung
Die Psoriasis ist eine häufige Hauterkrankung in Deutschland. Die interne Diagnosenvalidierung hat gezeigt, dass in zukünftigen Studien mit GKV‐Routinedaten, je nach Fragestellung, die engen oder weiten Kriterien zur Identifizierung von Patienten mit Psoriasis verwendet werden sollten.
PDF
