title: Patterns of vitamin D analog use for the treatment of psoriasis.
abstract: BACKGROUND
  Psoriasis is a chronic disease that significantly impacts patients' quality of life. It most commonly manifests as localized disease, for which there are various treatment options.
  
  
  OBJECTIVE
  To determine the prescription patterns of topical corticosteroids and vitamin D analogs for the treatment of psoriasis in the United States and how their use has changed over time.
  
  
  METHODS
  Data from the National Ambulatory Medical Care Survey (NAMCS) from 1994 to 2010 were queried for visits linked with a psoriasis diagnosis. Prescriptions for topical corticosteroids and vitamin D analogs were described. Vitamin D analogs usage was compared across physician specialties. For each sampled visit reported in the NAMCS, visits meeting our inclusion criteria that also mentioned the following medications were identified: topical calcipotriene, topical calcipotriene/betamethasone or any topical corticosteroid indicated for the treatment of psoriasis.
  
  
  RESULTS
  There were an estimated 2.05 million psoriasis visits per year over the 1994-2010 interval. Dermatologists were responsible for 67% of these encounters followed by family practice (14%) and internal medicine (11%). Dermatologists prescribed a vitamin D product at 15% of psoriasis visits, followed by family physicians at 12%, and internists at 5%. Dermatologists prescribed calcipotriene, calcipotriene/betamethasone, and topical corticosteroids in 15%, 4% and 59% of psoriasis visits, respectively. Over time, there was no significant change in the use of topical steroids or vitamin D products by physicians.This study is limited by the inability to determine the severity of psoriasis from the data collected, and the lack of data on the length of treatment with different medications.
  
  
  CONCLUSIONS
  Despite their demonstrated efficacy and safer side effect profile, vitamin D analogs are used less often than topical corticosteroids for the treatment of psoriasis. These findings suggest that vitamin D products may not be utilized to their fullest potential as effective topical therapy or adjuncts to therapy for localized plaque psoriasis.
authors.forename: Christine S
authors.initials: CS
authors.lastname: Ahn
authors.forename: Farah
authors.initials: F
authors.lastname: Awadalla
authors.forename: Karen E
authors.initials: KE
authors.lastname: Huang
authors.forename: Brad
authors.initials: B
authors.lastname: Yentzer
authors.forename: Tushar S
authors.initials: TS
authors.lastname: Dabade
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
mesh_terms: D000279:Administration, Cutaneous; D001623:Betamethasone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002117:Calcitriol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology; D013997:Time Factors; D014481:United States; D014807:Vitamin D / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D003879:Dermatologic Agents; D005938:Glucocorticoids; D014807:Vitamin D; C055085:calcipotriene; D001623:Betamethasone; D002117:Calcitriol