title: Systemic corticosteroids are frequently prescribed for psoriasis.
abstract: BACKGROUND
  The use of systemic corticosteroids is discouraged in major psoriasis treatment guidelines.
  
  
  OBJECTIVE
  Our objective was to assess how often systemic corticosteroids are prescribed for psoriasis and trends in their use over time.
  
  
  METHODS
  We used National Ambulatory Medical Care Survey (NAMCS) data to determine the systemic medications prescribed for psoriasis from 1989 to 2010. We confirmed the findings by analysis of 2003-2007 MarketScan Medicaid data.
  
  
  RESULTS
  Systemic corticosteroids were prescribed at 650,000 (95% CI 380,000-920,000) of 21,000,000 psoriasis visits; 93% of these visits were to dermatologists. Of the top nine systemic medications listed at psoriasis visits, three of them were corticosteroids. Corticosteroids were the second most commonly prescribed systemic medication for psoriasis. No significant change in the use of systemic corticosteroids for psoriasis over time was observed (p  =  .27). In the MarketScan data, prednisone was prescribed more commonly than either methotrexate or etanercept.
  
  
  CONCLUSIONS
  Corticosteroid doses and the length of treatment were not recorded in the NAMCS data.
  
  
  CONCLUSIONS
  Systemic corticosteroids are among the most common systemic treatments used for psoriasis despite current guidelines. Data are acutely needed on the risks and benefits so that physicians and patients can make evidence-based decisions about their use.
authors.forename: Amir
authors.initials: A
authors.lastname: Al-Dabagh
authors.forename: Rana
authors.initials: R
authors.lastname: Al-Dabagh
authors.forename: Scott A
authors.initials: SA
authors.lastname: Davis
authors.forename: Arash
authors.initials: A
authors.lastname: Taheri
authors.forename: Hsien-Chang
authors.initials: HC
authors.lastname: Lin
authors.forename: Rajesh
authors.initials: R
authors.lastname: Balkrishnan
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
mesh_terms: D000465:Algorithms; D005938:Glucocorticoids / Q000627:therapeutic use*; D019538:Health Care Surveys; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011565:Psoriasis / Q000188:drug therapy*; D014481:United States
chemical_list: D005938:Glucocorticoids