1. Use of topical antipsoriatic drugs in Denmark: A nationwide drug utilization study
M. T. Svendsen1,2*,, M.T. Ernst3*, K. E. Andersen1,2,4, F. Andersen1,4, H. Johannessen5, A. Pottegård3
1Dept. of Dermatology and Allergy Centre, Odense University Hospital, Odense, DK 2Centre for Innovative Medical Technology (CIMT), Clinical Institute, University of Southern Denmark, Odense, DK 3Clinical Pharmacology and Pharmacy, Dept. of Public Health, University of Southern Denmark, Odense, DK 4Dermatological Investigations Scandinavia, University of Southern Denmark, Odense, DK 5Research Unit of User Perspectives, Dept. of Public Health, University of Southern Denmark, Odense, DK
*These authors contributed equally to the work.
British Journal of Dermatology. DOI: /bjd.17074

2. Mathias Tiedemann Svendsen Martin Thomsen Ernst Anton Pottegård
Lead researchers
Mathias Tiedemann Svendsen Martin Thomsen Ernst Anton Pottegård

3. Introduction What’s already known?
The use of topical drugs for treatment of psoriasis shows considerable heterogeneity worldwide
Persistence to topical treatment in psoriasis patients is low
Psoriasis is associated with several co-morbidities, such as hypertension, hyperlipidemia, congestive heart failure, ischemic heart disease, diabetes mellitus and depression

4. Objectives
To investigate the use of topical antipsoriatic drugs among psoriasis patients in Denmark
To report psoriasis-associated comorbidities
To describe the use of concomitant antipsoriatic treatments

5. Method: Data sources
Data were extracted from the Danish health registries
Population data were obtained and linked by Statistics Denmark
Collected data was linked using a unique identifier that is assigned to all Danish residents

6. Methods – Data selection
Prescription data was obtained from:
Patients aged > 18 years consulted with psoriasis at a hospital dermatology clinic in Denmark
Study period: January 1, 2005 to December 31, 2015

7. Methods – Procedure
Data from each patient used from 1 year prior to the date of psoriasis diagnosis through 3 years after diagnosis
The study period was divided into 3:
, , and
Data was analysed by descriptive statistics

8. Results
The most frequently used topical drugs was corticosteroid with calcipotriol
25% of patients used 70% of the total amount of topical drugs
The most frequent comorbidities were hypertension (20-26%), hyperlipidemia (13-16%) and depression/anxiety (8-12%)
The use of biologics fluctuated between 2.3 and 6%, the use of methotrexate increased from 9.6 to 17%, while the use of phototherapy dropped from 11 to 5.9%

9. Results
The total use of topical antipsoriatic drugs dropped during the study period due to a reduction in the use of corticosteroids with calcipotriol

10. Results
Notice a 89% variation in use of moderate corticosteroids
Mainly similar patterns were observed for the remaining study period
Large regional variation in the use of topical antipsoriatic drugs

11. Discussion
The reduced use of topical drugs may reflect increased use of methotrexate and biologics or a marked reduction in adherence to prescribed treatment
The regional variation reflects local traditions and preferences among physicians
The variation in use among patients reflects heterogeneous clinical expression of psoriasis

12. Discussion - strengths
Use of real-life data
The Danish registries have a high level of completeness and validity
The pattern of drug use were described over several years for the individual patient

13. Discussion - limitations
Lack of data on scoring and monitoring the severity of psoriasis in the patients included
The study comprised of patients only diagnosed at hospital clinics

14. What does this study add?
Use of topical antipsoriatic drugs has decreased while the use of systemic drugs and biologics has increased
Use of topical therapy increases at the time of diagnosis at the hospital clinic and decreases thereafter
There is a skewness in the utilization of topical antipsoriatic treatments; 25% of patients consume 70% of the topical drugs

15. The rest of the research team
Klaus Ejner Andersen Flemming Andersen Helle Johannessen

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