Despite Current Recommendations, Corticosteroids Are Widely Prescribed for Psoriasis

Though the use of systematic corticosteroids is discouraged in psoriasis treatment guidelines, they are still widely prescribed for psoriasis patients, according to a study published in the Journal of Cutaneous Medicine and Surgery. Researchers from the Center for Dermatology Research at Wake Forest Baptist Medical Center examined prescription trends for prednisone, dexamethasone, and methylprednisolone.

“Expert guidelines discourage their use for psoriasis due to concerns about causing flares of generalized pustular psoriasis, but there are no randomized controlled trials of systemic corticosteroids in psoriasis to look at these issues,” said Scott A. Davis, MS, a co-author of the study and assistant director of the Center for Dermatology Research. “While corticosteroids have been available for decades, their use in psoriasis has not been extensively studied.”

Researchers analyzed data from the 1989-2010 National Ambulatory Medical Care Survey to explore medications prescribed for psoriasis. Scientists observed the prescription of 650,000 systematic corticosteroids per 21 million psoriasis visits, 93% of which were to dermatologists. Their findings were confirmed after studying 2003-2007 MarketScan Medicaid data.

“Of the top 9 systemic medications listed at psoriasis visits, 3 of them were corticosteroids,” the authors wrote. “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.”