{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T22:04:48Z","timestamp":1788991488387,"version":"build-2803163510"},"reference-count":9,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2024,3,1]]},"abstract":"\n Importance<\/jats:title>\n Laboratory testing for the presence of tuberculosis, hepatitis, and other conditions before starting most systemic immunomodulatory agents is recommended in patients with chronic inflammatory skin diseases (CISD) but current testing patterns in the US are unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine the prevalence of pretreatment testing that is recommended for patients with CISD (psoriasis, hidradenitis suppurativa, or atopic dermatitis).<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This descriptive analysis of US commercial insurance claims databases from December 31, 2002, to December 31, 2020, included adult patients with CISD (psoriasis, hidradenitis suppurativa, or atopic dermatitis) who started an immunomodulatory agent, including methotrexate, tumor necrosis factor \u03b1 inhibitors, interleukin (IL)\u201317Ai, ustekinumab, IL-23i, dupilumab, or apremilast.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The proportion of patients who underwent the screening tests as suggested by professional societies\u2014including for tuberculosis, hepatitis, and liver function; complete blood cell counts; and lipid panels\u2014were determined within 6 months before and during 2 years after treatment start.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 122\u202f308 patients with CISDs (median [IQR] age, 49 [38-58] years; 63\u202f663 [52.1%] male) starting systemic immunomodulatory treatment in the US were included. Treatment for patients with CISDs comprised methotrexate (28\u202f684), tumor necrosis factor \u03b1 inhibitors (40\u202f965), ustekinumab (12\u202f841), IL-23i (6116), IL-17Ai (9799), dupilumab (7787), or apremilast (16\u202f116). Complete blood cell count was the most common test, performed in 41% (3161\/7787) to 69% (19\u202f659\/28\u202f684) of individuals before initiation across treatments. Between 11% (889\/7787) and 59% (3613\/6116) of patients had tuberculosis screening within 6 months before treatment, and 3% (149\/4577) to 26% (1559\/6097) had updated tests 1 year later. Between 13% (1006\/7787) and 41% (16\u202f728\/40\u202f965) had hepatitis panels before treatment. Low pretreatment testing levels before apremilast (15% [2331\/16\u202f116] to 45% [7253\/16\u202f116]) persisted a year into treatment (9% [816\/8496] to 36% [2999\/8496]) and were similar to dupilumab (11% [850\/7787] to 41% [3161\/7787] vs 3% [149\/4577] to 25% [1160\/4577]).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this descriptive analysis of patients with CISDs starting systemic immunomodulatory treatment in the US, less than 60% received the recommended pretreatment testing. Additional research is required to understand whether variations in testing affect patient outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamadermatol.2023.5895","type":"journal-article","created":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T11:33:02Z","timestamp":1706700782000},"page":"334","source":"Crossref","is-referenced-by-count":6,"title":["Prevalence of Pretreatment Testing Recommended for Patients With Chronic Inflammatory Skin Diseases"],"prefix":"10.1001","volume":"160","author":[{"given":"Maria C.","family":"Schneeweiss","sequence":"first","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Department of Dermatology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denys","family":"Shay","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Ly","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Wyss","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Schneeweiss","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Glynn","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"},{"name":"Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arash","family":"Mostaghimi","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"1","key":"dbr230025r1","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1016\/j.jaad.2020.01.045","article-title":"Real-world trends in biologic, oral systemic, and phototherapy in US patients with psoriasis or psoriatic arthritis.","volume":"83","author":"Singh","year":"2020","journal-title":"J Am Acad Dermatol"},{"issue":"4","key":"dbr230025r2","doi-asserted-by":"publisher","first-page":"1029","DOI":"10.1016\/j.jaad.2018.11.057","article-title":"Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics.","volume":"80","author":"Menter","year":"2019","journal-title":"J Am Acad Dermatol"},{"issue":"2","key":"dbr230025r3","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/j.autrev.2008.07.011","article-title":"Screening for tuberculosis infection prior to initiation of anti-TNF therapy.","volume":"8","author":"Lalvani","year":"2008","journal-title":"Autoimmun Rev"},{"issue":"6","key":"dbr230025r4","doi-asserted-by":"publisher","first-page":"398","DOI":"10.7326\/M18-3079","article-title":"Graphical depiction of longitudinal study designs in health care databases.","volume":"170","author":"Schneeweiss","year":"2019","journal-title":"Ann Intern Med"},{"issue":"1","key":"dbr230025r6","doi-asserted-by":"publisher","first-page":"5126","DOI":"10.1038\/s41467-022-32310-3","article-title":"Reproducibility of real-world evidence studies using clinical practice data to inform regulatory and coverage decisions.","volume":"13","author":"Wang","year":"2022","journal-title":"Nat Commun"},{"issue":"16","key":"dbr230025r7","doi-asserted-by":"publisher","first-page":"1376","DOI":"10.1001\/jama.2023.4221","article-title":"Emulation of randomized clinical trials with non-randomized database analyses: results in 32 clinical trials.","volume":"329","author":"Wang","year":"2023","journal-title":"JAMA"},{"issue":"6","key":"dbr230025r8","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.1016\/j.jaad.2020.02.044","article-title":"Joint American Academy of Dermatology-National Psoriasis Foundation guidelines of care for the management of psoriasis with systemic nonbiologic therapies.","volume":"82","author":"Menter","year":"2020","journal-title":"J Am Acad Dermatol"},{"issue":"9","key":"dbr230025r9","doi-asserted-by":"publisher","first-page":"1409","DOI":"10.1111\/jdv.v36.9","article-title":"European guideline (EuroGuiDerm) on atopic eczema: part I\u2014systemic therapy.","volume":"36","author":"Wollenberg","year":"2022","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"dbr230025r5","unstructured":"Aetion? 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