{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:02:49Z","timestamp":1788825769068,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T00:00:00Z","timestamp":1630368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100003185","name":"National Psoriasis Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100003185","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001582","name":"Dermatology Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001582","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Dermatology"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Objectives<\/jats:title><jats:p>Systemic medications and phototherapy are used to treat pediatric psoriasis, but real\u2010world data on treatment utilization and persistence are limited. The study objective was to determine systemic and phototherapy treatment utilization and compare drug survival among systemics in pediatric psoriasis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using United States commercial insurance claims data, a cross\u2010sectional analysis was conducted to describe the prevalence of systemic treatment and phototherapy use among patients &lt;18\u00a0years old with psoriasis. We compared drug survival among new users of methotrexate, adalimumab, etanercept, and ustekinumab using a retrospective cohort design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 13\u00a0759 patients, 14.6% used systemic or phototherapy treatment during 2001\u20102016, with rising utilization of systemics over this period. Among 579 new users of methotrexate, adalimumab, etanercept, and ustekinumab, the median durations of the initial treatment course were 141 (IQR 59\u2010314), 179 (79\u2010339), 175 (90\u2010419), and 216 (64\u2010435) days, respectively (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.04). Drug discontinuation was less likely among ustekinumab (HR 0.47 [95% CI 0.27\u20100.83]), etanercept (0.74 [0.59\u20100.92]), and adalimumab (0.75 [0.55\u20101.02]) initiators than methotrexate initiators after adjustment for sociodemographic factors and psoriatic arthritis. Drug survival differences were limited to systemic\u2010na\u00efve patients. Potential limitations include short follow\u2010up and residual confounding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Utilization of systemic therapies for pediatric psoriasis is increasing, but differences in drug survival exist.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pde.14781","type":"journal-article","created":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T10:33:26Z","timestamp":1630406006000},"page":"1169-1177","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Treatment utilization and drug survival of systemic medications among commercially insured children with psoriasis"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0189-0442","authenticated-orcid":false,"given":"Joy","family":"Wan","sequence":"first","affiliation":[{"name":"Department of Dermatology University of Pennsylvania Perelman School of Medicine Philadelphia PA USA"},{"name":"Section of Pediatric Dermatology Children\u2019s Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4974-2561","authenticated-orcid":false,"given":"Daniel B.","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Pennsylvania Perelman School of Medicine Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3480-2661","authenticated-orcid":false,"given":"Joel M.","family":"Gelfand","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Pennsylvania Perelman School of Medicine Philadelphia PA USA"},{"name":"Department of Biostatistics, Epidemiology and Informatics University of Pennsylvania Perelman School of Medicine Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,31]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2009.09593.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2019.08.049"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2019.4835"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31189-3"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2012.370"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2018.0183"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40272-019-00335-9"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2015.171"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.13713"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.15579"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3109\/09546634.2014.996515"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3447"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.08.034"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12648"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2015.208"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2011.263"},{"issue":"2","key":"e_1_2_8_18_1","first-page":"187","article-title":"Prevalence of psoriasis in children and adolescents in the United States: a claims\u2010based analysis","volume":"17","author":"Paller AS","year":"2018","journal-title":"J Drugs Dermatol"},{"issue":"8","key":"e_1_2_8_19_1","first-page":"917","article-title":"Trends in systemic psoriasis treatment therapies from 1993 through 2010","volume":"13","author":"Shaw MK","year":"2014","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa066886"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2015.07.002"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.19301"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13611"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.19701"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.18734"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40261-017-0508-1"}],"container-title":["Pediatric Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pde.14781","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pde.14781","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pde.14781","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T20:08:21Z","timestamp":1696536501000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pde.14781"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,31]]},"references-count":25,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1111\/pde.14781"],"URL":"https:\/\/doi.org\/10.1111\/pde.14781","archive":["Portico"],"relation":{},"ISSN":["0736-8046","1525-1470"],"issn-type":[{"value":"0736-8046","type":"print"},{"value":"1525-1470","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,31]]},"assertion":[{"value":"2021-08-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}