Medication use patterns in pregnant women with psoriasis: a nationwide study in Taiwan

Abstract

Abstract Background Psoriasis, an autoimmune skin condition, affects 2–4% of the global population, with significant prevalence among women of childbearing age. Pregnancy presents challenges in managing psoriasis because of hormonal changes and treatment safety concerns. Understanding treatment patterns in pregnant women is crucial, given limited real-world evidence. Objectives To explore the utilization patterns of medications among pregnant women diagnosed with psoriasis within real-world data, utilizing data sourced from a nationwide database in Taiwan. Methods This nationwide study utilized Taiwan's National Health Insurance (NHI) database and birth certificate application records. It included registered pregnant women diagnosed with psoriasis from 2005 to 2014. Medication usage was tracked 3 years before conception to 3 years after delivery. Medications were categorized based on Anatomical Therapeutic Chemical codes, and statistical analyses were conducted using SAS software. Results In total, 30 267 pregnant women with psoriasis were studied. In total, 11 651 (38.5%) mothers had received ≥ 1 prescription during follow-up (exposed group) and 61.5% (18 616) had never received medication (unexposed group). Demographics and comorbidities were similar between these two groups. Topical corticosteroids were the most prescribed treatment, followed by phototherapy, with systemic drugs and biologics less common. During the study period, 11 096 women with psoriasis had used topical corticosteroids, 3376 had used nonsteroidal topical agents, 218 had used systemic agents or biologics and 519 had received treatment with phototherapy. Medication usage declined during pregnancy, reaching its lowest in the third trimester but rebounded postpartum. Conclusions Psoriasis medications, systemic, biological or topical, were largely discontinued during pregnancy, sometimes up to 2 years before and extending postpartum. Research is needed to understand its impact on maternal and child health.