Complementary and alternative medicine usage in the era of biologics among Korean patients with psoriasis

Background: Patients with long-standing psoriasis who are not treated with conventional medicine seek complementary and alternative medicine (CAM). The biological revolution in the field of psoriasis since the late 2000s has progressed, expecting clearance or almost clearance of the disease. The frequency and type of CAM usage may have changed after these advances. Object: To investigate the change in the use of CAM in Korean psoriasis patients before and after the prevalent use of biologics Methods: Patients with psoriasis, who visited Pusan National University Hospitals (Busan and Yangsan) between March 2020 and June 2022 were made to complete a face-to-face structured questionnaire. These results were compared with our previous study results conducted approximately 10 years ago. Results: In total, 207 patients were included. Compared with the previous results, the frequency of CAM use (67.63%) increased (p<0.0001). Oriental medicine (67.14%) has most commonly been used, followed by health supplements and bath therapy. The biggest reason for using CAM was “to try all the potential treatments.” Meanwhile, negative concerns about conventional medicine (13.52%) significantly decreased during the 10-year period (p<0.0001). Conclusion: Although treatment efficacy has increased with biologics development, CAM usage remains prevalent among Korean patients with psoriasis. Therefore, more efforts need to be made by dermatologists to improve patients’ understanding of conventional medicine, including biologics.研究背景：未接受常规治疗的长期银屑病患者，常会寻求补充与替代疗法（Complementary and Alternative Medicine, CAM）。自2000年代末以来，银屑病领域的生物治疗革新持续推进，以期实现疾病完全或几乎完全清除。随着此类治疗进展，CAM的使用频率与类型或已发生改变。 研究目的：探究韩国银屑病患者在生物制剂普及前后，其CAM使用情况的变化。 研究方法：选取2020年3月至2022年6月期间，于釜山国立大学医院（釜山及梁山院区）就诊的银屑病患者，令其填写面对面结构化问卷。将本次调研结果与约10年前开展的既往研究结果进行对比分析。 研究结果：本研究共纳入207例患者。与既往研究结果相比，本次调研中CAM的使用率达67.63%，显著升高（p<0.0001）。其中最常用的CAM类型为东方医学（Oriental medicine，占比67.14%），其次为保健食品与药浴疗法。患者使用CAM的最主要原因为“尝试所有潜在治疗方案”。与此同时，患者对常规治疗的负面顾虑占比为13.52%，在10年间显著降低（p<0.0001）。 研究结论：尽管随着生物制剂的研发与应用，银屑病的治疗疗效得以提升，但韩国银屑病患者中CAM的使用仍较为普遍。因此，皮肤科医师需付出更多努力，以提升患者对包括生物制剂在内的常规治疗的认知水平。