(104) Prevalence and advanced systemic treatment prescription patterns for scalp psoriasis in the real-world dermatology setting in the United States

Background: : For patients with plaque psoriasis (PsO), the scalp is among the most affected areas; however, treating the scalp can be challenging because of difficulties applying topical treatments to hair-bearing areas. As a result of these challenges, and the significant patient burden associated with PsO affecting the scalp, a better understanding of treatment patterns for patients with PsO of the scalp is needed, including the use of advanced systemic treatments (ASTs).

Objective: : To estimate the prevalence of PsO with scalp involvement and associated prescription patterns of ASTs (oral phosphodiesterase 4 inhibitor, oral Janus kinase inhibitor, or biologic therapy) in the real-world dermatology setting in the United States (US).

Methods: : A retrospective analysis (2017–2025) of electronic health records (EHRs) from outpatient dermatology practices in the US was conducted using the OMNY Health real-world data platform. Data extracted included the diagnosis of PsO, the presence of scalp involvement, and the use of ASTs. Body surface area affected (BSA) was also extracted, to understand its effect on treatment patterns for patients identified with scalp involvement.

Results: : Overall, 363,606 of 384,536 patients with PsO had location data available in their EHR. Of those patients, approximately one-half also had ≥1 BSA measurement recorded. The prevalence of PsO of the scalp was similar between the overall population (42.7%) and among patients with BSA data available (47.5%). Overall, 26.4% of patients with PsO of the scalp, regardless of a BSA record, were prescribed an AST, while 37.9% of patients with BSA >10% and 18.6% of patients with BSA ≤10% were prescribed an AST.

Conclusions: : PsO with scalp involvement was present in a substantial proportion of patients (>42%) in the US. These patients were likely to be prescribed an AST (>25% of patients). Despite having low BSA ( < 10%), indicative of mild-to-moderate psoriasis that is commonly managed with topical treatments, >18% of patients received AST, suggesting that scalp involvement is a factor in treatment choice. These results suggest an unmet need for innovative topical treatments for PsO of the scalp, which can be used prior to AST, with additional research needed to understand treatment decisions among patients with PsO of the scalp.

Sponsorship:: Arcutis Biotherapeutics, Inc.