Increased incapacity for work, comorbid burden associated with concomitant psoriasis, RP

Results presented at the 2021 American College of Rheumatology Annual Meeting showed that patients with concomitant psoriasis and psoriatic arthritis (RP) reported an increased incidence of obesity, hypertension, and diabetes, as well as a higher probability of incapacity for work than those with only psoriasis.

According to results presented at the 2021 American College of Rheumatology (ACR) annual meeting, the concomitant diagnosis of psoriasis and psoriatic arthritis (RP) may result in a greater burden of comorbidity and inability to work than psoriasis alone. .

Affecting more than 7.5 million American adults, psoriasis has been linked to the incidence of the development of RP. Previous research has suggested that about a third of patients with psoriasis will develop RP during their illness, which can pose additional health risks and greater health care utilization issues.

Seeking to assess the baseline characteristics and comorbidities in patients with psoriasis with or without a diagnosis of RP, the researchers conducted a retrospective observational study using data from the British Association of Dermatologists’ Biological and Immunomodulatory Registry (BADBIR ).

“As the patient cohorts included in randomized clinical trials are not necessarily representative of the real world, registry data can supplement information obtained on patient characteristics and disease outcomes,” they explained.

In the study, patients were stratified and compared according to whether they had psoriasis alone or in combination with psoriasis and RP, as well as whether they were using ustekinumab as a biologic treatment or receiving conventional systemic anti-psoriatic therapy:

  • Patients with psoriasis only on ustekinumab (n = 2697)
  • Patients with psoriasis and RP on ustekinumab (n = 590)
  • Patients with psoriasis only on conventional systemic therapy (n = 5105)
  • Patients with psoriasis and RP on conventional systemic therapy (n = 529)

Participants were initially assessed for several characteristics, including body mass index, smoking, occupational status, and co-morbidities such as diabetes, hypertension, myocardial infarction, and depression.

Compared with patients with psoriasis only, patients with concomitant psoriasis and RP were 73% less likely to report fitness for work when receiving ustekinumab treatment (odds ratio [OR], 0.27; 95% CI: 0.21-0.35) and 51% less likely when administered by the conventional systemic route (OR: 0.49; 95% CI: 0.37-0.65).

In addition, patients with concomitant psoriasis and RP in both types of treatment had a significantly higher risk of developing diabetes (ustekinumab: OR, 1.45; 95% CI, 1.10-1.89; conventional systemic treatment: OR, 1.51; 95% CI, 1.11-2.04), obesity (ustekinumab: OR, 1.34; 95% CI, 1.11-1.62; conventional systemic treatment: OR , 1.21; 95% CI, 1.01-1.46) and hypertension (ustekinumab: OR, 1.54; 95% CI, 1.26-1.87; conventional systemic treatment: OR, 1.30; 95% CI 1.03-1.62) compared to those with psoriasis only.

Patients with psoriasis and comorbid RP receiving ustekinumab were also more likely to be diagnosed with depression than those receiving conventional systemic therapy compared to those with psoriasis only (ustekinumab: OR: 1.54; CI 95%: 1.25-1.88; conventional systemic therapy: OR, 1.14; 95% CI: 0.91-1.42)

“These results potentially indicate a higher inflammatory burden and quality of life in patients with psoriasis and comorbid RP, underscoring the need for adequate patient assessment and follow-up to ensure a better holistic approach to the management of patients. patients, ”the study authors concluded.

Reference

Tillett W, Ogdie A, Gorecki P, Passey A. Differences in actual patient characteristics of 8,921 psoriasis patients with and without comorbid psoriatic arthritis using the UK BADBIR database. Presented at: ACR Convergence 2021; Virtual. Abstract 1354. https://bit.ly/3DAnH9P

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