Comparison of phenotype, comorbidities, therapy and adverse events between psoriatic patients with and without psoriatic arthritis. Biobadaderm registry

Pérez-Plaza, Alejandra; Carretero, G.; Ferrándiz, Carlos; Vanaclocha, F.; Gómez-García, Francisco; Herrera‐Ceballos, Enrique; Cueva‐Dobao, P. de la; Belinchón, Isabel; Sánchez‐Carazo, J.L.; Alsina, M.; López-Estebaranz, J.L.; Ferrán, Marta; Torrado, R.; Carrascosa, J.M.; Llamas‐Velasco, Mar; Rivera, R.; Jiménez‐Puya, R.; García‐Doval, I.; Descalzo, M.Á.

doi:10.1111/jdv.14188

Cited by 8 publications

(5 citation statements)

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“…Several studies have reported increased risk of infections with biologic use in patients with psoriasis [2, 4–7] and rheumatoid arthritis (RA) [2, 8–12]. Likewise, patients with PsA have been reported to have an increased risk of comorbidities and adverse events (AEs), including serious infections (SIs), compared with patients with psoriasis [13, 14]. Many investigators question whether the increased risk for AEs is due to the underlying inflammatory nature of psoriatic disease itself, or to the therapies used to treat the disease.…”

Section: Introductionmentioning

confidence: 99%

Serious infections in patients with self-reported psoriatic arthritis from the Psoriasis Longitudinal Assessment and Registry (PSOLAR) treated with biologics

et al. 2019

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BackgroundPatients with psoriatic arthritis (PsA) have increased risk of adverse events, including serious infections (SI), compared with psoriasis patients.MethodsPatients eligible for, or receiving conventional systemic and biologic agents for psoriasis were followed prospectively using PSOLAR. Cohorts included: ustekinumab, tumor necrosis factor (TNF) inhibitors; infliximab; etanercept; adalimumab; non-biologic/methotrexate (MTX) (reference group); and non-biologic/non-MTX. Multivariate analyses using Cox hazard regression were used to identify factors associated with time to first SI. Rates of SI in PSOLAR psoriasis patients with self-reported PsA and possible risks with biologic therapy were evaluated.ResultsPSOLAR enrolled 4315 psoriasis patients with self-reported PsA. The overall population (N = 2401) included patients (n): 628 ustekinumab; 1413 TNF inhibitors; 258 infliximab; 481 etanercept; 674 adalimumab; 54 other biologics, 98 non-biologic/MTX; 208 non-biologic/non-MTX. Overall, 138 SI were reported with incidence rates per 100 patient-years as follows: a) ustekinumab: 1.00; b) TNF inhibitors: 2.22; c) infliximab: 2.12; d) etanercept: 2.58; e) adalimumab: 1.99; f) non-biologic/MTX: 3.01; g) and non-biologic/non-MTX: 2.31. Age, time-dependent disease activity Physician’s Global Assessment (PGA) of 4, 5, history of infection, and diabetes were associated with increased risk for SI (p < 0.05) in self-reported PsA patients. Biologic groups, other than ustekinumab, had numerically higher rates of SI.ConclusionsPSOLAR psoriasis patients with self-reported PsA in the TNF inhibitors, infliximab, adalimumab, etanercept, and MTX cohorts had numerically higher SI rates than the ustekinumab cohort, although not statistically significant. Age, PGA 4, 5, history of infection, and diabetes were associated with an increased risk for SI, irrespective of biologic exposure.Trial registrationNCT00508547; Registered July 30, 2007.

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Section: Introductionmentioning

confidence: 99%

Serious infections in patients with self-reported psoriatic arthritis from the Psoriasis Longitudinal Assessment and Registry (PSOLAR) treated with biologics

et al. 2019

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“…Patients with psoriasis often have other comorbidities such as dyslipidemia, type 2 diabetes, obesity or metabolic syndrome, though one of the most common diseases is arterial hypertension [25,[34][35][36][37]. In this study, arterial hypertension was diagnosed for 40.5% of all subjects with severe psoriasis.…”

Section: Comorbiditiesmentioning

confidence: 71%

A Six-Year Analysis of Biological Therapy for Severe Psoriasis in a Lithuanian Reference Centre of Dermatovenereology

et al. 2020

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Background and Objectives: Biological therapy is widely used for the treatment of severe psoriasis. The objective of this study was to evaluate the efficacy and safety of biological therapy for patients with severe psoriasis. Materials and Methods: A retrospective study of 79 patients with severe psoriasis, who have been treated with biological therapy between 2012 and 2018, was conducted. During this study, the following data were collected and evaluated: sex, age, body mass index (BMI), duration of illness, the results of treatment with biological therapy, concomitant therapy, Psoriasis Area and Severity Index (PASI) and adverse events. Results: In total, 74.7% (n = 59) of subjects were male. Their overall average age was 47.4 ± 11.4 (range: 18–73) years. Their baseline BMI was 27.6 ± 5.9, which increased to 29.6 ± 4.5 after 6 years of treatment. The mean duration of psoriasis was 25.7 ± 12.5 years. In total, 39.2% (n = 31) of subjects received infliximab, 36.7% (n = 29)—etanercept, 24.1% (n = 19)—ustekinumab. The treatment duration for infliximab, etanercept and ustekinumab was 201.6 ± 86.8, 156.2 ± 137.4 and 219.1 ± 95.7 weeks (p < 0.01), respectively. Overall, 65.8% (n = 52) of subjects were also on methotrexate; 30.8% (n = 16) of them discontinued it due to clinical improvement (31.3% (n = 5)), impaired liver function (31.3% (n = 5)), and intolerance (25% (n = 4)). Baseline PASI was 20.8 ± 8.8. PASI 50 was achieved by 96.2% (n = 76) of patients at week 11, PASI 75 by 86.1% (n = 68) at week 16, PASI 90 by 54.4% (n = 43) at week 35, and PASI 100 by 13.9% (n = 11) at week 33. The overall incidence rate of adverse events was 0.362 per patient year of follow-up. Conclusion: Biological therapy is an effective and safe treatment for patients with severe psoriasis.

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“…Further, patients with psoriasis or PsA are not necessarily similar; only 20-30% of patients with psoriasis develop PsA 22 . A previous study comparing patients with psoriasis without arthritis to those with psoriasis and PsA found more comorbidities and combined systemic treatment such as biologic drugs in the PsA group 23 . Given that in this study the investigators could not differentiate between psoriasis and PsA using ICD-9 codes, it is possible that patients with mild psoriasis without IA were a substantial part of the SpA group.…”

mentioning

confidence: 84%

Pregnancy Outcome in Inflammatory Arthropathies — Are Population Database Studies the Right Tool?

Polachek

Eder

2020

J Rheumatol

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Comparison of phenotype, comorbidities, therapy and adverse events between psoriatic patients with and without psoriatic arthritis. Biobadaderm registry

Abstract: Given the differences between patients with psoriasis alone or with psoriasis associated with PsA, patients with psoriasis and PsA should be followed and managed more closely and with specific attention.

Cited by 8 publications

References 32 publications

Serious infections in patients with self-reported psoriatic arthritis from the Psoriasis Longitudinal Assessment and Registry (PSOLAR) treated with biologics

Serious infections in patients with self-reported psoriatic arthritis from the Psoriasis Longitudinal Assessment and Registry (PSOLAR) treated with biologics

A Six-Year Analysis of Biological Therapy for Severe Psoriasis in a Lithuanian Reference Centre of Dermatovenereology

Pregnancy Outcome in Inflammatory Arthropathies — Are Population Database Studies the Right Tool?

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