Psoriasis is Associated with a High Comedication Burden: A Population Based Register Study

Abstract

Introduction: A large body of evidence supports the association between psoriasis and concomitant diseases. However, the study of comedication for these diseases in patients with psoriasis is limited. The current study aimed to investigate the prescription and drug dispensation for comorbidity associated with psoriasis. Methods: We conducted a retrospective casecontrol study from 9 April 2008 until 1 January 2016 using an electronic medical records database covering the entire population of the County of Jönköping and the Swedish Prescribed Drug Register. ICD-10 and Anatomical Therapeutic Chemical codes were used to identify patients with psoriasis and dispensed pharmaceutical prescriptions. Individuals without psoriasis were selected as controls. Patients receiving systemic treatment for psoriasis were considered as having moderatesevere psoriasis. Odds ratios for being dispensed pharmaceutical prescriptions and differences in mean number of dispensed prescriptions were explored. Results: A total of 4587 patients with psoriasis were identified in the medical records, and 268,949 individuals served as controls. Patients with psoriasis had a significantly higher number of different drug dispensations compared to controls. Only 1.3% of all patients with psoriasis were without any prescription (excluding medication for psoriasis) during the study period while the number in the general population was 9.3%. Sex-and age-adjusted odds ratios for dispensation of drug groups related to comorbid disease were significantly higher among patients with psoriasis including drug groups Digital Features To view digital features for this article go to

Disease burden, symptoms, and use of analgesics in patients with psoriasis with or without psoriatic arthritis: A cross-sectional study

“…Disease severity was assessed according to selfreported body surface area (BSA) and psoriasis was categorized as mild (BSA \ 3), moderate (BSA between 3 and 10), or severe (BSA $ 10). Impact on quality of life was determined according to the Dermatology Life Quality Index (DLQI) and effect on quality of life was categorized as no (DLQI of 0-1), small (DLQI of 2-5), moderate (DLQI of 6-10), very large (DLQI of [11][12][13][14][15][16][17][18][19][20], and extremely large (DLQI of 21-30). 22 EuroQoL 5 Dimensions 5 Levels (EQ-5D-5L) were used to measure general health.…”

“…32 Along these lines, we found an increased use of nonsteroidal antiinflammatory drugs, opioids, paracetamol, and gabapentin with increased severity of skin symptoms, which could support the notion of analgesic use as a way of alleviating symptom in patients with psoriasis. 18 When adjusting for joint pain, the apparent association between skin pain or itch and use of analgesics was no longer observed. Additionally, use of analgesics was highly associated with joint pain, which more likely indicated the higher use of analgesics among patients with psoriasis to be a treatment of joint pain rather than skin symptoms.…”

“…As a result, patients might opt for pharmacotherapy (eg, analgesics) to alleviate skin pain. 18 Indeed, patients with psoriasis have a higher use of pain medication than the general population, [18][19][20] with an increase in opioid use during recent years. 21 Whether such use is due to skin pain or a consequence of joint pain resulting from PsA is not clear.…”

The Use of Apremilast in Psoriasis: An Indian Perspective on Real-World Scenarios

“…Another factor which further complicates the management of psoriasis that many patients are on polypharmacy because of their comorbidities. Duvetorp et al, 39 in a population-based register study, reported that polypharmacy was very common in patients with psoriasis, with only 1.3% of all patients being without any prescription. Thus, the management of patients with psoriasis becomes complicated because of the increased risk of drug–drug interactions.…”

Antihypertensive drug use and psoriasis: A systematic review, meta‐ and network meta‐analysis

“…Another 2317 studies were removed after screening for titles and abstracts, and the remaining 159 were subject to full-text reviews, from which 146 were excluded for the following reasons: case report and case series (n = 49); not original research articles (n = 41); not English (n = 6); inappropriate data (n = 38); not being confirmed if drugs were taken before psoriasis diagnosis (n = 2); inappropriate study design (n = 2); and repeated study population (n = 8). Finally, 13 studies [11][12][13]15,16,[24][25][26][27][28][29][30][31] with 6 378 116 individuals were included for meta-analysis, the characteristics of which are presented in Table 1. Of these, 5 were cohort studies, 16,[25][26][27]29 and 8 were casecontrol studies.…”