Background Psoriasis (PsO) and Psoriatic Arthritis (PsA) imposes significant burden among patients with these disease conditions. Patients with both of these conditions may experience an even higher disease burden, warranting a multi-faceted approach to patient management.
Objectives Assess the prevalence of comorbidities among Psoriasis patients with Psoriatic Arthritis (PsO+PsA) and without PsA (PsO-alone) treated with biologics in European Union (EU).
Methods A multi-country multi-center medical chart-review study of PsO patients was conducted in 4Q2012 among physician (mainly-dermatologists) in hospitals and private practices in UK, Germany, France, Italy & Spain (5EU) to collect de-identified data on patients who were recently treated with a biologic as part of usual care. Physicians were screened for duration of practice (3-30 yrs) and patient volume (incl. ≥2 PsO biologic patients/month) and recruited from a large panel to be geographically representative in each country. Physicians abstracted charts of next five consecutive patients within each center/practice, and collected patient diagnosis/symptomatology, disease-severity (physician-judgment), comorbidities and treatment patterns/dynamics. Prevalence of comorbidities among PsO+PsA and PsO-alone patients was evaluated.
Results 1064 eligible Psoriasis patients were included in the analysis (UK:19%, Germany:21%, France:21%, Italy:18%, SP:22%). Prevalence of PsA among PsO patients was: 13% (UK:13%, Germany:16%, France:15%, Italy:9%, SP:13%), thereby defining PsO+PsA (13%) and PsO-alone (87%) cohort size. Patient characteristics differed between patient groups (All/PsO+PsA/PsO-alone)- age:48/49/47yrs; female: 38%/46%.37%; in-remission: 42%/48%/41%; mild-disease-severity: 23%>each; moderate-disease-severity: 23%/18%/23%; severe-disease: 13%/11%/13%; UK (20%) and Germany (30%) had disproportionately more severe patients within PsO+PsA and PsO-alone groups respectively. Comorbidities (≥1) were observed in 55% of patients (UK: 55%, Germany: 52%, France: 63%, Italy: 44%, SP: 59%); top-10 comorbidities observed were (All/PsO+PsA/PsO-alone): obesity (20%/27%/19%), dyslipidemia (19%/21%/19%), diabetes (12%/19%/11%), anxiety (8%/10%/8%), heart disease (7%/6%/7%), depression (6%>per-group), liver disease (4%/8%/3%), migraine/headache (2%/4%/2%), asthma (2%/3%/2%), osteoarthritis (2%/2%/1%). Skin cancer, IBD, ankylosing spondylitis and other respiratory conditions were ∼1% each per group. Key comorbidity outliers were (country:All/PsO+PsA/PsO-alone): dyslipidemia (Spain:28%/40%/27%), obesity (Spain:24%/43%/21%), diabetes (France:16%/21%/15%), anxiety (France:17%/24%/15%), heart disease (Germany:15%/14%/15%) and liver-disease (Spain:7%/17%/5%).
Conclusions Burden of comorbidities among Psoriasis patients is high, and significantly more so among subset of patients with PsA. This burden varied within 5EU. A multi-faceted approach to patient management is warranted to manage these patients optimally and alleviate disease burden.
Disclosure of Interest None declared
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