Psychiatric Disorders, CVD, IBD More Prevalent in Psoriasis With PsA
Cardiovascular disease, psychiatric disorders and inflammatory bowel disease are more prevalent among patients with both psoriasis and psoriatic arthritis, compared with those with psoriasis only, according to findings published in BMC Rheumatology.
“Because most patients develop psoriasis first, they are often treated by a dermatologist, general practitioner, or other health care provider who may not have extensive experience in evaluating patients for symptoms of PsA,” Arthur Kavanaugh, MD, of the University of California, San Diego, and colleagues wrote. “Commonly, the treating physician refers the patient to a rheumatologist to make a PsA diagnosis only after the patient reports symptomatic musculoskeletal involvement. This delay in diagnosis and lack of recognition of PsA symptoms accounts for many cases of undiagnosed PsA in this patient population.”
The researchers added, “Due to the complexity and underdiagnosis of PsA, it is important to understand the typical profile of patients with PsA by considering demographics, disease characteristics, medical and family history, lifestyle risk factors, and prior treatment use.”
To analyze demographic information, family history and previous medication use of patients with psoriasis who also have self-reported PsA, Kavanaugh and colleagues reviewed baseline data from the Psoriasis Longitudinal Assessment and Registry (PSOLAR). According to the researchers, PSOLAR is a large, multicenter, international, longitudinal, disease-based database with, as of Aug. 23, 2015, an enrollment of 12,090 adults with psoriasis who are receiving, or are candidates for treatment with, systemic therapies for psoriasis.
Kavanaugh and colleagues evaluated the baseline demographics, disease characteristics, medical history and prior medication use among 4,315 patients in PSOLAR with psoriasis and self-reported PsA. Of those patients, 1,719 had a physician-confirmed diagnosis of PsA. The researchers also reviewed demographic, disease and medical history data for 7,775 patients in the study with psoriasis only, as well as the overall total PSOLAR population.
According to the researchers, baseline demographic characteristics of patients with psoriasis and self-reported PsA were distinct from those with psoriasis only. Among the patients with psoriasis and self-reported PsA, 44.4% demonstrated cardiovascular disease, 26.3% had psychiatric illness and 3.2% had inflammatory bowel disease. Each of these comorbidities were more prevalent among patients with both psoriasis and self-reported PsA than those with psoriasis only (P<.001). Overall, 17.5% of patients with psoriasis and self-reported PsA had a family history of PsA, 29.8% had used systemic steroids, 39.5% had used NSAIDs and 83.5% had used biologic drugs.
“Despite several differences noted between patients with psoriasis and patients with self-reported PsA in PSOLAR, no notable differences were observed between the subset of ‘PsA established by an [health care professional]’ patients and those with self-reported PsA, providing a rationale for the use of self-reported PsA cohort data for future long-term safety analyses,” Kavanaugh and colleagues wrote. “This analysis provides additional information that will be useful for health care providers to better understand patients with PsA in a real-world setting.” – by Jason Laday
Disclosure: Kavanaugh reports clinical research sponsored by, and consulting fees from, Janssen. Please see the study for all other authors’ relevant financial disclosures.