Aetion Inc., 5 Penn Plaza, New York, NY, 10001, USA.
UCB Pharma, Raleigh, NC, USA.
Adv Ther. 2021 May;38(5):2458-2471. doi: 10.1007/s12325-021-01698-7. Epub 2021 Apr 5.
Few studies have evaluated the clinical burden of concomitant joint disease in patients with psoriasis (PSO). The objective of this study was to assess comorbidity rates in patients with psoriatic arthritis (PsA) compared with PSO alone.
This was a retrospective study of US patients with prevalent PSO. Linked medical claims and electronic health records (EHR) in Optum's de-identified Integrated Claims-Clinical dataset were analyzed from 2007 to 2018. Patients were followed for up to 5 years after the first claim/diagnostic code for PSO (index date). Baseline comorbidity prevalence and follow-up rates (cases per 1000 person-years) were assessed using descriptive statistics. Comorbidity rate analysis included patients with the respective comorbidity at baseline.
Baseline demographics and comorbidity prevalence were numerically similar between patients with concomitant joint disease (PSO-PsA) and those with PSO alone (PSO-only). During follow-up, comorbidity rates were higher in patients in the PSO-PsA group than patients in the PSO-only group. Ratios of PSO-PsA comorbidity rates relative to PSO-only ranged from 1.1 for allergies and infections to 1.7 for fatigue, diabetes, and obesity. Comorbidity rate ratios increased from year 1 to year 5 for hypertension (1.05-1.34), hyperlipidemia (0.94-1.13), diabetes (1.00-1.49), cardiovascular disease (1.03-1.66), depression (0.97-1.19), and anxiety (0.87-0.98).
Patients with PsA have a larger clinical burden, characterized by higher comorbidity rates, than those with PSO. Future research should explore PsA risk factors and how physicians can monitor and treat patients with PSO to reduce the risk of PsA and the associated clinical burden.
很少有研究评估银屑病（PSO）患者合并关节疾病的临床负担。本研究的目的是评估与单独 PSO 相比，患有银屑病关节炎（PsA）的患者的合并症发生率。
这是一项在美国患有常见 PSO 的患者中进行的回顾性研究。从 2007 年到 2018 年，分析了 Optum 去识别综合索赔-临床数据集的链接医疗索赔和电子健康记录（EHR）。从 PSO （索引日期）的首次索赔/诊断代码后，对患者进行了长达 5 年的随访。使用描述性统计评估基线合并症的流行率和随访率（每 1000 人年的病例数）。合并症发生率分析包括基线时具有相应合并症的患者。
在患有合并关节疾病的患者（PSO-PsA）和患有单独 PSO 的患者（PSO-only）之间，基线人口统计学和合并症流行率在数值上相似。在随访期间，PSO-PsA 组患者的合并症发生率高于 PSO-only 组患者。PSO-PsA 合并症发生率与 PSO-only 的比值范围从过敏和感染的 1.1 到疲劳、糖尿病和肥胖的 1.7。高血压（1.05-1.34）、高脂血症（0.94-1.13）、糖尿病（1.00-1.49）、心血管疾病（1.03-1.66）、抑郁（0.97-1.19）和焦虑（0.87-0.98）的比值从第 1 年到第 5 年增加。
患有 PsA 的患者比患有 PSO 的患者具有更大的临床负担，其特征是合并症发生率更高。未来的研究应探讨 PsA 的危险因素以及医生如何监测和治疗 PSO 患者，以降低 PsA 的风险和相关的临床负担。
