Comorbidities in Chilean patients with psoriasis: a Global Healthcare Study on Psoriasis

Abstract

Background Psoriasis is a chronic inflammatory skin disease associated with several important medical comorbidities. There are scant data available on the comorbidities of patients with psoriasis in South America. Aim To examine the comorbidity profile of adult patients with psoriasis in Chile and its association with severity of psoriasis. Methods This was a multicentre, cross‐sectional study involving 16 hospitals and clinics in Chile, which used a 48‐item questionnaire to study clinician‐ and patient‐reported outcomes and comorbidities. Inferential analyses were performed by psoriasis severity, using Fisher exact test, Student t‐test and multivariable logistic regression. Results In total, 598 adult patients with psoriasis were included (51.1% male; mean age 49.2 ± 15.1 years); 48.5% mild and 51.4% moderate to severe; Psoriasis Area and Severity Index 11.6 ± 11.5; body surface area 14.7 ± 18.2%. Plaque psoriasis was the most common phenotype (90.2%), followed by guttate (13.4%). Psoriatic arthritis occurred in 27.3% of patients. Comorbidities were reported in 60.2% of all patients with psoriasis. Frequent concomitant diseases were obesity (25.3%), hypertension (24.3%), Type 2 diabetes mellitus (T2DM) (18.7%), dyslipidaemia (17.4%), metabolic syndrome (16.7%) and depression (14.4%). After adjustment, significant associations were found between moderate to severe psoriasis and obesity, T2DM and nonalcoholic fatty liver disease (NAFLD) compared with mild psoriasis. Conclusions We report a large study of comorbidities, including depression, dyslipidaemia, T2DM and NAFLD, in people with psoriasis in Chile. The prevalence of comorbidities with psoriasis in Chile appears similar to that found in Western countries, and emphasizes the importance of assessing patients with psoriasis for risk factors for and presence of, comorbid disease in a multidisciplinary setting.

Prevalence and risk of nonalcoholic fatty liver disease among adult psoriatic patients: A systematic review, meta-analysis, and trial sequential analysis

“…Forty-one studies [12–14,18,33–69] were included in the meta-analysis that 19 studies were case–control studies and 22 studies had no control groups (Table 1).…”

“…TSA showed that the analysis of OR included sufficient cases and there was a publication bias across the studies for the calculation of pooled ER and OR. [34] Turkey Caucasian 20/250 -44 MSP US, liver test, exclusion of other liver diseases Fahim, 2023 [35] Pakistan Asian 30/80 16/80 38 CPP US, liver test, exclusion of other liver diseases Ruan, 2022 [39] China Asian 96/148 4018/5524 38.8 NR US, liver test, exclusion of other liver diseases Ghafoor, 2021 [12] Pakistan Asian 53/101 29/101 46.4 NR US, liver test, exclusion of other liver diseases Gau, 2022 [36] China Asian 1191/5591 295,749/1,479,360 50.4 NR US, liver test, exclusion of other liver diseases Inci, 2016 [37] Turkey Caucasian 32/60 21/60 44.5 CPP US, liver test, exclusion of other liver diseases Lee, 2019 [38] China Asian 34/307 ->18 NR Not described Valenzuela, 2022 [40] Chile Mixed 28/598 -49.2 Mixed Not described Gandha, 2020 [41] Indonesia Asian 28/36 -40.1 Vulgaris US, liver test, exclusion of other liver diseases Shibata, 2022 [46] Japan Asian 13/46 14/138 50.6 Mixed US, liver test, exclusion of other liver diseases Li, 2022 [44] China Asian 46/127 -46.5 PsA US, liver test, exclusion of other liver diseases Yadav, 2023 [47] India Asian 17/50 2/50 38.9 CPP US, liver test, exclusion of other liver diseases Ho, 2019 [43] China Asian 58/223 -58 PsA US, liver test, exclusion of other liver diseases Ortolan, 2019 [45] Italy Caucasian 40/76 -57.7 PsA US, liver test, exclusion of other liver diseases Gisondi, 2016 [42] Italy Caucasian 55/124 21/79 55 CPP US, liver test, exclusion of other liver diseases Gisondi, 2009 [13] Italy [51] China Asian 34/307 ->18 NR Not described Magdaleno-Tapial, 2020 [52] Spain [58] India Asian 17/61 5/24 46 CPP US, liver test, exclus8ion of other liver diseases…”

Correlation between Dermatology Life Quality Index and Psoriasis Area and Severity Index in Patients with Psoriasis: A Cross-sectional Global Healthcare Study on Psoriasis

“…The Global Healthcare Study on Psoriasis (GHSP) is a multi-country, multi-centre, longitudinal observational study that collects cross-sectional data. This research project is an ongoing international, global survey performed since January 2020 in multiple countries across several continents ( 15 , 21 ). Socio-demographic and psoriasis-related disease and treatment data were obtained from 2 specialized dermatology centres in Europe (Switzerland), 31 in Latin America (Brazil and Chile), 4 in Asia (China and Singapore), and 1 in North America (USA).…”

“…Many patients achieve full or almost full skin clearance when treated with biologics, which often leads to considerable improvement in their quality of life ( 14 ). However, access to modern treatment, and impairment due to comorbidities, vary enormously worldwide ( 15 ). The availability of treatment resources is especially limited in low-income countries and for people with low socio-economic status.…”

Psoriasis in the pediatric population: comorbidities with psoriasis

“…On the other hand, NAFLD is more common in patients with moderate to severe psoriasis and its course is then more severe [151][152][153]. Several studies revealed that psoriasis is an independent risk factor for liver diseases [154][155][156][157][158][159][160][161][162][163][164][165][166][167][168][169]. All patients with psoriasis, including children and adolescents, should have NAFLD screening and be appropriately consulted by a hepatologist to detect the first symptoms early and prevent further liver damage.…”