Demography, baseline disease characteristics and treatment history of patients with psoriasis enrolled in a multicentre, prospective, disease‐based registry (PSOLAR)

Abstract

SummaryBackgroundPsoriasis is associated with several comorbidities and behavioural risk factors.ObjectivesTo evaluate demographic and disease characteristics in patients enrolled in the Psoriasis Longitudinal Assessment and Registry (PSOLAR).MethodsPSOLAR is a global, prospective, longitudinal, disease-based registry that includes a postmarketing commitment to evaluate safety in patients with psoriasis. Enrolled patients had to be receiving, or be eligible to receive, conventional systemic or biological agents. Demographic/disease characteristics, medical histories, lifestyle risk factors and previous treatments are collected at enrolment. Efficacy and safety data are collected every 6 months for 8 years, and data are extracted annually. Selected parameters are evaluated by age quartile using post hoc analyses.ResultsAs of 23 August 2012, 11 900 patients were enrolled at 301 sites in North America, Europe and Latin America. Over half of the PSOLAR population (54·7%) is male, with a mean age of 48·6 years and mean body mass index of 30·9 kg m−2 at enrolment. Mean duration of disease at enrolment was 17·5 years, and mean Physician's Global Assessment score was 2·0. Psoriatic arthritis (35·5%) and cardiovascular diseases (38·2%) were highly prevalent. Diabetes mellitus type II was reported in 11·4% of patients. Depression and anxiety were noted in 14·7% and 11·1% of patients, respectively; 79·0% reported any alcohol use and 56·7% reported smoking or a history of smoking. The occurrence of most comorbidities, including cardiovascular disease and risk factors, increased with age.ConclusionsIn the PSOLAR population, multiple and age-appropriate comorbidities are associated with psoriasis and may affect the selection of psoriasis treatments.What's already known about this topic?Psoriasis is a complicated disorder, often accompanied by multiple comorbidities.Demographic and disease characteristics of patients with psoriasis reported from large claims datasets may be affected by misclassification bias or coding errors.In clinical trials, many patients are excluded owing to strict inclusion criteria.What does this study add?Data collected by the Psoriasis Longitudinal Assessment and Registry reveal that the demographics and disease characteristics of patients with psoriasis who are receiving, or are candidates for, systemic therapy in actual clinical care resemble those reported in clinical trials.Most comorbidities occur more frequently in older patients, who, in turn, may require more comprehensive overall medical care.

Addiction: an underestimated problem in psoriasis health care

“…A smoking prevalence of 49% in the study population also supports previous publications that psoriasis patients are more likely to smoke compared with the general population . The distribution of BMI in all study patients also reflects the BMI distribution of previous studies, such as the results of the PSOLAR study . Thus, our cohort seems to be representative of other psoriasis populations and can be compared to other psoriasis care centres.…”

Measuring psoriatic disease in clinical practice. An expert opinion position paper

“…circulation in hearth and in other organs (such as lung and kidney), that justifies the recruitment of ischemic disease also in young patients without coronary alterations(101).It is thus mandatory for dermatologists and rheumatologists to screen their psoriatic patients for the early identification of cardiovascular risk factors and primary prevention of cardiovascular diseases. The guidelines developed by the American Heart association (AHA) in 2002 for the screening of CVD risk factors in general populations recommend a comprehensive screening by the age of 40 for individuals without known risk factors (102), while patients affected by comorbidities or risk factors should be screened more closely.…”

Psoriatic Arthritis for the Dermatologist

“…117 Similarly, the Psoriasis Longitudinal Assessment and Registry (PSOLAR) study found comparably low rates of MACE with ustekinumab (0.21 events per patient-years of observation) as seen with adalimumab and etanercept. 118 Ustekinumab is FDA pregnancy category B. A theoretic increased risk for infection with Mycobacterium and Salmonella has been suggested, given reports of increased susceptibility to these infections of patients with IL-12 receptor deficiency.…”