Patients’ demographic and socioeconomic characteristics influence the therapeutic decision-making process in psoriasis

Scala, Emanuele; Megna, Matteo; Amerio, Paolo; Argenziano, Giuseppe; Babino, Graziella; Bardazzi, Federico; Bianchi, Luca; Caldarola, Giacomo; Campanati, Anna; Cannavò, Serafinella Patrizia; Chiricozzi, Andrea; Conti, Andrea; Damiani, Giovanni; Dapavo, Paolo; Simone, Clara De; Esposito, Maria; Fabbrocini, Gabriella; Fargnoli, Maria Concetta; Ferrara, Francesca; Fidanza, Rosaria; Gualdi, Giulio; Guarneri, Claudio; Hansel, Katharina; Malagoli, Piergiorgio; Malara, Giovanna; Micali, Giuseppe; Mugheddu, Cristina; Musumeci, Maria Letizia; Odorici, Giulia; Offidani, Annamaria; Pescitelli, Leonardo; Prignano, Francesca; Raimondo, A.; Ribero, Simone; Rongioletti, Franco; Stingeni, Luca; Trifirò, Caterina; Zanframundo, Salvatore; Balato, Anna

doi:10.1371/journal.pone.0237267

Cited by 23 publications

(34 citation statements)

References 37 publications

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“…Due to limited capture of socioeconomic data, we were unable to fully adjust for this confounder in the analysis, however we did identify that household density was inversely associated with shielding. Both shielding behaviour and clinical decision making around systemic therapies globally (including access to medications) may be influenced by socioeconomic variables such as income and education 31,32 , which may in turn influence outcome of COVID-19 4 . Linkage between health, social, behavioural and employment data should thus be prioritised in future research.…”

Section: Discussionmentioning

confidence: 99%

Risk mitigating behaviours in people with inflammatory joint and skin disease during the COVID-19 pandemic differ by treatment type: a cross-sectional patient survey

Yates

Langan

Yiu

et al. 2020

Preprint

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Objectives Registry data suggest that people with immune-mediated inflammatory diseases (IMIDs) receiving targeted systemic therapies have fewer adverse COVID-19 outcomes compared to patients receiving no systemic treatments. We used international patient survey data to explore the hypothesis that greater risk-mitigating behaviour in those receiving targeted therapies may account, at least in part, for this observation. Methods Online surveys were completed by individuals with Rheumatic and Musculoskeletal Diseases (RMD) (UK only) or psoriasis (globally) between 4th May and 7th September 2020. We used multiple logistic regression to assess the association between treatment type and risk-mitigating behaviour, adjusting for clinical and demographic characteristics. We characterised international variation in a mixed effects model. Results Of 3,720 participants (2,869 psoriasis, 851 RMD) from 74 countries, 2,262 (60.8%) reported the most stringent risk-mitigating behaviour (classified here under the umbrella term shielding). A greater proportion of those receiving targeted therapies (biologics and JAK inhibitors) reported shielding compared to those receiving no systemic therapy (adjusted odds ratio [OR] 1.63, 95% CI 1.35-1.97) and standard systemic agents (OR 1.39, 95% CI 1.22-1.56). Shielding was associated with established risk factors for severe COVID-19 (male sex [OR 1.14, 95% CI 1.05-1.24], obesity [OR 1.38, 95% CI 1.23-1.54], comorbidity burden [OR 1.43, 95% CI 1.15-1.78]), a primary indication of RMD (OR 1.37, 95% CI 1.27-1.48) and a positive anxiety or depression screen (OR 1.57, 95% CI 1.36-1.80). Modest differences in the proportion shielding were observed across nations. Conclusions Greater risk-mitigating behaviour among people with IMIDs receiving targeted therapies may contribute to the reported lower risk of adverse COVID-19 outcomes. The behaviour variation across treatment groups, IMIDs and nations reinforces the need for clear evidence-based patient communication on risk mitigation strategies and may help inform updated public health guidelines as the pandemic continues.

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Section: Discussionmentioning

confidence: 99%

Risk mitigating behaviours in people with inflammatory joint and skin disease during the COVID-19 pandemic differ by treatment type: a cross-sectional patient survey

Yates

Langan

Yiu

et al. 2020

Preprint

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“…[9][10][11] Notably, a recent Italian study showed that women were less likely to receive biologics than men. 12 Two-thirds of the patients already had at least one child. The majority of those without children were rather confident about the outcome of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“… 9 – 11 Notably, a recent Italian study showed that women were less likely to receive biologics than men. 12 …”

Section: Discussionmentioning

confidence: 99%

<p>Contraception, Sexuality and Pregnancy in Women with Psoriasis: Real-Life Experience of 235 Women</p>

Maccari¹,

Fougerousse²,

Réguiai³

et al. 2020

CCID

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Background Little is known about how women of childbearing age with psoriasis experience contraception, sexuality and pregnancies through the lens of their skin condition. Objective To evaluate the experiences and expectations in this group of patients. Materials and Methods In total, 235 women aged between 18 and 45 years old completed an online survey. We collected the characteristics of psoriasis, contraception and pregnancy history. Psoriasis severity was measured using the Simplified Psoriasis Index. Patient quality of life was assessed using the Dermatology Life Quality Index (DLQI) and the Short Form-12. Results Psoriasis was mild in 78% of cases. The mean DLQI score was 8.8, highlighting a moderate impact of psoriasis. In total, 28% of the women had no current follow-ups, while at least two distinct physicians followed 21% of these patients. In total, 31.5% of the women felt that they could discuss sexuality during their consultations. In addition, 63% of respondents had a contraceptive method, but more than half of the women reported that contraception was rarely or never discussed during the consultations. In total, 63% had at least one pregnancy, and 61.5% reported that the doctor managing their psoriasis did not discuss their pregnancy during consultations. Psoriasis worsened during pregnancy for 21% of the respondents but improved in 34%. Among women who were not pregnant, less than 15% reported that the doctor in charge of their psoriasis discussed family planning and pregnancy possibilities. Conclusion Our study shows that the management of women of childbearing age with psoriasis must be improved with respect to sexuality, contraception and pregnancy planning.

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“…5,6 It is known that infections, 6 psychological stress, 6 diet, 6,7 medication, 6,7 smoking, [6][7][8][9][10] alcohol drinking, 6,9,11 so as the cold and dry weather, 12 could trigger the flare-ups of psoriasis. Systemic inflammation together with demographics 13 could drastically influence the prescription of treatment and therapeutic response by increasing psoriasis-related comorbidities burden (ie, cardiovascular, 14 respiratory 15 or hepatic disease 16 ). Previous studies confirmed that psoriasis conditions vary with the season, and severe psoriasis were more likely to happen in cold season, such as autumn or/and winter.…”

Section: Introductionmentioning

confidence: 99%

Seasonal Variation of Psoriasis and Its Impact in the Therapeutic Management: A Retrospective Study on Chinese Patients

Zheng¹,

Wang²,

Luo³

et al. 2021

CCID

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Background:The seasonal patterns of psoriasis have been observed in previous studies. However, no published data indicated the risk factors associated with the seasonal variation. Purpose: This study aimed to investigate potentially related factors associated with seasonal pattern of psoriasis and provide possible implications for alleviating psoriasis in clinical practice. Patients and Methods: The retrospective study was conducted in Chinese patients with psoriasis. Demographic and clinical information were collected. Multivariable logistic regression analyses (calculating adjusted odds ratios [AORs]) were used to analyze data. Results: We continually enrolled 2270 patients (1496 males and 774 females) with psoriasis based on inclusion criteria. Disease duration (AOR=1.06, 95% CI: 1.05-1.07), hyperlipidemia (AOR=1.77, 95% CI: 1.06-2.98) and smoking (AOR=1.40, 95% CI: 1.17-1.68) were significantly associated with severe psoriasis in autumn/winter. Age (AOR=0.98, 95% CI:0.97-0.99) and occupations with more sunlight exposure (AOR=0.78, 95% CI: 0.61-0.99) were negatively associated with the seasonal aggravation. Subgroup analysis showed that occupations with more sunlight exposure (AOR=0.64, 95% CI: 0.43-0.94) were protective factors only in late-onset psoriasis but not early-onset, while smoking (AOR=1.39, 95% CI: 1.11-1.74) was risk factor in the early-onset psoriasis. Conclusion: Psoriatic patients who had occupation with more sunlight exposure were less likely to report aggravation of psoriasis in autumn/winter. On the contrary, smoking and hyperlipidemia were positively associated with the seasonal aggravation. Additional prospective study is needed to identify the causality.

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Patients’ demographic and socioeconomic characteristics influence the therapeutic decision-making process in psoriasis

Abstract: Background Knowledge regarding differences in care for psoriatic patients is limited. The aim of this study was to investigate factors influencing prescription of systemic treatments for patients with psoriasis with a special focus on socioeconomic factors.

Cited by 23 publications

References 37 publications

Risk mitigating behaviours in people with inflammatory joint and skin disease during the COVID-19 pandemic differ by treatment type: a cross-sectional patient survey

Risk mitigating behaviours in people with inflammatory joint and skin disease during the COVID-19 pandemic differ by treatment type: a cross-sectional patient survey

<p>Contraception, Sexuality and Pregnancy in Women with Psoriasis: Real-Life Experience of 235 Women</p>

Seasonal Variation of Psoriasis and Its Impact in the Therapeutic Management: A Retrospective Study on Chinese Patients

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