Incremental burden of cardiovascular comorbidity and psoriatic arthritis among adults with moderate‐to‐severe psoriasis in five European countries. (1st June 2017)

• Record Type: Journal Article
• Authors: Augustin, M.; Vietri, J.; Tian, H.; Gilloteau, I.
• Is Part Of: Journal of the European Academy of Dermatology and Venereology. Volume 31:Number 8(2017)
• Page Start: 1316
• Page End: 1323
• Publication Date: 2017-06-01
• Subjects: Dermatology -- Periodicals; Sexually transmitted diseases -- Periodicals; 616.5
• DOI: 10.1111/jdv.14286
• Languages: English
• ISSNs: 0926-9959

Abstract

Abstract: Background: Moderate‐to‐severe psoriasis is associated with reduced health‐related quality of life (HRQoL). Individuals with psoriasis are at increased risk for other medical conditions, but little information quantifies the incremental burden of psoriasis‐associated comorbidity among European adults, and data have generally been limited to clinical samples. Objective: To quantify the incremental burden of cardiovascular comorbidity and psoriatic arthritis among adults with moderate‐to‐severe psoriasis in the general population of France, Germany, Italy, Spain and the United Kingdom (EU5). Methods: All measures were self‐reported and came from the 2010–2013 EU5 National Health and Wellness Surveys (NHWS). Moderate‐to‐severe psoriasis was identified by >10% body surface area affected by psoriasis and/or use of therapies for moderate–severe disease. Outcomes were SF‐12v2/SF‐36v2 mental and physical component summary scores (MCS and PCS, respectively), SF‐6D health utility, Work Productivity and Activity Impairment (WPAI) questionnaire and healthcare use in the past 6 months. Generalized linear models compared across cardiovascular comorbidity (CV) or psoriatic arthritis (PsA) groups vs. non‐CV or non‐PsA groups with appropriate link functions to adjust for covariates. Results: Among moderate‐to‐severe psoriasis respondents ( n = 957), 19.8% ( n = 190) reported CV comorbidity and 12.3% ( n = 118) reported PsA. After adjustment for covariates, CV comorbidity was associated with 3.0 points lower MCS, 3.4 points lower PCS and 0.05 points lower SF‐6D (all P < 0.01). Likewise, they had greater mean work impairment (48% vs. 33%), more activity impairment (48% vs. 37%), and more healthcare provider visits (8.8 vs. 6.9), emergency room visits (0.65 vs. 0.31) and hospitalizations (0.61 vs. 0.22) (all P < 0.05). Compared to non‐PsA respondents, PsA respondents also had worse mean MCS (2.6 points), PCS (6.3 points) and SF‐6D scores (0.07 points), and more work impairment (52% vs. 34%), activity impairment (54% vs. 38%) and healthcare provider visits (10.5 vs. 6.9) (all P < 0.05). Conclusion: CV comorbidity and PsA were associated with significant incremental burden among EU5 adults with moderate‐to‐severe psoriasis.