P280 Clinical burden of concomitant joint disease in psoriasis: a US-linked claims and electronic medical records database analysis

Abstract

Background: Psoriasis (PSO) is an inflammatory skin condition, impacting physical and psychological well-being. PSO patients may develop psoriatic arthritis (PsA), a painful joint disease that further impacts quality of life. The objective was to examine rates of metabolic disease and depression in patients with PSO and PsA. Methods: Claims data linked to electronic medical records were examined (Jan-2007-Mar-2018). Prevalent PSO patients were followed until end of data collection and categorized based on development of PsA (PSO+PsA cohort; defined by ICD9/10 codes in patients without PsA at baseline). Follow-up rates of comorbidities, including metabolic disease and depression, were compared for those with/without PsA, presented as cases per 1,000 patient-years (1000PY). Results: Progression to PsA occurred in 2,311 (12%) patients. Followup rates of hyperlipidemia, hypertension, diabetes, and cardiovascular disease in the PSO+PsA cohort were 1.4-times (326 vs 234/1000PY), 1.6-times (357 vs 228/1000PY), 1.7-times (119 vs 72/1000PY), and 1.4-times (71 vs 50/1000PY) that observed in the PSO-only cohort, respectively. In patients without baseline metabolic disease, higher rates in PSO+PsA vs PSO-only remained (approximately 1.5-times and 1.3-times higher rates of hypertension and hyperlipidemia, respectively). The rate of depression was 140 vs 92/1000PY in the PSO+PsA vs PSO-only cohort; when examined in patients without baseline depression, rates were about half that observed in the overall population (72 vs 49/1000PY). Conclusion: PSO+PsA patients had a substantial clinical burden, characterized by 40-70% higher rates of metabolic disease and depression than for patients who did not progress to PsA.