FRI0220 Prevalence of Comorbidites among Patients with Psoriasis with and without Psoriatic Arthritis in European Union

2014 
Background Psoriasis (PsO) and Psoriatic Arthritis (PsA) imposes significant burden among patients with these disease conditions. Patients with both of these conditions may experience an even higher disease burden, warranting a multi-faceted approach to patient management. Objectives Assess the prevalence of comorbidities among Psoriasis patients with Psoriatic Arthritis (PsO+PsA) and without PsA (PsO-alone) treated with biologics in European Union (EU). Methods A multi-country multi-center medical chart-review study of PsO patients was conducted in 4Q2012 among physician (mainly-dermatologists) in hospitals and private practices in UK, Germany, France, Italy & Spain (5EU) to collect de-identified data on patients who were recently treated with a biologic as part of usual care. Physicians were screened for duration of practice (3-30 yrs) and patient volume (incl. ≥2 PsO biologic patients/month) and recruited from a large panel to be geographically representative in each country. Physicians abstracted charts of next five consecutive patients within each center/practice, and collected patient diagnosis/symptomatology, disease-severity (physician-judgment), comorbidities and treatment patterns/dynamics. Prevalence of comorbidities among PsO+PsA and PsO-alone patients was evaluated. Results 1064 eligible Psoriasis patients were included in the analysis (UK:19%, Germany:21%, France:21%, Italy:18%, SP:22%). Prevalence of PsA among PsO patients was: 13% (UK:13%, Germany:16%, France:15%, Italy:9%, SP:13%), thereby defining PsO+PsA (13%) and PsO-alone (87%) cohort size. Patient characteristics differed between patient groups (All/PsO+PsA/PsO-alone)- age:48/49/47yrs; female: 38%/46%.37%; in-remission: 42%/48%/41%; mild-disease-severity: 23%>each; moderate-disease-severity: 23%/18%/23%; severe-disease: 13%/11%/13%; UK (20%) and Germany (30%) had disproportionately more severe patients within PsO+PsA and PsO-alone groups respectively. Comorbidities (≥1) were observed in 55% of patients (UK: 55%, Germany: 52%, France: 63%, Italy: 44%, SP: 59%); top-10 comorbidities observed were (All/PsO+PsA/PsO-alone): obesity (20%/27%/19%), dyslipidemia (19%/21%/19%), diabetes (12%/19%/11%), anxiety (8%/10%/8%), heart disease (7%/6%/7%), depression (6%>per-group), liver disease (4%/8%/3%), migraine/headache (2%/4%/2%), asthma (2%/3%/2%), osteoarthritis (2%/2%/1%). Skin cancer, IBD, ankylosing spondylitis and other respiratory conditions were ∼1% each per group. Key comorbidity outliers were (country:All/PsO+PsA/PsO-alone): dyslipidemia (Spain:28%/40%/27%), obesity (Spain:24%/43%/21%), diabetes (France:16%/21%/15%), anxiety (France:17%/24%/15%), heart disease (Germany:15%/14%/15%) and liver-disease (Spain:7%/17%/5%). Conclusions Burden of comorbidities among Psoriasis patients is high, and significantly more so among subset of patients with PsA. This burden varied within 5EU. A multi-faceted approach to patient management is warranted to manage these patients optimally and alleviate disease burden. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4822
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