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Muntyanu A, Milan R, Kaouache M, Ringuet J, Gulliver W, Pivneva I, Royer J, Leroux M, Chen K, Yu Q, Litvinov IV, Griffiths CEM, Ashcroft DM, Rahme E, Netchiporouk E. Tree-Based Machine Learning to Identify Predictors of Psoriasis Incidence at the Neighborhood Level: A Populational Study from Quebec, Canada. Am J Clin Dermatol 2024; 25:497-508. [PMID: 38498268 DOI: 10.1007/s40257-024-00854-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Psoriasis is a major global health burden affecting ~ 60 million people worldwide. Existing studies on psoriasis focused on individual-level health behaviors (e.g. diet, alcohol consumption, smoking, exercise) and characteristics as drivers of psoriasis risk. However, it is increasingly recognized that health behavior arises in the context of larger social, cultural, economic and environmental determinants of health. We aimed to identify the top risk factors that significantly impact the incidence of psoriasis at the neighborhood level using populational data from the province of Quebec (Canada) and advanced tree-based machine learning (ML) techniques. METHODS Adult psoriasis patients were identified using International Classification of Disease (ICD)-9/10 codes from Quebec (Canada) populational databases for years 1997-2015. Data on environmental and socioeconomic factors 1 year prior to psoriasis onset were obtained from the Canadian Urban Environment Health Consortium (CANUE) and Statistics Canada (StatCan) and were input as predictors into the gradient boosting ML. Model performance was evaluated using the area under the curve (AUC). Parsimonious models and partial dependence plots were determined to assess directionality of the relationship. RESULTS The incidence of psoriasis varied geographically from 1.6 to 325.6/100,000 person-years in Quebec. The parsimonious model (top 9 predictors) had an AUC of 0.77 to predict high psoriasis incidence. Amongst top predictors, ultraviolet (UV) radiation, maximum daily temperature, proportion of females, soil moisture, urbanization, and distance to expressways had a negative association with psoriasis incidence. Nighttime light brightness had a positive association, whereas social and material deprivation indices suggested a higher psoriasis incidence in the middle socioeconomic class neighborhoods. CONCLUSION This is the first study to highlight highly variable psoriasis incidence rates on a jurisdictional level and suggests that living environment, notably climate, vegetation, urbanization and neighborhood socioeconomic characteristics may have an association with psoriasis incidence.
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Affiliation(s)
- Anastasiya Muntyanu
- Department of Experimental Medicine, McGill University, Montreal, Canada
- Division of Dermatology, University of Toronto, Toronto, Canada
| | - Raymond Milan
- Department of Experimental Medicine, McGill University, Montreal, Canada
| | - Mohammed Kaouache
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Julien Ringuet
- Centre de Recherche Dermatologique de Québec, Québec, Canada
| | - Wayne Gulliver
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | | | | | | | | | - Qiuyan Yu
- Ecological and Biological Sciences, Exponent Inc, Menlo Park, USA
| | - Ivan V Litvinov
- Division of Dermatology, Department of Medicine, McGill University Health Centre, Montreal General Hospital, Montreal, QC, Canada
| | | | - Darren M Ashcroft
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Global Psoriasis Atlas, Manchester, UK
| | - Elham Rahme
- Department of Medicine, Division of Clinical Epidemiology, McGill University, Montreal, QC, Canada
| | - Elena Netchiporouk
- Division of Dermatology, Department of Medicine, McGill University Health Centre, Montreal General Hospital, Montreal, QC, Canada.
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Xu X, Wang SY, Wang R, Wu LY, Yan M, Sun ZL, Sun QH. Association of antihypertensive drugs with psoriasis: A trans-ancestry and drug-target Mendelian randomization study. Vascul Pharmacol 2024; 154:107284. [PMID: 38360195 DOI: 10.1016/j.vph.2024.107284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/02/2024] [Accepted: 02/11/2024] [Indexed: 02/17/2024]
Affiliation(s)
- Xiao Xu
- Department of Nursing, Nantong Health College of Jiangsu Province, Nantong, China.
| | - Shu-Yun Wang
- Academic Affair Office, Nantong Vocational University, Nantong, China; Department of Postgraduate, St. Paul University Philippines, Tuggegarau, Philippines.
| | - Rongyun Wang
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China.
| | - Lin-Yun Wu
- College of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China.
| | - Min Yan
- Department of Epidemiology, School of Public Health, Changzhou University, Changzhou, China; Faculty of Health and Welfare, Satakunta University of Applied Sciences, Pori, Finland.
| | - Zhi-Ling Sun
- Department of Rheumatology, School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China.
| | - Qiu-Hua Sun
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China.
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Lin TL, Fan YH, Chang YL, Ho HJ, Wu CY, Chen YJ. The epidemiology of pediatric psoriasis: A nationwide cohort study in Taiwan. J Dermatol 2024; 51:48-55. [PMID: 37870277 DOI: 10.1111/1346-8138.16996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 09/09/2023] [Accepted: 09/27/2023] [Indexed: 10/24/2023]
Abstract
Psoriasis can affect individuals of all age groups. While the epidemiology of psoriasis in adults has been extensively studied, there is limited research specifically investigating pediatric cases. This study aimed to investigate the prevalence and incidence of skin psoriasis (PsO) and psoriatic arthritis (PsA) among pediatric patients in Taiwan. A nationwide cohort of 17 535 patients with psoriatic diseases under the age of 18 was enrolled from the National Health Insurance Research Database for the period 2000-2013, including 16 129 PsO patients and 2022 PsA patients. The age- and sex-standardized prevalence and incidence of pediatric PsO and PsA were calculated. The 2007 yearly reports of age- and sex-specific distribution of the general population was adopted as a standard. The results showed that between 2000 and 2013, the prevalence for pediatric PsO increased from 0.03% to 0.07%, and from 0.003% to 0.014% for pediatric PsA. During the same period, the incidence slightly decreased from 19.81 to 17.55 per 100 000 for pediatric PsO but increased from 1.02 to 5.06 per 100 000 for pediatric PsA. Adolescents (12 to <18 years) had higher prevalence and incidence rates of PsO and PsA than children (aged ≤ 12 years), with no sex difference observed in either age group. PsA preceding PsO was more common among children than adolescents (27.07% vs. 13.46%). This study provides important insights into the prevalence and incidence of psoriatic diseases in the pediatric population. Further research is needed to identify risk factors for pediatric psoriasis and to investigate its long-term health outcomes.
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Affiliation(s)
- Teng-Li Lin
- Department of Dermatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- Ph.D. Program of Interdisciplinary Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Hsuan Fan
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yi-Ling Chang
- Department of Dermatology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Hsiu J Ho
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chun-Ying Wu
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Faculty of Medicine and Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Translational Research, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Public Health, China Medical University, Taichung, Taiwan
| | - Yi-Ju Chen
- Department of Dermatology, Taichung Veterans General Hospital, Taichung, Taiwan
- Faculty of Medicine and Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Post-Baccalaureate Medicine, National Chung-Hsing University, Taichung, Taiwan
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Rossetto CN, Palominos PE, Machado NP, Dos Santos Paiva E, Azevedo VF. Epidemiological analysis of patients with psoriatic arthritis in follow-up at the brazilian Unified Health System. Adv Rheumatol 2023; 63:47. [PMID: 37679833 DOI: 10.1186/s42358-023-00327-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/30/2023] [Indexed: 09/09/2023] Open
Abstract
INTRODUCTION/OBJECTIVES Psoriatic arthritis (PsA) is a chronic multisystem osteoarticular disease that requires specialized care. Most Brazilians depend on the public healthcare provided by the Unified Health System (Sistema Único de Saúde, SUS). This study aimed to describe the epidemiological characteristics of patients with PsA in follow-up in SUS, focusing on the incidence and prevalence of the disease, comorbidities, and hospitalizations. METHODS We collected data from the Outpatient Data System of SUS (Sistema de Informações Ambulatoriais do SUS, SIA/SUS) regarding outpatient visits and hospitalizations in the Brazilian public healthcare system from January 2008 to March 2021 using the Techtrials Disease Explorer® platform and the medical code related to PsA were selected. RESULTS We evaluated 40,009 patients and found a prevalence of 24.4 cases of visits due to PsA per 100,000 patients in follow-up in SUS. Female patients were predominant (54.38%). The incidence of visits due to PsA has been increasing in recent years and we observed an incidence of 8,982 new visits in 2020. The main comorbidities of these patients were osteoarthritis, lower back pain, shoulder injuries, oncological diseases, crystal arthropathies, and osteoporosis. Hospitalizations were mainly due to treating clinical or cardiovascular conditions and performing orthopedic procedures. CONCLUSION The number of visits due to PsA in SUS has increased in recent years, mainly on account of new diagnoses of the disease, although the prevalence found in this study's population was lower than that observed in the general population.
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Affiliation(s)
- Chayanne Natielle Rossetto
- Empresa Brasileira de Serviços Hospitalares - EBSERH - Hospital de Clínicas of the Federal University of Paraná (UFPR), Curitiba, Paraná, Brasil.
| | | | - Natalia Pereira Machado
- Empresa Brasileira de Serviços Hospitalares - EBSERH - Hospital de Clínicas of the Federal University of Paraná (UFPR), Curitiba, Paraná, Brasil
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Radić M, Đogaš H, Vrkić K, Gelemanović A, Marinović I, Perković D, Nazlić J, Radić J, Krstulović DM, Meštrović J. Prescription Trends of Biologic DMARDs in Treating Rheumatologic Diseases: Changes of Medication Availability in COVID-19. J Pers Med 2023; 13:1199. [PMID: 37623450 PMCID: PMC10455961 DOI: 10.3390/jpm13081199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/26/2023] [Accepted: 07/26/2023] [Indexed: 08/26/2023] Open
Abstract
Biologic disease-modifying antirheumatic drugs (DMARDs) are very effective in treating rheumatic diseases with a good patient tolerance. However, high cost and individualistic approach requires dedication of the physician. Therefore, the aim of this study was to determine how the COVID-19 pandemic has affected the prescription of biologic DMARDs in rheumatology at the University Hospital of Split. The data collection was conducted through an archive search in the Outpatient Clinic for Rheumatology in the University Hospital of Split, Split, Croatia. The search included the period before and after the start of the COVID-19 pandemic in Croatia (31 March 2020). Collected data included age, sex, ICD-10 code of diagnosis, generic and brand name of the prescribed drug, date of therapy initiation, and medication administration route. In the pre-COVID-19 period, 209 patients were processed, while in the COVID-19 period, 185 patients were processed (11.5% fewer). During pre-COVID-19, 231 biologic medications were prescribed, while during COVID-19, 204. During COVID-19, IL-6 inhibitors were less prescribed (48 (21%) vs. 21 (10%) prescriptions, p = 0.003), while IL-17A inhibitors were more prescribed (39 (17%) vs. 61 (30%) prescriptions, p = 0.001). In ankylosing spondylitis (AS), adalimumab was prescribed more during pre-COVID-19 (25 vs. 15 patients, p = 0.010), while ixekizumab was prescribed less (1 vs. 10 patients, p = 0.009). In rheumatoid arthritis, tocilizumab was prescribed more in the pre-COVID-19 period (34 vs. 10 patients, p = 0.012). Overall, the prescription trends of biologic DMARDs for rheumatologic diseases did not vary significantly in the University Hospital of Split, Croatia. Tocilizumab was prescribed less during COVID-19 due to shortages, while ixekizumab was more prescribed during COVID-19 due to an increase in psoriatic arthritis patients processed and due to being approved for treating AS.
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Affiliation(s)
- Mislav Radić
- Internal Medicine Department, Rheumatology, Allergology, and Clinical Immunology Division, University Hospital of Split, 21000 Split, Croatia
- Department of Internal Medicine, University of Split School of Medicine, 21000 Split, Croatia
| | - Hana Đogaš
- Internal Medicine Department, Nephrology and Haemodialysis Division, University Hospital of Split, 21000 Split, Croatia
| | - Karla Vrkić
- Internal Medicine Department, Rheumatology, Allergology, and Clinical Immunology Division, University Hospital of Split, 21000 Split, Croatia
| | - Andrea Gelemanović
- Mediterranean Institute for Life Sciences (MedILS), 21000 Split, Croatia
| | - Ivanka Marinović
- Physical Medicine and Rehabilitation with Rheumatology Division, University Hospital of Split, 21000 Split, Croatia
- University Department of Health Studies, University of Split, 21000 Split, Croatia
| | - Dijana Perković
- Internal Medicine Department, Rheumatology, Allergology, and Clinical Immunology Division, University Hospital of Split, 21000 Split, Croatia
- Department of Internal Medicine, University of Split School of Medicine, 21000 Split, Croatia
| | - Jurica Nazlić
- Internal Medicine Department, Emergency Medicine, Intensive Care, and Clinical Pharmacology with Toxicology Division, University Hospital of Split, 21000 Split, Croatia
| | - Josipa Radić
- Department of Internal Medicine, University of Split School of Medicine, 21000 Split, Croatia
- Internal Medicine Department, Nephrology and Haemodialysis Division, University Hospital of Split, 21000 Split, Croatia
| | - Daniela Marasović Krstulović
- Internal Medicine Department, Rheumatology, Allergology, and Clinical Immunology Division, University Hospital of Split, 21000 Split, Croatia
- Department of Internal Medicine, University of Split School of Medicine, 21000 Split, Croatia
| | - Julije Meštrović
- Paediatric Diseases Department, University Hospital of Split, 21000 Split, Croatia
- Department of Paediatrics, University of Split School of Medicine, 21000 Split, Croatia
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Chi CC, Wu YW, Chao TH, Chen CC, Chen YJ, Cheng HM, Chiu HY, Chiu YW, Chung WH, Hsieh TY, Huang PH, Huang YH, Lin SH, Lin TH, Ueng KC, Wang CC, Wang YC, Wu NL, Jia-Yin Hou C, Tsai TF. 2022 Taiwanese Dermatological Association (TDA), Taiwanese Association for Psoriasis and Skin Immunology (TAPSI), and Taiwan Society of cardiology (TSOC) joint consensus recommendations for the management of psoriatic disease with attention to cardiovascular comorbidities. J Formos Med Assoc 2023; 122:442-457. [PMID: 36347733 DOI: 10.1016/j.jfma.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/09/2022] [Accepted: 10/20/2022] [Indexed: 11/08/2022] Open
Abstract
Psoriatic disease is a chronic inflammatory disorder with skin and joint manifestations. Due to the persistent inflammatory state exhibited by patients with psoriasis, multiple systemic comorbidities occur more frequently in patients with psoriasis than in the general population, and the risk of cardiovascular (CV) diseases is significantly increased. As the pathophysiology of psoriatic disease is becoming better understood, the sharing of underlying pathogenic mechanisms between psoriatic and CV diseases is becoming increasingly apparent. Consequently, careful attention to CV comorbidities that already exist or may potentially develop is needed in the management of patients with psoriasis, particularly in the screening and primary prevention of CV disease and in treatment selection due to potential drug-drug and drug-disease interactions. Furthermore, as the use of effective biologic therapy and more aggressive oral systemic treatment for psoriatic disease is increasing, consideration of the potential positive and negative effects of oral and biologic treatment on CV disease is warranted. To improve outcomes and quality of care for patients with psoriasis, the Taiwanese Dermatological Association, the Taiwanese Association for Psoriasis and Skin Immunology, and the Taiwan Society of Cardiology established a Task Force of 20 clinicians from the fields of dermatology, cardiology, and rheumatology to jointly develop consensus expert recommendations for the management of patients with psoriatic disease with attention to CV comorbidities.
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Affiliation(s)
- Ching-Chi Chi
- Department of Dermatology, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yen-Wen Wu
- Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ting-Hsing Chao
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan; College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Chiang Chen
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Ju Chen
- Department of Dermatology, Taichung Veterans General Hospital, Taichung, Taiwan; College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Hao-Min Cheng
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Center for Evidence-Based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsien-Yi Chiu
- Department of Dermatology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan; College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Wei Chiu
- Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Computer Science and Engineering, Yuan Ze University, Taoyuan, Taiwan
| | - Wen-Hung Chung
- Department of Dermatology, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Tsu-Yi Hsieh
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Po-Hsun Huang
- Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Huei Huang
- Department of Dermatology, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shang-Hung Lin
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Tsung-Hsien Lin
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kwo-Chang Ueng
- Division of Cardiology, Department of Internal Medicine, Chung-Shan Medical University Hospital, Taichung, Taiwan; College of Medicine, Chung-Shan Medical University, Taichung, Taiwan
| | - Chun-Chieh Wang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan
| | - Yu-Chen Wang
- Division of Cardiology, Department of Internal Medicine, Asia University Hospital, Taichung, Taiwan; Department of Medical Laboratory Science and Biotechnology, Asia University, Taichung, Taiwan
| | - Nan-Lin Wu
- Department of Dermatology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Charles Jia-Yin Hou
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.
| | - Tsen-Fang Tsai
- College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan.
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Chiu HY, Lan JL, Chiu YM. Lifetime risk, life expectancy, loss-of-life expectancy, and lifetime healthcare expenditures for psoriasis in Taiwan: a nationwide cohort followed from 2000 to 2017. Ther Adv Chronic Dis 2023; 14:20406223231168488. [PMID: 37152349 PMCID: PMC10155019 DOI: 10.1177/20406223231168488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/21/2023] [Indexed: 05/09/2023] Open
Abstract
Background Patients with psoriasis have a significant disease burden throughout the life course. Nevertheless, the lifetime risk and disease burden of psoriasis across the entire lifespan is rarely quantified in an easily understandable way. Objective To estimate the cumulative incidence rate, life expectancy, loss-of-life expectancy, and lifetime healthcare expenditures for incident psoriasis. Design and methods Using real-world nationwide data from the National Health Insurance Research Database of Taiwan for 2000-2017, along with the life tables of vital statistics, we estimated cumulative incidence rate, life expectancy, loss-of-life expectancy, and lifetime healthcare expenditures for those with psoriasis using a semi-parametric survival extrapolation method. Results A total of 217,924 new psoriasis cases were identified. The lifetime risk of psoriasis in patients aged 18-80 for both sexes decreased in Taiwan with a cumulative incidence rate of 7.93% in 2000 to 3.25% in 2017. The mean (±standard error) life expectancy after diagnosis was 27.11 (± 1.15) and 27.14 (±1.17) years for patients with moderate-to-severe psoriasis and psoriatic arthritis, respectively. Patients with moderate-to-severe psoriasis and psoriatic arthritis had a mean (±standard error) loss-of-life expectancy of 6.41 (±1.16) and 6.48 (±1.17) due to psoriasis, respectively. Male patients have higher lifetime and annual lifetime healthcare expenditures than female. Mean life expectancy, loss-of-life expectancy, and lifetime cost were relatively higher for younger patients. Conclusion Among psoriatic patients, patients with moderate-to-severe psoriasis and psoriatic arthritis had substantial years of life lost, particularly for younger patients. Our results provide a reliable estimation of lifetime disease burden, and these estimates will help health authorities in cost-effectiveness assessments of public health interventions and allocation of services resources to minimize loss-of-life expectancy, and lifetime healthcare expenditures in patients with psoriasis.
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Affiliation(s)
- Hsien-Yi Chiu
- Department of Dermatology, National Taiwan
University Hsin-Chu Hospital, Hsinchu
- Department of Dermatology, National Taiwan
University Hospital Hsin-Chu Branch, Hsinchu
- Department of Dermatology, National Taiwan
University Hospital, Taipei
- Department of Dermatology, College of Medicine,
National Taiwan University, Taipei
| | - Joung-Liang Lan
- Rheumatology and Immunology Center, China
Medical University Hospital, Taichung City
- Department of Medicine, China Medical
University, Taichung City
- Hsien-Yi Chiu is also affiliated to Department
of Medical Research, National Taiwan University Hospital Hsinchu Branch,
Hsinchu, Taiwan
| | - Ying-Ming Chiu
- Department of Allergy, Immunology, and
Rheumatology, Tungs’ Taichung MetroHarbor Hospital, No. 699, Section 8,
Taiwan Boulevard, Wuqi District, Taichung City 43503
- Department of Nursing, Jen-Teh Junior College
of Medicine, Nursing and Management, Miaoli
- Department of Post-Baccalaureate Medicine,
College of Medicine, National Chung Hsing University, Taichung City
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Eun Y, Hwang J, Seo GH, Ahn JK. Risk of cancer in Korean patients with psoriatic arthritis: a nationwide population-based cohort study. RMD Open 2023; 9:rmdopen-2022-002874. [PMID: 36958767 PMCID: PMC10040019 DOI: 10.1136/rmdopen-2022-002874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/08/2023] [Indexed: 03/25/2023] Open
Abstract
OBJECTIVE While many studies on the increased risk of cancer in patients with psoriasis are available, data on the risk of cancer in patients with psoriatic arthritis (PsA) are still scarce. We assessed the risk of cancer in patients with PsA in a nationwide population-based cohort in Korea. METHODS From 2010 to June 2021, patients newly diagnosed with PsA and 1:10 age-matched and sex-matched controls were included in this study. The outcome was the incidence of overall and specific cancers. RESULTS Total 162 cancers occurred in 4688 PsA patients (incidence rate 83.2 (95% CI 70.8 to 97.0) per 10 000 person-years) and 1307 cancers occurred in 46 880 controls (incidence rate 66.9 (95% CI 63.3 to 70.6) per 10 000 person-years). The adjusted HR (aHR) of overall cancer in PsA patients was 1.20 (95% CI 1.02 to 1.41). However, this significance disappeared when non-melanoma skin cancer (NMSC) was excluded (aHR 1.16, 95% CI 0.98 to 1.37). Among specific cancers, the risk of NMSC (aHR 3.64 (95% CI 1.61 to 8.23)), lymphoma (aHR 2.63 (95% CI 1.30 to 5.30)) and thyroid cancer (aHR 1.83 (95% CI 1.18 to 2.85)) was higher in patients with PsA than in controls. CONCLUSION The risk of overall cancer was higher in patients with PsA than in the general population. Patients with PsA had increased risks of NMSC, lymphoma and thyroid cancer compared with the general population. Our findings suggest a need to conduct cancer screening by a detailed history and comprehensive clinical examination in patients with PsA.
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Affiliation(s)
- Yeonghee Eun
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jiwon Hwang
- Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Gi Hyeon Seo
- Healthcare Review and Assessment Committee, Health Insurance Review & Assessment Service, Wonju, South Korea
| | - Joong Kyong Ahn
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Leng X, Lin W, Liu S, Kanik K, Wang C, Wan W, Jiang Z, Liu Y, Liu S, Zhang Z, Zhang Z, Xu J, Tan W, Hu J, Li J, Liu J, Gunay LM, Dina O, Kinch C, Zeng X. Efficacy and safety of tofacitinib in Chinese patients with active psoriatic arthritis: a phase 3, randomised, double-blind, placebo-controlled study. RMD Open 2023; 9:e002559. [PMID: 36720560 PMCID: PMC9890804 DOI: 10.1136/rmdopen-2022-002559] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/17/2022] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES Efficacy and safety of tofacitinib, an oral Janus kinase inhibitor, were evaluated in a 6-month, double-blind, phase 3 study in Chinese patients with active (polyarthritic) psoriatic arthritis (PsA) and inadequate response to ≥1 conventional synthetic disease-modifying antirheumatic drug. METHODS Patients were randomised (2:1) to tofacitinib 5 mg twice daily (N=136) or placebo (N=68); switched to tofacitinib 5 mg twice daily after month (M)3 (blinded). PRIMARY ENDPOINT American College of Rheumatology (ACR50) response at M3. Secondary endpoints (through M6) included: ACR20/50/70 response; change from baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI); ≥75% improvement in Psoriasis Area and Severity Index (PASI75) response, and enthesitis and dactylitis resolution. Safety was assessed throughout. RESULTS The primary endpoint was met (tofacitinib 5 mg twice daily, 38.2%; placebo, 5.9%; p<0.0001). M3 ACR20/ACR70/PASI75 responses, and enthesitis and dactylitis resolution rates, were higher and HAQ-DI reduction was greater for tofacitinib 5 mg twice daily versus placebo. Incidence of adverse events (AEs)/serious AEs (M0-3): 68.4%/0%, tofacitinib 5 mg twice daily; 75.0%/4.4%, placebo. One death was reported with placebo→tofacitinib 5 mg twice daily (due to accident). One serious infection, non-serious herpes zoster, and lung cancer case each were reported with tofacitinib 5 mg twice daily; four serious infections and one non-serious herpes zoster case were reported with placebo→tofacitinib 5 mg twice daily (M0-6). No non-melanoma skin cancer, major adverse cardiovascular or thromboembolism events were reported. CONCLUSION In Chinese patients with PsA, tofacitinib efficacy was greater than placebo (primary and secondary endpoints). Tofacitinib was well tolerated; safety outcomes were consistent with the established safety profile in PsA and other indications. TRIAL REGISTRATION NUMBER NCT03486457.
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Affiliation(s)
- Xiaomei Leng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | | | | | | | | | - Weiguo Wan
- Huashan Hospital, Fudan University, Shanghai, China
| | - Zhenyu Jiang
- First Affiliated Hospital of Jilin University, Changchun, China
| | - Yi Liu
- Sichuan Huaxi Hospital, Sichuan, China
| | - Shengyun Liu
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhuoli Zhang
- Peking University First Hospital, Beijing, China
| | - Zhiyi Zhang
- First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jian Xu
- First Affiliated Hospital of Kunming Medical University, Kunming, China
| | | | - Jiankang Hu
- Pingxiang People's Hospital, Pingxiang, China
| | | | - Ju Liu
- Jiujiang No. 1 People's Hospital, Jiujiang, China
| | | | | | | | - Xiaofeng Zeng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
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10
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Hamgård N, Duvetorp A, Hägg A, Jerkovic Gullin S, Seifert O. Exploring comorbidity and pharmacological treatment patterns in psoriasis - a retrospective population-based cross-sectional study. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2023; 13:26335565231212336. [PMID: 37915465 PMCID: PMC10617277 DOI: 10.1177/26335565231212336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 10/19/2023] [Indexed: 11/03/2023]
Abstract
Background Individuals with psoriasis face an increased risk of suffering from various comorbid conditions. However, there haven´t been any studies conducted in Sweden to examine the frequency of comorbidities and the corresponding treatment for these conditions among psoriasis patients. Methods The Cosmic electronic medical record represents a comprehensive repository of medical information including all residents of Region Jönköping. To conduct a population-based retrospective cross-sectional study, all individuals diagnosed with psoriasis between April 9, 2008 and July 1, 2016, were identified via the electronic medical records using ICD-10 codes. Data on comorbidity and dispensation of prescribed drugs against these comorbid conditions were analyzed. Results During the study period, 1.7% of the population (4,587 individuals) were diagnosed with psoriasis, with 74.3% of cases classified as mild to moderate psoriasis and 25.7% as severe. The remaining 268,949 individuals did not receive a psoriasis diagnosis. The study showed that psoriasis patients had higher odds of experiencing the majority of the comorbid conditions examined. Arthritis other than psoriasis arthritis was found to be the most prevalent comorbid diagnosis among psoriasis patients (adjusted OR 7.2, CI 95% 6.4-8.2, p < 0.001), followed by obesity (OR 2.4, CI 95% 1.9-3.1, p < 0,001). There was no significant difference in drug prescription for comorbid diseases between patients with psoriasis and patients without psoriasis except for arthritis and smoking cessation treatment. Conclusions Individuals with psoriasis are more susceptible to experiencing multiple comorbid conditions compared to the general population, particularly those with severe psoriasis. There is no evidence of undertreatment of comorbidity except for arthritis among psoriasis patients.
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Affiliation(s)
- Nelly Hamgård
- Division of Cell Biology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Albert Duvetorp
- Department of Dermatology and Venereology, Lund University, Skane University Hospital, Malmö, Sweden
| | - Anna Hägg
- Department of Dermatology and Venereology, Värnamo Hospital, Region Jönköping County, Sweden
| | - Sandra Jerkovic Gullin
- Division of Cell Biology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Oliver Seifert
- Division of Cell Biology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Scott IC, Whittle R, Bailey J, Twohig H, Hider SL, Mallen CD, Muller S, Jordan KP. Rheumatoid arthritis, psoriatic arthritis, and axial spondyloarthritis epidemiology in England from 2004 to 2020: An observational study using primary care electronic health record data. THE LANCET REGIONAL HEALTH. EUROPE 2022; 23:100519. [PMID: 36246147 PMCID: PMC9557034 DOI: 10.1016/j.lanepe.2022.100519] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Contemporary data on rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritits (SpA) epidemiology in England are lacking. This knowledge is crucial to planning healthcare services. We updated algorithms defining patients with diagnoses of RA, PsA, and axial SpA in primary care and applied them to describe their incidence and prevalence in the Clinical Practice Research Datalink Aurum, an electronic health record (EHR) database covering ∼20% of England. METHODS Algorithms for ascertaining patients with RA, axial SpA, and PsA diagnoses validated in primary care EHR databases using Read codes were updated (to account for the English NHS change to SNOMED CT diagnosis coding) and applied. Updated diagnosis and synthetic disease-modifying anti-rheumatic drug code lists were devised by rheumatologists and general practitioners. Annual incidence/point-prevalence of RA, PsA, and axial SpA diagnoses were calculated from 2004 to 2020 and stratified by age/sex. FINDINGS Point-prevalence of RA/PsA diagnoses increased annually, peaking in 2019 (RA 0·779% [95% confidence interval (CI) 0·773, 0·784]; PsA 0·287% [95% CI 0·284, 0·291]) then falling slightly. Point-prevalence of axial SpA diagnoses increased annually (except in 2018/2019), peaking in 2020 (0·113% [95% CI 0·111, 0·115]). RA diagnosis annual incidence was higher between 2013-2019 (after inclusion in the Quality and Outcomes Framework, range 49·1 [95% CI 47·7, 50·5] to 52·1 [95% CI 50·6, 53·6]/100,000 person-years) than 2004-2012 (range 34·5 [95% CI 33·2, 35·7] to 40·0 [95% CI 38·6, 41·4]/100,000 person-years). Increases in the annual incidence of PsA/axial SpA diagnosis occurred following new classification criteria publication. Annual incidence of RA, PsA and axial SpA diagnoses fell by 40·1%, 67·4%, and 38·1%, respectively between 2019 and 2020, likely reflecting the COVID-19 pandemic's impact on their diagnosis. INTERPRETATION Recorded RA, PsA, and axial SpA diagnoses are increasingly prevalent in England, underlining the importance of organising healthcare services to provide timely, treat-to-target care to optimise the health of >1% of adults in England. FUNDING National Institute for Health and Care Research (NIHR300826).
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Affiliation(s)
- Ian C. Scott
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
- Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership NHS Foundation Trust, High Lane, Burslem, Staffordshire, UK
| | - Rebecca Whittle
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - James Bailey
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - Helen Twohig
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - Samantha L. Hider
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
- Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership NHS Foundation Trust, High Lane, Burslem, Staffordshire, UK
| | - Christian D Mallen
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
- Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership NHS Foundation Trust, High Lane, Burslem, Staffordshire, UK
| | - Sara Muller
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - Kelvin P. Jordan
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
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12
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Choon SE, Wright AK, Griffiths CE, Tey KE, Wong KW, Lee YW, Suvelayutnan U, Mariapun J, Ashcroft DM. Incidence and prevalence of psoriasis in multiethnic Johor Bahru, Malaysia: a population-based cohort study using electronic health data routinely captured in the Teleprimary Care (TPC®) clinical information system from 2010 to 2020: Classification: Epidemiology. Br J Dermatol 2022; 187:713-721. [PMID: 35830199 PMCID: PMC9804555 DOI: 10.1111/bjd.21768] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 07/04/2022] [Accepted: 07/09/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND There are no population-based epidemiological data on psoriasis in Southeast Asia, including Malaysia. OBJECTIVES To determine the incidence and prevalence of psoriasis over 11 years in multiethnic Johor Bahru, Malaysia. METHODS A population-based cohort study was made using the Teleprimary Care database between January 2010 and December 2020. Cases of psoriasis, identified by ICD-10 diagnostic codes, were validated by dermatologists. Annual prevalence and incidence were estimated and stratified by age, sex and ethnicity. RESULTS We identified 3932 people with dermatologist-confirmed psoriasis, including 1830 incident cases, among 1 164 724 Malaysians, yielding an 11-year prevalence of 0·34% [95% confidence interval (CI) 0·33-0·35] and incidence of 34·2 per 100 000 person-years (95% CI 32·6-35·8). Rates were higher in Indian patients; the prevalences were 0·54% (0·50-0·58) in Indian, 0·38% (0·36-0·40) in Chinese and 0·29% (0·28-0·30) in Malay patients, and the respective incidences per 100 000 person-years were 52·5 (47·3-57·7), 38·0 (34·1-41·8) and 30·0 (28·2-31·8). Rates were higher in males; the prevalence was 0·39% (0·37-0·41) in males and 0·29% (0·27-0·30) in females, and the respective incidences per 100 000 person-years were 40·7 (38·2-43·2) and 28·3 (26·4-30·3). Between 2010 and 2020, annual psoriasis prevalence and incidence increased steadily from 0·27% to 0·51% and from 27·8 to 60·9 per 100 000 person-years, respectively. Annual rates were consistently higher in male and Indian patients. Overall, psoriasis was significantly more common in males than females [odds ratio (OR) 1·37, 95% CI 1·29-1·46] and in Indian and Chinese patients vs. Malay (OR 1·85, 1·71-2·01 and OR 1·30, 1·20-1·41, respectively). Prevalence increased with age, with the highest rates in the groups aged 50-59 and 60-69 years at 0·67% and 0·66%, respectively. A modest bimodal trend in age of psoriasis onset was observed, with first and second peaks at 20-29 and 50-59 years. Disease onset was significantly earlier in females than males [mean (SD) 36·8 (17·3) vs. 42·0 (17·2) years, P < 0·001] and in Malay vs. Indian and Chinese patients [mean (SD): Malay 36·4 (17·5), Indian 40·8 (15·2), Chinese 47·4 (16·9) years, P < 0·001]. CONCLUSIONS We found that psoriasis incidence and prevalence are increasing and varied by age, sex and ethnicity. Our findings should help inform healthcare planning and management for patients with psoriasis in Malaysia. What is already known about this topic? The incidence and prevalence of psoriasis are generally lower in Asian populations and children. There is a lack of agreement on sex-specific differences in psoriasis incidence and prevalence. There has been no population-based study on the incidence and prevalence of psoriasis in Southeast Asia, including Malaysia. There is no information on differences in psoriasis prevalence and incidence by sex, age and ethnicity in Malaysia. What does this study add? Psoriasis incidence and prevalence are increasing in the multiethnic population of Johor Bahru, Malaysia. Incidence and prevalence rates were higher in male than female patients and were consistently highest among Indian patients, followed by Chinese and Malay. A modest bimodality in the age of psoriasis onset was observed among the groups aged 20-29 and 50-59 years. Psoriasis onset was significantly later in male than female patients and in Chinese vs. Indian and Malay patients.
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Affiliation(s)
- Siew Eng Choon
- Department of DermatologyHospital Sultanah Aminah Johor BahruJohorMalaysia,Clinical School Johor Bahru, Jeffrey Cheah School of Medicine & Health SciencesMonash UniversityJohorMalaysia
| | - Alison K. Wright
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - Christopher E.M. Griffiths
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science CentreUniversity of ManchesterManchesterUK,Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Science CentreUniversity of ManchesterManchesterUK
| | - Kwee Eng Tey
- Department of DermatologyHospital Sultanah Aminah Johor BahruJohorMalaysia,Clinical School Johor Bahru, Jeffrey Cheah School of Medicine & Health SciencesMonash UniversityJohorMalaysia
| | - Kit Wan Wong
- Department of DermatologyHospital Sultanah Aminah Johor BahruJohorMalaysia,Clinical School Johor Bahru, Jeffrey Cheah School of Medicine & Health SciencesMonash UniversityJohorMalaysia
| | - Yoong Wei Lee
- Department of DermatologyHospital Sultanah Aminah Johor BahruJohorMalaysia
| | - Ushananthiny Suvelayutnan
- Department of Information and Communication TechnologyHospital Sultanah Aminah Johor BahruJohorMalaysia
| | - Jeevitha Mariapun
- Clinical School Johor Bahru, Jeffrey Cheah School of Medicine & Health SciencesMonash UniversityJohorMalaysia
| | - Darren M. Ashcroft
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK,NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science CentreUniversity of ManchesterManchesterUK
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Artamonova OG, Karamova AE, Chikin VV, Kubanov AA. HLA-B27 and its role of the pathogenesis of psoriatic arthritis. VESTNIK DERMATOLOGII I VENEROLOGII 2022. [DOI: 10.25208/vdv1362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The literature review presents the characteristics of the human leukocyte antigen (HLA)-B27 as a factor contributing to the development of psoriatic arthritis. HLA-B27 is a class I surface antigen encoded by the major histocompatibility complex (MHC) B locus located on chromosome 6. The main function is to present antigenic peptides to the CD8+ T-cells. HLA-B27 is the most important genetic biomarker for psoriatic arthritis, as it provides phenotypic differentiation in the patient population. The prevalence of HLA-B27 in various population groups are presented. The structural features of the HLA-B27 molecule are described. The characteristics of methods for detecting HLA-B27 status and determining its subtypes are given. The main mechanisms of the HLA-B27 polymorphism influence on the development of psoriatic arthritis are considered, and hypotheses are analyzed that explain the pathogenic effect of HLA-B27: the arthritogenic peptide hypothesis, the misfolding hypothesis, the HLA-B27 heavy chain homodimer formation hypothesis. The features of the clinical manifestations and course of HLA-B27-positive psoriatic arthritis are presented, allowing the use of HLA-B27 to predict the development of psoriatic joint damage.
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Zhou Y, Zhong L, Shen L, Chen S, Zeng Q, Lai L, Tang S. Psoriasis and medical ramifications: A comprehensive analysis based on observational meta-analyses. Front Med (Lausanne) 2022; 9:998815. [PMID: 36106326 PMCID: PMC9465012 DOI: 10.3389/fmed.2022.998815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose Based on a large number of systematic reviews and meta-analyses exploring the relationship between psoriasis and various health outcomes, we conducted an comprehensive analysis to assess the strength and evidence for the association between psoriasis and medical end-point ramifications in patients. Methods We searched related meta-analyses, investigating the links between psoriasis and medical ramifications from three databases. All summary effect sizes, 95% CIs, heterogeneity, and small-study effects in the included meta-analyses were recalculated. We assessed the methodological quality of included articles with the AMSTAR 2 tool and graded the epidemiological evidence. Subgroup analysis based on the severity of psoriasis and study design were also performed. Results A total of 38 articles comprising 85 unique meta-analyses were included in this study. Although 69 outcomes were statistically significant, only 8 outcomes (nonvascular dementia, ulcerative colitis, pediatric dyslipidemia, gestational diabetes, gestational hypertension, fracture, multiple sclerosis, and schizophrenia) showed a high quality of epidemiological evidence. Conclusion We found that psoriasis increased the risk of 69 health outcomes, and 8 outcomes were graded as high-quality evidence. No evidence was found that psoriasis was beneficial for any medical end point. However, to verify our results, more large-sample, multi-center prospective cohort studies are needed.
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Affiliation(s)
- Yun Zhou
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China
- Department of Gastroenterology, The First Affiliated Hospital, Gannan Medical University, Ganzhou, China
| | - Lixian Zhong
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Lianli Shen
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Sisi Chen
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Qiuting Zeng
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Leizhen Lai
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Shaohui Tang
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China
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15
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Wang Z, Zhang HM, Guo YR, Li LL. Molecular mechanisms of Biyu decoction as treatment for psoriasis: A network pharmacology and molecular docking study. World J Clin Cases 2022; 10:7224-7241. [PMID: 36158000 PMCID: PMC9353920 DOI: 10.12998/wjcc.v10.i21.7224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/24/2022] [Accepted: 06/03/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The therapeutic effects of a combination of Chinese medicines called Biyu decoction have been clinically verified, although its molecular targets in psoriasis remain unknown.
AIM To explore the molecular mechanisms of Biyu decoction for psoriasis treatment.
METHODS In this network pharmacology and molecular docking study, the Traditional Chinese Medicine Systems Pharmacology database was searched for Biyu decoction active ingredients. GeneCards, Online Mendelian Inheritance in Man, PharmGkb, Therapeutic Target Database, and DrugBank databases were searched for psoriasis-related genes. The genes targeted by the decoction’s active ingredient and disease genes were intersected to obtain predictive targets of the drug during psoriasis treatment. Cytoscape 3.8.0 was used to construct a drug component/ target disease network. The The functional protein association networks database and Cytoscape were used to construct a protein-protein interaction network and streamline the core network. The Gene Ontology and Kyoto Encyclopedia of Genes and Genomes were used for pathway enrichment analysis. Molecular docking technology was used to verify the drug component/target disease network.
RESULTS We screened 117 major active ingredients, including quercetin, kaempferol, naringenin, and acetyl-shikonin, and identified 213 gene targets, such as MAPK3, JUN, FOS, MYC, MAPK8, STAT3, and NFKBIA. Using a molecular docking analysis, the main active ingredients demonstrated good binding to the core targets. The Gene Ontology analysis showed that these ingredients were significantly associated with biological activities, such as transcription factor DNA binding, RNA polymerase II-specific DNA binding of transcription factors, and cytokine receptor binding; responses to lipopolysaccharides, molecules of bacterial origin, and oxidative stress; and were mainly distributed in membrane rafts, microdomains, and regions. The Kyoto Encyclopedia of Genes and Genomes analysis showed that decoction ingredients act on Th17 cell differentiation, tumor necrosis factor and mitogen-activated protein signaling pathways, the interleukin-17 signaling pathway, and the PI3K-Akt signaling pathway.
CONCLUSION Biyu decoction may be effective against psoriasis through multi-component, multi-target, and multi-channel synergy.
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Affiliation(s)
- Zi Wang
- Department of Dermatology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Hao-Min Zhang
- Department of Dermatology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Yuan-Rui Guo
- Department of Dermatology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Ling-Ling Li
- Department of Dermatology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
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Time Trends in Psoriasis and Psoriatic Arthritis Incidence from 2002 to 2016 in Taiwan: An Age–Period–Cohort Analysis. J Clin Med 2022; 11:jcm11133744. [PMID: 35807026 PMCID: PMC9267639 DOI: 10.3390/jcm11133744] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 06/26/2022] [Accepted: 06/26/2022] [Indexed: 02/08/2023] Open
Abstract
Background: Psoriatic disease is a chronic inflammatory disease that is associated with morbidity and a poor quality of life. However, studies on the trends of psoriatic disease incidence are limited. We examined trends in psoriasis and psoriatic arthritis from 2002 to 2016 in Taiwan and distinguished the effects of age, period, and cohort on those trends. Methods: Data from the National Health Insurance Research Database were analyzed for the annual incidence of psoriasis and psoriatic arthritis. An age–period–cohort model was designed in order to investigate the effects of each age, period, and birth cohort on the incidence. Results: From 2002 to 2016, the incidence of psoriasis significantly decreased from 43.33 to 23.14 per 100,000 persons. The incidence of psoriatic arthritis significantly increased from 3.57 to 5.22 per 100,000 persons. In the age–period–cohort analysis, the net age effect on the incidence of psoriasis and psoriatic arthritis increased with advancing age (6-fold and 7.7-fold difference, respectively). Conclusion: The age–period–cohort analysis revealed that the incidence of psoriasis and psoriatic arthritis is associated with older age and early birth cohorts. Elderly individuals in Taiwan may be at a higher risk of developing new-onset psoriasis and psoriatic arthritis.
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Chiu HY, Chang Liao NF, Lin Y, Huang YH. Perception of the threat, mental health burden, and healthcare-seeking behavior change among psoriasis patients during the COVID-19 pandemic. PLoS One 2021; 16:e0259852. [PMID: 34882690 PMCID: PMC8659332 DOI: 10.1371/journal.pone.0259852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 10/27/2021] [Indexed: 11/29/2022] Open
Abstract
This study aimed to investigate the perceived threat, mental health outcomes, behavior changes, and associated predictors among psoriasis patients during the COVID-19 pandemic. The COVID-19 has been known to increase the health risks of patients with psoriasis owing to patients’ immune dysregulation, comorbidities, and immunosuppressive drug use. A total of 423 psoriasis patients not infected with COVID-19 was recruited from the Department of Dermatology, National Taiwan University Hospital Hsin-Chu Branch, Chang Gung Memorial Hospital, and China Medical University Hospital from May 2020 to July 2020. A self-administered questionnaire was used to evaluate the perceived threat, mental health, and psychological impact on psoriasis patients using the Perceived COVID-19-Related Risk Scale score for Psoriasis (PCRSP), depression, anxiety, insomnia, and stress-associated symptoms (DAISS) scales, and Impact of Event Scale-Revised (IES-R), respectively. Over 94% of 423 patients with psoriasis perceived threat to be ≥ 1 due to COVID-19; 18% of the patients experienced psychological symptoms more frequently ≥ 1, and 22% perceived psychological impact during the pandemic to be ≥ 1. Multivariable linear regression showed that the higher psoriasis severity and comorbidities were significantly associated with higher PCRSP, DAISS, and IES-R scores. The requirement for a prolonged prescription and canceling or deferring clinic visits for psoriasis treatment among patients are the two most common healthcare-seeking behavior changes during the COVID-19 pandemic. Psoriasis patients who perceived a higher COVID-19 threat were more likely to require a prolonged prescription and have their clinic visits canceled or deferred. Surveillance of the psychological consequences in psoriasis patients due to COVID-19 must be implemented to avoid psychological consequences and inappropriate treatment delays or withdrawal.
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Affiliation(s)
- Hsien-Yi Chiu
- Department of Medical Research, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
- Department of Dermatology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
- Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Dermatology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | - Yu Lin
- Research Services Center for Health Information, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Huei Huang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- * E-mail:
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Karmacharya P, Crowson CS, Bekele D, Achenbach SJ, Davis JM, Ogdie A, Duarte-García A, Ernste FC, Maradit-Kremers H, Tollefson MM, Wright K. The Epidemiology of Psoriatic Arthritis Over Five Decades: A Population-Based Study. Arthritis Rheumatol 2021; 73:1878-1885. [PMID: 33779070 PMCID: PMC8476658 DOI: 10.1002/art.41741] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 03/16/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To determine the incidence of psoriatic arthritis (PsA) in a US population and describe trends in incidence and mortality over 5 decades. METHODS The previously identified population-based cohort that included Olmsted County, Minnesota residents ≥18 years of age who fulfilled PsA criteria during 1970-1999 was extended to include patients with incident PsA during 2000-2017. Age- and sex-specific incidence rates and point prevalence, adjusted to the 2010 US White population, were reported. RESULTS There were 164 incident cases of PsA in 2000-2017 (mean ± SD age 46.4 ± 12.0 years; 47% female). The overall age- and sex-adjusted annual incidence of PsA per 100,000 population was 8.5 (95% confidence interval [95% CI] 7.2-9.8) and was higher in men (9.3 [95% CI 7.4-11.3]) than women (7.7 [95% CI 5.9-9.4]) in 2000-2017. Overall incidence was highest in the 40-59 years age group. The incidence rate was relatively stable during 2000-2017, with no evidence of an overall increase or an increase in men only (but a modest increase of 3% per year in women), compared to 1970-1999 when a 4%-per-year increase in incidence was observed. Point prevalence was 181.8 per 100,000 population (95% CI 156.5-207.1) in 2015. The percentage of women among those with PsA increased from 39% in 1970-1999 and 41% in 2000-2009 to 54% in 2010-2017 (P = 0.08). Overall survival in PsA did not differ from the general population (standardized mortality ratio 0.85 [95% CI 0.61-1.15]). CONCLUSION The incidence of PsA in this predominantly White US population was stable in 2000-2017, in contrast to previous years. However, an increasing proportion of women with PsA was found in this study.
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Affiliation(s)
| | - Cynthia S. Crowson
- Division of Rheumatology, Mayo Clinic, Rochester, MN
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Delamo Bekele
- Division of Rheumatology, Mayo Clinic, Rochester, MN
| | | | - John M. Davis
- Division of Rheumatology, Mayo Clinic, Rochester, MN
| | - Alexis Ogdie
- Departments of Medicine/Rheumatology and Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Alí Duarte-García
- Division of Rheumatology, Mayo Clinic, Rochester, MN
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | | | | | - Megha M. Tollefson
- Departments of Dermatology and Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Kerry Wright
- Division of Rheumatology, Mayo Clinic, Rochester, MN
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19
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Karmacharya P, Chakradhar R, Ogdie A. The epidemiology of psoriatic arthritis: A literature review. Best Pract Res Clin Rheumatol 2021; 35:101692. [DOI: 10.1016/j.berh.2021.101692] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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20
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Proteinuria and Psoriasis Risk: A Nationwide Population-Based Study. J Clin Med 2021; 10:jcm10112356. [PMID: 34071993 PMCID: PMC8199156 DOI: 10.3390/jcm10112356] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/20/2021] [Accepted: 05/24/2021] [Indexed: 11/17/2022] Open
Abstract
Psoriasis, a chronic inflammatory dermatosis, has been associated with chronic kidney disease or end-stage renal disease. However, the association of the changes or amount of proteinuria with psoriasis development has not been evaluated. Using the Korean National Health Screening database, we assessed psoriasis development until 2018 in 6,576,851 Koreans who underwent health examinations in 2009 and 2011. Psoriasis was defined using the International Classification of Diseases, 10th revision (ICD-10) code L40. The risk of psoriasis was evaluated according to change in proteinuria (never [Neg (no proteinuria)/Neg], new [Neg/Pos (proteinuria present)], past [Pos/Neg] and persistent [Pos/Pos] proteinuria) and the proteinuria amount. During a median 7.23-year follow-up, 162,468 (2.47%) individuals developed psoriasis. After adjustments, the hazard ratio (HR) for psoriasis was higher in the persistent proteinuria group (1.32 [1.24–1.40]) than in the never proteinuria group. The past proteinuria group showed better renal outcome (1.03 [1.00–1.07]) than the new (1.05 [1.01–1.07]) and never proteinuria (reference, 1.00) groups did. The amount of random urine proteinuria was associated with increased HR for psoriasis. Subgroup analyses for age, sex, estimated glomerular filtration rate (eGFR), hypertension and diabetes showed that the persistent proteinuria group had a higher risk of psoriasis than the never proteinuria group, especially at eGFR < 60 mL/min/1.73 m2. Persistent proteinuria is associated with psoriasis risk, and the proteinuria amount significantly affects psoriasis development.
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21
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Lecaros C, Dunstan J, Villena F, Ashcroft DM, Parisi R, Griffiths CEM, Härtel S, Maul JT, De la Cruz C. The incidence of psoriasis in Chile: an analysis of the National Waiting List Repository. Clin Exp Dermatol 2021; 46:1262-1269. [PMID: 33914930 PMCID: PMC8518053 DOI: 10.1111/ced.14713] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/08/2021] [Accepted: 04/26/2021] [Indexed: 01/03/2023]
Abstract
Background Psoriasis is a serious and chronic noncommunicable disease. However, the fundamental measure of disease occurrence, the incidence, has been scarcely reported globally. There are no previous studies of psoriasis incidence in Latin America. Aim To estimate the incidence rates of psoriasis in Chile during 2016 and 2017 using an administrative database, the Waiting List Repository. Methods We examined referrals of psoriasis at onset, made by physicians to dermatologists, evaluated the agreement of diagnosis, and estimated the incidence of the disease considering the eligible population at risk. Results In most cases, the referrals corresponded to incident cases of psoriasis (73.3%; 95% CI: 66.6–79.2). The national incidence rates of psoriasis were 22.1 (95% CI: 21.1–23.1) and 22.7 (95% CI: 21.8–23.6) per 100 000 person‐years in 2016 and 2017, respectively. The most common type of psoriasis was the late‐onset type. We observed a high variation in the figures throughout the country, with a range from 0.75 (95% CI: 0.3–1.5) per 100 000 person‐years in the Metropolitan region to 164.9 (95% CI: 138.6–195.1) per 100 000 person‐years in the Aysen region. Conclusion We describe for the first time the incidence of psoriasis in a Latin American country. Our findings could potentially guide collaborations to improve our global understanding of psoriasis in Latin America.
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Affiliation(s)
- C Lecaros
- Centre for Medical Informatics and Telemedicine, Biomedical Neuroscience Institute, ICBM, Faculty of Medicine, University of Chile, Santiago, Chile.,Psoriasis Research Centre, Dermacross Clinic, Santiago, Chile
| | - J Dunstan
- Centre for Medical Informatics and Telemedicine, Biomedical Neuroscience Institute, ICBM, Faculty of Medicine, University of Chile, Santiago, Chile.,Centre for Mathematical Modeling, Faculty of Physical and Mathematical Sciences, University of Chile, Santiago, Chile
| | - F Villena
- Centre for Medical Informatics and Telemedicine, Biomedical Neuroscience Institute, ICBM, Faculty of Medicine, University of Chile, Santiago, Chile.,Centre for Mathematical Modeling, Faculty of Physical and Mathematical Sciences, University of Chile, Santiago, Chile
| | - D M Ashcroft
- Centre for Pharmacoepidemiology and Drug Safety, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - R Parisi
- Division of Informatics, Imaging amd Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - C E M Griffiths
- Dermatology Centre, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - S Härtel
- Centre for Medical Informatics and Telemedicine, Biomedical Neuroscience Institute, ICBM, Faculty of Medicine, University of Chile, Santiago, Chile.,National Center for Health Information Systems, Santiago, Chile
| | - J T Maul
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - C De la Cruz
- Psoriasis Research Centre, Dermacross Clinic, Santiago, Chile
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22
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Griffiths CEM, Armstrong AW, Gudjonsson JE, Barker JNWN. Psoriasis. Lancet 2021; 397:1301-1315. [PMID: 33812489 DOI: 10.1016/s0140-6736(20)32549-6] [Citation(s) in RCA: 878] [Impact Index Per Article: 292.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/07/2020] [Accepted: 11/13/2020] [Indexed: 12/19/2022]
Abstract
Psoriasis is a common, chronic papulosquamous skin disease occurring worldwide, presenting at any age, and leading to a substantial burden for individuals and society. It is associated with several important medical conditions, including depression, psoriatic arthritis, and cardiometabolic syndrome. Its most common form, chronic plaque or psoriasis vulgaris, is a consequence of genetic susceptibility, particularly in the presence of the HLA-C*06:02 risk allele, and of environmental triggers such as streptococcal infection, stress, smoking, obesity, and alcohol consumption. There are several phenotypes and research has separated pustular from chronic plaque forms. Immunological and genetic studies have identified IL-17 and IL-23 as key drivers of psoriasis pathogenesis. Immune targeting of these cytokines and of TNFα by biological therapies has revolutionised the care of severe chronic plaque disease. Psoriasis cannot currently be cured, but management should aim to minimise physical and psychological harm by treating patients early in the disease process, identifying and preventing associated multimorbidity, instilling lifestyle modifications, and employing a personalised approach to treatment.
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Affiliation(s)
- Christopher E M Griffiths
- Dermatology Centre, Salford Royal NHS Foundation Trust, University of Manchester, Manchester, UK; NIHR Manchester Biomedical Research Centre, Manchester, UK.
| | - April W Armstrong
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Jonathan N W N Barker
- St John's Institute of Dermatology, Faculty of Life Sciences and Medicine, King's College London, London, UK
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23
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Tsai TF, Hsieh TY, Chi CC, Chou CT, Hsieh LF, Chen HH, Hui RCY, Lee CH, Liu CH, Liu HC, Yeo KJ, Chen CH, Chen HA, Chen YC, Chen YJ, Chiu HY, Ho JC, Huang YH, Lai PJ, Lee WR, Liao HT, Lin SH, Tseng JC, Wang TS, Wu NL, Yang DH, Tsai WC, Wei JCC. Recommendations for psoriatic arthritis management: A joint position paper of the Taiwan Rheumatology Association and the Taiwanese Association for Psoriasis and Skin Immunology. J Formos Med Assoc 2021; 120:926-938. [PMID: 33012636 DOI: 10.1016/j.jfma.2020.08.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/25/2020] [Accepted: 08/18/2020] [Indexed: 01/14/2023] Open
Abstract
In Taiwan, the incidence and prevalence of psoriatic arthritis (PsA) have risen significantly in recent years. Moreover, data from the Taiwan National Health Insurance Research Database (NHIRD) show that more than 85% of PsA patients are treated with just non-steroidal anti-inflammatory drugs (NSAIDs) and/or conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs). Taiwanese clinicians have also expressed concerns regarding uncertainties in the diagnosis of PsA and the delayed, interrupted, and/or tapered use of biologics, as well as differences in therapeutic preferences between and within dermatologists and rheumatologists. To address these issues, the Taiwan Rheumatology Association and the Taiwanese Association for Psoriasis and Skin Immunology jointly convened a committee of 28 clinicians from the fields of rheumatology, dermatology, orthopedics, and rehabilitation, to develop evidence-based consensus recommendations for the practical management of PsA in Taiwan. A total of six overarching principles and 13 recommendations were developed and approved, as well as a treatment algorithm with four separate tracks for axial PsA, peripheral PsA, enthesitis, and dactylitis. Psoriasis (PsO) management was not discussed here, as the Taiwanese Dermatological Association has recently published a comprehensive consensus statement on the management of PsO. Together, these recommendations provide an up-to-date, evidence-based framework for PsA care in Taiwan.
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Affiliation(s)
- Tsen-Fang Tsai
- Department of Dermatology, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan
| | - Tsu-Yi Hsieh
- Division of Allergy-Immunology-Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan; Program of Business, College of Business, Feng Chia University, Taichung, Taiwan
| | - Ching-Chi Chi
- Department of Dermatology, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chung-Tei Chou
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Lin-Fen Hsieh
- Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Hsin-Hua Chen
- Division of Allergy-Immunology-Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Rosaline Chung-Yee Hui
- Department of Dermatology, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Dermatology, Chang Gung Memorial Hospital-Keelung, Keelung, Taiwan
| | - Chih-Hung Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chin-Hsiu Liu
- Division of Allergy, Immunology and Rheumatology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Hwa-Chang Liu
- Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei, Taiwan; Department of Orthopedics Surgery, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Kai-Jieh Yeo
- Division of Rheumatology and Immunology, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Hsiung Chen
- Division of Allergy, Immunology and Rheumatology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Hung-An Chen
- Department of Allergy, Immunology, and Rheumatology, Chi Mei Medical Center, Tainan, Taiwan
| | - Ying-Chou Chen
- Department of Rheumatology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yi-Ju Chen
- Department of Dermatology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Hsien-Yi Chiu
- Department of Dermatology, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan; Department of Dermatology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Ji-Chen Ho
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Department of Dermatology, Chang Gung Memorial Hospital-Chiayi, Chiayi, Taiwan
| | - Yu-Huei Huang
- Department of Dermatology, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Po-Ju Lai
- Division of Dermatology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Woan-Ruoh Lee
- Department of Dermatology, Taipei Medical University Shuang Ho Hospital, Taipei, Taiwan; Department of Dermatology, School of Medicine, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Medical Science, Taipei Medical University, Taipei, Taiwan
| | - Hsien-Tzung Liao
- Division of Allergy, Immunology and Rheumatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shang-Hung Lin
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Jui-Cheng Tseng
- Division of Allergy, Immunology, and Rheumatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ting-Shun Wang
- Department of Dermatology, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan; Division of Dermatology, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Dermatology, Chung Shan Medical University, Taichung, Taiwan
| | - Nan-Lin Wu
- Department of Dermatology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Deng-Ho Yang
- Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Taichung Armed-Forces General Hospital, Taichung, Taiwan; Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan; Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wen-Chan Tsai
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
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24
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Kubanov AA, Bogdanova EE. Epidemiology of psoriasis among the elderly population and volume of specialized medical care provided to patients with psoriasis in the Russian Federation in 2010–2019. VESTNIK DERMATOLOGII I VENEROLOGII 2020. [DOI: 10.25208/vdv1171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background. Population ageing is ongoing in the Russian Federation. Demographic changes may influence the age structure and dynamics of epidemiological rates of chronic skin disorders, as well as the need of elderly patients in specialized medical care.
Aims. To study the dynamics of number of cases, incidence and prevalence of psoriasis, and the dynamics of the number of hospital admissions for psoriasis among elderly population (males 60 years and older, females 55 years and older) in 20102019 in the Russian Federation.
Materials and methods. Analysis of federal statistic surveillance data, psoriasis prevalence and incidence rates among different age groups of population.
Results. In the Russian Federation there is an increase in absolute number of cases, prevalence and incidence rates of psoriasis among elderly population. There is an increase in the number of hospital admissions due to psoriasis among patients with psoriasis of this age.
Conclusions. An increase of the number and proportion of cases of psoriasis among elderly population is due to both, an increase of prevalence and incidence rates in this age group and population ageing. There is a high need in specialized medical care among elderly population with psoriasis.
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25
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Kubanov AA, Bogdanova EE. Epidemiology of psoriasis among the elderly population and volume of specialized medical care provided to patients with psoriasis in the Russian Federation in 2010–2019. VESTNIK DERMATOLOGII I VENEROLOGII 2020. [DOI: 10.25208/vdv1171-2020-96-5-07-18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background. Population ageing is ongoing in the Russian Federation. Demographic changes may influence the age structure and dynamics of epidemiological rates of chronic skin disorders, as well as the need of elderly patients in specialized medical care.
Aims. To study the dynamics of number of cases, incidence and prevalence of psoriasis, and the dynamics of the number of hospital admissions for psoriasis among elderly population (males 60 years and older, females 55 years and older) in 20102019 in the Russian Federation.
Materials and methods. Analysis of federal statistic surveillance data, psoriasis prevalence and incidence rates among different age groups of population.
Results. In the Russian Federation there is an increase in absolute number of cases, prevalence and incidence rates of psoriasis among elderly population. There is an increase in the number of hospital admissions due to psoriasis among patients with psoriasis of this age.
Conclusions. An increase of the number and proportion of cases of psoriasis among elderly population is due to both, an increase of prevalence and incidence rates in this age group and population ageing. There is a high need in specialized medical care among elderly population with psoriasis.
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26
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Wei CY, Lee YH, Wei JCC. Comment on: ‘EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update’ by Gossec et al. Ann Rheum Dis 2020; 81:e138. [DOI: 10.1136/annrheumdis-2020-218385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 06/29/2020] [Indexed: 12/28/2022]
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27
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Iskandar IYK, Parisi R, Griffiths CEM, Ashcroft DM. Systematic review examining changes over time and variation in the incidence and prevalence of psoriasis by age and gender. Br J Dermatol 2020; 184:243-258. [PMID: 32358790 DOI: 10.1111/bjd.19169] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND There is a lack of any overview of changes over time and variation in the epidemiology of psoriasis with age and between genders. OBJECTIVES To perform a systematic review of published population-based studies on variations in psoriasis incidence and prevalence with age and between genders, and to explore trends in psoriasis epidemiology over time. METHODS Eleven electronic and regional databases were searched from their inception dates to October 2019. No language restrictions were applied. Studies were eligible if they reported on changes in psoriasis incidence and/or prevalence over time and/or by age group and gender. RESULTS In total 308 papers were critically appraised, from which 90 studies from 22 countries were included. Incidence data confirmed a clear bimodal age pattern in psoriasis onset, with the first and second peaks at around 30-39 and 60-69 years of age, respectively, and evidence suggesting that it presents slightly earlier in women than in men. Prevalence data showed an increasing trend with age until around 60 or 70 years, after which it decreases. Although there was lack of agreement on specific gender differences in psoriasis incidence and prevalence, a slight male predominance was reported in several studies. Studies worldwide suggested a stable or slightly decreasing trend in psoriasis incidence, while an increasing trend in psoriasis prevalence has been consistently reported. One particular challenge faced was the vastly different methodologies used in the included studies, which contributed to some of the heterogeneity of the results. CONCLUSIONS Studies on changes over time in the occurrence of psoriasis have contributed to a greater appreciation of the increasing burden of the disease. However, further research is required to determine the reasons driving the increase in psoriasis prevalence over time.
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Affiliation(s)
- I Y K Iskandar
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - R Parisi
- NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,Division of Informatics, Imaging & Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - C E M Griffiths
- NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,Dermatology Centre, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - D M Ashcroft
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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28
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Parisi R, Iskandar IYK, Kontopantelis E, Augustin M, Griffiths CEM, Ashcroft DM. National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study. BMJ 2020; 369:m1590. [PMID: 32467098 PMCID: PMC7254147 DOI: 10.1136/bmj.m1590] [Citation(s) in RCA: 485] [Impact Index Per Article: 121.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To systematically review and provide information on the incidence of psoriasis and quantify global, regional, and country specific estimates of its prevalence. DESIGN Systematic review and meta-analysis. DATA SOURCES Medline, Embase, Web of Science, SciELO, Korean Journal Databases, Russian Science Citation Index, WPRIM, SaudiMedLit, Informit, IndMed, and HERDIN were searched systematically from their inception dates to October 2019. METHODS Studies were included if they reported on the incidence or prevalence of psoriasis in the general population. Incidence data were summarised descriptively, whereas bayesian hierarchical models were fitted to estimate the global, regional, and country specific prevalence of psoriasis. RESULTS 41 164 records were identified and 168 studies met the inclusion criteria. In adults, the incidence of psoriasis varied from 30.3 per 100 000 person years (95% confidence interval 26.6 to 34.1) in Taiwan to 321.0 per 100 000 person years in Italy. The prevalence of psoriasis varied from 0.14% (95% uncertainty interval 0.05% to 0.40%) in east Asia to 1.99% (0.64% to 6.60%) in Australasia. The prevalence of psoriasis was also high in western Europe (1.92%, 1.07% to 3.46%), central Europe (1.83%, 0.62% to 5.32%), North America (1.50%, 0.63% to 3.60%), and high income southern Latin America (1.10%, 0.36% to 2.96%). CONCLUSIONS Eighty one per cent of the countries of the world lack information on the epidemiology of psoriasis. The disease occurs more frequently in adults than in children. Psoriasis is unequally distributed across geographical regions; it is more frequent in high income countries and in regions with older populations. The estimates provided can help guide countries and the international community when making public health decisions on the appropriate management of psoriasis and assessing its natural history over time. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019160817.
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Affiliation(s)
- Rosa Parisi
- Division of Pharmacy and Optometry, University of Manchester, Manchester, UK
- Division of Informatics, Imaging & Data Sciences, University of Manchester, Manchester, UK
| | - Ireny Y K Iskandar
- Division of Pharmacy and Optometry, University of Manchester, Manchester, UK
| | | | - Matthias Augustin
- Institute of Health Care Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Christopher E M Griffiths
- Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester, UK
- NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, UK
| | - Darren M Ashcroft
- Division of Pharmacy and Optometry, University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, UK
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29
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Schonmann Y, Ashcroft DM, Iskandar IYK, Parisi R, Sde-Or S, Comaneshter D, Batat E, Shani M, Vinker S, Griffiths CEM, Cohen AD. Incidence and prevalence of psoriasis in Israel between 2011 and 2017. J Eur Acad Dermatol Venereol 2019; 33:2075-2081. [PMID: 31237370 DOI: 10.1111/jdv.15762] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 06/06/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Psoriasis is a common chronic inflammatory skin disease associated with a heavy burden of morbidity, disability and cost. The occurrence of the disease in Israel has not been previously investigated. OBJECTIVES To provide standardized estimates of trends in psoriasis incidence, prevalence and mortality among patients in Israel between 2011 and 2017. METHODS Using electronic health records from Clalit Health Services, the largest nationwide public health provider in Israel, we conducted a population-based study investigating trends in the annual incidence and prevalence of psoriasis between the years 2011 and 2017. We report age- and sex-adjusted rates, using the standard European population as a reference. RESULTS We identified 71 094 incident psoriasis cases. The mean (SD) age of onset was 42.4 (21.0) years with a bimodal distribution, peaking in the early '30s and early '60s. Late-onset psoriasis, occurring after 40 years of age, accounted for 51.1% of incident cases. The annual psoriasis incidence rate was constant throughout the study period (280/100 000 person-years). Psoriasis prevalence rose from 2.5% in 2011 to 3.8% in 2017. CONCLUSIONS Psoriasis prevalence is increasing in Israel, although its incidence is stable. Clinicians and policymakers should plan to address the growing demands in the clinical, economic and societal burden of psoriasis.
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Affiliation(s)
- Y Schonmann
- Department of Family Medicine, Rabin Medical Center, Clalit Health Services, Petach Tikva, Israel.,Department of Quality Measurements and Research, Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel.,Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - D M Ashcroft
- Centre for Pharmacoepidemiology and Drug Safety, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK
| | - I Y K Iskandar
- Centre for Pharmacoepidemiology and Drug Safety, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK
| | - R Parisi
- Centre for Pharmacoepidemiology and Drug Safety, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK
| | - S Sde-Or
- Department of Quality Measurements and Research, Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel
| | - D Comaneshter
- Department of Quality Measurements and Research, Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel
| | - E Batat
- Department of Quality Measurements and Research, Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel
| | - M Shani
- Department of Quality Measurements and Research, Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel.,Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Vinker
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - C E M Griffiths
- Dermatology Centre, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, UK
| | - A D Cohen
- Department of Quality Measurements and Research, Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel.,Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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30
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Solmaz D, Eder L, Aydin SZ. Update on the epidemiology, risk factors, and disease outcomes of psoriatic arthritis. Best Pract Res Clin Rheumatol 2018; 32:295-311. [PMID: 30527433 DOI: 10.1016/j.berh.2018.09.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/21/2018] [Accepted: 09/09/2018] [Indexed: 02/08/2023]
Abstract
Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects different structures of the musculoskeletal system in addition to the skin and the nail. The complexity of the disease had been a barrier to understand the pathogenesis and define valid outcome tools; however, our understanding about the disease has considerably increased with time mainly because of the advances in imaging, new discoveries in genetics and underlying inflammatory pathways, and better understanding of the epidemiology of the disease and environmental risk factors. The purpose of this review is to summarize developments and changes in epidemiology, risk factors for developing PsA, and outcome measures with a focus on data obtained in the last 10 years.
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Affiliation(s)
- Dilek Solmaz
- Division of Rheumatology, University of Ottawa, 1967 Riverside Drive, Ottawa, ON, K1H 7W9, Canada; Izmir Katip Celebi University, Izmir, Turkey.
| | - Lihi Eder
- Women's College Research Institute, Women's College Hospital, The Department of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Sibel Zehra Aydin
- Division of Rheumatology, University of Ottawa, 1967 Riverside Drive, Ottawa, ON, K1H 7W9, Canada; The Ottawa Hospital Research Institute, University of Ottawa, 1967 Riverside Drive, Ottawa, ON, K1H 7W9, Canada.
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Psoriasis risk in patients with diabetic retinopathy: A nationwide population-based study. Sci Rep 2018; 8:9086. [PMID: 29904118 PMCID: PMC6002525 DOI: 10.1038/s41598-018-27147-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 05/27/2018] [Indexed: 02/08/2023] Open
Abstract
Psoriasis is a chronic cutaneous disease known to be related with systemic disease; however, the association between psoriasis and diabetic complications has not been previously reported. Diabetic microvascular complications include diabetic retinopathy (DR), nephropathy, and neuropathy, and overt diabetic nephropathy can lead to the end-stage renal disease (ESRD).The present study investigated the association between psoriasis and non-proliferative DR (NPDR) or proliferative DR (PDR) or ESRD. We analyzed the relationship between diabetic complication and psoriasis using data from the National Health Insurance Service between 2009 and 2015. During a mean follow-up of 5.18 years, 43,792 patients were newly diagnosed with psoriasis. In Cox proportional hazard models, patients with NPDR (hazard ratio [HR] 1.26) had a higher incidence of psoriasis and patients with PDR patients had a higher risk of psoriasis (HR 1.35). ESRD was defined by the ICD-10 code, including chronic kidney disease/renal failure, transplantation, and dialysis. The incidence of psoriasis increased in DR patients with ESRD (HR 2.99, 95% CI 2.49–3.59, p < 0.001) compared to non-DR patients without ESRD. This is the first association study between psoriasis and diabetic complications including DR and ESRD. DR and its severity were related to the onset of psoriasis. In addition, ESRD was related with an increased psoriasis in DR patients.
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