Clinical characteristic and outcomes of psoriasis patients in a multicentre outpatient healthcare institution in Colombia

Abstract

IntroductionPsoriasis is a chronic inflammatory disease characterized by scaly erythematous plaques, systemic inflammation, and an elevated cardiovascular risk. Due to its complexity in treatment and the frequent occurrence of comorbidities, characterizing patients diagnosed with psoriasis enrolled in care programmes becomes paramount for enhancing health outcomes. ObjectiveTo provide a comprehensive description of the sociodemographic, clinical features, and outcomes of a cohort of patients diagnosed with psoriasis in a multicentre outpatient healthcare institution in Colombia. Materials and methodsA cohort study was conducted involving patients diagnosed with psoriasis. Inclusion criteria required a minimum follow-up duration of three months. Quantitative variables were summarized using the median and interquartile range, while qualitative variables were presented with measures of frequency and 95% confidence interval. Changes in the final values of PASI, DLQI, NAPSI, and BSA from baselines were assessed through percentage comparisons, analysed using chi-square test. ResultsA total of 1155 patients were included, with a median age of 53 years and the majority were men (58%). Plaque psoriasis was the predominant type, observed in 78.7%. Psoriatic arthritis was diagnosed in 18.9%. The most prevalent comorbidity was hypertension, identified in 23.0% (95% CI 20.6 to 25.6%), followed by diabetes at 12.5% (95% CI 10.6 to 14.5%) and cardiovascular disease at 10.6%. A significant proportion of patients were classified as overweight and obese, 43.9% (n=479) and 20.9% (n=228), respectively. Regarding treatment modalities, the majority received biological therapies (39%), followed by systemic therapy (22.2%), and topical therapy (17.5%).During the follow-up period, a considerable percentage of patients experienced some decrease in disease activity. A PASI75 response was achieved by 28.5% (95% CI 25.4% to 31.8%), and PASI90% was achieved by 18% (95% CI 15.4% to 20.9%). A bivariate analysis based on Body Mass Index showed a lower response in patients with overweight or obesity, thought these differences were not statistically significant (p=.937). Notably, a higher percentage of patients with no response were observed among those with hypertension (62.9% p=.123), diabetes mellitus (64.7% p=.393), cardiovascular disease (51.5% p<.001), and chronic kidney disease (55.6% p=.014) when compared with patients who achieved therapeutic goals. ConclusionsWe present the largest psoriasis cohort in Colombia. A majority of our patients showed improvement in disease activity based on clinimetric measures. Nevertheless, the presence of comorbidities significantly reduces the likelihood of achieving a treatment response. A multidisciplinary approach combined with tight follow-up ensures better outcomes, highlighting the importance of implementing real-world, multidisciplinary care programmes.