Medical and social care program for patients with psoriasis and/or psoriatic arthritis eligible for biological dmards in real clinical practice

Abstract

High prevalence in different age groups, a significant decrease in patient’s quality of life, and potentially unfavorable outcomes, especially in association with comorbid pathologies define the medico-social significance of psoriasis. The article analyzes the clinical and anamnestic data obtained within the program of medical and social support of patients with psoriasis (PsO) and / or high-to-moderate severity psoriatic arthritis (PsA) “Take control of psoriasis”, launched by ROOI “Human Health” in the conjunction with the Interregional Charitable Public Organization “Skin and Allergic Diseases”. The study involved 20 physicians (8 dermatologists and 12 rheumatologists) from 11 cities and regions of Russia. The program lasted for 3 months and included one-time epidemiologic data collection of 564 patients and educational sessions, aimed to inform patients about their disease features, risk factors, and current international approaches to diagnostics. Every third patient demonstrated the features of both – psoriatic arthritis and psoriasis, established by two specialties – dermatologists and rheumatologists co-existing PsO+PsA in the majority of patients (94%). Patients with various forms of PsO and PsA had comorbid conditions, with prevailing cardiovascular, endocrine and metabolic disorders. Cardiovascular diseases prevailed in the structure of comorbid pathology showing 44% incidence, followed by endocrine disorders (metabolic syndrome, diabetes mellitus) diagnosed in 23% sometimes associated with other diseases in a proportion of patients; 37% patients were overweight or obese based on BMI, especially those receiving biologics. 58% and 49% of patients in the age group of 45–59 years received biologic therapy under the supervision of dermatologists and rheumatologists, respectively. In contrast, patients aged 18–44 years were more likely to be on biologic therapy administered by a rheumatologist – 43%, with only 27% treated by dermatologists. Among all patients on biologic therapy dermatological patients’ mean age was 47.95 years and rheumatological – 40.84 years. Therapy with biologics made it possible to achieve PASI 75 in PsO and minimal disease activity in PsA significantly more often (in 95% and 72% of patients) than therapy with conventional DMARDs / tsDMARD (in 43% and 27%) and other types of therapy (in 64% and 14%, respectively).