OP0231 DIFFERENCES IN REAL-WORLD PATIENT CHARACTERISTICS OF 8921 PSORIASIS PATIENTS WITH AND WITHOUT COMORBID PSORIATIC ARTHRITIS USING THE UK BADBIR DATABASE

Abstract

Background:Psoriatic arthritis (PsA) is a chronic inflammatory arthritis associated with psoriasis (PsO) and multiple comorbidities.1 Approximately one-third of PsO patients develop PsA during the course of their disease.2 As patient cohorts included in randomised clinical trials are not necessarily representative of the real world, registry data can complement any information gained on patient characteristics and disease outcomes.3 The British Association of Dermatologists Biologic and Immunomodulators Register (BADBIR) is one such registry for patients with plaque PsO, with PsA being one of the recorded comorbidities at time of patient enrolment into the database.Objectives:The primary objective of this study was to evaluate baseline characteristics and comorbidities in PsO patients with and without a PsA diagnosis using the BADBIR database. The hypothesis was that patients with both diseases show a higher likelihood of being diagnosed with additional comorbid conditions vs. PsO alone.Methods:This was a retrospective observational study using two cohorts of BADBIR data (i.e. adult PsO patients either receiving ustekinumab [UST] as their biologic treatment or receiving conventional systemic anti-psoriatic medication [conventional systemic]). Comparisons were made between PsA and PsO alone in each cohort at baseline, additionally stratifying by biologic experience in the UST treatment group. Baseline characteristics of interest were evaluated, including body mass index, smoking and employment status, as well as comorbidities (i.e. diabetes, hypertension, myocardial infarction and depression). Effect sizes and 95% confidence intervals were generated via matching with a two-sided Fisher’s exact test.Results:Cohort patient counts were as follows: 2697 UST treated without PsA; 590 UST treated with PsA; 5105 conventional systemic without PsA; 529 conventional systemic with PsA. PsO patients with a PsA diagnosis had a higher prevalence of diabetes, obesity and hypertension across both conventional systemic and UST cohorts vs. PsO alone (Table 1). Similarly, inability to work was notably higher in PsO patients with PsA vs. PsO alone (Figure 1). Patients with PsO and comorbid PsA who were receiving UST were more likely to have a diagnosis of depression than those receiving conventional systemic treatment (Table 1).Table 1.Prevalence odds ratio of baseline characteristics of patients with PsO treated with either UST or a conventional systemic agent.Baseline variableTreatment cohortOdds ratio95% CIAbility to workUST0.270.21–0.35Conventional systemic0.490.37–0.65SmokingUST0.940.76–1.17Conventional systemic0.720.58–0.89DepressionUST1.541.25–1.88Conventional systemic1.140.91–1.42Obesity*UST1.341.11–1.62Conventional systemic1.211.01–1.46DiabetesUST1.451.10–1.89Conventional systemic1.511.11–2.04HypertensionUST1.541.26–1.87Conventional systemic1.301.03–1.62Myocardial infarctionUST1.670.98–2.76Conventional systemic1.170.56–2.21Odds ratios and 95% CIs are shown for the prevalence of each patient baseline characteristic in the PsO with comorbid PsA group vs. the prevalence in the PsO group. *Obesity is defined as a BMI ≥30 kg/m2. BMI, body mass index; CI, confidence interval; PsA, psoriatic arthritis; PsO, psoriasis; UST, ustekinumab.Conclusion:These results indicate that PsO patients with PsA had a higher prevalence of obesity, diabetes, hypertension and inability to work vs. PsO alone. Depression also seems to be more prevalent in PsO patients with comorbid PsA receiving biologic treatment vs. those receiving conventional systemics. These results potentially indicate a higher inflammatory and quality-of-life burden in PsO patients with a PsA diagnosis, highlighting the need for adequate patient assessment and follow-up to ensure a best possible holistic patient management approach.