Corrona Psoriasis Registry Research Articles

JAAD Game Changer: “Comorbid obesity and history of diabetes are independently associated with poorer treatment response to biologics at 6 months: A prospective analysis in the Corrona Psoriasis Registry”

JAAD Game Changer: “Comorbid obesity and history of diabetes are independently associated with poorer treatment response to biologics at 6 months: A prospective analysis in the Corrona Psoriasis Registry”

26588 Patient-reported outcomes from a large, North American-based cohort, highlight a greater disease burden for generalized pustular psoriasis vs plaque psoriasis: Real-world evidence from the Corrona Psoriasis Registry

Generalized pustular psoriasis (GPP) is a rare, systemic disease characterized by recurrent flares of painful neutrophilic aseptic pustules. There is limited real-word evidence characterizing patients with GPP. Establishing the distinguishing characteristics of GPP relative to plaque psoriasis may help inform future treatment and improve patient outcomes. Adults with GPP (n = 60) or plaque psoriasis (n = 4894) identified from the North American-based Corrona Psoriasis Registry were included in descriptive analyses.

26698 Characteristics and disease burden in patients with mild to moderate vs severe plaque psoriasis in real-world settings: Results from the Corrona Psoriasis Registry

Background: Mild-to-moderate psoriasis may present with high disease burden despite limited skin involvement, particularly when psoriasis involves special areas (eg, scalp, nails, palms/soles). We compared characteristics of adults with mild-to-moderate vs severe psoriasis who initiated systemic treatment at enrollment in the real-world Corrona Psoriasis Registry (4/2015-6/2020).

25696 Impact of guselkumab on quality of life and work productivity outcomes among patients with moderate-to severe plaque psoriasis in the Corrona Psoriasis Registry

Background: Guselkumab is an IL-23 inhibitor approved for the treatment of moderate-to-severe plaque psoriasis (PsO). Plaque PsO is known to impact patient-reported outcomes (PROs). Little is known about the impact of persistent guselkumab treatment on PROs among real-world patients.

26916 Effectiveness of guselkumab among patients with moderate-to-severe plaque psoriasis in the Corrona Psoriasis Registry

Background: Guselkumab is an IL-23 inhibitor approved for the treatment of moderate-to-severe plaque psoriasis (PsO). To date, there is limited information on the effect of persistent guselkumab treatment on disease severity in a real-world setting.

25031 Greater disease burden associated with palmoplantar pustulosis versus plaque psoriasis: Real-world evidence from the North American–based Corrona Psoriasis Registry

Palmoplantar pustulosis (PPP) is a subtype of psoriasis, localized to the palms and soles. Relatively little is known about the natural history of PPP. Given the paucity of available information, this descriptive study outlines the characteristics, clinical outcomes, and patient-reported outcomes (PROs) of patients with PPP versus those with plaque psoriasis. Enrollment data from the Corrona Psoriasis Registry (a prospective, multicenter registry for patients with psoriasis) were analyzed, comparing patients with PPP (n = 64) and plaque psoriasis (n = 4894). Data include sociodemographics, disease characteristics, PROs, and medication use. There are notable differences between patients with PPP and plaque psoriasis. Although patients with PPP had a smaller median (p25, p75) percentage body surface area (BSA) affected (3 [1, 5.5] vs 5 [1, 12]), when assessing median (p25, p75) visual analog scores (range 0-100), they had greater itch (40 [15, 76] vs 22 [5, 70]), higher fatigue (35 [10, 60] vs 20 [4, 50]), and more pain (35 [5, 63] vs 5 [0, 35]) than patients with plaque psoriasis. Importantly, median reported percentage of impairment while working (10 [0, 53] vs 0 [0, 15]) and in daily activities (30 [5, 50] vs 3 [0, 25]) was greater for patients with PPP. Despite affecting a smaller BSA than plaque psoriasis, the presence of pustules on the palms and soles among patients with PPP has a distinct impact on patient wellbeing, with greater itch, fatigue, and pain reported. These translate into a considerable impairment in both work and daily activities.

Comorbid obesity and history of diabetes are independently associated with poorer treatment response to biologics at 6 months: A prospective analysis in Corrona Psoriasis Registry

Psoriasis is associated with comorbid systemic metabolic disease. To assess possible associations of comorbid obesity, history of diabetes, hypertension, and hyperlipidemia with response to biologic treatment at 6months among patients in CorEvitas' Psoriasis Registry. Participants included 2924 patients initiating biologic therapy (tumour necrosis factor inhibitors [TNFi], interleukin [IL]-17i, IL-12/23i, or IL-23i) with baseline and 6-month follow-up visits available. Logistic regressions resulted in adjusted odd ratios (OR) and 95% confidence intervals (CI) for achievement of response in select outcomes for those with obesity and history of diabetes, hypertension, and hyperlipidemia relative to those without each. Overall, obesity reduced by 25% to 30% odds of achieving PASI75 (OR, 0.75; 95% CI, 0.64-0.88) and PASI90 (OR, 0.70; 95% CI, 0.59-0.81). History of diabetes reduced odds of achieving PASI75 by 31% (OR, 0.69; 95% CI, 0.56-0.85) and PASI90 by 21% (OR, 0.79; 95% CI, 0.63-0.98). Obesity was associated with lower response to TNFi and IL-17i classes. Independent of obesity, diabetes was associated with poorer outcomes when on IL-17i therapy and hypertension, to a lesser extent, when on the TNFi class. No significant associations were found in the hyperlipidemia group. The study assessed only short-term effectiveness and small sample sizes limited the power to detect differences. Assessment of comorbid disease burden is important for improved likelihoods of achieving treatment response with biologics.

Psoriasis Severity, Comorbidities, and Treatment Response Differ among Geographic Regions in the United States

Little is known about how psoriatic disease characteristics and treatment outcomes differ geographically in the United States. Our aim was to explore real-world, geographic variations in the use of biologic classes and outcomes within the Corrona Psoriasis Registry. Patient demographics and disease characteristics were assessed at biologic initiation and at 6 months. Logistic regressions were conducted to evaluate the odds of achieving targeted outcomes for seven United States geographic regions. We examined 737 biologic initiations among 717 patients. IL-17 inhibitors were used most frequently (45%), followed by IL-12‒IL-23 and IL-23 inhibitors (38%) and TNF inhibitors (17%). The proportions of patients with obesity (body mass index > 30) and very severe psoriasis (body surface area > 20) were greatest in the East South Central and West South Central regions. After adjusting for age, sex, race, body mass index, and baseline body surface area, decreased odds of achieving 75% improvement in PASI at 6 months were observed among patients in the East South Central (OR = 0.47, 95% confidence interval = 0.28–0.79, P = 0.004), West South Central (OR = 0.43, 95% confidence interval = 0.22–0.87, P = 0.019), and Pacific (OR = 0.49, 95% confidence interval = 0.28–0.84, P = 0.010) regions compared with those observed among patients in the Northeast. The East South Central and West South Central regions may have the greatest frequencies of very severe disease burden and, along with the Pacific region, may be less likely to achieve targeted response within 6 months of initiating biologic therapy.

301 Psoriatic arthritis risk in psoriasis patients in the Corrona® Psoriasis Registry

Background: Understanding characteristics that predict the onset of psoriatic arthritis (PsA) in psoriasis (PsO) patients would help effectively direct treatment. We aimed to develop a model to predict the 2-year PsA risk for real-world PsO patients. Methods: Patients in the prospective, multicenter, non-interventional Corrona Psoriasis Registry without PsA at enrollment and with a 24-month follow-up visit (FU) were included. Demographic and clinical variables collected at enrollment were used to construct logistic regression models to predict PsA diagnosis at FU. Data were randomly partitioned into training (70%) and testing (30%) sets. Models were developed using stepwise forward selection, backward elimination, and elastic net to select predictors. Performance was compared using area under the receiver-operating-characteristic curve (AUC), sensitivity (SE), and specificity (SP). Results: 1489 patients were analyzed (n=1042, training; n=447, test). In the training set, mean age was 49 years, 43% were female, and 119 (11%) developed PsA; those who developed PsA had higher mean Psoriasis Epidemiology Screening Tool (PEST) scores (2.8 vs 1.8), and patient-reported fatigue (33 vs 25, VAS-100) and skin pain (23 vs 19, VAS-100) at enrollment vs those who did not. Nine unique models were constructed; PEST and BMI were common in all. In the testing set, the most predictive model included PEST, BMI, modified Rheumatic Disease Comorbidity Index, work status, alcohol use, and fatigue (AUC= 68.9%, SE=82.9%, SP=48.8%). A more parsimonious model (PEST and BMI only) performed similarly (AUC=68.8%; SE=92.7%, SP=36.5%). Conclusions: While predictive ability was limited, and further refinement and external validation are needed, our findings provide insight for developing a tool to evaluate PsA risk in PsO patients.

Drug survival of ixekizumab, TNF inhibitors, and other IL-17 inhibitors in real-world patients with psoriasis: The Corrona Psoriasis Registry.

To compare drug survival of ixekizumab to other IL‐17 inhibitors (IL‐17i) and TNF inhibitors (TNFi) among patients with psoriasis (PsO) in a real‐world setting. Participants included adult PsO patients enrolled in the Corrona Psoriasis Registry who initiated ixekizumab, TNFi, or other IL‐17i between 16 March 2016 to 10 August 2019 and completed ≥1 follow‐up visit. Multivariable adjusted hazard ratios (HR) were calculated to estimate the risk for drug discontinuation in the ixekizumab group relative to the other drugs. Among the 1604 drug initiations, 552 initiated ixekizumab, 450 initiated TNFi, and 602 initiated other IL‐17i. Mean age was 51 years, 49% were women, and 52% were obese (BMI > 30). Ixekizumab patients had a higher proportion of patients with PASI >12 at drug initiation (24%) than TNFi (15%) and other IL‐17i (19%). Over a median of 11 months of follow‐up, 723/1604 (45%) drug discontinuations occurred. Persistence of ixekizumab, TNFi, and other IL‐17i at 24‐months were 68%, 33%, and 46%, among biologic‐naïve patients (n = 543), and 46%, 23%, and 36%, for biologic‐experienced patients (n = 1061), respectively. Ixekizumab patients had a 64% lower risk of discontinuation vs TNFi (HR = 0.36; 95% CI 0.27‐0.47) and a 31% lower risk vs other IL‐17i (HR = 0.69, 95% CI 0.55‐0.87) after adjustment for biologic experience and other covariates. HRs were similar when limited to patients with moderate‐to‐severe PsO (BSA > 3, PASI > 3, and IGA > 1, n = 1076) at initiation. In our study of real‐world patients with PsO, initiators of ixekizumab had more prolonged drug survival than both initiators of TNFi and other IL‐17i up to 2 years of follow‐up.

Characteristics of Patients with Psoriasis Treated with Apremilast in the Corrona Psoriasis Registry.

IntroductionData on the characteristics of apremilast patients in real-world settings are limited. We assessed the demographics and disease characteristics of apremilast-treated patients in the Corrona Psoriasis Registry overall and by treatment history.MethodsThe Corrona Psoriasis Registry is a large, independent, prospective, observational registry of adult patients (age ≥ 18 years) who initiate an eligible systemic medication for treatment of psoriasis at or after enrollment (incident users) or within 12 months before enrollment (prevalent users). The current analyses included psoriasis patients enrolled in the Corrona Psoriasis Registry between April 1, 2015, and January 7, 2018. Patients were adults (age ≥ 18 years) with psoriasis who were enrolled between April 1, 2015, and January 7, 2018 and initiated apremilast at the time of registry enrollment or a subsequent visit (incident users) or within the 12 months prior to registry enrollment (prevalent users). Patient characteristics were evaluated descriptively at the index date, defined as the enrollment date for prevalent users and the visit when apremilast was initiated for incident users.ResultsAmong 660 patients who initiated apremilast at registry enrollment or a visit thereafter, psoriatic arthritis, hypertension, and hyperlipidemia were common. There were more systemic-experienced (61.4%) versus systemic-naive (38.6%) patients; 43.8% had prior biologic exposure. Most patients were not receiving concomitant systemic treatment (70.2%); 27.4% were receiving concomitant biologic therapy. Most patients had mild or moderate disease (psoriasis-involved body surface area ≤ 10% [76.0%], Investigator Global Assessment ≤ 3 [88.3%], Psoriasis Area and Severity Index ≤ 10 [84.5%]). Dermatologist-reported psoriatic arthritis was present in 47.0% of patients; 33.9% of patients had a Psoriasis Epidemiology Screening Tool score of ≥ 3, suggestive of psoriatic arthritis. Systemic-experienced apremilast patients had higher rates of obesity and comorbidities and experienced a greater impact on quality of life (mean Dermatology Life Quality Index, 7.3 vs. 6.5) versus systemic-naive patients.ConclusionIn this real-world observational study of apremilast users in the Corrona Psoriasis Registry, most patients had less-severe disease and higher rates of prior exposure to biologic treatments compared with patients with moderate-to-severe psoriasis enrolled in phase 3 clinical studies.

Disease response and patient-reported outcomes among initiators of ixekizumab

Objectives There is limited real-world evidence on using ixekizumab in psoriasis patients. Therefore, we characterized patients with psoriasis initiating ixekizumab and report 6-month changes in disease and patient-reported outcomes. Methods Adult patients with psoriasis who initiated ixekizumab and completed a 6-month follow-up visit were enrolled from the Corrona Psoriasis Registry. Disease characteristics and outcomes were assessed at ixekizumab initiation. Outcomes included the mean 6-month change in Psoriasis Area and Severity Index (PASI), body surface area (BSA), Investigator Global Assessment (IGA), and IGA*BSA. Results From baseline to follow-up in all patients (n = 136), means decreased for IGA*BSA (−45.5) and BSA (−12.4), and a higher % achieved an absolute PASI ≤ 5 (84.6%), BSA 0–3 (72.1%), and IGA 0/1 (50.7%). Within stratified groups, means decreased for PASI <12 for IGA*BSA (−21.1) and BSA (−6.3); PASI≥12 for IGA*BSA (−94.8) and BSA (−24.6); weight <100 kg for IGA*BSA (−45.1) and BSA (−12.4); weight ≥100 kg for IGA*BSA (−46.2) and BSA (−12.3); concomitant PsA for IGA*BSA (−56.0) and BSA (−15.3); and in no concomitant PsA for IGA*BSA (−36.9) and BSA (−10.0). Conclusions We provide real-world evidence on the benefits of ixekizumab for treating psoriasis, regardless of baseline disease severity, weight, or concomitant PsA.

Understanding characteristics of patients newly initiating ixekizumab: findings from the Corrona Psoriasis Registry.

Background: Real-world data on patients newly initiating ixekizumab is limited. Our study describes the characteristics of patients who initiated ixekizumab and other biologics for psoriasis treatment in North American dermatological practices. Materials & methods: Characteristics of patients ascertained at registry enrollment are described via means and frequencies. Results: Compared with other biologic initiators, ixekizumab initiators had: longer disease duration (17.1 vs 15.1 years); more were considered least severe by body surface area (33vs 26%); moderate-to-severe by IGA (56vs 48%); were biologic-experienced (80vs 52%); obese (54 vs 47%); and experienced greater impact in work productivity (5.3 vs 2.9%) versus other biologic initiators. Conclusion: Psoriasis patients initiating ixekizumab had more severe disease, biologic experience, and worse patient-reported outcomes than those initiating other biologics.

16534 Real-world disease severity of patients with psoriasis initiating brodalumab: Findings from the Corrona Psoriasis Registry

Background: Brodalumab is a fully human anti–interleukin-17 (IL-17) receptor A monoclonal antibody efficacious for treatment of moderate to severe plaque psoriasis. We describe real-world baseline disease severity of patients initiating brodalumab or other biologic therapies in the Corrona Psoriasis Registry.

16533 Real-world characteristics of patients with psoriasis initiating brodalumab: Findings from the Corrona Psoriasis Registry

Background: Brodalumab is a fully human anti–interleukin-17 (IL-17) receptor A monoclonal antibody efficacious for the treatment of moderate to severe plaque psoriasis in adults. Limited information on the characteristics of those receiving brodalumab in a real-world setting exists. We describe baseline characteristics of Corrona Psoriasis Registry patients who initiated brodalumab, relative to other biologics for psoriasis.

15169 Impact of guselkumab on quality of life and work productivity outcomes among patients with plaque psoriasis in the Corrona Psoriasis Registry

Background: Guselkumab is an IL-23 inhibitor approved for the treatment of moderate to severe plaque psoriasis (PsO). Little is known about the impact of guselkumab on patient-reported outcomes (PROs) in a real-world setting.

15457 Secukinumab significantly improves clinical and patient-reported outcomes up to 18 months of follow-up: Real-world evidence from a US psoriasis registry

Background: We examined the real-world effectiveness of secukinumab in improving disease severity and patient-reported outcomes (PROs) at 18 months in patients with psoriasis in the US Corrona Psoriasis Registry.

13807 Characterization of nonresponders to interleukin-17 inhibitors in moderate to severe psoriasis patients enrolled in the Corrona Psoriasis Registry

Background: While interleukin-17 (IL-17) inhibitors are effective for many patients with psoriasis, there is limited data characterizing patients who respond or do not respond to this treatment.

16629 2018 geographic variations in the use of biologic therapy for psoriasis in the Corrona Psoriasis Registry

Background: There are currently 12 FDA-approved biologic therapies for the treatment of psoriatic disease. Little is known about the real-world use of these medications, both geographically and over time.

Geographic Variations in Biologic Therapy and Disease Characteristics: A Pilot-Study in the Corrona Psoriasis Registry.

Geographic Variations in Biologic Therapy and Disease Characteristics: A Pilot-Study in the Corrona Psoriasis Registry.