Effect of Psoriatic Arthritis on Treatment Response in Patients With Moderate to Severe Psoriasis

J Drugs Dermatol. 2016 Aug 1;15(8):917-22.

Abstract

Background: Among patients with moderate-to-severe psoriasis, efficacy, and tolerability of available treatments based on psoriatic arthritis (PsA) history are not well-described.<BR />

Objective: We evaluate disease characteristics and treatment response variation in the moderate-to-severe psoriasis population based on PsA history.<BR />

Methods: Simple-measure for assessing psoriasis activity (S-MAPA) was used to retrospectively analyze treatment responses.<BR />

Results: 191 moderate-to-severe psoriatic patients, 58 with and 133 without rheumatologist-diagnosed PsA were analyzed. Regardless of PsA history, S-MAPA improvement was similar with biologic monotherapy (46.2 versus 44.1; <em>P</em>=0.74), traditional systemic monotherapy (62.29 versus 38.12; <em>P</em>=0.22), and combination treatments (64.62 versus 52.71; <em>P</em>=0.40) after 12 weeks. PsA patients on biologic monotherapy experienced a higher infection rate than patients without PsA (0.57% versus 0.19%; <em>P</em>=0.01). PsA patients experienced more adverse events (AEs) associated with traditional systemic monotherapy than biologic monotherapy (3.25 versus 1.04; <em>P</em>=.001).<BR />

Limitations: The relatively small PsA cohort was the primary limitation.<BR />

Conclusions: Patients with moderate-to-severe psoriasis responded similarly to all treatments independent of PsA history. PsA patients received more overall treatments and more biologic monotherapy prescriptions. PsA patients had a greater infection risk on biologic monotherapy compared to those without PsA, and greater adverse events risk on traditional systemic monotherapy compared to biologic monotherapy.<BR /><BR /> <EM>J Drugs Dermatol</EM>. 2016;15(8):917-922.

MeSH terms

  • Adult
  • Aged
  • Arthritis, Psoriatic / diagnosis*
  • Arthritis, Psoriatic / drug therapy*
  • Biological Products / administration & dosage*
  • Cross-Sectional Studies
  • Drug Therapy, Combination
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Severity of Illness Index*
  • Treatment Outcome

Substances

  • Biological Products