Cardiometabolic multimorbidity is common among patients with psoriasis and is associated with poorer outcomes compared to those without comorbidity

Abstract

Background

Associations between cardiometabolic multimorbidity and response to therapy in psoriasis are unknown.

Objective

Determine the associations of multimorbidity with response to biologic treatment in psoriasis patients.

Methods

CorEvitas Psoriasis Registry participants who initiated biologic therapy and had 6-month follow-up were stratified by 0, 1, 2+ comorbidities (diabetes, hypertension, hyperlipidemia). Adjusted odds ratios (95% CIs) were calculated overall and separately by biologic class (TNFi, IL-17i, IL-12/23i + IL-23i), to assess the likelihood of achieving response for the 1 and 2+ groups vs. 0.

Results

Of 2,923 patients, 49.5%, 24.7% and 25.8% reported 0, 1 and 2+ comorbidities, respectively. Overall, likelihood of PASI75 was 18% (OR = 0.82; 95%CI: 0.67, 1.00) and 23% (OR = 0.77; 95%CI: 0.63, 0.96) lower in those with 1 and 2+ comorbidities, respectively, vs. 0. In those who initiated IL-17i, odds of PASI75 and PAS90 were 34% (OR = 0.66; 95%CI: 0.48-0.91) and 35% (OR = 0.65; 95%CI: 0.47-0.91) lower in the 2+ multimorbidity cohort. No significant associations were found among users of TNFi or IL-12/23i + IL-23i groups in the multimorbidity group.

Limitations

Patients may not be representative of all psoriasis patients.

Conclusion

Multimorbidity in psoriasis may decrease the likelihood of achieving treatment response to biologic therapy and should be considered when discussing treatment expectations with patients.

Keywords:

• Psoriasis
• multimorbidity
• comorbid disease
• metabolic disease
• biologics
• biologic therapy
• psoriatic disease
• outcomes
• treatment response

Acknowledgements

The authors thank the participating providers and patients for contributing data to CorEvitas Psoriasis Registry. This study was supported through a partnership between Psoriasis Registry and the National Psoriasis Foundation Medical Board.

IRB approval status

Exempt.

Disclosure statement

Dr. Enos has served as a consultant on an advisory board for UCB and Amgen. Dr. Van Voorhees has received grants and research support from Lilly and AbbVie. She has also served as a consultant for Amgen, Boehringer Ingelheim, BMS, UCB, and Novartis. Vanessa Ramos has no conflicts of interest. Blessing Dube, Robert McClean, and Nicole Foster are employees of CorEvitas, LLC. Tin-Chi Lin was an employee of CorEvitas, LLC, at the time of this analysis.

Data availability statement

Data are available from CorEvitas, LLC through a commercial subscription agreement and are not publicly available. No additional data are available from the authors.

Disclosure: (Grant/Research Support) Lilly, AbbVie; Consultant: Amgen, Boehringer Ingelheim, BMS, UCB, and Novartis.

Additional information

Funding

This study was sponsored by CorEvitas (formerly Corrona), LLC and the analysis was funded by CorEvitas, LLC. Access to study data was limited to CorEvitas and CorEvitas statisticians completed all of the analysis; all authors contributed to the interpretation of the results. CorEvitas has been supported through contracted subscriptions in the last two years by AbbVie, Amgen, Arena, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Chugai, Eli Lilly and Company, Genentech, Gilead, GSK, Janssen, LEO, Novartis, Ortho Dermatologics, Pfizer Inc., Regeneron, Sanofi, Sun and UCB.