Cardiometabolic profile, clinical features, quality of life and treatment outcomes in patients with moderate-to-severe psoriasis and psoriatic arthritis

Abstract

Cardiometabolic, clinical and quality-of-life (QoL) measures were assessed before and after etanercept treatment in patients who had moderate-to-severe plaque psoriasis with and without psoriatic arthritis (PsA) in the PRISTINE trial. Adult patients were randomized to receive etanercept 50 mg once weekly or twice weekly double-blind for 12 weeks; all patients subsequently received etanercept 50 mg once weekly open-label through week 24. Metabolic syndrome was identified in 44 and 41% of patients with and without PsA, elevated blood pressure in 73 and 56% (p < 0.05) and diabetes in 21 and 9% (p < 0.01), respectively. Significant improvements from baseline in Psoriasis Area Severity Index were observed with etanercept therapy at all time points over 24 weeks (p < 0.001) independent of PsA history. At baseline, patients with PsA had worse QoL than patients without PsA. After 24 weeks of etanercept, both groups had significant improvement from baseline in QoL, but the PsA group had greater improvement than that without PsA. Cardiovascular comorbidities were common in psoriasis patients with and without PsA, suggesting that clinicians need to be attentive to cardiometabolic parameters in this population. Worse QoL was demonstrated in PsA versus psoriasis alone. Regardless of patients’ PsA status, treatment with etanercept significantly improved skin symptoms and QoL measures.

• cardiovascular disease risk
• disease characteristics
• efficacy
• etanercept

Acknowledgements

The academic and sponsor authors were involved in study/analysis design, study conduct and/or data interpretation, contributing equally to manuscript development and approving the decision to publish. The authors thank all the patients who participated in the study and investigators and medical staff of all participating centers. In addition to authors LP, RS, T-FT and NN, the PRISTINE trial investigators include Peter Altmeyer, Bochum, Germany; Mario Amaya-Guerra, Nuevo León, Mexico; Matthias Augustin, Hamburg, Germany; Hugo Cabrera, Buenos Aires, Argentina; Petra Cetkovska, Plzen-Bory, Czech Republic; Edgardo Chouela, Buenos Aires, Argentina; Jozef De Weert, Gent, Belgium; Stefan Duban, Jihlava, Czech Republic; Dagmar Galatikova, Bruntal, Czech Republic; Ricardo Galimberti, Buenos Aires, Argentina; Pierre-Dominique Ghislain, Brussels, Belgium; Minerva Gomez, Nuevo León, Mexico; Zsuzsanna Karolyi, Miskolc, Hungary; Sarolta Karpati, Budapest, Hungary; Andreas Katsambas, Athens, Greece; Lajos Kemeny, Szeged, Hungary; Joo-Heung Lee, Gangnam-gu, Korea; Woan Lee, Taipei, Taiwan; Ulrich Mrowietz, Kiel, Germany; Ketty Peris, L’Aquila, Italy; Natta Rajatanavin, Bangkok, Thailand; Eva Remenyik, Debrecen, Hungary; Johannes Ring, Muenchen, Germany; Thomas Rosenbach, Osnabrueck, Germany; Michael Sticherling, Erlangen, Germany; Diamant Thai, Frankfurt, Germany; Guadalupe Villanueva, Jalisco, Mexico; and Jai II Youn, Seoul, Korea.

Declaration of interest

This study was sponsored by Wyeth Research, which was acquired by Pfizer Inc in October 2009. Medical writing support was provided by Donna McGuire of Engage Scientific Solutions and funded by Pfizer Inc. LP has been a paid consultant of and has received research grants from Pfizer Inc; he has served on Pfizer advisory boards and speakers bureau. R.S. has been a paid consultant of and has received research grants from Pfizer Inc.; he is a member of Pfizer European expert board and Pfizer speakers bureau. E.H. has received financial compensation for advisory or consultant roles at Abbott, Amgen, Centers for Disease Control, Janssen and Novartis. T-FT has been a paid consultant of Pfizer Inc.; he has served as an investigator and received honoraria for his role as an advisor and speaker for Pfizer. N.N. has been a paid consultant of and has received research grants from Pfizer Inc. A.S. is an employee of Inventive Health, paid contractors to Pfizer Inc. in providing statistical support for the PRISTINE study and the development of this manuscript; S.Y. was an employee of Inventive Health, paid contractors to Pfizer Inc., at the time that she provided statistical support for the study and manuscript development. D.R. and A.S.K. are current employees of Pfizer Inc.; R.B. was an employee of Pfizer Inc. when the manuscript was developed.