Safety Assessment of Conventional and Biological Systemic Therapy in Older Adults with Psoriasis, a Real-world Multicentre Cohort Study

Authors

  • Elke L.M. ter Haar Department of Dermatology, Radboud University Medical Centre, Post Office Box 9101, NL-6500 HB Nijmegen, The Netherlands
  • Eline E. ten Bruin Department of Dermatology, Radboud University Medical Centre, Post Office Box 9101, NL-6500 HB Nijmegen, The Netherlands
  • Ewald E. Bronkhorst Department for Health Evidence, Radboud university medical centre, Nijmegen, the Netherlands
  • Rinke J. Borgonjen Department of Dermatology, Gelderse Vallei Hospital and Padberg Clinic, Ede, the Netherlands
  • Marloes M. Kleinpenning Department of Dermatology, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands
  • Else N. Kop Department of Dermatology, Bernhoven Hospital, Uden, the Netherlands
  • M. Birgitte Visch Department of Dermatology, Rijnstate Hospital, Arnhem, the Netherlands
  • Peter C.M. van de Kerkhof Department of Dermatology, Radboud University Medical Centre, Post Office Box 9101, NL-6500 HB Nijmegen, The Netherlands
  • Elke M.G.J. de Jong Department of Dermatology, Radboud University Medical Centre (Radboudumc), Nijmegen, The Netherlands.
  • Satish F.K. Lubeek Department of Dermatology, Radboud University Medical Centre (Radboudumc), Nijmegen, The Netherlands.

DOI:

https://doi.org/10.2340/actadv.v102.2412

Keywords:

psoriasis, elderly, geriatric psoriasis, older adults, systemic treatment, treatment safety

Abstract

Optimal selection of systemic therapy in older adults with psoriasis can be challenging, due to sparse evidence-based guidance. This multicentre retrospective study investigated the safety of systemic therapy with causality assessment in a real-world cohort of older adults (≥ 65 years) with psoriasis. Data from 6 hospitals on (serious) adverse events were collected, causality assessment performed and incidence rate ratios calculated. Potential predictors for adverse events-occurrence were studied using multivariable logistic regression analysis. In total, 117 patients with 176 treatment episodes and 390 patient-years were included, comprising 115 (65.3%) and 61 (34.7%) treatment episodes with conventional systemic therapy and biologics/apremilast, respectively. After causality assessment, 232 of 319 (72.7%) adverse events remained and were analysed further, including 12 serious adverse events. No significant differences in incidence rate ratios were found between the systemic treatment types. In regression analysis, increasing age was associated with causality assessed adverse events-occurrence (odds ratio 1.195; p=0.022). Comorbidity, polypharmacy, and treatment type were not associated with causality assessed adverse events-occurrence. In conclusion, increasing age was associated with a higher causality assessed adverse events-occurrence. Causality assessed serious adverse events were rare, reversible and/or manageable in clinical practice. In conclusion, the safety profile of systemic antipsoriatic therapy within this population is reassuring.

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Published

2022-10-31

How to Cite

ter Haar, E. L., ten Bruin, E. E., Bronkhorst, E. E., Borgonjen, R. J., Kleinpenning, M. M., Kop, E. N., Visch, M. B., van de Kerkhof , P. C., de Jong , E. M., & Lubeek, S. F. (2022). Safety Assessment of Conventional and Biological Systemic Therapy in Older Adults with Psoriasis, a Real-world Multicentre Cohort Study. Acta Dermato-Venereologica, 102, adv00805. https://doi.org/10.2340/actadv.v102.2412

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