Epidemiology, Comorbidity and Risk Factors for Psoriatic Arthritis: A Health Insurance Claims Database Analysis
DOI:
https://doi.org/10.2340/00015555-3879Abstract
Psoriatic arthritis is a frequent manifestation of psoriasis, and has a high level of impact on physical functioning, work ability and quality of life. However, there have been few studies of the epidemiology, development of and risk factors for concomitant psoriatic arthritis in patients with psoriasis. This study analysed data from a German public health insurance database of > 2 million individuals. Factors influencing the development of psoriatic arthritis were determined by descriptively analysing comorbidities and Cox regression modelling. The prevalences of psoriasis and psoriatic arthritis were 2.63% and 0.29% in adults (18+ years) and, respectively, 0.30% and 0.01% in children (0–17 years). The proportion of adult patients with incident psoriasis who developed concomitant psoriatic arthritis within five years after diagnosis of psoriasis (mean 2.3 years) was 2.6%. Cardiovascular diseases are the most frequent comorbidity in patients with psoriasis with or without concomitant psoriatic arthritis. Depression and neurosis/stress disorder were identified as indicators for the development of psoriatic arthritis.
Downloads
References
Augustin M, Reich K, Glaeske G, Schaefer I, Radtke M. Co-morbidity and age-related prevalence of psoriasis: analysis of health insurance data in Germany. Acta Derm Venereol 2010; 90: 147-151.
https://doi.org/10.2340/00015555-0770 DOI: https://doi.org/10.2340/00015555-0770
Schäfer I, Rustenbach S, Radtke M, Augustin J, Glaeske G, Augustin M. Epidemiology of psoriasis in Germany - analysis of secondary health insurance data. Gesundheitswesen 2011; 73: 308-313.
https://doi.org/10.1055/s-0030-1252022 DOI: https://doi.org/10.1055/s-0030-1252022
Reich K, Krüger K, Mössner R, Augustin M. Epidemiology and clinical pattern of psoriatic arthritis in Germany: a prospective interdisciplinary epidemiological study of 1511 patients with plaque-type psoriasis. Br J Dermatol 2009; 160: 1040-1047.
https://doi.org/10.1111/j.1365-2133.2008.09023.x DOI: https://doi.org/10.1111/j.1365-2133.2008.09023.x
Radtke MA, Schafer I, Glaeske G, Jacobi A, Augustin M. Prevalence and comorbidities in adults with psoriasis compared to atopic eczema. J Eur Acad Dermatol Venereol 2017; 31: 151-157.
https://doi.org/10.1111/jdv.13813 DOI: https://doi.org/10.1111/jdv.13813
Augustin M, Glaeske G, Radtke MA, Christophers E, Reich K, Schafer I. Epidemiology and comorbidity of psoriasis in children. Br J Dermatol 2010; 162: 633-636.
https://doi.org/10.1111/j.1365-2133.2009.09593.x DOI: https://doi.org/10.1111/j.1365-2133.2009.09593.x
Rosen CF, Mussani F, Chandran V, Eder L, Thavaneswaran A, Gladman DD. Patients with psoriatic arthritis have worse quality of life than those with psoriasis alone. Rheumatology 2011; 51: 571-576.
https://doi.org/10.1093/rheumatology/ker365 DOI: https://doi.org/10.1093/rheumatology/ker365
Langenbruch A, Radtke MA, Krensel M, Jacobi A, Reich K, Augustin M. Nail involvement as a predictor of concomitant psoriatic arthritis in patients with psoriasis. Br J Dermatol 2014; 171: 1123-1128.
https://doi.org/10.1111/bjd.13272 DOI: https://doi.org/10.1111/bjd.13272
McHugh N, Balachrishnan C, Jones S. Progression of peripheral joint disease in psoriatic arthritis: a 5-yr prospective study. Rheumatology 2003; 42: 778-783.
https://doi.org/10.1093/rheumatology/keg217 DOI: https://doi.org/10.1093/rheumatology/keg217
Villani AP, Rouzaud M, Sevrain M, Barnetche T, Paul C, Richard M-A, et al. Prevalence of undiagnosed psoriatic arthritis among psoriasis patients: systematic review and meta-analysis. J Am Acad Dermatol 2015; 73: 242-248.
https://doi.org/10.1016/j.jaad.2015.05.001 DOI: https://doi.org/10.1016/j.jaad.2015.05.001
Prey S, Paul C, Bronsard V, Puzenat E, Gourraud P-A, Aractingi S, et al. Assessment of risk of psoriatic arthritis in patients with plaque psoriasis: a systematic review of the literature. J Eur Acad Dermatol Venereol 2010; 24: 31-35.
https://doi.org/10.1111/j.1468-3083.2009.03565.x DOI: https://doi.org/10.1111/j.1468-3083.2009.03565.x
Radtke MA, Reich K, Blome C, Rustenbach S, Augustin M. Prevalence and clinical features of psoriatic arthritis and joint complaints in 2009 patients with psoriasis: results of a German national survey. J Eur Acad Dermatol Venereol 2009; 23: 683-691.
https://doi.org/10.1111/j.1468-3083.2009.03159.x DOI: https://doi.org/10.1111/j.1468-3083.2009.03159.x
Busse K, Liao W. Which psoriasis patients develop psoriatic arthritis? Psoriasis Forum 2010; 16: 17-25.
https://doi.org/10.1177/247553031016a00403 DOI: https://doi.org/10.1177/247553031016a00403
Tillett W, Charlton R, Nightingale, Snowball J, Green A, Smith CA, et al. Interval between onset of psoriasis and psoriatic arthritis comparing the UK Clinical Practice Research Datalink with a hospital-based cohort. Rheumatology 2017; 56: 2109-2113.
https://doi.org/10.1093/rheumatology/kex323 DOI: https://doi.org/10.1093/rheumatology/kex323
Ritchlin CT, Colbert RA, Gladman DD. Psoriatic arthritis. N Engl J Med 2017; 376: 957-970.
https://doi.org/10.1056/NEJMra1505557 DOI: https://doi.org/10.1056/NEJMra1505557
Faustini F, Simon D, Oliveira I, Kleyer A, Haschka J, Englbrecht M, et al. Subclinical joint inflammation in patients with psoriasis without concomitant psoriatic arthritis: a cross-sectional and longitudinal analysis. Ann Rheum Dis 2016; 75: 2068-2074.
https://doi.org/10.1136/annrheumdis-2015-208821 DOI: https://doi.org/10.1136/annrheumdis-2015-208821
Mease PJ, Armstrong AW. Managing patients with psoriatic disease: the diagnosis and pharmacologic treatment of psoriatic arthritis in patients with psoriasis. Drugs 2014; 74: 423-441.
https://doi.org/10.1007/s40265-014-0191-y DOI: https://doi.org/10.1007/s40265-014-0191-y
Gladman DD, Thavaneswaran A, Chandran V, Cook RJ. Do patients with psoriatic arthritis who present early fare better than those presenting later in the disease? Ann Rheum Dis 2011; 70: 2152-2154.
https://doi.org/10.1136/ard.2011.150938 DOI: https://doi.org/10.1136/ard.2011.150938
Haroon M, Kirby B, FitzGerald O. High prevalence of psoriatic arthritis in patients with severe psoriasis with suboptimal performance of screening questionnaires. Ann Rheum Dis 2013; 72: 736-740.
https://doi.org/10.1136/annrheumdis-2012-201706 DOI: https://doi.org/10.1136/annrheumdis-2012-201706
Busse R, Blümel M. Germany: health system review. Health Syst Transit 2014; 16: 1-296, xxi.
Statistisches Bundesamt. Bevölkerung Deutschlands bis 2060 - 13. koordinierte Bevölkerungsvorausberechnung. 2015. [cited 2019 Dec 30]. Available from: https://www.destatis.de/DE/Publikationen/Thematisch/Bevoelkerung/VorausberechnungBevoelkerung/BevoelkerungDeutschland2060Presse5124204159004.pdf?__blob=publicationFile.
Deutsche Gesellschaft für Epidemiologie (DGEpi). Leitlinien und Empfehlungen zur Sicherung von Guter Epidemiologischer Praxis (GEP): Langversion. 2018. [cited 2020 April 15]. Available from: https://www.dgepi.de/assets/Leitlinien-und-Empfehlungen/Leitlinien_fuer_Gute_Epidemiologische_Praxis_GEP_vom_September_2018.pdf.
Swart E. Health care utilization research using secondary data. In: Janssen C, Ladebeck N, von Lengerke T, editors. Health care utilization in Germany: theory, methodology, and results. Springer, New York; 2014: p. 63-86.
https://doi.org/10.1007/978-1-4614-9191-0_5 DOI: https://doi.org/10.1007/978-1-4614-9191-0_5
Hagenström K, Augustin M, Köster I, Protz K, Petersen J, Schmitt J, et al. Interne Diagnosevalidierung von Patienten mit einer floriden chronischen Wunde - Möglichkeiten der Identifizierung auf der Basis von Routinedaten. Z Evid Fortbild Qual Gesundhwes 2019; 140: 22-34.
https://doi.org/10.1016/j.zefq.2019.02.004 DOI: https://doi.org/10.1016/j.zefq.2019.02.004
Busse R, Blümel M, Knieps F, Bärnighausen T. Statutory health insurance in Germany: a health system shaped by 135 years of solidarity, self-governance, and competition. Lancet 2017; 390: 882-897.
https://doi.org/10.1016/S0140-6736(17)31280-1 DOI: https://doi.org/10.1016/S0140-6736(17)31280-1
Ogdie A, Schwartzman S, Husni ME. Recognizing and managing comorbidities in psoriatic arthritis. Curr Opin Rheumatol 2015; 27: 118−126.
https://doi.org/10.1097/BOR.0000000000000152 DOI: https://doi.org/10.1097/BOR.0000000000000152
Augustin M, Eissing L, Langenbruch A, Enk A, Luger T, Maaßen D, et al. The German National Program on Psoriasis Health Care 2005-2015: results and experiences. Arch Dermatol Res 2016; 308: 389-400.
https://doi.org/10.1007/s00403-016-1637-8 DOI: https://doi.org/10.1007/s00403-016-1637-8
World Health Organization. Global report on psoriasis. 2016. [cited 2020 April 15]. Available from: https://apps.who.int/iris/bitstream/handle/10665/204417/9789241565189_eng.pdf?sequence=1&isAllowed=y.
Gladman D, Antoni C, Mease P, Clegg D, Nash P. Psoriatic arthritis: epidemiology, clinical features, course, and outcome. Ann Rheum Dis 2005; 64: ii14-ii7.
https://doi.org/10.1136/ard.2004.032482 DOI: https://doi.org/10.1136/ard.2004.032482
Eder L, Polachek A, Rosen CF, Chandran V, Cook R, Gladman DD. The development of psoriatic arthritis in patients with psoriasis is preceded by a period of nonspecific musculoskeletal symptoms: a prospective cohort study. Arthrit Rheumatol 2017; 69: 622-629.
https://doi.org/10.1002/art.39973 DOI: https://doi.org/10.1002/art.39973
Trettel A, Spehr C, Korber A, Augustin M. The impact of age on psoriasis health care in Germany. J Eur Acad Dermatol Venereol 2017; 31: 870-875.
https://doi.org/10.1111/jdv.14115 DOI: https://doi.org/10.1111/jdv.14115
Feldman SR, Hur P, Zhao Y, Tian H, Wei Z, Wang X, et al. Incidence rates of comorbidities among patients with psoriasis in the United States. Dermatol Online J 2018; 24: 13030/qt2m18n6vj.
https://doi.org/10.5070/D32410041706 DOI: https://doi.org/10.5070/D32410041706
Dan S, Savi R. Payment systems and incentives in primary care: implications of recent reforms in Estonia and Romania. Int J Health Plann Manage 2015; 30: 204-218.
https://doi.org/10.1002/hpm.2230 DOI: https://doi.org/10.1002/hpm.2230
Harris M. Payment for performance in the Family Health Programme: lessons from the UK Quality and Outcomes Framework. Rev Saude Publica 2012; 46: 577-582.
https://doi.org/10.1590/S0034-89102012005000032 DOI: https://doi.org/10.1590/S0034-89102012005000032
Beinsberger J, Heemskerk J, Cosemans J. Chronic arthritis and cardiovascular disease: altered blood parameters give rise to a prothrombotic propensity. Semin Arthritis Rheum 2014; 44: 345-352.
https://doi.org/10.1016/j.semarthrit.2014.06.006 DOI: https://doi.org/10.1016/j.semarthrit.2014.06.006
Khraishi M, Aslanov R, Rampakakis E, Pollock C, Sampalis JS. Prevalence of cardiovascular risk factors in patients with psoriatic arthritis. Clin Rheumatol 2014; 33: 1495-1500.
https://doi.org/10.1007/s10067-014-2743-7 DOI: https://doi.org/10.1007/s10067-014-2743-7
Husted JA, Thavaneswaran A, Chandran V, Eder L, Rosen CF, Cook RJ, et al. Cardiovascular and other comorbidities in patients with psoriatic arthritis: a comparison with patients with psoriasis. Arthritis Care Res (Hoboken) 2011; 63: 1729-1735.
https://doi.org/10.1002/acr.20627 DOI: https://doi.org/10.1002/acr.20627
Koo J, Marangell LB, Nakamura M, Armstrong A, Jeon C, Bhutani T, et al. Depression and suicidality in psoriasis: review of the literature including the cytokine theory of depression. J Eur Acad Dermatol Venereol 2017; 31: 1999-2009.
https://doi.org/10.1111/jdv.14460 DOI: https://doi.org/10.1111/jdv.14460
Eberhard S. Lassen sich GKV-Routinedaten nutzen, um auf leitliniengerechte Versorgung zu schließen? Eine Analyse am Beispiel der arteriellen Hypertonie. Gesundheits- Und Sozialpolitik 2013; 67: 29-36.
https://doi.org/10.5771/1611-5821-2013-1-29 DOI: https://doi.org/10.5771/1611-5821-2013-1-29
Günster C, Klose J, Schmacke N. Versorgungs-Report 2011. Schwerpunkt: Chronische Erkrankungen. Schattauer, Stuttgart; 2011.
Nationale Konferenz zur Versorgung der Psoriasis (NVKP). Nationale Versorgungsziele Psoriasis 2016-2020. [cited 2020 April 15]. Available from: www.versorgungsziele.de/versorgungsziele/.
Langenbruch A, Radtke MA, Jacobi A, Purwins S, Haack K, Reich K, et al. Quality of psoriasis care in Germany: results of the national health care study "PsoHealth3". Arch Dermatol Res 2016; 308: 401-408.
https://doi.org/10.1007/s00403-016-1651-x DOI: https://doi.org/10.1007/s00403-016-1651-x
Johansen, CB, Egeberg, A, Solem, EJ, Vittrup, I, Skov, L, Thomsen, SF. Comorbidities, socioeconomic status, drug use, and health care consumption in Danish women with psoriasis: a nationwide cross-sectional study. Int J Women's Dermatol 2020; 7: 246-258.
https://doi.org/10.1016/j.ijwd.2020.11.004 DOI: https://doi.org/10.1016/j.ijwd.2020.11.004
Hoffmann F, Icks A. Diabetes prevalence based on health insurance claims: large differences between companies. Diabet Med 2011; 28: 919-923.
https://doi.org/10.1111/j.1464-5491.2011.03305.x DOI: https://doi.org/10.1111/j.1464-5491.2011.03305.x
Additional Files
Published
How to Cite
License
Copyright (c) 2021 Reinhardt Maximilian, Claudia Garbe, Jana Petersen, Matthias Augustin, Natalia Kirsten, Mona H.C. Biermann, Benjamin M. Häberle, Kristina Hagenström
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All digitalized ActaDV contents is available freely online. The Society for Publication of Acta Dermato-Venereologica owns the copyright for all material published until volume 88 (2008) and as from volume 89 (2009) the journal has been published fully Open Access, meaning the authors retain copyright to their work.
Unless otherwise specified, all Open Access articles are published under CC-BY-NC licences, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.
