Comorbidities and Medication Use in Finnish Patients with Psoriasis: A Population-Based Registry Study

Authors

  • Aino Vesikansa MedEngine Oy, Helsinki, Finland
  • Juha Mehtälä MedEngine Oy, Helsinki, Finland
  • Marko Pesu Gilead Sciences Finland Oy, Karhumäentie 3, 01530 Vantaa, Finland
  • Jaakko Aaltonen AbbVie Oy, Pasilan Asema Aukio 1, 00520 Helsinki, Finland
  • Riikka Konttinen AbbVie Oy, Helsinki, Finland
  • Kaisa Tasanen Department of Dermatology and Medical Research Center, Oulu University Hospital; Research Group of Clinical Medicine, University of Oulu, Oulu, Finland
  • Laura Huilaja Department of Dermatology and Medical Research Center, Oulu University Hospital; PEDEGO Research Unit, University of Oulu, Oulu, Finland

DOI:

https://doi.org/10.2340/actadv.v103.3491

Keywords:

Biologic, Biologic treatment, Comorbidity, Plaque psoriasis, Psoriasis vulgaris, Treatment

Abstract

Therapeutic options for psoriasis vulgaris have changed during recent decades with the introduction of biologics. Few nationwide studies are available on psoriasis treatment patterns, and those from Finland predate the use of biologics. The aim of this retrospective, population-based registry study was to identify patients with psoriasis vulgaris and their treatment patterns in the secondary care setting in Finland. The study cohort included 41,456 adults with a diagnosis of psoriasis vulgaris in the public secondary healthcare setting from 2012 through 2018. Data on comorbidities, pharmacotherapy, and phototherapy were collected from nationwide healthcare and drug registries. Patients in the cohort had a wide range of comorbidities, with 14.9% having psoriatic arthritis. Treatment was based largely on topical and conventional systemic medications. Conventional medications were used by 28.9% of patients, and methotrexate was the most common option (20.9%). Biologics were used by 7.3% of patients, mostly as second- and third-line treatment. The use of conventional systemic medications, topical treatments, and phototherapy decreased after the initiation of biologics. This study of psoriasis vulgaris in Finland provides a framework for the development of future care practices. 

Downloads

Download data is not yet available.

References

Boehncke WH, Schön MP. Psoriasis. Lancet Lond Engl 2015; 386: 983-994.

https://doi.org/10.1016/S0140-6736(14)61909-7 DOI: https://doi.org/10.1016/S0140-6736(14)61909-7

Parisi R, Iskandar IYK, Kontopantelis E, Augustin M, Griffiths CEM, Ashcroft DM. National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study. BMJ 2020; 369: m1590.

https://doi.org/10.1136/bmj.m1590 DOI: https://doi.org/10.1136/bmj.m1590

Armstrong AW, Read C. Pathophysiology, clinical presentation, and treatment of psoriasis: a review. JAMA 2020; 323: 1945-1960.

https://doi.org/10.1001/jama.2020.4006 DOI: https://doi.org/10.1001/jama.2020.4006

AlQassimi S, AlBrashdi S, Galadari H, Hashim MJ. Global burden of psoriasis - comparison of regional and global epidemiology, 1990 to 2017. Int J Dermatol 2020; 59: 566-571.

https://doi.org/10.1111/ijd.14864 DOI: https://doi.org/10.1111/ijd.14864

Peng C, Xu X, Chen W, Li X, Yi X, Ding Y, et al. Epidemiological variations in the global burden of psoriasis, an analysis with trends from 1990 to 2017. Front Med 2021; 8: 24.

https://doi.org/10.3389/fmed.2021.585634 DOI: https://doi.org/10.3389/fmed.2021.585634

Yeung H, Takeshita J, Mehta NN, Kimmel SE, Ogdie A, Margolis DJ, et al. Psoriasis severity and the prevalence of major medical comorbidity: a population-based study. JAMA Dermatol 2013; 149: 1173-1179.

https://doi.org/10.1001/jamadermatol.2013.5015 DOI: https://doi.org/10.1001/jamadermatol.2013.5015

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

Takeshita J, Grewal S, Langan SM, Mehta NN, Ogdie A, Van Voorhees AS, et al. Psoriasis and comorbid diseases: epidemiology. J Am Acad Dermatol 2017; 76: 377-390.

https://doi.org/10.1016/j.jaad.2016.07.064 DOI: https://doi.org/10.1016/j.jaad.2016.07.064

Bhosle MJ, Kulkarni A, Feldman SR, Balkrishnan R. Quality of life in patients with psoriasis. Health Qual Life Outcomes 2006; 4: 35.

https://doi.org/10.1186/1477-7525-4-35 DOI: https://doi.org/10.1186/1477-7525-4-35

Dowlatshahi EA, Wakkee M, Arends LR, Nijsten T. The prevalence and odds of depressive symptoms and clinical depression in psoriasis patients: a systematic review and meta-analysis. J Invest Dermatol 2014; 134: 1542-1551.

https://doi.org/10.1038/jid.2013.508 DOI: https://doi.org/10.1038/jid.2013.508

Dalgard FJ, Gieler U, Tomas-Aragones L, Lien L, Poot F, Jemec GBE, et al. The psychological burden of skin diseases: a cross-sectional multicenter study among dermatological out-patients in 13 European countries. J Invest Dermatol 2015; 135: 984-991.

https://doi.org/10.1038/jid.2014.530 DOI: https://doi.org/10.1038/jid.2014.530

Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 6. Guidelines of care for the treatment of psoriasis and psoriatic arthritis: case-based presentations and evidence-based conclusions. J Am Acad Dermatol 2011; 65: 137-174.

https://doi.org/10.1016/j.jaad.2010.11.055 DOI: https://doi.org/10.1016/j.jaad.2010.11.055

Pathirana D, Ormerod AD, Saiag P, Smith C, Spuls PI, Nast A, et al. European S3-guidelines on the systemic treatment of psoriasis vulgaris. J Eur Acad Dermatol Venereol 2009; 23: 1-70.

https://doi.org/10.1111/j.1468-3083.2009.03389.x DOI: https://doi.org/10.1111/j.1468-3083.2009.03389.x

Psoriasis and Psoriatic Arthritis. Current Care Guidelines. Working group set up by the Finnish Medical Society Duodecim, the Finnish Dermatological Society and the Finnish Society for Rheumatology. Helsinki: The Finnish Medical Society Duodecim, 2022 (cited 2022, November 25). Available from: www.kaypahoito.fi/hoi50062.

Griffiths CEM, Armstrong AW, Gudjonsson JE, Barker JNWN. Psoriasis. The Lancet 2021; 397: 1301-1315.

https://doi.org/10.1016/S0140-6736(20)32549-6 DOI: https://doi.org/10.1016/S0140-6736(20)32549-6

Sbidian E, Chaimani A, Garcia-Doval I, Do G, Hua C, Mazaud C, et al. Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis. Cochrane Database Syst Rev 2017; 12: CD011535.

https://doi.org/10.1002/14651858.CD011535.pub2 DOI: https://doi.org/10.1002/14651858.CD011535.pub2

Feldman SR, Kaura S, Li S, Tencer T. Treatment persistence in psoriasis patients initiated on apremilast, oral systemics, or biologic therapies. Value Health 2017; 20: A805.

https://doi.org/10.1016/j.jval.2017.08.2397 DOI: https://doi.org/10.1016/j.jval.2017.08.2397

Rønholt K, Iversen L. Old and new biological therapies for psoriasis. Int J Mol Sci 2017; 18: 2297.

https://doi.org/10.3390/ijms18112297 DOI: https://doi.org/10.3390/ijms18112297

Ragnarson Tennvall G, Hjortsberg C, Bjarnason A, Gniadecki R, Heikkilä H, Jemec GBE, et al. Treatment patterns, treatment satisfaction, severity of disease problems, and quality of life in patients with psoriasis in three Nordic countries. Acta Derm Venereol 2013; 93: 442-445.

https://doi.org/10.2340/00015555-1485 DOI: https://doi.org/10.2340/00015555-1485

Mustonen A, Mattila K, Leino M, Koulu L, Tuominen R. Psoriasis causes significant economic burden to patients. Dermatol Ther 2014; 4: 115-124.

https://doi.org/10.1007/s13555-014-0053-2 DOI: https://doi.org/10.1007/s13555-014-0053-2

Könönen M, Torppa J, Lassus A. An epidemiological survey of psoriasis in the greater Helsinki area. Acta Derm Venereol 1986; Suppl 124: 1-10.

Sinikumpu SP, Huilaja L, Jokelainen J, Koiranen M, Auvinen J, Hägg PM, et al. High prevalence of skin diseases and need for treatment in a middle-aged population. A Northern Finland Birth Cohort 1966 study. PloS One 2014; 9: e99533.

https://doi.org/10.1371/journal.pone.0099533 DOI: https://doi.org/10.1371/journal.pone.0099533

Haverinen S, Vihervaara A, Löyttyniemi E, Peltonen S, Koulu L, Tasanen K, et al. Validation of psoriasis diagnoses recorded in Finnish biobanks. Acta Derm Venereol 2020; 100: adv00297.

https://doi.org/10.2340/00015555-3656 DOI: https://doi.org/10.2340/00015555-3656

Warren RB, Smith CH, Yiu ZZN, Ashcroft DM, Barker JNWN, Burden AD, et al. Differential drug survival of biologic therapies for the treatment of psoriasis: a prospective observational cohort study from the British Association of Dermatologists Biologic Interventions Register (BADBIR). J Invest Dermatol 2015; 135: 2632-2640.

https://doi.org/10.1038/jid.2015.208 DOI: https://doi.org/10.1038/jid.2015.208

Duan X, Liu J, Mu Y, Liu T, Chen Y, Yu R, et al. A systematic review and meta-analysis of the association between psoriasis and hypertension with adjustment for covariates. Medicine (Baltimore) 2020; 99: e19303.

https://doi.org/10.1097/MD.0000000000019303 DOI: https://doi.org/10.1097/MD.0000000000019303

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

Gladman DD, Antoni C, Mease P, Clegg DO, Nash P. Psoriatic arthritis: epidemiology, clinical features, course, and outcome. Ann Rheum Dis 2005; 64: ii14-17.

https://doi.org/10.1136/ard.2004.032482 DOI: https://doi.org/10.1136/ard.2004.032482

Fu Y, Lee CH, Chi CC. Association of psoriasis with inflammatory bowel disease: a systematic review and meta-analysis. JAMA Dermatol 2018; 154: 1417-1423.

https://doi.org/10.1001/jamadermatol.2018.3631 DOI: https://doi.org/10.1001/jamadermatol.2018.3631

Jousimaa J, Alenius H, Atula S, Kattainen A, Kunnamo I, Pelttari H, et al. [Phisicians' Handbook]. Duodecim; 2017.

Huilaja L, Tiri H, Jokelainen J, Timonen M, Tasanen K. Patients with hidradenitis suppurativa have a high psychiatric disease burden: a Finnish nationwide registry study. J Invest Dermatol 2018; 138: 46-51.

https://doi.org/10.1016/j.jid.2017.06.020 DOI: https://doi.org/10.1016/j.jid.2017.06.020

Markkula N, Suvisaari J, Saarni SI, Pirkola S, Peña S, Saarni S, et al. Prevalence and correlates of major depressive disorder and dysthymia in an eleven-year follow-up - results from the Finnish Health 2011 Survey. J Affect Disord 2015; 173: 73-80.

https://doi.org/10.1016/j.jad.2014.10.015 DOI: https://doi.org/10.1016/j.jad.2014.10.015

Perälä J, Suvisaari J, Saarni SI, Kuoppasalmi K, Isometsä E, Pirkola S, et al. Lifetime prevalence of psychotic and bipolar I disorders in a general population. Arch Gen Psychiatry 2007; 64: 19-28.

https://doi.org/10.1001/archpsyc.64.1.19 DOI: https://doi.org/10.1001/archpsyc.64.1.19

Ungprasert P, Wijarnpreecha K, Cheungpasitporn W. Patients with psoriasis have a higher risk of schizophrenia: a systematic review and meta-analysis of observational studies. J Postgrad Med 2019; 65: 141-145.

https://doi.org/10.4103/jpgm.JPGM_253_18 DOI: https://doi.org/10.4103/jpgm.JPGM_253_18

Svedbom A, Dalén J, Mamolo C, Cappelleri JC, Petersson IF, Ståhle M. Treatment patterns with topicals, traditional systemics and biologics in psoriasis - a Swedish database analysis. J Eur Acad Dermatol Venereol 2015; 29: 215-223.

https://doi.org/10.1111/jdv.12494 DOI: https://doi.org/10.1111/jdv.12494

Murage MJ, Kern DM, Chang L, Sonawane K, Malatestinic WN, Quimbo RA, et al. Treatment patterns among patients with psoriasis using a large national payer database in the United States: a retrospective study. J Med Econ 2018; 1-9.

https://doi.org/10.1080/13696998.2018.1540424 DOI: https://doi.org/10.1080/13696998.2018.1540424

Hjalte F, Carlsson KS, Schmitt-Egenolf M. Sustained Psoriasis Area and Severity Index, Dermatology Life Quality Index and EuroQol-5D response of biological treatment in psoriasis: 10 years of real-world data in the Swedish National Psoriasis Register. Br J Dermatol 2018; 178: 245-252.

https://doi.org/10.1111/bjd.15757 DOI: https://doi.org/10.1111/bjd.15757

Egeberg A, Ottosen MB, Gniadecki R, Broesby-Olsen S, Dam TN, Bryld LE, et al. Safety, efficacy and drug survival of biologics and biosimilars for moderate-to-severe plaque psoriasis. Br J Dermatol 2018; 178: 509-519.

https://doi.org/10.1111/bjd.16102 DOI: https://doi.org/10.1111/bjd.16102

Egeberg A, Andersen YMF, Thyssen JP. Prevalence and characteristics of psoriasis in Denmark: findings from the Danish skin cohort. BMJ Open 2019; 9: e028116.

https://doi.org/10.1136/bmjopen-2018-028116 DOI: https://doi.org/10.1136/bmjopen-2018-028116

Davison NJ, Warren RB, Mason KJ, McElhone K, Kirby B, Burden AD, et al. Identification of factors that may influence the selection of first-line biological therapy for people with psoriasis: a prospective, multicentre cohort study. Br J Dermatol 2017; 177: 828-836.

https://doi.org/10.1111/bjd.15551 DOI: https://doi.org/10.1111/bjd.15551

van den Reek JMPA, Seyger MMB, van Lümig PPM, Driessen RJB, Schalkwijk CJM, Berends MAM, et al. The journey of adult psoriasis patients towards biologics: past and present - results from the BioCAPTURE registry. J Eur Acad Dermatol Venereol 2018; 32: 615-623.

https://doi.org/10.1111/jdv.14684 DOI: https://doi.org/10.1111/jdv.14684

Additional Files

Published

2023-03-09

How to Cite

Vesikansa, A., Mehtälä, J., Pesu, M., Aaltonen, J., Konttinen, R., Tasanen, K., & Huilaja, L. (2023). Comorbidities and Medication Use in Finnish Patients with Psoriasis: A Population-Based Registry Study. Acta Dermato-Venereologica, 103, adv00886. https://doi.org/10.2340/actadv.v103.3491