Psoriasis severity, comorbidity burden, and biologic therapy: a multicenter observational study using the Charlson...

Area of Science:

• Dermatology and Immunology
• Clinical Epidemiology
• Pharmacology

Background:

• Psoriasis is a chronic inflammatory condition linked to systemic comorbidities.
• The Charlson Comorbidity Index (CCI) measures comorbidity burden and survival, but its relation to psoriasis severity and biologic treatments is not well-understood.

Purpose of the Study:

• To investigate the association between psoriasis severity and comorbidities.
• To assess the impact of biologic disease-modifying antirheumatic drugs (bDMARDs), specifically adalimumab (ADA), risankizumab (RISA), and secukinumab (SECU), on CCI.
• To estimate 10-year survival in psoriatic patients compared to controls.

Main Methods:

• A multicenter, cross-sectional study involving 343 psoriasis patients and 343 matched controls from 13 Italian centers.
• CCI scores and comorbidity profiles were analyzed based on Psoriasis Area and Severity Index (PASI) scores and bDMARD treatment groups.
• Survival probabilities were estimated using a predictive model.

Main Results:

• Psoriasis patients exhibited significantly higher age-adjusted CCI than controls (p=0.021), especially those with severe psoriasis (PASI >10; p=0.003).
• Peripheral vascular disease, cerebrovascular disease, and myocardial infarction were correlated with psoriasis severity.
• Patients treated with ADA had lower CCI compared to those on RISA or SECU (p<0.05).

Conclusions:

• Psoriasis severity is linked to an increased comorbidity burden, underscoring the importance of cardiovascular and metabolic screening.
• Biologic therapies might influence comorbidity progression differently, supporting personalized treatment strategies for psoriasis management.