P30 Disease burden, treatment outcomes and new onset of cardiometabolic diseases and psoriatic arthritis with biologics and non-biologics in The Malaysian Psoriasis Registry patients: 10 years data
Year: 2024
Type: conference-abstract
Abstract: Psoriasis (PsO) is a chronic autoimmune skin and joint inflammatory disease affecting ∼0.34% of people in Malaysia. PsO patients are at an increased risk of cardiometabolic diseases (CMDs) and psoriatic arthritis (PsA). Understanding how biologics and non-biologics impact CMDs and PsA development in PsO patients is crucial. This study aims to explore the disease burden, treatment outcomes, and new onset of CMDs and PsA with biologic and non-biologic systemic treatments in adult Malaysian PsO patients. This was a retrospective, cross-sectional study based on the Malaysian Psoriasis Registry (MPR) data (January 2013–December 2022) of adult PsO patients who had received non-biologic systemic treatment (acitretin, methotrexate, cyclosporine or combinations) or biologics [interleukin inhibitors (IL17i, IL12/23i and IL23i), tumour necrosis factor inhibitors (TNFi)] for at least 12 months. Descriptive analyses were performed on baseline characteristics, and treatment outcomes by treatment regimens at 12 and 24 months. The incidence rates of CMDs [ischemic heart disease (IHD), stroke, diabetes, hyperlipidaemia, hypertension, non-alcoholic fatty liver disease (NAFLD)] and PsA were compared by treatment regimens over 2 years. This analysis included 1721 PsO patients. At baseline, patients on biologics were younger (41 vs. >46 years), had earlier disease onset (26 vs. >29 years), more severe disease [psoriasis area and severity index (PASI) 20 vs. <15], and a higher rate of PsO family history (35 vs. <26%) than non-biologic patients. Biologic-treated patients experienced more pain, itch, and worse quality of life (QoL) than the non-biologics patients at baseline. More patients in the biologic group (especially IL17i) had less body surface area affected (<5% body surface area) at 12 and 24 months and better QoL [lower dermatology life quality index (DLQI)] at 12 months. At 24 months, QoL (DLQI) was similar for biologics and non-biologics, but the IL17i biologic group had the highest reduction in DLQI scores. At both time points, biologically treated patients had lower incidences of diabetes, hypertension, and hyperlipidaemia, and no newly reported IHD, stroke, depression, or NAFLD (at 12 months). Additionally, a lower PsA incidence was reported in biologic-treated patients at 12 months, with the IL17i group remaining PsA-free. At 24 months, the non-biologic cohort reported lower PsA incidence while the IL17i and TNFi biologic groups had no new PsA. PsO patients on biologics had better improvement in disease severity and lower risk of developing CMDs compared with non-biologics. Only IL17i-treated patients reported no new incidences of PsA over 2 years. Initiating biologic therapy (especially IL17i) early may enhance treatment outcomes and reduce the risk of new onset of CMDs and PsA in PsO patients.
Source: British Journal of Dermatology
Language: English
Subfield: Immunology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: bronze
OpenAlex ID: W4405231109