Unrecognized Comorbidities of Psoriatic Arthritis

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This is ReachMD. Welcome to this special series, Beyond Skin Deep: Impacts of Psoriatic Arthritis, sponsored by Lilly.

Dr. Ogdie:
Psoriatic arthritis is associated with many comorbidities, actually.  The one that’s probably best known at this point is the association with cardiovascular disease.  So, among patients with psoriatic arthritis, there is about a 30% increase in the risk for cardiovascular endpoints including myocardial infarction or heart attack, stroke, and cardiovascular death, as a composite endpoint, so that’s pretty substantial.  It’s similar, in part, to RA, maybe a little bit less than rheumatoid arthritis, but it’s also similar to patients with severe psoriasis.  Beyond that, though, I think there are other under-recognized comorbidities, and those are some of the cardiovascular risk factors, so diabetes—the incidence of diabetes is increased in patients with psoriatic arthritis, and the hazard ratio for that is about 1.4 or 1.45, so it’s, again, a pretty substantial increase over the general population.  In addition, hyperlipidemia and hypertension are more common.  Obesity is much more prevalent in patients with psoriasis and psoriatic arthritis, in particular patients with psoriatic arthritis, compared to the general population.  And I think that really the hidden ones, not so hidden to patients but to physicians in that we don’t ask about it enough, are depression and anxiety.  About 30 to 40% of patients with psoriatic arthritis have depression or anxiety, or both, and so we need to ask about those because those have a big impact on quality of life.  Additionally, there’s an increased risk for suicide in patients with psoriatic arthritis, and that’s also important, another important reason to ask about depression and anxiety.

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