Chronologic order of appearance of immune-mediated inflammatory diseases relative to diagnosis of psoriasis - 28/08/19

Doi : 10.1016/j.jaad.2019.04.033

Yuki M.F. Andersen, MD, PhD ^a, Jashin J. Wu, MD ^b, Jacob P. Thyssen, MD, PhD, DMSci ^a, Alexander Egeberg, MD, PhD ^a,^⁎
^a Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
^b Dermatology Research and Education Foundation, Irvine, California

^∗Correspondence to: Alexander Egeberg, MD, PhD, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, 2900 Hellerup, Denmark.Department of Dermatology and AllergyHerlev and Gentofte HospitalUniversity of CopenhagenHellerup2900Denmark

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Abstract

Background

Psoriasis is a common inflammatory skin disease associated with several immune-mediated inflammatory diseases (IMIDs); however, little is known of the chronology of disease development.

Objective

To investigate the chronology of IMIDs relative to psoriasis.

Methods

We utilized routinely collected data from Danish nationwide administrative registries to examine the occurrence of IMIDs in patients with psoriasis (n = 10,923) and general population controls (n = 109,230).

Results

Approximately 20% of patients with psoriasis developed ≥1 IMID, with a 5-fold increased risk compared with the general population. Most IMIDs were diagnosed before psoriasis, except for psoriatic arthritis. Psoriasis was significantly associated with having multiple IMIDs (odds ratio 15.2, 95% confidence interval 11.6-20.0). Human leukocyte antigen B27 positivity was significantly more frequent among psoriasis patients.

Limitations

Clinical measurements were unavailable.

Conclusion

IMIDs occur frequently in patients with psoriasis and most are diagnosed before psoriasis. The observed chronology might represent important mechanisms of disease development.

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Key words : autoimmune, comorbidity, epidemiology, HLA-B27, inflammation, psoriasis, psoriatic arthritis

Abbreviations used : CI, DNPR, ICD-10, IBD, IL, IMID, IQR, IRR, OR, PsA, SD

Plan

Materials and methods

Data sources and study population

Outcomes

Statistical analysis

Results

Chronologic order of IMIDs relative to psoriasis diagnosis

	Funding sources: None.
	Conflicts of interest: Dr Andersen has received research funding from the Lundbeck Foundation, the Aage Bang Foundation, and the A.P. Møller Foundation. Dr Wu is an investigator for AbbVie, Amgen, Eli Lilly, Janssen, and Novartis; a consultant for AbbVie, Almirall, Amgen, Bristol-Myers Squibb, Celgene, Dermira, Dr Reddy's Laboratories, Eli Lilly, Janssen, LEO Pharma, Novartis, Promius Pharma, Regeneron, Sun Pharmaceutical, UCB, and Valeant Pharmaceuticals North America LLC; and a speaker for AbbVie, Celgene, Novartis, Regeneron, Sun Pharmaceutical, UCB, and Valeant Pharmaceuticals North America LLC. Dr Thyssen is supported by an unrestricted research grant from the Lundbeck Foundation; has received speaker honoraria from Galderma, Sanofi-Genzyme, LEO Pharma, and MEDA; and attended advisory board meetings for Roche, Eli Lilly, and Sanofi-Genzyme. Dr Thyssen is also an investigator for LEO Pharma and Eli Lilly. Dr Egeberg has received research funding from Pfizer, Eli Lilly, the Danish National Psoriasis Foundation, and the Kgl Hofbundtmager Aage Bang Foundation and has received honoraria as a consultant or speaker from AbbVie, Almirall, Leo Pharma, Samsung Bioepis Co Ltd, Bristol-Myers Squibb, Dermavant, Pfizer, Eli Lilly, Novartis, Galderma, and Janssen Pharmaceuticals.
	Reprints not available from the authors.