Depressive symptoms, depression, and the effect of biologic therapy among patients in Psoriasis Longitudinal Assessment and Registry (PSOLAR) - 13/12/17
, Melinda Gooderham, MD, MSc c, d, Elke M.G.J. de Jong, MD, PhD e, Alexa B. Kimball, MD, MPH f, Richard G. Langley, MD, FRCPC g, Nikita Lakdawala, MD h, Kavitha Goyal, MD i, Fabio Lawson, MD i, Wayne Langholff, PhD j, Lori Hopkins, PharmD i, Steve Fakharzadeh, MD, PhD i, Bhaskar Srivastava, MD, PhD i, Alan Menter, MD kAbstract |
Background |
Patients with psoriasis are at an increased risk for depression. However, the impact of treatment on this risk is unclear.
Objective |
Evaluate the incidence and impact of treatment on depression among patients with moderate-to-severe psoriasis.
Methods |
We defined a study population within the Psoriasis Longitudinal Assessment and Registry and measured the incidence of depressive symptoms (Hospital Anxiety and Depression Scale–Depression score ≥8) and adverse events (AEs) of depression within cohorts receiving biologics, conventional systemic therapies, or phototherapy. Patients were evaluated at approximately 6-month intervals. Multivariate modeling determined the impact of treatment on risk.
Results |
The incidence rates of depressive symptoms were 3.01 per 100 patient-years (PYs) (95% confidence interval [CI], 2.73-3.32), 5.85 per 100 PYs (95% CI, 4.29-7.97), and 5.70 per 100 PYs (95% CI, 4.58-7.10) for biologics, phototherapy, and conventional therapy, respectively. Compared with conventional therapy, biologics reduced the risk for depressive symptoms (hazard ratio, 0.76; 95% CI, 0.59-0.98), whereas phototherapy did not (hazard ratio, 1.05; 95% CI, 0.71-1.54). The incidence rates for AEs of depression were 0.21 per 100 PYs (95% CI, 0.15-0.31) for biologics, 0.55 per 100 PYs (95% CI, 0.21-1.47) for phototherapy, and 0.14 per 100 PYs (95% CI, 0.03-0.55) for conventional therapy; the fact that there were too few events (37 AEs) precluded modeling.
Limitations |
Incomplete capture of depression and confounders in the patients on registry.
Conclusion |
Compared with conventional therapy, biologics appear to be associated with a lower incidence of depressive symptoms among patients with psoriasis.
Le texte complet de cet article est disponible en PDF.Key words : biologic therapy, depression, phototherapy, PSOLAR, psoriasis, systemic therapy
Abbreviations used : AE, CI, HADS-D, HR, HRQoL, IR, MedDRA, PGA, PSOLAR, PY, TNF–α
Plan
| Supported by Janssen Scientific Affairs, LLC. |
|
| Disclosure: Dr Strober has received honoraria from AbbVie, Almirall, Amgen, Boehringer Ingelheim, Celgene Corporation, Dermira, Eli Lilly and Company, Janssen-Ortho, Leo Pharma, Merck and Company, Maruho Company, Novartis Pharmaceuticals Corporation, Pfizer, Sanofi/Regeneron, Sun Pharmaceutical Industries, and UCB for services as a consultant, advisory board member, and/or principal investigator. Dr Gooderham has received honoraria from AbbVie, Actelion Pharmaceuticals, Akros Pharma, Amgen, Boehringer Ingelheim International GmbH, Bristol-Myers Squibb Company, Celgene Corporation, Dermira, Eli Lilly and Company, Galderma SA, GlaxoSmithKline, Janssen Pharmaceuticals, Leo Pharma, MedImmune, Novartis Pharmaceuticals Corporation, Pfizer, Regeneron Pharmaceuticals, Roche Laboratories, Sanofi Genzyme, UCB, and Valeant Pharmaceuticals for services as a consultant, advisory board member, principal investigator, and/or speaker. Dr de Jong has received research grants or honoraria (paid to either him or his institution) from AbbVie, Amgen, Celgene Corporation, Eli Lilly and Company, Janssen Pharmaceuticals, Leo Pharma, Novartis Pharmaceuticals Corporation, and Pfizer for services as a consultant and/or speaker. Dr Kimball has received grants and/or honoraria (paid to either her or her institution) from AbbVie, Bristol-Myers Squibb Company, Dermira, UCB, Eli Lilly and Company, Janssen Pharmaceuticals, Novartis Pharmaceuticals Corporation, and Regeneron Pharmaceuticals for services as a consultant and/or principal investigator. Dr Langley has received honoraria from AbbVie, Amgen, Centocor, Pfizer, Janssen Pharmaceuticals, Leo Pharma, Boehringer Ingelheim International GmbH, Eli Lilly and Company, and Valeant Pharmaceuticals for serving as an advisory board member, principal investigator, and/or speaker. Drs Goyal, Lawson, Langholff, Hopkins, Fakharzadeh, and Srivastava are all employees of either Janssen Scientific Affairs or Janssen Research & Development and own stock/stock options in the company. Dr Menter has received either grants or honoraria from AbbVie, Allergan, Amgen, Anacor, Boehringer Ingelheim International GmbH, Celgene Corporation, Dermira, Eli Lilly and Company, Galderma SA, Janssen Biotech, Leo Pharma, Merck & Company, Neothetics, Novartis Pharmaceuticals Corporation, Pfizer, Regeneron Pharmaceuticals, Symbio/Maruho Company, Vitae, and Xenoport for serving as a consultant, advisory board member, principal investigator, and/or speaker. Dr Lakdawala has no conflicts of interests to declare. |
Vol 78 - N° 1
P. 70-80 - janvier 2018 Retour au numéro
Article précédent
- Risk of infection in patients with atopic dermatitis treated with dupilumab: A meta-analysis of randomized controlled trials
- Patrick Fleming, Aaron M. Drucker
- Psychiatric adverse events during treatment with brodalumab: Analysis of psoriasis clinical trials
- Mark G. Lebwohl, Kim A. Papp, Lauren B. Marangell, John Koo, Andrew Blauvelt, Melinda Gooderham, Jashin J. Wu, Shipra Rastogi, Susan Harris, Radhakrishnan Pillai, Robert J. Israel
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?