PARIS — Patients with moderate to severe psoriasis are at increased risk for cardiovascular disorders and diabetes, which often go undiagnosed, according to an analysis of three clinical trials.
“There was a substantial number of psoriasis patients with previously undiagnosed cardiovascular risk factors in this psoriasis clinical trial population,” wrote Dr. Alexandra B. Kimball and her colleagues in a poster presented at the annual congress of the European Academy of Dermatology and Venereology.
Of 2,316 psoriasis patients, 27% had a diagnosis of hypertension at baseline; another 13% met the criteria for hypertension but were undiagnosed. Likewise, 20% had a diagnosis of hyperlipidemia at baseline; another 6% met the criteria but were undiagnosed. Last, 11% were diagnosed with diabetes at baseline; another 6% met the criteria but were undiagnosed, wrote Dr. Kimball of the department of dermatology at Harvard Medical School, Boston.
The researchers examined the medical histories of patients with moderate to severe psoriasis in one phase II and two phase III trials investigating the efficacy and safety of ustekinumab. They were enrolled in either the phase II C0379T04 trial (320), the phase III PHOENIX II trial (766), or the phase III PHOENIX III trial (1,230).
Body mass index was used to evaluate the proportion of patients who were overweight (BMI of 25–29 kg/m
Diabetes was defined by a fasting plasma glucose level of at least 7.0 mmol/L. Hypertension was defined as systolic blood pressure of at least 140 mm Hg or diastolic blood pressure of at least 90 mm Hg. Hyperlipidemia was defined as a total cholesterol level of at least 6.2 mmol/L.
Half of the patients were obese (49%) and a third (33%) were overweight. In addition, a third (32%) smoked, a quarter (27%) had hypertension, 20% had hyperlipidemia, and 11% had diabetes.
Patients with moderate to severe psoriasis were 56% more likely to be diabetic than the general U.S. population (prevalence ratio [PR], 1.6). Psoriasis patients were 50% more likely to be obese (PR, 1.5), 37% more likely to smoke (PR, 1.37), 18% more likely to be overweight (PR, 1.18), and 11% more likely to have hyperlipidemia (PR, 1.11).
The study was supported by Centocor Inc., which is developing ustekinumab. Two of Dr. Kimball's coauthors are employed by the company.