Bruce Strober1, Melinda Gooderham2, Elke M G J de Jong3, Alexa B Kimball4, Richard G Langley5, Nikita Lakdawala6, Kavitha Goyal7, Fabio Lawson7, Wayne Langholff8, Lori Hopkins7, Steve Fakharzadeh7, Bhaskar Srivastava7, Alan Menter9. 1. University of Connecticut Health Center, Farmington, Connecticut; Probity Medical Research, Waterloo, Ontario, Canada. Electronic address: strober@uchc.edu. 2. Queen's University, Kingston, Ontario, Canada; SKiN Centre for Dermatology, Peterborough, Ontario, Canada. 3. Radboud University Medical Center and Radboud University, Nijmegen, The Netherlands. 4. Beth Israel Deaconess Hospital and Harvard Medical School, Boston, Massachusetts. 5. Dalhousie University, Halifax, Nova Scotia, Canada. 6. Medical College of Wisconsin, Milwaukee, Wisconsin. 7. Janssen Scientific Affairs, LLC, Horsham, Pennsylvania. 8. Janssen Research & Development, LLC, Spring House, Pennsylvania. 9. Baylor University Medical Center at Dallas, Dallas, Texas.
Abstract
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.
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.
Authors: Bruna da Silva Soley; Leonardo Martins Silva; Daniel Augusto Gasparin Bueno Mendes; André Báfica; João Bosco Pesquero; Michael Bader; Deborah A Witherden; Wendy L Havran; João B Calixto; Michel Fleith Otuki; Daniela Almeida Cabrini Journal: Br J Pharmacol Date: 2020-05-30 Impact factor: 8.739
Authors: C Elise Kleyn; Peter S Talbot; Nehal N Mehta; Francesca Sampogna; Chris Bundy; Darren M Ashcroft; Alexa B Kimball; Peter C M van de Kerkhof; Christopher E M Griffiths; Fernando Valenzuela; Joelle M van der Walt; Tsion Aberra; Lluís Puig Journal: Acta Derm Venereol Date: 2020-01-07 Impact factor: 3.875