SpringerLink
Log in

Racial disparities in comorbidities of patients with psoriatic arthritis

  • Comorbidities
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

There have been significant advances in the treatment of psoriatic arthritis (PsA). Despite these advances, racial and ethnic disparities in clinical outcomes may still exist in patients with PsA. We aimed to examine the racial differences in clinical characteristics, medication usage and comorbidities in PsA patients. This retrospective study was conducted using the IBM Explorys platform. Search criteria included ICD diagnosis code for PsA and at least two visits with a rheumatologist, between 1999 and 2019. We further stratified by adding the following variables to the search: race, sex, laboratory data, and clinical characteristics, medication use, and comorbidities. Data sets were recorded as proportions and compared using chi-squared tests (p < 0.05). We identified 28,360 patients with PsA. AAs had a higher prevalence of hypertension (59% vs 52%, p < 0.0001), diabetes (31% vs 23% p < 0.0001), obesity (47% vs 30%, p < 0.0001), and gout (12% vs 8%, p < 0.0001). Caucasian patients were more likely to have cancer (20% vs 16%, p = 0.002), anxiety (28% vs 23%, p < 0.0001), and osteoporosis (14% vs 12%, p = 0.001). NSAIDs were used in 80% of Caucasians and 78% of AAs (p < 0.009), TNFs in 51% of Caucasians and 41% of AAs, and DMARDs in 72% of Caucasians and 98% of AAs (p < 0.0001). Our findings from a large US real-world database revealed that certain comorbidities were more frequent in AA patients with PsA, which warrants increased risk stratification. There was increased biologic use in Caucasians with PsA compared to AA who were more commonly on DMARDs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The data that supports these findings is available on reasonable request from the corresponding author [YR].

References

  1. Ritchlin CT, Colbert RA, Gladman DD (2017) Psoriatic arthritis. N Engl J Med 376:2095–2096

    Article  PubMed  Google Scholar 

  2. Jafri K, Bartels CM, Shin D, Gelfand JM, Ogdie A (2017) Incidence and management of cardiovascular risk factors in psoriatic arthritis and rheumatoid arthritis: a population-based study. Arthritis Care Res (Hoboken) 69:51–57

    Article  PubMed  Google Scholar 

  3. Kerr GS, Qaiyumi S, Richards J, Vahabzadeh-Monshie H, Kindred C, Whelton S, Constantinescu F (2015) Psoriasis and psoriatic arthritis in African-American patients–the need to measure disease burden. Clin Rheumatol 34(10):1753–1759

    Article  PubMed  Google Scholar 

  4. Ogdie A, Matthias W, Thielen RJ, Chin D, Saffore CD (2021) Racial differences in prevalence and treatment for psoriatic arthritis and ankylosing spondylitis by insurance coverage in the USA. Rheumatol Ther 8(4):1725–1739

    Article  PubMed  PubMed Central  Google Scholar 

  5. Ogdie A, Schwartzman S, Husni ME (2015) Recognizing and managing comorbidities in psoriatic arthritis. Curr Opin Rheumatol 27(2):118–126

    Article  PubMed  Google Scholar 

  6. Perez-Chada LM, Merola JF (2020) Comorbidities associated with psoriatic arthritis: Review and update. Clin Immunol 214:108397

    Article  CAS  PubMed  Google Scholar 

  7. Edson-Heredia E, Zhu B, Lefevre C, Wang M, Barrett A, Bushe CJ, Cox A, Wu JJ, Maeda-Chubachi T (2015) Prevalence and incidence rates of cardiovascular, autoimmune, and other diseases in patients with psoriatic or psoriatic arthritis: a retrospective study using clinical practice research datalink. J Eur Acad Dermatol Venereol 29(5):955–963

    Article  CAS  PubMed  Google Scholar 

  8. Kaine J, Song X, Kim G, Hur P, Palmer JB (2019) Higher incidence rates of comorbidities in patients with psoriatic arthritis compared with the general population using U.S. administrative claims data. J Manag Care Spec Pharm 25(1):122–132

    PubMed  Google Scholar 

  9. Husted JA, Thavaneswaran A, Chandran V, Eder L, Rosen CF, Cook RJ et al (2011) Cardiovascular and other comorbidities in patients with psoriatic arthritis: a comparison with patients with psoriasis. Arthritis Care Res 63(12):1729–1735

    Article  Google Scholar 

  10. Maksabedian Hernandez EJ, Tkacz J, Lopez-Gonzalez L, Higgins K, Ogdie A, Stolshek BS (2020) Psoriatic arthritis treatment patterns and costs among pharmacologic treatment-naïve patients. Am J Manag Care 26(8):e252–e257

    Article  PubMed  Google Scholar 

  11. Simone D, Nowik M, Gremese E, Ferraccioli GF (2015) Disease-modifying antirheumatic drugs (DMARD) and combination therapy of conventional DMARD in patients with spondyloarthritis and psoriatic arthritis with axial involvement. J Rheumatol Suppl 93:65–69

    Article  CAS  PubMed  Google Scholar 

  12. Raychaudhuri SP, Wilken R, Sukhov AC, Raychaudhuri SK, Maverakis E (2017) Management of psoriatic arthritis: early diagnosis, monitoring of disease severity and cutting edge therapies. J Autoimmun 76:21–37

    Article  PubMed  Google Scholar 

  13. Gupta S, Syrimi Z, Hughes DM, Zhao SS (2021) Comorbidities in psoriatic arthritis: a systematic review and meta-analysis. Rheumatol Int 41(2):275–284

    Article  PubMed  PubMed Central  Google Scholar 

  14. Puig L (2017) Cardiometabolic comorbidities in psoriasis and psoriatic arthritis. Int J Mol Sci 19(1):58

    Article  PubMed  PubMed Central  Google Scholar 

  15. Ren XS, Amick BC, Williams DR (1999) Racial/ethnic disparities in health: the interplay between discrimination and socioeconomic status. Ethn Dis 9:151–165

    CAS  PubMed  Google Scholar 

  16. Alexis AF, Blackcloud P (2014) Psoriasis in skin of color: epidemiology, genetics, clinical presentation, and treatment nuances. J Clin Aesthet Dermatol 7(11):16–24

    PubMed  PubMed Central  Google Scholar 

  17. Labitigan M, Bahče-Altuntas A, Kremer JM, Reed G, Greenberg JD, Jordan N, Putterman C, Broder A (2014) Higher rates and clustering of abnormal lipids, obesity, and diabetes mellitus in psoriatic arthritis compared with rheumatoid arthritis. Arthritis Care Res (Hoboken) 66(4):600–607

    Article  CAS  PubMed  Google Scholar 

  18. Kimhi O, Caspi D, Bornstein NM, Maharshak N, Gur A, Arbel Y, Comaneshter D, Paran D, Wigler I, Levartovsky D, Berliner S, Elkayam O (2007) Prevalence and risk factors of atherosclerosis in patients with psoriatic arthritis. Semin Arthritis Rheum 36(4):203–209

    Article  PubMed  Google Scholar 

  19. Graham G (2015) Disparities in cardiovascular disease risk in the United States. Curr Cardiol Rev 11(3):238–245

    Article  PubMed  PubMed Central  Google Scholar 

  20. Walsh JA, Adejoro O, Chastek B, Palmer JB, Hur P (2018) Treatment patterns among patients with psoriatic arthritis treated with a biologic in the United States: descriptive analyses from an administrative claims database. J Manag Care Spec Pharm 24(7):623–631

    PubMed  Google Scholar 

  21. Chastek B, White J, Van Voorhis D, Tang D, Stolshek BS (2016) A retrospective cohort study comparing utilization and costs of biologic therapies and JAK inhibitor therapy across four common inflammatory indications in adult US managed care patients. Adv Ther 33(4):626–642

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Howe A, Eyck LT, Dufour R, Shah N, Harrison DJ (2014) Treatment patterns and annual drug costs of biologic therapies across indications from the Humana commercial database. J Manag Care Spec Pharm 20(12):1236–1244

    PubMed  Google Scholar 

  23. Singh DK, Magrey MN (2020) Racial differences in clinical features and comorbidities in ankylosing spondylitis in the United States. J Rheumatol 47:835–838

    Article  CAS  PubMed  Google Scholar 

  24. Curbelo RJ, Loza E, de Yébenes MJ, Carmona L (2014) Databases and registers: useful tools for research, no studies. Rheumatol Int 34(4):447–452

    Article  PubMed  Google Scholar 

  25. Williams WG (2010) Uses and limitations of registry and academic databases. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 13(1):66–70. https://doi.org/10.1053/j.pcsu.2010.02.007

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Dr. Muhammad Asim Khan for reviewing the manuscript

Author information

Authors and Affiliations

  1. WellStar Health System, Marietta, GA, 30060, USA

    Y. Ross

  2. PMSI Division of Rheumatology, Pottstown, PA, 19464, USA

    S. Jaleel

  3. Case Western Reserve University School of Medicine, University Hospital, Cleveland, OH, 44106, USA

    M. Magrey

Authors
  1. Y. Ross
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Jaleel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Magrey
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Y. Ross.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ross, Y., Jaleel, S. & Magrey, M. Racial disparities in comorbidities of patients with psoriatic arthritis. Rheumatol Int 43, 1525–1529 (2023). https://doi.org/10.1007/s00296-023-05322-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-023-05322-5

Keywords

Search

Navigation