An examination of biologic treatment groups of psoriasis patients in a cohort of the Newfoundland and Labrador population

Morrissey, Andrea Nicole (2012) An examination of biologic treatment groups of psoriasis patients in a cohort of the Newfoundland and Labrador population. Masters thesis, Memorial University of Newfoundland.

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Abstract

Objective: -- To examine psoriasis patients receiving biologic treatment by biologic treatment type, demographic factors and various prognostic factors. Also, to examine health service utilization and comorbid conditions among biologic patients. In addition, to determine the risk of developing specified comorbidities based on treatment type received. Finally, to examine whether or not biologic treatment is associated with an increased Charlson Comorbidity Index (CCI) score. -- Methods: -- In this cross-sectional study, psoriasis demographic, clinical and treatment data were linked to physician claims, hospital and mortality data to investigate health service utilization of psoriasis patients between 1995/96 and 2007/08. -- Results: -- Findings indicate that the majority of patients receiving biologic treatment had moderate/severe psoriasis. Among biologic patients, 63.7% had at least one hospital separation, and 96.3% had at least one physician visit. Female biologic patients had a higher number of mean comorbidities compared to males (9.53±2.77 versus 8.20±2.78, respectively, p<0.01), as well as a higher mean CCI score (2.37±1.54 versus 1.93±1.32, respectively, p=0.04). The odds of having a 'skin and sub-cutaneous disorder' diagnosis was found to be 10 times greater if the psoriasis patient is taking biologics versus not taking biologics [10.49 (confidence interval 1.41-78.18), p=0.02]. -- Conclusions: -- Biologic patients are likely to have moderate/severe psoriasis, and to utilize health services (both physician and hospital), more so than non-biologic patients. Female biologic patients appear to be at a greater risk of developing comorbid conditions than male biologic patients; therefore, different comorbidity and treatment monitoring may be necessary for males and females. Biologic patients are more likely to develop skin and sub-cutaneous disorders than non-biologic patients.

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