Original articleUnderdiagnosis and undertreatment of cardiovascular risk factors in patients with moderate to severe psoriasis
Section snippets
Study population
The pooled study population consisted of all patients enrolled in phase III clinical trials of ustekinumab, including the PHOENIX 118 (n = 766), PHOENIX 219 (n = 1230), and ACCEPT20 (n = 903) trials. Each of these multicenter trials enrolled patients with moderate to severe plaque-type psoriasis based on a Psoriasis Area and Severity Index score of at least 12, at least 10% body surface area involvement, and disease severity that warranted phototherapy or systemic therapy. At baseline, patients
Study population
Baseline skin disease characteristics of the overall pooled patient population were consistent with other clinical trial populations and may indicate more severe disease than in the general psoriasis population.12 At baseline, 39.6% (1147 of 2899) of all patients had at least one modifiable CV risk factor (diabetes, hypertension, or hyperlipidemia). Adding obesity or current tobacco use would have significantly increased the proportion of patients with at least one modifiable CV risk factor to
Discussion
Using a large pooled psoriasis clinical trial database, this study for the first time to our knowledge documents the underdiagnosis and undertreatment of CV risk factors in patients with moderate to severe plaque psoriasis. Despite the known association between psoriasis and CV risk factors, diabetes, hypertension, and hyperlipidemia were moderately underdiagnosed in these patient cohorts. Furthermore, even if the diagnosis of these CV risk factors was recognized, there was a high rate of
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Cited by (0)
Supported by Centocor Research and Development Inc.
Disclosures: Dr Kimball was a consultant and investigator for Abbott, Amgen, Centocor, and Novartis; a consultant for Idera; and an investigator for Pfizer. Dr Mrowietz has received honoraria as a speaker and/or advisor, travel reimbursement, or educational grants from Abbott, Biogen-Idec, Celgene, Centocor, Forward Pharma, Janssen, Leo Pharma, MSD, and Wyeth/Pfizer. Dr Reich has received honoraria as a consultant and/or advisory board member and/or acted as paid speaker and/or contributed in clinical trials sponsored by Abbott, Basilea, Biogen-Idec, Celgene, Centocor, Essex Pharma, Forward Pharma, Janssen-Cilag, Leo Pharma, Novartis, Pfizer, Schering-Plough, UCB, and Wyeth. Dr Langley has received research grants, served on scientific advisory boards, and been a speaker for Amgen, Biogen-Idec, Centocor, Genentech, Novartis, Schering-Plough, and Serono. Ms You and Dr Hsu are employees of Centocor. Drs Szapary and Yeilding are employees of Centocor and own stock in Johnson & Johnson, of which Centocor is a fully owned subsidiary. Dr Rader has been a consultant for Johnson & Johnson. Dr Mehta has no conflicts of interest to declare.