Taiwan study on infections in psoriasis patients

[Fred]

This cohort study from Taiwan looked at infections in patients with psoriasis.

Quote:

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Background:
The risks of serious infections that lead to hospitalisation and mortality in patients with psoriasis in Asia have not been comprehensively studied.

Objectives:
We examined the incidence of serious infection and infection mortality in patients with psoriasis.

Methods:
This population-based retrospective cohort study used the Taiwan National Health Insurance claims database from 2000 to 2017. Adult patients with psoriasis were identified by a relevant International Classification of Diseases (ICD) code and matched to six comparators without psoriasis on age and sex. Psoriasis patients were categorised as having moderate-to-severe disease once exposed to systemic therapies, phototherapy or biologic therapies. The incidence of serious infection and infection mortality were identified by ICD codes from inpatient hospitalisation and death registration. Cox proportional hazard models were used to compare the risk, and the results were adjusted for covariates and presented as adjusted hazard ratios (aHR) and 95% confidence interval (95%CI).

Results:
Overall, 185,434 psoriasis patients and 1,112,581 comparators were included. A higher rate of serious infection (aHR:1.21, 95%CI: 1.19-1.22) was found in patients with psoriasis compared to matched comparators without psoriasis, and the risk was enhanced when patients had moderate-to-severe psoriasis (aHR:1.30, 95%CI: 1.27-1.34). Specifically, there was an increased risk of serious infection due to respiratory infections (aHR:1.11, 95%CI: 1.09-1.13), skin/soft-tissue infections (aHR:1.57, 95%CI: 1.52-1.62), sepsis (aHR:1.23, 95%CI: 1.19-1.27), urinary tract infections (aHR:1.11, 95%CI: 1.08-1.14), hepatitis B (aHR:1.18, 95%CI: 1.06-1.30), and hepatitis C (aHR:1.49, 95%CI: 1.32-1.69). Furthermore, psoriasis patients were associated with a higher risk of infection-related mortality (aHR:1.15, 95%CI: 1.11-1.18) compared to matched comparators.

Conclusion:
Patients with psoriasis had a higher risk of serious infection and infection mortality, which was enhanced by moderate-to-severe psoriasis. Practitioners should be aware of the increased risk in patients with psoriasis, but it should not be a barrier to offering effective treatment.

Source: onlinelibrary.wiley.com

*Early view funding unknown. 

[Caroline]

I feel that it makes sense, but it is very difficult for me to derive that from the measurements that are given, the statistics I mean. As there is no explanation on how to interpret them.
So I can get there is an increased risk, but don’t have a clue if I have to worry about that.

And I also do think that the treatments that are available work positive in the sense that they will reduce the occurrence of infections with psoriasis patients.

[Fred]

I feel that it makes sense, but it is very difficult for me to derive that from the measurements that are given, the statistics I mean. As there is no explanation on how to interpret them.
So I can get there is an increased risk, but don’t have a clue if I have to worry about that.

There may be more in the final release.

And I also do think that the treatments that are available work positive in the sense that they will reduce the occurrence of infections with psoriasis patients.

Yes some work positive, but Bio's for example often suggest a greater risk of infections.

[Caroline]

That is true for the bio’s and MTX and DMF and perhaps others

But it may be, and I think it does, that that increase is compensated by the reduction of infections of problems with the psoriasis.

[Fred]

I was a bit concerned about the possible increase of infections when I started Bio's, but I've only had a bladder infection once in all those years and no other infections.