Psoriasis Research Update
A review of recent news, research, and treatment related to psoriasis.
Nonadherence in Psoriasis Often Influenced by Patients’ Beliefs
Patients’ beliefs about medication and habit strength are promising targets for the improvement of medication adherence in patients with psoriasis, according to a recent study.
Medication nonadherence often interferes with therapeutic benefit in the treatment of psoriasis. To explore real-world levels of self-reported medication nonadherence and potential barriers to adherence, the researchers evaluated 811 patients with psoriasis who were enrolled in the British Association of Dermatologists Biologic Interventions Register via multivariable analyses. Latent profile analysis (LPA) was implemented to determine whether patients could be classified into groups with similar beliefs about medication and represented by a categorical latent variable.
A total of 617 patients used a self-administered systemic therapy. Results indicated that 22.4% of patients were nonadherent, of whom 12% were intentionally nonadherent and 10.9% were unintentionally nonadherent. The researchers found that more patients who used an oral conventional systemic agent (29.2%) were nonadherent to treatment vs those who used etanercept (Enbrel) or adalimumab (Humira) (16.4%). They also noted that LPA supported a 3-group model.
Strong beliefs were held by all groups regarding their need for systemic therapy. However, according to the researchers, their beliefs differed by degree of medication concerns. Group 1 (26.4% of the cohort) had the strongest concerns, followed by group 2 (61%) and group 3 (12.6%). Group 1 was associated with intentional nonadherence (odds ratio [OR] 2.27), and weaker medication-related habit strength was associated with unintentional nonadherence (OR 0.92).
“Medication beliefs and habit strength are modifiable targets for strategies to improve adherence in psoriasis,” the researchers concluded.
Thorneloe RJ, Griffiths CEM, Emsley R, Ashcroft DM, Cordingley L; BADBIR and PSORT Study Groups. Intentional and unintentional medication non-adherence in psoriasis: the role of patients’ medication beliefs and habit strength [published online November 25, 2017]. J Invest Dermatol. doi:10.1016/j.jid.2017.11.015
Study: Bariatric Surgery Reduces Psoriasis Risk
Bariatric surgery reduced the risk for psoriasis among individuals with obesity, according to a recent study.
For their study, the researchers analyzed data from the Swedish Obese Subjects study, which included 1991 participants with obesity who underwent bariatric surgery and 2018 participants with obesity who received usual care. Participants did not have psoriasis or psoriatic arthritis (PsA) at baseline and were followed for 26 years. Diagnoses of psoriasis and PsA were identified using data from the Swedish National Patient Register and questionnaires.
Compared with usual care, bariatric surgery was associated with a lower incidence of psoriasis (hazard ratio 0.65).
While smoking and a longer duration of obesity were independently associated with a higher risk for psoriasis, baseline confounders did not influence the association between bariatric surgery and lower psoriasis risk. Additionally, the researchers did not find any significant differences between the effects of the 3 surgical procedures on psoriasis risk, and there was no significant difference in the risk of developing PsA between the surgery and control groups.
“This study shows that bariatric surgery is associated with a lower risk of developing psoriasis compared with usual care,” the researchers concluded.
Maglio C, Peltonen M, Rudin A, Carlsson LMS. Bariatric surgery and the incidence of psoriasis and psoriatic arthritis in the Swedish Obese Subjects study. Obesity (Silver Spring). 2017;25(912):2068-2073.
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