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Psoriasis and psoriatic arthritis in African-American patients—the need to measure disease burden

Abstract

Gaps in knowledge exist regarding the clinical characteristics of psoriatic disease in ethnic minority patients. We evaluated validated clinical disease measures of psoriasis and psoriatic arthritis in African-American and Caucasian patients. Adult outpatients with confirmed diagnoses of psoriasis and psoriatic arthritis and seen at four urban academic institutions were eligible for evaluation. Validated patient and physician-reported disease outcome parameters, quality of life measures of psoriasis and psoriatic arthritis, and frequencies of systemic immunosuppressive therapies and patient comorbidities were documented. Psoriatic arthritis was less frequent in African-Americans compared to Caucasians (30 vs. 64.5 %, respectively, p < 0.001); however, African-Americans had more severe skin involvement [Psoriasis Area and Severity Index 8.4 (10.0) vs. Caucasians 5.5 (6.4), p = 0.06], with greater psychological impact and impaired quality of life. Use of biologic therapies was greater in Caucasian patients (46.2 vs. 13.3 % in African-Americans, p < 0.0001); yet, only one in four patients of the study cohort achieved minimal disease activity. Comorbidity was not associated with frequency of immunosuppressive drug use. In order to achieve a target of low disease activity and to reduce ethnic disparities in the care of psoriatic disease, the routine application of measures of disease status is needed.

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Acknowledgments

The study was supported by an investigator-initiated grant from AbbVie and Amgen pharmaceutical companies. The funding sources had no role in design, analysis, or manuscript preparation. The authors thank Kepher Makambi, PhD, and Yaru Shi, MS, for their assistance with statistical analyses.

Conflict of interest

Gail Kerr has served on a Pfizer Advisory Panel for Psoriatic Arthritis. Seema Quayumi, John Richards, Hashem Vahabzadeh-Monshie, Chesahna Kindred, Sean Whelton, and Florina Constantinescu declare that they have no conflict of interest.

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Correspondence to Gail S. Kerr.

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Kerr, G.S., Qaiyumi, S., Richards, J. et al. Psoriasis and psoriatic arthritis in African-American patients—the need to measure disease burden. Clin Rheumatol 34, 1753–1759 (2015). https://doi.org/10.1007/s10067-014-2763-3

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  • DOI: https://doi.org/10.1007/s10067-014-2763-3

Keywords

  • Disease activity measures
  • Ethnic minorities
  • Psoriasis
  • Psoriatic arthritis