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Pharmacotherapy and inappropriate prescriptions in patients with psoriasis

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Abstract

Background Psoriasis is a chronic inflammatory and systemic disease that primarily affects the skin, nails, and joints. Some medications have been linked to worsening clinical manifestations of cutaneous psoriasis. Objective To identify pharmacological treatments and drugs related to worsening dermatological lesions in patients with psoriasis. Setting Patients diagnosed with psoriasis or psoriatic arthritis between November 1, 2018, and October 30, 2019. Methods This was a cross-sectional study from a population database that identified the prescriptions of patients with psoriasis during 2019. All medications prescribed for the treatment of psoriasis and other comorbidities were investigated. Main outcome measure Potentially inappropriate medications. Results We identified 2088 patients with psoriasis, with a mean age of 53.6 ± 15.5 years, and 52.9% were men. A total of 92.6% received pharmacological treatment, and of these, topical corticosteroids were the most commonly used group (76.6%). A total of 55.3% of patients with cutaneous psoriasis received at least one drug associated with worsening dermatological lesions. The most frequent were naproxen (25.5%), diclofenac (14.7%), and dexamethasone (10.8%). Residing in Barranquilla (odds ratio 1.27, 95%confidence interval 1.009–1.607), having any chronic comorbidities (odds ratio 1.94, 95%confidence interval 1.566–2.402), and having a history of coronary heart disease (odds ratio 6.25, 95%confidence interval 1.895–20.645) increased the probability of receiving these prescriptions. Conclusions The pharmacological treatment of psoriasis was in accordance with the recommendations of the clinical practice guidelines, but the high proportion of potentially inappropriate prescriptions makes it necessary to promote educational and pharmacovigilance strategies that improve the formulation habits of the physicians involved in the treatment of these patients.

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Data availability

Data Repository: https://dx.doi.org/10.17504/protocols.io.bcrpiv5n

References

  1. Psoriasis LM. Ann Intern Med. 2018;168(7):ITC49–ITC64.

    Article  Google Scholar 

  2. Balak DM, Hajdarbegovic E. Drug-induced psoriasis: clinical perspectives. Psoriasis (Auckl). 2017;7:87–94.

    CAS  Google Scholar 

  3. Mohd Affandi A, Khan I, Ngah SN. Epidemiology and clinical features of adult patients with Psoriasis in Malaysia: 10-year review from the Malaysian psoriasis registry (2007–2016). Dermatol Res Pract. 2018;2018:4371471.

    Article  PubMed  PubMed Central  Google Scholar 

  4. von Csiky-Sessoms S, Lebwohl M. What's new in Psoriasis. Dermatol Clin. 2019;37(2):129–36.

    Article  CAS  Google Scholar 

  5. Valenzuela F, Silva P, Valdés MP, Papp K. Epidemiology and quality of life of patients with Psoriasis in Chile. Actas Dermosifiliogr. 2011;102(10):810–6.

    Article  CAS  PubMed  Google Scholar 

  6. Schleicher SM. Psoriasis: pathogenesis, assessment, and therapeutic update. Clin Podiatr Med Surg. 2016;33(3):355–66.

    Article  PubMed  Google Scholar 

  7. Al-Mutairi N, Al-Farag S, Al-Mutairi A, Al-Shiltawy M. Comorbidities associated with psoriasis: an experience from the Middle East. J Dermatol. 2010;37(2):146–55.

    Article  PubMed  Google Scholar 

  8. Deng Y, Chang C, Lu Q. The inflammatory response in psoriasis: a comprehensive review. Clin Rev Allergy Immunol. 2016;50(3):377–89.

    Article  CAS  PubMed  Google Scholar 

  9. Parisi R, Symmons DPM, Griffiths CEM, Ashcroft DM. Global epidemiology of psoriasis: a systematic review of incidence and prevalence. J Invest Dermatol. 2013;133(2):377–85.

    Article  CAS  PubMed  Google Scholar 

  10. Brandon A, Mufti A, Gary SR. Diagnosis and management of cutaneous psoriasis: a review. Adv Skin Wound Care. 2019;32(2):58–69.

    Article  PubMed  Google Scholar 

  11. Kaushik SB, Lebwohl MG. Psoriasis: which therapy for which patient—Psoriasis comorbidities and preferred systemic agents. J Am Acad Dermatol. 2019;80(1):27–40.

    Article  PubMed  Google Scholar 

  12. Strober B, Karki C, Mason M, Guo N, Holmgren SH, Greenberg JD, et al. Characterization of disease burden, comorbidities, and treatment use in a large, US-based cohort: results from the Corrona Psoriasis Registry. J Am Acad Dermatol. 2018;78(2):323–32.

    Article  PubMed  Google Scholar 

  13. Dhana A, Yen H, Yen H, Cho E. All-cause and cause-specific mortality in psoriasis: a systematic review and meta-analysis. J Am Acad Dermatol. 2019;80(5):1332–433.

    Article  PubMed  Google Scholar 

  14. Kimball AB, Leonardi C, Stahle M, Gulliver W, Chevrier M, Fakharzadeh S, et al. Demography, baseline disease characteristics and treatment history of patients with psoriasis enrolled in a multicentre, prospective, disease-based registry (PSOLAR). Br J Dermatol. 2014;171(1):137–47.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies. J Am Acad Dermatol. 2009;60(4):643–59.

    Article  PubMed  Google Scholar 

  16. Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 4. Guidelines of care for the management and treatment of psoriasis with traditional systemic agents. J Am Acad Dermatol. 2009;61(3):451–85.

    Article  CAS  PubMed  Google Scholar 

  17. Kogan N, Raimondo N, Gusis SE, Izcovich A, Abarca Duran JA, Barahona-Torres L, et al. Latin American clinical practice guidelines on the systemic treatment of psoriasis SOLAPSO - Sociedad Latinoamericana de Psoriasis (Latin American Psoriasis Society). Int J Dermatol. 2019;58(Suppl 1):4–28.

    Article  PubMed  Google Scholar 

  18. Menter A, Strober BE, Kaplan DH, Kivelevitch D, Prater EF, Stoff B, et al. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics. J Am Acad Dermatol. 2019;80(4):1029–72.

    Article  PubMed  Google Scholar 

  19. Smith CH, Jabbar-Lopez ZK, Yiu ZZ, Bale T, Burden AD, Coates LC, et al. British Association of Dermatologists guidelines for biologic therapy for psoriasis 2017. Br J Dermatol. 2017;177(3):628–36.

    Article  CAS  PubMed  Google Scholar 

  20. Kim GK, Del Rosso JQ. Drug-provoked psoriasis: is it drug induced or drug aggravated? understanding pathophysiology and clinical relevance. J Clin Aesthet Dermatol. 2010;3(1):32–8.

    PubMed  PubMed Central  Google Scholar 

  21. Dika E, Varotti C, Bardazzi F, Maibach HI. Drug-induced psoriasis: an evidence-based overview and the introduction of psoriatic drug eruption probability score. Cutan Ocul Toxicol. 2006;25(1):1–11.

    Article  CAS  PubMed  Google Scholar 

  22. Hauben M, Reich L, Magliano S, Song A. Drug-induced psoriasis: results from pharmacovigilance tools under investigation. Cutan Ocul Toxicol. 2008;27(1):55–9.

    Article  CAS  PubMed  Google Scholar 

  23. Hong J, Bernstein D. A Review of Drugs that Induce or Exacerbate Psoriasis. Psoriasis Forum. 2012;18(1):2–11.

    Article  Google Scholar 

  24. Fernández-Armenteros JM, Gómez-Arbonés X, Buti-Solé M, Betriu-Bars A, Sanmartin-Novell V, Ortega-Bravo M, et al. Epidemiology of Psoriasis a population-based study. Actas Dermosifiliogr. 2019;110(5):385–92.

    Article  PubMed  Google Scholar 

  25. Gerdes S, Zahl VA, Knopf H, Weichenthal M, Mrowietz U. Comedication related to comorbidities: a study in 1203 hospitalized patients with severe psoriasis. Br J Dermatol. 2008;159(5):1116–23.

    Article  CAS  PubMed  Google Scholar 

  26. Han JH, Lee JH, Han KD, Seo HM, Bang CH, Park YM, et al. Epidemiology and medication trends in patients with psoriasis: a nationwide population-based cohort study from Korea. Acta Derm Venereol. 2018;98(4):396–400.

    Article  PubMed  Google Scholar 

  27. Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 6. Guidelines of care for the treatment of psoriasis and psoriatic arthritis: case-based presentations and evidence-based conclusions. J Am Acad Dermatol. 2011;65(1):137–74.

    Article  PubMed  Google Scholar 

  28. Canadian Psoriasis Guidelines Addendum Committee. Addendum to the Canadian Guidelines for the Management of Plaque Psoriasis. J Cutan Med Surg. 2016;20(5):375–43131.

    Article  Google Scholar 

  29. Song HJ, Park CJ, Kim TY, Choe YB, Lee SJ, Kim NI, et al. The clinical profile of patients with Psoriasis in Korea: A nationwide cross-sectional study (EPI-PSODE). Ann Dermatol. 2017;29(4):462–70.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Svendsen MT, Ernst MS, Andersen KE, Andersen F, Johannessen H, Pottegard A. Use of topical antipsoriatic drugs in Denmark: a nationwide drug utilization study. Br J Dermatol. 2019;180(1):157–64.

    Article  CAS  PubMed  Google Scholar 

  31. Armstrong AW. Psoriasis provoked or exacerbated by medications: identifying culprit drugs. JAMA Dermatol. 2014;150(9):963.

    Article  PubMed  Google Scholar 

  32. Dogra S, Kamat D. Drug-induced psoriasis. Indian J Rheumatol. 2019;14(5):37–433.

    Google Scholar 

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Acknowledgements

Soffy Claritza López, for her work in obtaining the database.

Funding

The present study did not receive funding.

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Authors and Affiliations

  1. Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Calle 105 No. 14-140, 660003, Pereira, Risaralda, Colombia

    Luis Fernando Valladales-Restrepo & Jorge Enrique Machado-Alba

  2. Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de Las Américas, Pereira, Colombia

    Luis Fernando Valladales-Restrepo

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  1. Luis Fernando Valladales-Restrepo
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  2. Jorge Enrique Machado-Alba
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Correspondence to Jorge Enrique Machado-Alba.

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Valladales-Restrepo, L.F., Machado-Alba, J.E. Pharmacotherapy and inappropriate prescriptions in patients with psoriasis. Int J Clin Pharm 42, 1270–1277 (2020). https://doi.org/10.1007/s11096-020-01061-w

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