Comorbid Metabolic Syndrome, Psoriatic Arthritis Linked to Reduced Health-Related Quality of Life

Metabolic syndrome and psoriatic arthritis (PsA) are important comorbidities among patients with plaque psoriasis (PsO), with a reduced health-related quality of life (HRQoL) observed among patients with these comorbid disorders, thus highlighting the relevance of diagnosis and treatment beyond the care of skin lesions. A cross-sectional, observational study on the subject was conducted in 9 tertiary centers in southeastern, southern, and northern Brazilian regions that specialize in the treatment of PsO. Findings from the analysis were published in the Journal of Dermatology.

The investigators sought to assess the prevalence of metabolic syndrome and PsA, as well as to explore HRQoL and the prevalence of secondary comorbidities such as hypertension, type 2 diabetes mellitus, obesity, and dyslipidemia among the study population. Patients diagnosed with PsO responded to an interview and standardized questionnaires (ie, Dermatology Life Quality Index, 36-Item Short Form Health Survey, and EuroQoL Five-Dimension Questionnaire Three-Level version [EQ-5D-3L]). During 3 visits, a dermatologist and a rheumatologist conducted physical examinations, along with several tests, to evaluate the desired outcomes.

The prevalence of PsA was 41.8% (95% CI, 36.0%-47.6%) among patients who met Classification Criteria for Psoriatic Arthritis (35.7%) and/or had reported a medical history of PsA (23.1%). The prevalence of metabolic syndrome, based on physician diagnosis or history, was 50.0% (95% CI, 44.2%-55.8%). The most prevalent secondary comorbidity reported was dyslipidemia (74.5%), which was followed by hypertension (61.8%), obesity (52.5%), and type 2 diabetes mellitus (30.9%).

The mean Dermatology Life Quality Index score reported was 6.5±6.9. The mean physical and mental 36-Item Short Form Health Survey measures were 45.2±10.4 and 45.5±12.3, respectively. Regarding the EQ-5D-3L, the mean utility index was 0.68±0.27, and the mean EQ-5D-3L visual analog scale was 72.7±19.7. Among the 5 dimensions on the EQ-5D-3L, self-care was the least affected, with 84.6% of the respondents reporting an absence of problems. Moreover, the highest impairment was reported for the dimension of pain and discomfort, with 66.4% of respondents reporting experiencing problems, some problems, or extreme problems. Overall, 9.4% of respondents reported experiencing extreme problems on the dimension of anxiety and depression.

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The investigators concluded that the results of this study demonstrate that patients with plaque PsO have a reduced HRQoL, mainly in terms of emotional aspects, thus reinforcing existing data on feelings of stigmatization among these individuals. The findings also demonstrate the relevance of HRQoL scores among this population to evaluate patient response to therapy in a more comprehensive fashion.

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Souza CS, de Castro CCS, Carneiro FRO, et al. Metabolic syndrome and psoriatic arthritis among patients with psoriasis vulgaris: Quality of life and prevalence [published online November 26, 2018]. J Dermatol. doi: 10.1111/1346-8138.14706.