Friday, 27 Mar 2020

You are here

Obesity Outweighs Psoriasis in Comorbidity Risk with Children

Like their adult counterparts, psoriasis in children is an independent risk factor for comorbidity, but not as much as  obesity.

Using claims data from Optum Laboratories Data Warehouse (150 million privately insured and Medicare enrollees), of 29 957 children with psoriasis were matched with a comparator cohort (children without psoriasis) and studied for the effects of psoriasis and obsesity. 

Psoriasis children were likely to be obese (2.9% vs 1.5%; P < .001). They were also significantly more likely to develop each of the studied comorbidities than those without psoriasis (P < .01).

In nonobese children, psoriasis was associated with a 40% to 75% risk of comorbidity:

  • Hyperlipidemia - HR, 1.42; 95% CI, 1.25-1.62
  • HTN - HR, 1.64; 95% CI, 1.40-1.93
  • Diabetes - HR, 1.58; 95% CI, 1.27-1.95
  • Metabolic syndrome -  HR, 1.62; 95% CI, 1.13-2.33
  • Polycystic ovarian syndrome - HR, 1.49; 95% CI, 1.18-1.88
  • Nonalcoholic liver disease (HR, 1.76; 95% CI, 1.16-2.65
  • Elevated liver enzymes - HR, 1.46; 95% CI, 1.27-1.67

 

Obesity was a strong risk factor for development of comorbidity, even without psoriasis (HR ranging from 2.26 to 18.11).

Children with psoriasis are at greater risk of developing obesity, hyperlipidemia, hypertension, diabetes, metabolic syndrome, polycystic ovarian syndrome, nonalcoholic liver disease, and elevated liver function enzyme levels than children without psoriasis.

However, obesity is a much stronger risk factor for comorbidity in children with psoriasis.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Start with Anti-TNF in RA? Not So Fast

The suggestion to hit rheumatoid arthritis (RA) early and hard with biologic therapies itself took a hit in a new study.

Use of first-line etanercept (Enbrel) plus methotrexate in very early RA was not associated with a substantially higher rate of remission compared with a strategy of treat-to-target methotrexate monotherapy, a randomized open-label trial found.

Best of 2019 - The Shame Behind Adalimumab Biosimilars

JAMA has an article this week on the shift from biologic drugs to less expensive therapeutic biosimilar agents. The impact of biosimilars can be easily represented by the shift from adalimuamb - a biologic with nearly $19 billion in sales in 2018 - to any one of the four FDA approved biosimilars for adalimumab (see the daily download for slides on new adalimumab and other biosimilars).

Psoriasis Risk Increased with TNF Inhibitors in Juveniles

Children with inflammatory diseases who were treated with tumor necrosis factor (TNF) inhibitors had a higher rate of incident psoriasis than those not exposed to these biologics, a single-center retrospective study found.

The Shame Behind Adalimumab Biosimilars

JAMA has an article this week on the shift from biologic drugs to less expensive therapeutic biosimilar agents. The impact of biosimilars can be easily represented by the shift from adalimuamb - a biologic with nearly $19 billion in sales in 2018 - to any one of the four FDA approved biosimilars for adalimumab (see the daily download for slides on new adalimumab and other biosimilars).

Pain Persists Despite TNF Inhibitor Use

Control of pain in patients with rheumatoid arthritis (RA) often focuses on control of inflammation as a means to better control pain. However, a new claims data study shows that while anti-tumor necrosis factor inhibitor (TNFi) may lower the use of opioids, the reduction is nominal, suggesting that a substantial amount of pain is not adequately addressed by TNFi - a potent anti-inflammatory approach.