Summary
Several observational studies have assessed the association between psoriasis, psoriatic arthritis (PsA) and type 2 diabetes mellitus, with inconclusive results. We set out to investigate the ...association between psoriasis, PsA and type 2 diabetes mellitus. Observational studies assessing the relationship between psoriasis or PsA and type 2 diabetes mellitus up to December 2012 were identified by electronic and hand searches in Medline, Embase, PubMed, the Cochrane Database of Systematic Reviews and Google Scholar. For each study we collected the first author's last name, publication year, country of origin, study design, characteristics of participants (sample size, age and sex), the variables incorporated into the multivariable analyses, and the odds ratios (ORs) of psoriasis associated with diabetes along with the corresponding 95% confidence intervals (CIs). From the data provided in each article, the crude OR was also calculated. Forty‐four observational studies (in 37 articles) were identified for the final analysis. The pooled OR from random‐effects analysis was determined to be 1·76 (95% CI 1·59–1·96). The highest risk was for patients suffering from PsA (OR 2·18, 95% CI 1·36–3·50). We also observed a dose effect in the risk of suffering from type 2 diabetes mellitus, as patients considered as having severe psoriasis had higher risk (OR 2·10, 95% CI 1·73–2·55) than the pooled OR. We perform meta‐regression and sensitivity analyses to explore sources of heterogeneity among the studies and to determine how they would influence the estimates, and found no significant influence in the results of the meta‐analyses. The findings support the association between psoriasis, PsA and type 2 diabetes mellitus. Some caution must be taken in the interpretation of these results because there may be heterogeneity between studies.
What's already known about this topic?
Several observational studies have assessed the association between psoriasis, psoriatic arthritis and type 2 diabetes mellitus, with inconclusive results.
What does this study add?
A systematic review and meta‐analysis including all observational studies up to December 2012.
Investigation of the influence of psoriatic arthritis and the severity of the disease on the risk of diabetes.
The Simplified Psoriasis Index (SPI) is a recently validated tool in Spanish that measures psoriasis severity by integrating 3 different spheres: clinical severity (SPI-s), psychosocial impact ...(SPI-p), and natural history (SPI-i). Our objective was to study the validity and equivalence of this new scale compared to routinely used scales such as the Psoriasis Area and Severity Index, PASI, and the Dermatology Life Quality Index (DLQI).
This was a cross-sectional and observational study that included 45 patients aged 18 to 74 years. Demographic data and information associated with psoriasis severity and the patients' quality of life were collected, using PASI, DLQI, and SPI simultaneously. The correlation of reference scales (PASI and DLQI) with SPI was examined. The degree of agreement between the 2 versions of SPI completed by the physician (proSPI-s) and self-administered by the patient (saSPI-s), was also studied.
The mean age of the study population was 51 years, with a mean psoriasis history of 14.05 years. A strong correlation was found between PASI and proSPI-s (r=0.89), as well as between DLQI and SPI-p (r=0.89), with a moderate correlation being reported between PASI and saSPI-s (r=0.52). The degree of agreement between proSPI-s and saSPI-s was moderate.
These findings represent the initial results of real clinical practice using the validated Spanish version of SPI, making its use truly promising in the routine clinical practice.
In 2017, the Spanish Academy of Dermatology and Venereology Psoriasis Working Group (PWG) designed the Minimal Disease Activity (MDA) criteria to determine the level of disease activity. We hereby ...present the results of an observational, cross-sectional, multicenter study of the nationwide application of these criteria.INTRODUCTIONIn 2017, the Spanish Academy of Dermatology and Venereology Psoriasis Working Group (PWG) designed the Minimal Disease Activity (MDA) criteria to determine the level of disease activity. We hereby present the results of an observational, cross-sectional, multicenter study of the nationwide application of these criteria.We conducted a non-randomized sampling, stratified to achieve autonomic and provincial representation of consecutive patients with psoriasis (Ps) vulgaris without active arthritis. A total of 830 patients were included: 493 men (59.5%), with a mean age of 51.4 years (SD, 14.2), from all autonomous regions of Spain (except for Ceuta and Melilla) and 44 (88%) out of the 50 provinces. A questionnaire was obtained with demographic data, DLQI, subjective assessment-on a scale from 0 to 10-of itching, erythema, desquamation, visibility, and the patients' PASI and BSA.MATERIAL AND METHODSWe conducted a non-randomized sampling, stratified to achieve autonomic and provincial representation of consecutive patients with psoriasis (Ps) vulgaris without active arthritis. A total of 830 patients were included: 493 men (59.5%), with a mean age of 51.4 years (SD, 14.2), from all autonomous regions of Spain (except for Ceuta and Melilla) and 44 (88%) out of the 50 provinces. A questionnaire was obtained with demographic data, DLQI, subjective assessment-on a scale from 0 to 10-of itching, erythema, desquamation, visibility, and the patients' PASI and BSA.More than 50% failed to meet the MDA criteria (491; 59.2%), with significant differences being reported by region, sex, and age. Additionally, significant differences were reported based on the therapy used (P<.001). The use of biological therapies was associated with higher MDA compliance compared to other therapies (59.4% vs 23.3%). No differences were reported among various biological therapies.RESULTSMore than 50% failed to meet the MDA criteria (491; 59.2%), with significant differences being reported by region, sex, and age. Additionally, significant differences were reported based on the therapy used (P<.001). The use of biological therapies was associated with higher MDA compliance compared to other therapies (59.4% vs 23.3%). No differences were reported among various biological therapies.The overall rate of MDA compliance is low, with differences being based on geographic location, sex, age, and drug used, yet none of these factors separately justify them.CONCLUSIONSThe overall rate of MDA compliance is low, with differences being based on geographic location, sex, age, and drug used, yet none of these factors separately justify them.
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El Grupo de Psoriasis de la Academia Española de Dermatología y Venereología (GPs) diseño en 2017 la medida Actividad Mínima de Enfermedad en Psoriasis (AME). Se presentan los ...resultados de un estudio observacional, transversal y multicéntrico de la aplicación de esta escala a nivel nacional.
Se realizó un muestreo no aleatorizado, estratificado para alcanzar representación autonómica y provincial, de pacientes consecutivos con psoriasis (Ps) vulgar sin artritis activa. Se incluyeron 830 pacientes: 493 eran varones (59,5%), con una edad media de 51,4 años (DE=14,2), de todas las autonomías del país (excepto Ceuta y Melilla) y 44 (88%) de las 50 provincias. Se obtuvo un cuestionario recogiendo datos demográficos, DLQI, valoración subjetiva en escalas de 0 a 10 de picor, eritema, descamación y visibilidad; y el PASI y el BSA del paciente.
Más de la mitad no cumplían criterio de AME (491; 59,2%), con diferencia significativa entre regiones, por el sexo y por la edad. También había diferencias según el tratamiento realizado (p<0,001). El uso de un medicamento biológico se asoció a un mayor cumplimiento AME frente al uso de otro tipo de medicamentos (59,4 vs. 23,3%). No se observaron diferencias entre los tratamientos biológicos.
El porcentaje global de cumplimiento AME es bajo, con diferencias por la localización geográfica, el sexo, la edad y el fármaco utilizado, si bien ninguno de esos factores por separado las justifica.
In 2017, the Spanish Academy of Dermatology and Venereology Psoriasis Working Group (PWG) designed the Minimal Disease Activity (MDA) criteria to determine the level of disease activity. We hereby present the results of an observational, cross-sectional, multicenter study of the nationwide application of these criteria.
We conducted a non-randomized sampling, stratified to achieve autonomic and provincial representation of consecutive patients with psoriasis (Ps) vulgaris without active arthritis. A total of 830 patients were included: 493 men (59.5%), with a mean age of 51.4 years (SD, 14.2), from all autonomous regions of Spain (except for Ceuta and Melilla) and 44 (88%) out of the 50 provinces. A questionnaire was obtained with demographic data, DLQI, subjective assessment—on a scale from 0 to 10—of itching, erythema, desquamation, visibility, and the patients’ PASI and BSA.
More than 50% failed to meet the MDA criteria (491; 59.2%), with significant differences being reported by region, sex, and age. Additionally, significant differences were reported based on the therapy used (P<.001). The use of biological therapies was associated with higher MDA compliance compared to other therapies (59.4% vs 23.3%). No differences were reported among various biological therapies.
The overall rate of MDA compliance is low, with differences being based on geographic location, sex, age, and drug used, yet none of these factors separately justify them.
El Simplified Psoriasis Index (SPI) es una herramienta recientemente validada al español, que mide la gravedad de la psoriasis integrando 3esferas: gravedad clínica (SPI-s), impacto psicosocial ...(SPI-p) e historia natural (SPI-i). Nuestro objetivo fue estudiar la validez y equivalencia de esta nueva escala con las escalas que usamos de forma habitual (Psoriasis Area and Severity Index o PASI, y Dermatology Life Quality Index o DLQI).
Estudio observacional de corte transversal, con 45 pacientes de edades comprendidas entre los 18 y 74 años. Se recogieron sus datos demográficos y los relativos a la gravedad de la psoriasis y a la calidad de vida de los pacientes, utilizando simultáneamente estas escalas (PASI, DLQI y SPI). Se estudió la correlación de las escalas de referencia (PASI y DLQI) con el SPI. Se estudió el grado de concordancia entre las 2versiones del SPI: versión cumplimentada por el médico (proSPI) y versión autocumplimentada por el paciente (saSPI).
La edad media fue de 51 años, con un tiempo de evolución media de la psoriasis de 14,05 años. Se obtuvo una buena correlación entre PASI y proSPI-s (r=0,89) y entre DLQI y SPI-p (r=0,89), y una correlación moderada entre PASI y saSPI-s (r=0,52). El grado de concordancia entre proSPI-s y saSPI-s fue moderado.
Estos datos suponen los primeros resultados de uso en la práctica clínica real del SPI en su versión en español validada, y hacen que el uso de esta escala sea prometedor en la práctica clínica habitual.
The Simplified Psoriasis Index (SPI) is a recently validated tool in Spanish that measures psoriasis severity by integrating 3 different spheres: clinical severity (SPI-s), psychosocial impact (SPI-p), and natural history (SPI-i). Our objective was to study the validity and equivalence of this new scale compared to routinely used scales such as the Psoriasis Area and Severity Index, PASI, and the Dermatology Life Quality Index (DLQI).
This was a cross-sectional and observational study that included 45 patients aged 18 to 74 years. Demographic data and information associated with psoriasis severity and the patients’ quality of life were collected, using PASI, DLQI, and SPI simultaneously. The correlation of reference scales (PASI and DLQI) with SPI was examined. The degree of agreement between the 2 versions of SPI completed by the physician (proSPI-s) and self-administered by the patient (saSPI-s), was also studied.
The mean age of the study population was 51 years, with a mean psoriasis history of 14.05 years. A strong correlation was found between PASI and proSPI-s (r=0.89), as well as between DLQI and SPI-p (r=0.89), with a moderate correlation being reported between PASI and saSPI-s (r=0.52). The degree of agreement between proSPI-s and saSPI-s was moderate.
These findings represent the initial results of real clinical practice using the validated Spanish version of SPI, making its use truly promising in the routine clinical practice.
