Psoriatic arthritis rates increasing in Taiwan despite psoriasis plateau

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Prevalence and incidence rates of psoriatic arthritis increased significantly in Taiwan from 2000 to 2013, while psoriasis exhibited no substantial change in incidence, according to findings published in the Journal of Rheumatology.

The researchers also noted changes in medication patterns during this period, with an increase in the use of biologics and disease-modifying antirheumatic drugs and decreased use of topical therapies.

“Psoriasis disease can be divided into two parts, the psoriatic arthritis (PsA) and other psoriasis (PsO),” James Cheng-Chung Wei, MD, PhD, of the Chung Shan Medical University Hospital, in Taichung, Taiwan, told Healio Rheumatology. “However, the prevalence and incidence in Asia were unrecognized. Our study is the first population-based, national wide survey to disclose the prevalence and incidence of PsA and PsO in Taiwan from 2000 to 2013.”

To examine and describe the rates of PsA and psoriasis, as well as changes in prescribing practices, in Taiwan, the researchers collected information from the Taiwan National Health Insurance Research Database, which covered at least 95% of the population from 2003 to 2013. For the purposes of their study, the researchers focused on patients aged 16 years and older.

The researchers used the ICD-9 to identify PsA and other psoriasis conditions, and they analyzed treatments through the Anatomical Therapeutic Chemical Classification Code. Additionally, they used the Poisson regression to test trends by Wald chi-square statistic.

According to the researchers, the prevalence of PsA between 2000 and 2013 increased from 11.12 per 100,000 population to 37.75, and from 179.2 to 281.5 for psoriasis. Meanwhile, the incidence of PsA increased from 3.64 to 6.91 per 100,000 person-years, with no significant change in the psoriasis rate. Moreover, the ratio of men-to-women with PsA decreased from 2 in 2000 to 1.5 in 2013. During that same time, the use of disease-modifying antirheumatic drugs and biologics increased, while treatments with topical therapies decreased.

“Our study may raise the awareness of PsA, and may contribute to early diagnosis and better treatment for patients,” Wei said. “On the other hand, our study recommends the reimbursement in the Taiwan National Health Insurance program should cover more medications, such as biologics and [disease-modifying antirheumatic drugs], since biologics are increasingly become the essential aspect in treating PsA and PsO.” – by Jason Laday

Disclosure: The researchers report no relevant financial disclosures.

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