Cardiometabolic profile, clinical features, quality of life and treatment outcomes in patients with moderate-to-severe psoriasis and psoriatic arthritis

Cardiometabolic, clinical and quality-of-life (QoL) measures were assessed before and after etanercept treatment in patients who had moderate-to-severe plaque psoriasis with and without psoriatic arthritis (PsA) in the PRISTINE trial. Adult patients were randomized to receive etanercept 50mg once weekly or twice weekly double-blind for 12 weeks; all patients subsequently received etanercept 50mg once weekly open-label through week 24. Metabolic syndrome was identified in 44 and 41% of patients with and without PsA, elevated blood pressure in 73 and 56% (p<0.05) and diabetes in 21 and 9% (p<0.01), respectively. Significant improvements from baseline in Psoriasis Area Severity Index were observed with etanercept therapy at all time points over 24 weeks (p<0.001) independent of PsA history. At baseline, patients with PsA had worse QoL than patients without PsA. After 24 weeks of etanercept, both groups had significant improvement from baseline in QoL, but the PsA group had greater improvement than that without PsA. Cardiovascular comorbidities were common in psoriasis patients with and without PsA, suggesting that clinicians need to be attentive to cardiometabolic parameters in this population. Worse QoL was demonstrated in PsA versus psoriasis alone. Regardless of patients' PsA status, treatment with etanercept significantly improved skin symptoms and QoL measures.