Demographics and disease characteristics of patients with psoriasis enrolled in the British Association of Dermatologists Biologic Interventions Register

• Published in: British journal of dermatology (1951) Vol. 173; no. 2; pp. 510 - 518
• Main Authors: Iskandar, I.Y.K., Ashcroft, D.M., Warren, R.B., Yiu, Z.Z.N., McElhone, K., Lunt, M., Barker, J.N.W.N., Burden, A.D., Ormerod, A.D., Reynolds, N.J., Smith, C.H., Griffiths, C.E.M.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01-08-2015; Oxford University Press
• Subjects: Adolescent; Adult; Age of Onset; Aged; Arthritis; Biological Factors - therapeutic use; Biological products; Body mass index; Comorbidity; Demography; Dermatologic Agents - therapeutic use; Dermatology; Esters; Etanercept; Female; Fumaric acid; Humans; Infliximab; Male; Methotrexate; Middle Aged; Monoclonal antibodies; Pharmacovigilance; Prospective Studies; Psoriasis; Psoriasis - complications; Psoriasis - drug therapy; Psoriasis - epidemiology; Psoriatic arthritis; Quality of Life; Registries; Tumor necrosis factor-α; United Kingdom - epidemiology; Young Adult; United Kingdom > UK; Ireland
• ISSN: 0007-0963; 1365-2133
• DOI: 10.1111/bjd.13908

Summary
Background
The British Association of Dermatologists Biologic Interventions Register (BADBIR) is a prospective, observational cohort designed to assess the long‐term safety of biologic and conventional systemic therapies used for adults with moderate‐to‐severe psoriasis in the U.K. and Republic of Ireland.
Objectives
To describe the demographics, disease severity and comorbidities of patients with psoriasis on enrolment into BADBIR, and to highlight differences in those commencing biologics compared with those on conventional systemic therapies.
Methods
Baseline data were collected from 151 dermatology departments in the U.K. and Republic of Ireland. Descriptive analysis was conducted.
Results
As of August 2014, 8399 patients were registered with BADBIR; 5065 (60%) received biologics, of whom 52·8% received adalimumab, 24·6% etanercept, 18·7% ustekinumab and 3·9% infliximab. In the comparator cohort 44·1% received methotrexate, 23·1% ciclosporin, 18·0% acitretin and 7·6% fumaric acid esters. Overall 4897 (58%) were male. Patients on biologics had a higher mean ± SD age and disease duration than patients on conventional systemic therapies (46·3 ± 12·7 vs. 44·3 ± 14·3 years and 23·0 ± 12·6 vs. 19·0 ± 13·4 years, respectively; both P < 0·001). Mean body mass index, Psoriasis Area and Severity Index and Dermatology Life Quality Index scores for patients on biologics were higher than for those on conventional systemic therapies (31·0 ± 7·2 vs. 30·1 ± 7·3 kg m−2; 16·4 ± 8·3 vs. 15·5 ± 7·9 and 17·4 ± 7·5 vs. 15·0 ± 7·1, respectively; all P < 0·001). In total 71% of all patients had comorbidities and 47% had more than one comorbidity. The most frequent comorbidities were obesity (42·1%), hypertension (25·7%), depression (22·1%) and psoriatic arthritis (17·1%).
Conclusions
BADBIR is an invaluable resource to study the safety and effectiveness of both biologic and conventional systemic therapies. Understanding differences in baseline characteristics between cohorts is crucial in undertaking future pharmacovigilance studies.
What's already known about this topic?
The baseline demographics of patients with psoriasis commencing biologic therapies are well described in the setting of clinical trials.
What does this study add?
Data collected by the British Association of Dermatologists Biologic Interventions Register reveal that the demographics (e.g. male‐to‐female ratio), phenotypes of psoriasis and comorbidities of patients with psoriasis commencing conventional systemic or biologic therapies in routine clinical practice in the U.K. and Republic of Ireland are different from those reported in a clinical trial setting.