Psoriasis is a systemic autoimmune inflammatory disorder that may lead to the development of other serious medical conditions known as “comorbidities”. These may include cardiovascular disease, liver disease, diabetes, depression, cancer, autoimmune disorders and more. It is thought that comorbidities occur due to the inflammatory state of psoriasis. However, with proper management, the risk for many of these comorbidities can be minimized.
Comorbidities may include the following:
Up to 30% of people with psoriasis develop psoriatic arthritis, according to the National Psoriasis Foundation. It affects nearly 6% to 42% of those with psoriasis. This debilitating disease causes joint damage and a loss of function in some joints. Symptoms include pain, stiffness, nail changes, a reduced range of motion and swelling in and around the joints.
Studies show that delaying treatment for psoriatic arthritis can result in permanent joint damage. Early recognition, diagnosis and treatment is critical to relieve pain and help prevent joint damage. If you’ve been diagnosed with psoriasis, it is important to tell your dermatologist if you have any aches and pains.
Recent studies have found that those with psoriasis and psoriatic arthritis have an increased risk of certain types of cancer, such as lymphoma and non-melanoma skin cancer. In fact, the relative risk of developing lymphoma was found to be nearly three times that of the general population. People with psoriatic disease should incorporate regular cancer screenings into their routine care.
Certain eye disorders – conjunctivitis, blepharitis and uveitis – are more common in people with psoriasis. Uveitis, an inflammatory disease of the eye, affects about 7% of people with psoriatic arthritis. Uveitis requires specific treatment so consult your rheumatologist for more information.
People with moderate or severe psoriasis are more likely to be obese, according to the Mayo Clinic. Studies show that nearly 46% of those with moderate or severe psoriasis were obese. Obesity is quantified as a body mass index (BMI) of 30 or greater. The inflammation linked to obesity may contribute to the development of psoriasis, or it may be that people with psoriasis are more likely to gain weight due to a less active lifestyle. Research shows that losing weight can improve psoriatic disease symptoms and help make treatments more effective.
TYPE 2 DIABETES
According to the National Psoriasis Foundation, studies show that people with severe psoriasis are 30% more likely to have type 2 diabetes. The more severe the psoriasis, the greater the likelihood of type 2 diabetes. Symptoms of diabetes include increased thirst, hunger, blurred vision and fatigue.
The risk for heart attacks is almost three times greater for those with psoriasis, possibly due to the excess inflammation associated with psoriasis or the increased risk for obesity with patients. There is also an elevated risk of irregular heartbeats and strokes. In addition, some psoriasis treatments may cause abnormal cholesterol levels and increase the risk of hardened arteries. Treating your psoriasis can greatly reduce your risk of heart attacks and stroke.
High blood pressure, elevated insulin levels and abnormal cholesterol levels all fall under the term “metabolic syndrome” and may increase the risk for heart disease for those with psoriasis. A recent study showed that 40% of those with psoriasis had metabolic syndrome compared to just 23% of the general population and affected more women than men.
In a recent study of women with psoriasis, 10% developed a form of inflammatory bowel disease such as Crohn’s disease or ulcerative colitis. Those who had both psoriasis and psoriatic arthritis were at even greater risk of developing Crohn’s.
Patients with psoriasis are 1.5 times more likely to experience depression and use more anti-depressant medications than the general population. Nearly 80% psoriasis patients reported self-esteem issues, social isolationism, depression and even suicidal thoughts. Studies show that treating psoriasis can alleviate many of these symptoms.
People with psoriasis and psoriatic arthritis may be at greater risk for developing a liver condition called non-alcoholic fatty liver disease (NAFLD). This could be due to the increasing incidence of obesity and the metabolic syndrome in these regions.
Moderate to severe psoriasis has been linked to higher risk of kidney disease. People with severe psoriasis are twice more likely to develop chronic kidney disease than those whose psoriasis was mild.
Psoriasis is a chronic inflammatory condition, making it imperative that the specialist evaluate every organ system. Consistent monitoring for signs and symptoms of these associated diseases is vital. With proper management, the risk for many of these things can be minimized.
OptiMed Specialty Pharmacy is a privately-held healthcare entity that is ACHC- and URAC- accredited and uniquely qualified to optimize treatment outcomes not only for psoriasis but other comorbid diseases as described above, including psoriatic arthritis, Crohn’s disease, ulcerative colitis and more. OptiMed is devoted to helping these individuals optimize treatment outcomes by providing personalized medication management and research-based clinical information. We work closely with each patient, prescriber and payer to create a personalized plan that will lead to treatment success and improved quality of life.
Our pharmacists are available to answer questions by calling 877-385-0535. For more information about our services, visit www.optimedspecialtyrx.com.
Sources: Mayo Clinic, National Psoriasis Foundation, Rheumatology News