Epidemiology and comorbidities of psoriasis patients in a national database in Taiwan

Tsen Fang Tsai, Ting Shun Wang, Sheng Tzu Hung, Phiona I Ching Tsai, Brad Schenkel, Mingliang Zhang, Chao Hsiun Tang

Research output: Contribution to journalArticle

159 Citations (Scopus)

Abstract

Background: Recent findings in psoriasis research have shown that psoriasis is frequently associated with systemic comorbidities. Objectives: This study aims to describe the epidemiology of psoriasis and the prevalence of comorbidities in patients with psoriasis in Taiwan. Methods: Patients who had at least one outpatient visit or admission with ICD-9-CM diagnosis code 696.0-1 in the Taiwan National Health Insurance (NHI) claims database during 2006 were identified as psoriasis cases. The cases were further classified into moderate to severe psoriasis (sPsO) for those who had previously received systemic therapy during the study period and mild psoriasis (mPsO) for those who had not. The cases were matched in a 1:4 ratio with controls from a sample cohort of 997,771 enrolees representative of the Taiwan population. Matching variables included age, gender and residential area. Prevalence of comorbidities was assessed using prevalence relative risk (RR) based upon a Cox proportional regression model. Results: 51,800 psoriasis cases were identified (prevalence = 0.235%; mean age = 46.4 ± 18.6; male:female = 1.6:1) and 17.5% of cases were sPsO type. Psoriasis was associated with a significantly increased prevalence ratio (RR; [95% confidence interval]) for hypertension (1.51; [1.47, 1.56]), diabetes (1.64; [1.58, 1.70]), hyperglyceridaemia (1.61; [1.54, 1.68]), heart disease (1.32; [1.26, 1.37]), hepatitis B viral infection (1.73; [1.47, 2.04]), hepatitis C viral infection (2.02; [1.67, 2.44]), rheumatoid arthritis (3.02; [2.68, 3.41]), systemic lupus erythematosus (6.16; [4.70, 8.09]), vitiligo (5.94; [3.79, 9.31]), pemphigoid (14.75; [5.00, 43.50]), pemphigus (41.81; [12.41, 140.90]), alopecia areata (4.71; [2.98, 7.45]), lip, oral cavity and pharynx cancer (1.49; [1.22, 1.80]), digestive organs and peritoneum cancer (1.57; [1.41, 1.74]), depression (1.50; [1.39, 1.61]), fatty liver (2.27; [1.90, 2.71]), chronic airways obstruction (1.47; [1.34, 1.61]), sleep disorder (3.89; [2.26, 6.71]), asthma (1.29; [1.18, 1.40]), and allergic rhinitis (1.25; [1.18, 1.33]). Conversely, psoriasis was not associated with an increased risk of Crohn's disease. Conclusions: Psoriasis was associated with a significantly increased risk of comorbidities, especially for those patients with moderate to severe disease. These health associations should be taken into consideration when evaluating the burdens of psoriasis and designing effective treatment plans.

Original languageEnglish
Pages (from-to)40-46
Number of pages7
JournalJournal of Dermatological Science
Volume63
Issue number1
DOIs
Publication statusPublished - Jul 2011

Fingerprint

Epidemiology
Taiwan
Psoriasis
Comorbidity
Databases
Health insurance
Medical problems
Liver
Health
Virus Diseases
Alopecia Areata
Bullous Pemphigoid
Vitiligo
Pemphigus
Mouth Neoplasms
Peritoneum
National Health Programs
International Classification of Diseases
Airway Obstruction
Fatty Liver

Keywords

  • Claims data
  • Comorbidities
  • Epidemiology
  • Metabolic syndrome
  • National Health Insurance
  • Psoriasis
  • Taiwan

ASJC Scopus subject areas

  • Dermatology
  • Biochemistry
  • Molecular Biology

Cite this

Epidemiology and comorbidities of psoriasis patients in a national database in Taiwan. / Tsai, Tsen Fang; Wang, Ting Shun; Hung, Sheng Tzu; Tsai, Phiona I Ching; Schenkel, Brad; Zhang, Mingliang; Tang, Chao Hsiun.

In: Journal of Dermatological Science, Vol. 63, No. 1, 07.2011, p. 40-46.

Research output: Contribution to journalArticle

Tsai, Tsen Fang ; Wang, Ting Shun ; Hung, Sheng Tzu ; Tsai, Phiona I Ching ; Schenkel, Brad ; Zhang, Mingliang ; Tang, Chao Hsiun. / Epidemiology and comorbidities of psoriasis patients in a national database in Taiwan. In: Journal of Dermatological Science. 2011 ; Vol. 63, No. 1. pp. 40-46.
@article{2958d13854574e1e9e593b6ca7791d69,
title = "Epidemiology and comorbidities of psoriasis patients in a national database in Taiwan",
abstract = "Background: Recent findings in psoriasis research have shown that psoriasis is frequently associated with systemic comorbidities. Objectives: This study aims to describe the epidemiology of psoriasis and the prevalence of comorbidities in patients with psoriasis in Taiwan. Methods: Patients who had at least one outpatient visit or admission with ICD-9-CM diagnosis code 696.0-1 in the Taiwan National Health Insurance (NHI) claims database during 2006 were identified as psoriasis cases. The cases were further classified into moderate to severe psoriasis (sPsO) for those who had previously received systemic therapy during the study period and mild psoriasis (mPsO) for those who had not. The cases were matched in a 1:4 ratio with controls from a sample cohort of 997,771 enrolees representative of the Taiwan population. Matching variables included age, gender and residential area. Prevalence of comorbidities was assessed using prevalence relative risk (RR) based upon a Cox proportional regression model. Results: 51,800 psoriasis cases were identified (prevalence = 0.235{\%}; mean age = 46.4 ± 18.6; male:female = 1.6:1) and 17.5{\%} of cases were sPsO type. Psoriasis was associated with a significantly increased prevalence ratio (RR; [95{\%} confidence interval]) for hypertension (1.51; [1.47, 1.56]), diabetes (1.64; [1.58, 1.70]), hyperglyceridaemia (1.61; [1.54, 1.68]), heart disease (1.32; [1.26, 1.37]), hepatitis B viral infection (1.73; [1.47, 2.04]), hepatitis C viral infection (2.02; [1.67, 2.44]), rheumatoid arthritis (3.02; [2.68, 3.41]), systemic lupus erythematosus (6.16; [4.70, 8.09]), vitiligo (5.94; [3.79, 9.31]), pemphigoid (14.75; [5.00, 43.50]), pemphigus (41.81; [12.41, 140.90]), alopecia areata (4.71; [2.98, 7.45]), lip, oral cavity and pharynx cancer (1.49; [1.22, 1.80]), digestive organs and peritoneum cancer (1.57; [1.41, 1.74]), depression (1.50; [1.39, 1.61]), fatty liver (2.27; [1.90, 2.71]), chronic airways obstruction (1.47; [1.34, 1.61]), sleep disorder (3.89; [2.26, 6.71]), asthma (1.29; [1.18, 1.40]), and allergic rhinitis (1.25; [1.18, 1.33]). Conversely, psoriasis was not associated with an increased risk of Crohn's disease. Conclusions: Psoriasis was associated with a significantly increased risk of comorbidities, especially for those patients with moderate to severe disease. These health associations should be taken into consideration when evaluating the burdens of psoriasis and designing effective treatment plans.",
keywords = "Claims data, Comorbidities, Epidemiology, Metabolic syndrome, National Health Insurance, Psoriasis, Taiwan",
author = "Tsai, {Tsen Fang} and Wang, {Ting Shun} and Hung, {Sheng Tzu} and Tsai, {Phiona I Ching} and Brad Schenkel and Mingliang Zhang and Tang, {Chao Hsiun}",
year = "2011",
month = "7",
doi = "10.1016/j.jdermsci.2011.03.002",
language = "English",
volume = "63",
pages = "40--46",
journal = "Journal of Dermatological Science",
issn = "0923-1811",
publisher = "Elsevier Ireland Ltd",
number = "1",

}

TY - JOUR

T1 - Epidemiology and comorbidities of psoriasis patients in a national database in Taiwan

AU - Tsai, Tsen Fang

AU - Wang, Ting Shun

AU - Hung, Sheng Tzu

AU - Tsai, Phiona I Ching

AU - Schenkel, Brad

AU - Zhang, Mingliang

AU - Tang, Chao Hsiun

PY - 2011/7

Y1 - 2011/7

N2 - Background: Recent findings in psoriasis research have shown that psoriasis is frequently associated with systemic comorbidities. Objectives: This study aims to describe the epidemiology of psoriasis and the prevalence of comorbidities in patients with psoriasis in Taiwan. Methods: Patients who had at least one outpatient visit or admission with ICD-9-CM diagnosis code 696.0-1 in the Taiwan National Health Insurance (NHI) claims database during 2006 were identified as psoriasis cases. The cases were further classified into moderate to severe psoriasis (sPsO) for those who had previously received systemic therapy during the study period and mild psoriasis (mPsO) for those who had not. The cases were matched in a 1:4 ratio with controls from a sample cohort of 997,771 enrolees representative of the Taiwan population. Matching variables included age, gender and residential area. Prevalence of comorbidities was assessed using prevalence relative risk (RR) based upon a Cox proportional regression model. Results: 51,800 psoriasis cases were identified (prevalence = 0.235%; mean age = 46.4 ± 18.6; male:female = 1.6:1) and 17.5% of cases were sPsO type. Psoriasis was associated with a significantly increased prevalence ratio (RR; [95% confidence interval]) for hypertension (1.51; [1.47, 1.56]), diabetes (1.64; [1.58, 1.70]), hyperglyceridaemia (1.61; [1.54, 1.68]), heart disease (1.32; [1.26, 1.37]), hepatitis B viral infection (1.73; [1.47, 2.04]), hepatitis C viral infection (2.02; [1.67, 2.44]), rheumatoid arthritis (3.02; [2.68, 3.41]), systemic lupus erythematosus (6.16; [4.70, 8.09]), vitiligo (5.94; [3.79, 9.31]), pemphigoid (14.75; [5.00, 43.50]), pemphigus (41.81; [12.41, 140.90]), alopecia areata (4.71; [2.98, 7.45]), lip, oral cavity and pharynx cancer (1.49; [1.22, 1.80]), digestive organs and peritoneum cancer (1.57; [1.41, 1.74]), depression (1.50; [1.39, 1.61]), fatty liver (2.27; [1.90, 2.71]), chronic airways obstruction (1.47; [1.34, 1.61]), sleep disorder (3.89; [2.26, 6.71]), asthma (1.29; [1.18, 1.40]), and allergic rhinitis (1.25; [1.18, 1.33]). Conversely, psoriasis was not associated with an increased risk of Crohn's disease. Conclusions: Psoriasis was associated with a significantly increased risk of comorbidities, especially for those patients with moderate to severe disease. These health associations should be taken into consideration when evaluating the burdens of psoriasis and designing effective treatment plans.

AB - Background: Recent findings in psoriasis research have shown that psoriasis is frequently associated with systemic comorbidities. Objectives: This study aims to describe the epidemiology of psoriasis and the prevalence of comorbidities in patients with psoriasis in Taiwan. Methods: Patients who had at least one outpatient visit or admission with ICD-9-CM diagnosis code 696.0-1 in the Taiwan National Health Insurance (NHI) claims database during 2006 were identified as psoriasis cases. The cases were further classified into moderate to severe psoriasis (sPsO) for those who had previously received systemic therapy during the study period and mild psoriasis (mPsO) for those who had not. The cases were matched in a 1:4 ratio with controls from a sample cohort of 997,771 enrolees representative of the Taiwan population. Matching variables included age, gender and residential area. Prevalence of comorbidities was assessed using prevalence relative risk (RR) based upon a Cox proportional regression model. Results: 51,800 psoriasis cases were identified (prevalence = 0.235%; mean age = 46.4 ± 18.6; male:female = 1.6:1) and 17.5% of cases were sPsO type. Psoriasis was associated with a significantly increased prevalence ratio (RR; [95% confidence interval]) for hypertension (1.51; [1.47, 1.56]), diabetes (1.64; [1.58, 1.70]), hyperglyceridaemia (1.61; [1.54, 1.68]), heart disease (1.32; [1.26, 1.37]), hepatitis B viral infection (1.73; [1.47, 2.04]), hepatitis C viral infection (2.02; [1.67, 2.44]), rheumatoid arthritis (3.02; [2.68, 3.41]), systemic lupus erythematosus (6.16; [4.70, 8.09]), vitiligo (5.94; [3.79, 9.31]), pemphigoid (14.75; [5.00, 43.50]), pemphigus (41.81; [12.41, 140.90]), alopecia areata (4.71; [2.98, 7.45]), lip, oral cavity and pharynx cancer (1.49; [1.22, 1.80]), digestive organs and peritoneum cancer (1.57; [1.41, 1.74]), depression (1.50; [1.39, 1.61]), fatty liver (2.27; [1.90, 2.71]), chronic airways obstruction (1.47; [1.34, 1.61]), sleep disorder (3.89; [2.26, 6.71]), asthma (1.29; [1.18, 1.40]), and allergic rhinitis (1.25; [1.18, 1.33]). Conversely, psoriasis was not associated with an increased risk of Crohn's disease. Conclusions: Psoriasis was associated with a significantly increased risk of comorbidities, especially for those patients with moderate to severe disease. These health associations should be taken into consideration when evaluating the burdens of psoriasis and designing effective treatment plans.

KW - Claims data

KW - Comorbidities

KW - Epidemiology

KW - Metabolic syndrome

KW - National Health Insurance

KW - Psoriasis

KW - Taiwan

UR - http://www.scopus.com/inward/record.url?scp=79957557452&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79957557452&partnerID=8YFLogxK

U2 - 10.1016/j.jdermsci.2011.03.002

DO - 10.1016/j.jdermsci.2011.03.002

M3 - Article

VL - 63

SP - 40

EP - 46

JO - Journal of Dermatological Science

JF - Journal of Dermatological Science

SN - 0923-1811

IS - 1

ER -