The following article is a part of conference coverage from the 2019 American College of Rheumatology/Association of Rheumatology Professionals (ACR/ARP) Annual Meeting, being held in Atlanta, Georgia. The team at Rheumatology Advisor will be reporting on the latest news and research conducted by leading experts in rheumatology. Check back for more from the 2019 ACR/ARP Annual Meeting.


ATLANTA — Patients with psoriatic arthritis (PsA) treated with either corticosteroids or interleukin (IL) inhibitors, either alone or in combination with other drugs, may be more likely to experience depression, according to research presented at the 2019 American College of Rheumatology/Association of Rheumatology Professionals Annual Meeting (ACR/ARP), held November 8 to 13, 2019, in Atlanta, Georgia.

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Researchers conducted a population-based cohort study, using data from the US MarketScan database, of patients with PsA treated with either apremilast, tumor necrosis factor inhibitors (TNFi), IL-17 or IL-12/23 inhibitors, conventional disease-modifying antirheumatic drugs (DMARDs), or systemic corticosteroids, between 2014 and 2018. Investigators aimed to assess the relationship between depression and PsA treatment type.

The total study population included 31,720 patients (median age, 53 years; 44% women), of whom 4.8% had a history of depression. Overall, 643 cases of treated depression were recorded. Incidence rates were similar across all treatments, with the highest rates found with corticosteroids and IL inhibitors (incidence rate 11.9 and 11.7; 95% CI, 8.6-15.9 and 8.4-15.8, respectively). The lowest incidence rate was associated with apremilast therapy (incidence rate, 8.6; 95% CI, 5.1-13.6).


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For combination therapies, the highest incidence rate was associated with IL inhibitors plus DMARDS (incidence rate, 18; 95% CI, 7.2-37.1), followed by corticosteroids plus any other study drug (incidence rate 14.7; 95% CI, 11.8-18). The lowest incidence rate was associated with TNFis plus DMARDs (incidence rate, 9.4; 95% CI, 6.8-12.7).

“Rates of treated depression were similar across PsA treatments,” the researchers concluded, “with somewhat higher rates of treated depression among patients exposed to corticosteroids alone or in combination with any other study drug and among patients exposed to IL [inhibitors] or in combination with DMARDs.”

Disclosure: All authors declared affiliations with Celgene Corporation.

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Reference

Vasilakis-Scaramozza C, Persson R, Wilcox Hagberg K, et al. Rates of treated depression among patients with psoriatic arthritis treated with apremilast, biologics, DMARDs, and corticosteroids in the US MarketScan database. Presented at: 2019 ACR/ARP Annual Meeting; November 8-13, 2019; Atlanta, GA. Abstract 2441.