Geographic Patterns in Psoriasis: An Observational Study of CorEvitas Psoriasis Registry.

Background

How psoriasis disease characteristics, management, and outcomes each vary across the US is not fully understood.

Objective

Assess regional disease characteristics for patients enrolled in CorEvitas Psoriasis Registry, report biologic initiations by class over the period, and evaluate regional outcome data for initiations with 6-month follow-up.

Methods

Participants included new biologic initiations in CorEvitas Psoriasis Registry from 2014-2019 categorized into 7 different geographic regions: Northeast, East North Central, Mountain/West North Central, South Atlantic, East South Central, West South Central, and Pacific. Baseline demographics and disease characteristics are described by region. For participants with 6-month follow-up data, we report treatment patterns and treatment outcomes.

Results

7520 biologic initiations from 6320 patients were available. Over time, biologic initiations in most US regions within the Registry resulted in a pattern where IL-17 inhibitors were used most frequently, followed by IL-12/23 and IL-23 inhibitors, and lastly by TNF inhibitors. Baseline disease severity varied among regions with the East South Central reporting the largest proportion (25.1%) of very severe disease by body surface area. Frequencies of metabolic comorbid diseases varied between regions (obesity, diabetes, hyperlipidemia, each P < .001; hypertension P < .019), with the East South Central reporting the largest proportions. Rates of achieving PASI75 and IGA 0/1 varied at 6-months (P = .008 and P = .001, respectively), with the East South Central reporting the lowest frequencies. At 6-months 28.2% of biologic initiations in the East South Central were discontinued, of which 22% had switched to another therapy.

Conclusion

Providers should be aware of regional trends in disease characteristics to improve overall care of psoriasis patients.