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Diabetic Patients with Psoriasis May Have Higher Risk of Complications

Condition increased risk of microvascular and macrovascular complications…

In a new study, diabetic patients with psoriasis generally had an increased risk of microvascular and macrovascular complications compared with diabetic patients without psoriasis. However, greater severity of psoriasis was not associated with a greater risk of diabetic complications.

April W. Armstrong, MD, MPH, of the department of dermatology, University of Colorado at Denver, and colleagues reviewed MarketScan databases between 2000 and 2006 to select adult patients with two more diabetes diagnoses. Patients were divided into two cohorts: 6,164 patients with one or more psoriasis diagnoses (27% moderate to severe) and 6,164 patients without psoriasis. Propensity score was used to help match patients with psoriasis and those without, and Cox regression models were used to compare outcomes.

Researchers looked at 12,328 diabetes patients with and without psoriasis, and found that those with psoriasis were more likely to develop microvascular events than patients without psoriasis. The study also found an overall higher risk of macrovascular events among patients with mild psoriasis and those without the condition, but no increased risk was observed among those with moderate-to-severe psoriasis.

The development of microvascular events overall was more likely in the cohort with psoriasis compared with the cohort without psoriasis, with a hazard ratio (HR) of 1.14. Microvascular events were also more likely to develop based on psoriasis severity, with a HR of 1.13 for patients with mild psoriasis and a HR of 1.16 in patients with moderate-to-severe psoriasis.

Patients without psoriasis had higher risk of macrovascular events overall (HR = 1.13; 95% CI, 1.05-1.22), as did patients with mild psoriasis (HR = 1.15; 95% CI, 1.05-1.25). However, patients with moderate-to-severe psoriasis did not have a higher risk of macrovascular events (HR = 1.10; 95% CI, 0.95-1.26), according to the researchers.

The researchers concluded that when treating diabetic patients with psoriasis, clinicians should consider screenings for diabetic complications.

Practice Pearls:

  • Diabetic patients with psoriasis generally had an increased risk microvascular and macrovascular complications compared with diabetic patients without psoriasis.
  • Patients without psoriasis had higher risk of macrovascular events overall.
  • Patients with moderate-to-severe psoriasis did not have a higher risk of macrovascular events.

Armstrong A, et al. J Am Acad Dermatol. 2015;10.1016/j.jaad.2015.02.0195. Abstract