The risk of treated anxiety and treated depression among patients with psoriasis and psoriatic arthritis treated with apremilast compared to biologics, DMARDs and corticosteroids: a cohort study in the United States MarketScan database. Vasilakis-Scaramozza, C., Persson, R., Hagberg, K., & Jick, S. Journal of the European Academy of Dermatology and Venereology, 2020.
abstract   bibtex   
© 2020 European Academy of Dermatology and Venereology Background: Anxiety and depression are common among psoriasis and psoriatic arthritis (PsA) patients, but rates may differ by treatment. Objective: To quantify the risk of incident treated anxiety, depression and mixed anxiety + depression in users of apremilast compared with users of other treatments for psoriasis and PsA. Methods: We conducted two separate cohort studies of psoriasis and PsA patients treated with apremilast, tumour necrosis factor inhibitor biologics, interleukin-17, -23 or -12/23 inhibitor biologics, conventional DMARDs or systemic corticosteroids in the United States MarketScan database. Cohort entry was date of first study drug after 21 March 2014. We identified cases who had a depression and/or anxiety diagnosis with a prescription for antidepressant/antianxiety medication within 30 days of the diagnosis code. We calculated incidence rates (IRs) and incidence rate ratios with 95% confidence intervals (CIs) for treated anxiety, treated depression and treated anxiety + depression per 1000 patient-years (PY) among patients. Results: Among the psoriasis cohort, IRs for each outcome were similar between exposure categories and highest among users of systemic corticosteroids alone. IRs (95% CI) for apremilast alone were 9.2 (6.6–12.5), 4.6 (2.8–7.1) and 4.6 (2.8–7.1) per 1000 PY for treated anxiety, treated depression and treated anxiety + depression, respectively. In the PsA cohort, the rate of anxiety was highest among users of apremilast alone; rates of depression and anxiety + depression were similar for apremilast compared with other PsA treatments. IRs for each outcome were also high for users of corticosteroids in both the psoriasis and PsA cohorts. Conclusions: Among patients with psoriasis, users of apremilast had similar rates of anxiety and depression as users of other non-corticosteroid systemic psoriasis treatments. Among PsA patients, users of apremilast had similar rates of depression and anxiety + depression compared with users of other systemic non-corticosteroid PsA drugs; however, the rate of anxiety was slightly higher.
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 title = {The risk of treated anxiety and treated depression among patients with psoriasis and psoriatic arthritis treated with apremilast compared to biologics, DMARDs and corticosteroids: a cohort study in the United States MarketScan database},
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 year = {2020},
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 abstract = {© 2020 European Academy of Dermatology and Venereology Background: Anxiety and depression are common among psoriasis and psoriatic arthritis (PsA) patients, but rates may differ by treatment. Objective: To quantify the risk of incident treated anxiety, depression and mixed anxiety + depression in users of apremilast compared with users of other treatments for psoriasis and PsA. Methods: We conducted two separate cohort studies of psoriasis and PsA patients treated with apremilast, tumour necrosis factor inhibitor biologics, interleukin-17, -23 or -12/23 inhibitor biologics, conventional DMARDs or systemic corticosteroids in the United States MarketScan database. Cohort entry was date of first study drug after 21 March 2014. We identified cases who had a depression and/or anxiety diagnosis with a prescription for antidepressant/antianxiety medication within 30 days of the diagnosis code. We calculated incidence rates (IRs) and incidence rate ratios with 95% confidence intervals (CIs) for treated anxiety, treated depression and treated anxiety + depression per 1000 patient-years (PY) among patients. Results: Among the psoriasis cohort, IRs for each outcome were similar between exposure categories and highest among users of systemic corticosteroids alone. IRs (95% CI) for apremilast alone were 9.2 (6.6–12.5), 4.6 (2.8–7.1) and 4.6 (2.8–7.1) per 1000 PY for treated anxiety, treated depression and treated anxiety + depression, respectively. In the PsA cohort, the rate of anxiety was highest among users of apremilast alone; rates of depression and anxiety + depression were similar for apremilast compared with other PsA treatments. IRs for each outcome were also high for users of corticosteroids in both the psoriasis and PsA cohorts. Conclusions: Among patients with psoriasis, users of apremilast had similar rates of anxiety and depression as users of other non-corticosteroid systemic psoriasis treatments. Among PsA patients, users of apremilast had similar rates of depression and anxiety + depression compared with users of other systemic non-corticosteroid PsA drugs; however, the rate of anxiety was slightly higher.},
 bibtype = {article},
 author = {Vasilakis-Scaramozza, C. and Persson, R. and Hagberg, K.W. and Jick, S.},
 journal = {Journal of the European Academy of Dermatology and Venereology}
}

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