Identifying depression in primary care: a comparison of different methods in a prospective cohort study

Abstract

Background Guselkumab is the first human monoclonal antibody that binds selectively to the p19 subunit of IL23. It’s approved for the treatment of moderate to severe psoriasis and psoriatic arthritis. Objectives We present a case series of patients with psoriasis and / or psoriatic arthritis who had a good response to Guselkumab and theirs cardiovascular risk factors. Methods An observational and retrospective study of patients with psoriasis and / or psoriatic arthritis under treatment with Guselkumab in the Dermatology and Rheumatology consultation at our hospital. A total of 11 patients were included. Baseline characteristics, comorbidities, and cardiovascular risk were collected. The SCORE (European High Risk Chart) and cardiovascular risk categories (European Society of Cardiology, European Atherosclerosis Society 2019) were used. Disease severity and treatment response were assessed by PASI, DLQI, DAPSA and ASDAS at baseline and after 12, 24 and 36 weeks. Results Our cases had a mean age of 52.45 years, 63.6% of them were women. A total of 45.5% had polyarticular psoriatic arthritis. 90.9% were obese, 45.45% were type 2 obesity, with a mean BMI of 34.88. Dyslipidemia and hypertension were observed in 54.5% and 72.7% of the patients, respectively. They all had varying degrees of Non-alcoholic fatty liver disease (NAFLD). A total of 45.5% had SCORE >1% and 90.9% were in moderate category of cardiovascular risk. At baseline their disease parameters were: PASI=11.09 (± 7.01), DLQI=15.09 (± 7.33), DAPSA=19.11 (± 9.95) and ASDAS=2.12 (± 0.43). After 12 weeks of treatment, the mean reduction of PASI and DLQI was 7.09 and 6.45, which continued improving at week 36. None of them were naive. There were no adverse effects, with a treatment survival of 76.73 weeks (± 42.93). Conclusion Guselkumab showed excellent results in our clinical practice in the control of psoriasis and / or psoriatic arthritis in non-naive patients with cardiovascular risk factors, with a good safety profile. References [1]Hawkes JE, Yan BY, Chan TC, Krueger JG. Discovery of the IL-23/IL-17 Signaling Pathway and the Treatment of Psoriasis. J Immunol. 2018;201(6):1605-1613. doi:10.4049/jimmunol.1800013 [2]Nawas Z, Hatch M, Ramos E, et al. A Review of Guselkumab, an IL-23 Inhibitor, for Moderate-to-Severe Plaque Psoriasis. Skin Therapy Lett. 2017;22(2):8-10 [3]Mease PJ, McInnes IB, Tam LS, et al. Comparative effectiveness of guselkumab in psoriatic arthritis: results from systematic literature review and network meta-analysis. Rheumatology (Oxford). 2021;60(5):2109-2121. doi:10.1093/rheumatology/keab119. [4]Sans S, Fitzgerald AP, Royo D, Conroy R, Graham I. Calibración de la tabla SCORE de riesgo cardiovascular para España [Calibrating the SCORE cardiovascular risk chart for use in Spain]. Rev Esp Cardiol. 2007;60(5):476-485. [5]Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk [published correction appears in Eur Heart J. 2020 Nov 21;41(44):4255]. Eur Heart J. 2020;41(1):111-188. doi:10.1093/eurheartj/ehz455 Disclosure of Interests None declared