Prevalence and treatment patterns of psoriatic arthritis in the UK

Alexis Ogdie*, Sinéad Langan, Thorvardur Love, Kevin Haynes, Daniel Shin, Nicole Seminara, Nehal N. Mehta, Andrea Troxel, Hyon Choi, Joel M. Gelfand

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

76 Citations (Scopus)


Objectives: The objectives of this study were to determine the prevalence of PsA in The Health Improvement Network (THIN), a large population-based medical records database in the UK, to examine factors associated with prevalent PsA among patients with psoriasis and to describe the use of DMARDs in patients with PsA. Methods: Two cohorts were derived from THIN to examine the prevalence of PsA in a cross-sectional study among all patients aged 18-90 years and among a subcohort of 4900 psoriasis patients aged 45-65 years. Prescription codes were used to describe therapies after the diagnosis of PsA. Associations for prevalent PsA among psoriasis patients were assessed using logistic regression analysis. Results: Among 4.8 million patients in THIN between the ages of 18 and 90 years, 9045 patients had at least one medical code for PsA, giving an overall prevalence of 0.19% (95% CI 0.19%, 0.19%). Of those patients, 45.9% with PsA have been prescribed DMARDs. Among the 4064 confirmed psoriasis patients, the prevalence of PsA was 8.6% (95% CI 7.7%, 9.5%). PsA was more prevalent among patients with severe psoriasis [odds ratio (OR) 3.34; 95% CI 2.40, 4.65], obesity (OR 1.77; 95% CI 1.30, 2.41) and duration of psoriasis for ≥10 years (OR 7.42; 95% CI 3.86, 14.25) in the fully adjusted model. Conclusion. The prevalence of PsA in THIN is consistent with previous population-based estimates. Limitations include a definition of PsA based on a diagnostic code rather than Classification Criteria for Psoriatic Arthritis (CASPAR) criteria. Given the large population of PsA patients, THIN is an important resource for the study of PsA.

Original languageEnglish
Pages (from-to)568-575
Number of pages8
JournalRheumatology (United Kingdom)
Issue number3
Publication statusPublished - Mar 2013

Bibliographical note

Funding Information:
We would like to thank Sean Hennessy, PharmD, PhD for his assistance in interpretation of the data. A.O. was supported by NIH T32 GM075766-05 and the ACR Research and Education Foundation. N.N.M. was supported by NIH K23HL97151-3. D.S. and N.S. were supported by NIH T32-AR07465. A.O. and J.M.G. conceptualized and designed the study with input from K.H., T.L., H.C. and S.L., and these authors were integral in interpretation of the results. A.O. performed the programming, statistical analysis, preparation of the data and the first draft of the manuscript. K.H., N.S. and D.S. performed data abstraction from THIN and assisted in programming. All authors were involved in critical review of the data as well as drafting and revision of the manuscript, and all have approved the final version of the article to be published.

Funding Information:
Disclosure statement: J.M.G. serves as a consultant to and received consulting fees from Amgen, Abbott, Centocor, Celgene, Novartis and Pfizer. He has received grants from Amgen, Abbott, Pfizer, Novartis and Genentech. All other authors have declared no conflicts of interest.

Funding Information:
Funding: This project was funded by NIH R01-HL089744 and the ACR.

Other keywords

  • DMARDs
  • Epidemiology
  • Primary care rheumatology
  • Spondyloarthritis (including psoriatic arthritis)


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