Of these, 9,654 had a diagnosis of psoriasis and 1,745 had a diagnosis of HT
Of these, 9,654 had a diagnosis of psoriasis and 1,745 had a diagnosis of HT. and Hashimotos thyroiditis, even after adjusting for confounding variables that included sex, age, psoriatic arthropathy and the use of systemic anti-psoriatic agents (OR=2.49; 95%CI 1.79C3.48; p 0.0001). Conclusions This association has broad clinical impact and deserves further attention LED209 with regards to patient care, clinical research, and developmental therapeutics. strong class=”kwd-title” Keywords: psoriasis, Hashimotos thyroiditis, comorbidities, metabolic syndrome, autoimmune diseases Introduction Psoriasis is a chronic, immune-mediated, inflammatory skin disorder affecting up to 3% of the worlds population1. It negatively affects clinical outcome, and psychosocial health2; 3. Psoriasis is associated with a variety of other morbidities including metabolic syndrome, diabetes mellitus, cardiovascular disease4 as well as with other inflammatory autoimmune diseases such as rheumatoid arthritis, celiac disease and Crohns disease.5 Hashimotos thyroiditis (HT) is a chronic autoimmune disorder6 of unknown etiology affecting nearly 2% of the general population7, and characterized by lymphocytic infiltration of the thyroid gland along with circulating anti-thyroid antibodies and increased serum levels of thyroid-stimulating hormone (TSH)8. Notably, unlike psoriasis, HT is ten times more prevalent in women than in men7; 9. The co-existence of psoriasis and autoimmune thyroiditis suggests a possible association between these two conditions10. However, a link LED209 between these two disorders has yet to be established. We sought to determine if an association existed between psoriasis and HT in a large, urban, academic-based, electronic medical record data repository. Materials and Methods We conducted a cross-sectional study to determine if an association between HT and psoriasis was detectable in a large data repository, the Northwestern Medicine Enterprise Data Warehouse (NMEDW), consisting of Electronic Medical Record (EMR) data for over 8 million individuals. Data were limited to clinical encounters that took place between January 1, 2010 and December 31, 2013. Baseline characteristics included the patients age, gender, race, and diagnoses of both psoriasis and HT. Data on psoriatic arthritis were also collected. Data on the use of systemic anti-psoriatic agents, both biological agents (infliximab, adalimumab, etanercept, golimumab, certolizumab pegol and ustekimumab), as well as non-biological anti-psoriatic agents (methotrexate, cyclosporine, acitretin), were collected. Psoriasis, psoriatic arthritis and HT diagnoses were collected using ICD-9 codes (ICD-9 CM 696.1; 696.0 and 245.2 respectively). Considering the relatively non-specific clinical symptoms and insidious onset of HT, only those patients with laboratory data (anti-thyroid peroxidase (anti-TPO) antibodies; thyroglobulin antibodies; serum TSH and free T3) that confirmed HT were included for analyses. The control populations consisted of all individuals who had an encounter between January 1, 2010 and December 31, 2013 (within the same EMR repository) who did not meet inclusion criteria. Logistic regression analysis was used to determine the odds ratio (OR) for an association between psoriasis and Hashimotos thyroiditis. The dependent variable was Hashimotos thyroiditis (HT) and the OR was defined as the odds of HT in the presence of psoriasis divided by the odds of HT in the absence of psoriasis. Multivariate logistic regression was used to adjust this analysis for potential confounders such as age, gender, psoriatic arthritis and the use of biological and non-biological anti-psoriatic systemic agents. Results A total of 856,615 individuals were determined to have medical record documentation LED209 of an encounter between January 1, 2010 and December 31, 2013. Of these, LED209 9,654 had a diagnosis of psoriasis and 1,745 had Rabbit Polyclonal to Cytochrome P450 4F11 a diagnosis of HT. For these patients, 41 patients were diagnosed with both disorders (35 female/6 male; mean age: 49.9 years, SD: +16.7; range: 30C74). After adjusting for potential confounding factors such as.