Researchers at several Chinese medical and research institutions investigated the effects of biologics therapy — namely tumor necrosis factor inhibitors — on the psychological symptoms and well-being of psoriasis patients, and found that the therapy may be associated with reduced depression and insomnia and reduced rates of antidepressant use.
The research paper, “Depression and Insomnia in Patients With Psoriasis and Psoriatic Arthritis Taking Tumor Necrosis Factor Antagonists,” was published in Medicine.
According to the National Psoriasis Foundation, people affected by this condition are twice as likely to become depressed when compared to the rest of the population, and depression is said to be the No. 1 comorbidity of psoriasis. Symptoms of depression include insomnia and anxiety, leading to the use, at a much higher rate, of antidepressants.
Studies have also suggested that psychological symptoms in psoriasis are higher than in other skin disfiguring diseases and as high as in other major clinical diseases, such as cancer and diabetes.
In this study, researchers identified 980 patients with psoriasis or psoriatic arthritis who had received biologics therapy, such as TNF antagonist medicines, from 2009 to 2012. The scientists compared the rates of patients taking medications for depression and insomnia before and after biologics therapy. They also investigated the use of these medications among different patient subgroups.
Results indicated that, before starting biologics therapy, about 20 percent of patients were taking regular antidepressants. After two years of biologics therapy, there was more than a 40 percent reduction in the prevalence of antidepressant use.
Researchers also identified people older than 45, women, presence of comorbidities, and psoriatic arthritis as independent factors associated with depression and insomnia. And, those on biologics therapy who were younger than 45 and without psoriatic arthritis had a more rapid and significant reduction in depression and insomnia that other patients.
“The results suggest that biologics therapy may be associated with reduced rates of depression and insomnia, and a reduced rate of regular antidepressant use in psoriasis patients,” the authors concluded, adding that further analyses are warranted.