Cause-specific mortality in patients with psoriasis and psoriatic arthritis

Cause-specific mortality in patients with psoriasis and psoriatic arthritis

Background: There are limited data regarding causes of mortality in patients with psoriasis (PsO) or psoriatic arthritis (PsA).

Objective: This retrospective cohort study evaluated the risk and leading causes of mortality in patients with PsO/PsA.

Methods: Individuals with a hospital-based diagnosis of PsA/PsO were identified using the Danish National Patient Registry. Matched control individuals were identified from the general population. Main outcome measures were risk of death and cause-specific mortality in patients with PsO/PsA.

Results: Death rates per 1,000 patient-years (95% confidence interval [CI]), vs. controls, were 22.29 (19.71-24.87) vs. 13.89 (11.75-16.03) for PsO patients, and 10.83 (8.90-12.76) vs. 11.63 (9.64-13.62) for PsA patients, respectively. Survival, according to stratified hazard ratios (HRs), was significantly lower vs. controls in PsO (1.74, P<0.001), but not in PsA (1.06, P=0.190) patients. Significantly increased risk of death was observed in PsO patients vs. controls due to a number of causes; highest risks were observed for diseases of the digestive system, endocrine, nutritional and metabolic diseases, and certain infectious and parasitic diseases (HRs 3.61, 3.02 and 2.71, respectively). In patients with PsA, increased mortality was only observed for certain infectious and parasitic diseases (HR 2.80) and diseases of the respiratory system (HR 1.46). Patients with PsO died at a younger age than controls (mean age: 70.96 vs. 74.51 years; P<0.0001).

Conclusions: Patients with severe PsO have an increased mortality risk vs. matched controls, due to a number of causes. Evidence to support an increased risk for PsA patients was less convincing.


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