Psoriasis ups risk of all-cause, cause-specific mortality
Psoriasis appears to be a risk factor for mortality from all causes in a dose-response manner with disease severity and from several specific causes, suggest the results of a systematic review and meta-analysis.
The investigators searched for studies reporting all-cause or cause-specific mortality risk estimates in patients with psoriasis compared with general population or individuals free of psoriasis. They calculated pooled relative risks (RRs) and 95 percent confidence intervals (CIs).
A total of 12 studies were included. The pooled RRs for all-cause mortality were 1.21 (95 percent CI, 1.14–1.28) in psoriasis, 1.13 (1.09–1.16) in mild psoriasis and 1.52 (1.35–1.71) in severe psoriasis, while the corresponding pooled RRs for cardiovascular mortality were 1.15 (1.09–1.21), 1.05 (0.92–1.20) and 1.38 (1.09–1.74).
Mortality risk from noncardiovascular causes, particularly liver disease, kidney disease and infection, was significantly elevated in psoriasis patients regardless of disease severity. The highest mortality risk was observed in those with liver and kidney disease.
In addition, a significant increase in mortality risk was associated with neoplasms in severe psoriasis patients and chronic lower respiratory disease in all and mild psoriasis patients.
The study was limited by the heterogenous magnitude in spite of the consistent associations seen, according to the investigators.
An earlier study found an association between severe psoriasis and mortality risk from several causes, with cardiovascular death being the most common aetiology. Psoriasis patients were also at risk of death from previously unreported causes, such as infection, dementia and kidney disease. [Br J Dermatol 2010;163:586-592]