All-cause and cause-specific mortality in psoriasis: A systematic review and meta-analysis

Dhana, Ashar; Yen, Hsu-Chun; Yen, Hsuan; Cho, Eunyoung

doi:10.1016/j.jaad.2018.12.037

Cited by 63 publications

(55 citation statements)

References 66 publications

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“…Previous studies investigating health outcomes of children with skin disorders are limited in number. Whilst adults with skin disorders reportedly suffer from increased mortality [35,36], studies reporting hospitalisation and mortality among children and adolescents are rare [37,38]. However, our finding of increased risk of death does concur with a previous study reporting greater premature mortality among children with psoriasis [38].…”

Section: Discussionsupporting

confidence: 83%

Health, educational and employment outcomes among children treated for a skin disorder: Scotland-wide retrospective record linkage cohort study of 766,244 children

et al. 2020

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Background To compare health, educational and employment outcomes of schoolchildren receiving medication for a skin disorder with peers. Methods This retrospective population cohort study linked eight Scotland-wide databases, covering dispensed prescriptions, hospital admissions, maternity records, death certificates, annual pupil census, school examinations, school absences/exclusions and unemployment to investigate educational (absence, exclusion, special educational need, academic attainment), employment, and health (admissions and mortality) outcomes of 766,244 children attending local authority run primary, secondary and special schools in Scotland between 2009 and 2013. Results After adjusting for sociodemographic and maternity confounders the 130,087 (17.0%) children treated for a skin disorder had increased hospitalisation, particularly within one year of commencing treatment (IRR 1.38, 95% CI 1.35–1.41, p<0.001) and mortality (HR 1.50, 95% CI 1.18–1.90, p<0.001). They had greater special educational need (OR 1.19, 95% CI 1.17–1.21, p<0.001) and more frequent absences from school (IRR 1.07, 95% CI 1.06–1.08, p<0.001) but did not exhibit poorer exam attainment or increased post-school unemployment. The associations remained after further adjustment for comorbid chronic conditions. Conclusions Despite increased hospitalisation, school absenteeism, and special educational need, children treated for a skin disorder did not have poorer exam attainment or employment outcomes. Whilst findings relating to educational and employment outcomes are reassuring, the association with increased risk of mortality is alarming and merits further investigation.

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Section: Discussionsupporting

confidence: 83%

Health, educational and employment outcomes among children treated for a skin disorder: Scotland-wide retrospective record linkage cohort study of 766,244 children

et al. 2020

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“…[6][7][8][9] Several additional studies have confirmed an increased risk of mortality in patients with psoriasis compared with control individuals. [10][11][12][13][14] On average, inflammatory comorbidities associated with psoriasis are estimated to reduce a patient's lifespan by approximately 5 years, independent of traditional risk factors. 9,[15][16][17] As psoriasis severity increases, risks of systemic comorbidities and mortality increase, 9,15 with the highest mortality risk observed in patients with psoriasis affecting more than 10% of their body surface area (BSA).…”

mentioning

confidence: 99%

Reduced risk of mortality associated with systemic psoriasis treatment in the Psoriasis Longitudinal Assessment and Registry (PSOLAR): A nested case-control analysis

Langley

Poulin

Bhaskar

et al. 2021

Journal of the American Academy of Dermatology

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Background: The effects of systemic therapy on mortality risk among patients with psoriasis are not fully understood. Objective: To evaluate the impact of systemic treatment on mortality risk in patients enrolled in the Psoriasis Longitudinal Assessment and Registry. Methods: Nested case-control analyses were performed to estimate mortality risk. Cases were defined as patients who died while participating in the Psoriasis Longitudinal Assessment and Registry. Cases were matched (1:4) with controls by age, race, sex, and geographic region. Evaluated treatments included methotrexate, ustekinumab, and tumor necrosis factor a inhibitors. Exposure was defined as at least 1 dose of treatment within 3 months before death and was stratified by duration of therapy. Results: Among 12,090 patients, 341 deaths occurred, matched to 1364 controls. Biologic treatment within the preceding 3 months was protective against mortality versus no exposure: odds ratio (OR) for exposure of less than 1 year, 0.08 (95% confidence interval [

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“…Other causes that were also prevalent were infections, neoplasms, and chronic respiratory disease of the lower airways. 16)…”

Section: Epidemiological Association Between Psoriasis and Cardiovascmentioning

confidence: 99%

Psoriasis and Cardiovascular Disease: A Narrative Review

2021

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Psoriasis is a chronic, autoimmune, and inflammatory disease that affects 2% of the world's population. In recent years, it has been demonstrated that psoriasis confers a 25% increase in relative risk of cardiovascular disease, independent of factors such as hyperlipidemia, smoking, and obesity. The objective of this review was to analyze and describe the association between psoriasis and cardiovascular disease. In this review, we describe the epidemiological association of psoriasis and cardiovascular disease, pathophysiology, mechanisms, and its association with the well-known cardiovascular risk calculators. In addition, we describe diagnostic tools, such as imaging techniques and novel biomarkers, that are useful in the evaluation of atherosclerotic cardiovascular disease. Finally, we present different systemic therapies that are used in patients with psoriasis and their effect on atherosclerotic cardiovascular disease. This article provides an overview of the current literature on psoriasis and cardiovascular risk, which can be useful for primary care physicians in their daily clinical practice.

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All-cause and cause-specific mortality in psoriasis: A systematic review and meta-analysis

Cited by 63 publications

References 66 publications

Health, educational and employment outcomes among children treated for a skin disorder: Scotland-wide retrospective record linkage cohort study of 766,244 children

Health, educational and employment outcomes among children treated for a skin disorder: Scotland-wide retrospective record linkage cohort study of 766,244 children

Reduced risk of mortality associated with systemic psoriasis treatment in the Psoriasis Longitudinal Assessment and Registry (PSOLAR): A nested case-control analysis

Psoriasis and Cardiovascular Disease: A Narrative Review

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