The Risk of Chronic Pancreatitis in Patients with Psoriasis: A Population-Based Cohort Study

Abstract

BackgroundPsoriasis is a chronic systemic inflammatory disorder, and studies have revealed its association with a variety of comorbidities. However, the risk of chronic pancreatitis (CP) in psoriasis has not been studied. This study aimed to investigate the risk of CP among patients with psoriasis.MethodsUsing the Taiwan National Health Insurance Research Database, this population-based cohort study enrolled 48430 patients with psoriasis and 193720 subjects without psoriasis. Stratified Cox proportional hazards models were used to compare the risks of CP between the patients with and without psoriasis.ResultsThe incidence of CP was 0.61 per 1000 person-years in patients with psoriasis and 0.34 per 1000 person-years in controls during a mean 6.6-year follow-up period. Before adjustment, patients with psoriasis had a significantly higher risk of CP (crude hazard ratio (HR) = 1.81; 95% confidence interval (CI) = 1.53–2.15), and the risk remained significantly higher after adjustments for gender, age group, medications, and comorbidities (adjusted HR (aHR) = 1.76; 95% CI = 1.47–2.10). All psoriasis patient subgroups other than those with arthritis, including those with mild and severe psoriasis and those without arthritis, had significantly increased aHRs for CP, and the risk increased with increasing psoriasis severity. Psoriasis patients taking nonsteroidal anti-inflammatory drugs (aHR = 0.33; 95% CI = 0.22–0.49) and methotrexate (aHR = 0.28; 95% CI = 0.12–0.64) had a lower risk of developing CP after adjustments.ConclusionsPsoriasis is associated with a significantly increased risk of CP. The results of our study call for more research to provide additional insight into the relationship between psoriasis and CP.

Association of Psoriasis With the Risk of Developing or Dying of Cancer

“…This explanation may hold particular sway when considering the suggested increased risk of pancreatic cancer incidence in people with psoriasis. Indeed, previous studies have noted an association between psoriasis and pancreatitis, with acknowledged links between pancreatitis and pancreatic cancer. Beyond the underlying inflammatory mechanisms of psoriasis, the use of immunomodulatory agents and potentially carcinogenic therapies in psoriasis treatment has also been explored as a mechanism for increased cancer risk, particularly for cancers such as lymphoma.…”

Connecting the Human Microbiome and Pancreatic Cancer

“…Psoriasis is normally found to be on the skin as abnormal growth of plaques but in a handful of patients (7%–26%) can also turn to psoriatic arthritis, a painful autoimmune condition, which has a similar presentation to RA. Severe cases have been linked to an increased risk of chronic pancreatitis, pancreatic and other gastrointestinal cancer development [ 27 , 28 ]. Infection with the human papillomavirus (HPV), which can cause warts on the skin, has been linked to a variety of cancers including cervical, anal and oral cancer [ 29 ].…”

Risk of head and neck cancer after chronic pancreatitis

“…CP would develop in 10% of patients with initial diagnosis of acute pancreatitis and 36% of patients with recurrent attacks of acute pancreatitis, respectively (26). Furthermore, the course CP may be insidious without prior history of acute pancreatitis (27). We therefore control for acute pancreatitis in the matching and the analysis.…”