The Risk of Mortality in Patients With Psoriasis

Gelfand, Joel M.; Troxel, Andrea B.; Lewis, James D.; Kurd, Shanu Kohli; Shin, Daniel B.; Wang, Xingmei; Margolis, David J.; Strom, Brian L.

doi:10.1001/archderm.143.12.1493

Cited by 474 publications

(415 citation statements)

References 31 publications

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“…These findings are in agreement with earlier published studies carried out to determine the risk of mortality in patients with psoriasis when compared to the general population and that PsA, by itself, is an independent risk factor for comorbidities particularly CVD [29]. Another Swedish study reported that patients with mild psoriasis did not have high mortality risk whereas severe psoriasis patients had an increased cardiovascular mortality risk [30]. This was supported by the data revealed from an independent study [31] which demonstrated that psoriasis patients may have decreased longevity.…”

Section: Discussionsupporting

confidence: 92%

“…This was endorsed by the results of another work which revealed that the hazard ratio of mortality in psoriatic patients was increased, particularly in patients with severe psoriasis who are aged under 55years. These results were in concordance with the outcomes of Gelfand et al study [37], where patients with very severe psoriasis were found to be associated with increased non-cardiovascular mortality. Furthermore, in agreement with this work, the study showed that data on comorbidity could be collected with questionnaires, as well as ICD-10.…”

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

Psoriatic arthritis comorbidity index: development and validation of a new specific tool for classifying prognostic comorbidity in psoriasis and psoriatic arthritis patients

Miedany¹,

Gaafary²,

Youssef³

et al. 2017

Rheumatol Orthop Med

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Objective: 1. identify comorbidities with greatest impact on PsA patients' health status. 2.develop and validate a prospectively applicable comorbidity index for classifying PsA patients according to their comorbid conditions. Methods:This was a retrospective multicenter cohort analysis of PsA patients in a rheumatology clinical registry, assessing the effect of different comorbidities measured at patients' visits over 10-years period. Outcomes of interest included functional ability, quality of life, medications induced complications, hospitalization/ death. A weighted index that was developed in a cohort of 1707 PsA patients. Internal and external validation were carried out.Results: PsA patients who had higher incidence of comorbid condition and were at high risk of hospitalization were men, with older age at disease onset, high BMI (p < 0.05). Multivariate regression analysis identified 29 comorbidities. A comorbidity index weighted according to the regression coefficient of the variables was developed (the score range: 0-37). A cut off point of 8 was associated with a sensitivity of 97.5% and a specificity of 87%. The developed PsACI correlated significantly with the 4 tested comorbidity indices: Charlson comorbidity index, Functional comorbidity index, Rheumatic Diseases comorbidity index, and Multimorbidity index at 1-, 3-, 5-and 10-years. Similar significant correlation was seen on external validation assessment. Conclusion:The PsA-comorbidity index is a valid method for estimating comorbidity risk in PsA patients. It enables the clinicians to include comorbidities assessment and management in their practice. It can be used to predict resource utilization, identify targets for reducing costs, by prospectively identifying PsA patients at high risk.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Psoriatic arthritis comorbidity index: development and validation of a new specific tool for classifying prognostic comorbidity in psoriasis and psoriatic arthritis patients

Miedany¹,

Gaafary²,

Youssef³

et al. 2017

Rheumatol Orthop Med

View full text Add to dashboard Cite

show abstract

“…A population-based study showed an increased risk of mortality in patients with severe psoriasis. 2 Interestingly, the one prospective cohort study examining this question in a group of patients exposed to PUVA was not able to detect an effect on mortality, using age and sex matched US mortality rates. 14 The relationship between systemic treatment of psoriasis and cardiovascular risk factors has not been adequately studied, however, in rheumatoid arthritis and psoriasis systemic treatment with methotrexate has been shown to decrease vascular risk.…”

Section: General Cardiovascular Riskmentioning

confidence: 99%

“…2 Further, psoriasis patients often suffer from depression, and more frequently smoke and drink alcohol to excess, which may negatively compound the health status of these patients. Evolving research suggests the chronic inflammatory nature of psoriasis itself may lead to adverse health outcomes including coronary artery disease and myocardial infarction (MI).…”

Section: Introductionmentioning

confidence: 99%

National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening

Kimball

Gladman

Gelfand

et al. 2008

Journal of the American Academy of Dermatology

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381

321

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“…Se ha demostrado una asociación de la psoriasis con factores de riesgo predictivos de enfermedad cardiovascular (CV) aterosclerótica 32 . Amplios estudios prospectivos han demostrado que la psoriasis en sí misma podría suponer un riesgo independiente de infarto de miocardio (IM), ictus, muerte por causa CV y mortalidad general 33,34 . Sin embargo, los efectos del ustekinumab en los factores de riesgo CV en los ensayos clinicoanalíticos no son significativos en cuanto a tensión arterial, frecuencia cardíaca, peso, electrocardiograma, lípidos y perfil de glucosa.…”

Section: Contraindicaciones Absolutasunclassified

Elección de fármaco biológico en la psoriasis moderada-grave. Protocolo

Guerra¹

2012

Más Dermatol.

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RESUMENHasta la fecha, se han publicado diferentes guías clínicas acerca del tratamiento de la psoriasis en placas moderada-grave. Sin embargo, no se ha publicado un protocolo que recoja los puntos que deben considerarse en la elección de fármacos biológicos en la psoriasis moderada-grave.Las características basales de gravedad (PASI) de los pacientes no permiten por sí solas establecer a priori la selección del fármaco biológico. La presencia de caracterís-ticas individuales del paciente o de la enfermedad y la forma de administración a menudo determinan el perfil de eficacia y seguridad de cada fármaco en cada paciente. Valoraremos, por tanto, en el proceso de selección de un determinado fármaco biológico, los factores que permiten tomar una decisión terapéutica individualizada, como son eficacia, seguridad, contraindicaciones, precauciones y otros datos.Este protocolo debe ser revisado periódicamente, puesto que los datos recogidos a lo largo del tiempo sobre estas terapias aún jóvenes, el mayor número de pacientes en tratamiento, los datos de los registros (BIOBADADERM) todavía con escaso recorrido, los nuevos estudios y la incorporación de fármacos nuevos aportarán información que modificará la toma de decisión de tratamiento biológico en un futuro.Palabras clave: protocolo, terapia biológica, guías clínicas, etanercept, adalimumab, infliximab, ustekinumab. ABSTRACTTo date, various clinical guides have been published about the treatment of moderate-severe plaque psoriasis. However, no protocol has been published that summarizes the aspects to be considered when choosing the biologic drug for treatment of moderate-severe psoriasis.The Psoriasis Area and Severity Index (PASI) does not by itself allow making an a priori choice of biologic drug for patients. The individual characteristics of the patient or of the disease, as well as the form of administering the drug, often determine the efficacy and safety profile of each drug for each individual patient. Therefore, in the process of choosing a particular biologic drug, we will evaluate the factors that help decision making regarding individualized therapy, such as efficacy, safety, contraindications, precautions and other data.This protocol should be reviewed regularly because the data collected over time about these still novel therapies, the larger number of patients receiving treatment, the data from records (BIOBADADERM) that have only recently been implemented, the new studies and the incorporation of new drugs will all provide more information that will modify future decision making about biologic treatment.

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The Risk of Mortality in Patients With Psoriasis

Cited by 474 publications

References 31 publications

Psoriatic arthritis comorbidity index: development and validation of a new specific tool for classifying prognostic comorbidity in psoriasis and psoriatic arthritis patients

Psoriatic arthritis comorbidity index: development and validation of a new specific tool for classifying prognostic comorbidity in psoriasis and psoriatic arthritis patients

National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening

Elección de fármaco biológico en la psoriasis moderada-grave. Protocolo

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