Patients of Psoriasis at increased risk of mortality, finds recent study

USA: People with psoriasis are at increased risk of mortality, finds a recent study published in the Journal of the American Academy of Dermatology. This is partially mediated by an increased prevalence of cardiovascular disease, cancer, and infectious disorders in psoriatics.

Psoriasis is a common, chronic inflammatory disease of the skin caused by the overactive immune system. It involves multiple organ systems and affects approximately 3.2% of the world’s population. The disease can involve nails, joints and skin, and is also known to be associated with a range systemic comorbidities including stroke, high blood pressure, cardiovascular diseases, metabolic syndrome, hyperlipidemia, and obesity.

Yevgeniy R. Semenov, the Washington University School of Medicine in St. Louis, and colleagues determined the independent relationship between psoriasis and all-cause mortality in a nationally-representative sample of the US population.

The retrospective cohort study involved 13,031 adults and adolescents >10 years who participated in the National Health and Nutrition Examination Surveys (2003 to 2006 and 2009 to 2010). Psoriasis status was determined from self-reported medical history questionnaire.

Also Read: People with abdominal adiposity at increased risk of psoriasis

Key findings include:

• Psoriasis was identified in 2.7 percent of the study population.


• After adjustment for demographics, smoking, and comorbidities, including cardiovascular disease, diabetes, chronic obstructive pulmonary disease, cancer, chronic kidney disease, and stroke, psoriasis was significantly associated with an increased mortality risk during an average of 52.3 months of median follow-up (hazard ratio, 1.99).


• Overall, 15.5, 5.9, 8.7, 11.7, 4.2, and 4.7 percent, respectively, of the association between psoriasis and mortality was mediated by these comorbidities.

Also Read: Management and treatment of psoriasis with phototherapy: AAD/NPF guidelines

"These findings call for intensive monitoring of psoriasis patients, particularly those on systemic therapies and increased awareness of the mortality burden in psoriasis," write the authors.

"As a significant portion of the mortality burden in psoriasis remains unexplained by known risk factors, future studies should explore whether pathophysiologic mechanisms in psoriasis are independently tied to mortality," they concluded.

To read the complete study log on to https://doi.org/10.1016/j.jaad.2019.08.011