TY - JOUR
T1 - Cause-specific mortality in patients with severe psoriasis
T2 - A population-based cohort study in the U.K.
AU - Abuabara, K.
AU - Azfar, R. S.
AU - Shin, D. B.
AU - Neimann, A. L.
AU - Troxel, A. B.
AU - Gelfand, J. M.
PY - 2010/9
Y1 - 2010/9
N2 - Background Severe psoriasis is associated with excess mortality and increased risk of cardiovascular death. Population-based data evaluating cause-specific mortality in patients with psoriasis are limited. Objectives To describe cause-specific mortality in patients with severe psoriasis. Methods We performed a cohort study from 1987 to 2002 of patients ≥ 18 years using the General Practice Research Database. We compared patients with a psoriasis code and a history of systemic therapy consistent with severe psoriasis (n = 3603) with patients with no history of psoriasis (n =14 330). Age- and sex-adjusted Cox models were created for each of the leading causes of death defined by the Centers for Disease Control. Results Patients with severe psoriasis were at increased risk of death from cardiovascular disease [hazard ratio (HR) 1·57, 95% confidence interval (CI) 1·26-1·96], malignancies (HR 1·41, 95% CI 1·07-1·86), chronic lower respiratory disease (HR 2·08, 95% CI 1·24-3·48), diabetes (HR 2·86, 95% CI 1·08-7·59), dementia (HR 3·64, 95% CI 1·36-9·72), infection (HR 1·65, 95% CI 1·26- 2·18), kidney disease (HR 4·37, 95% CI 2·24-8·53) and unknownmissing causes (HR 1·43, 95% CI 1·09-1·89). The absolute and excess risk of death was highest for cardiovascular disease (61·9 and 3·5 deaths per 1000 patient-years, respectively). Conclusions Severe psoriasis is associated with an increased risk of death from a variety of causes, with cardiovascular death being the most common aetiology. These patients were also at increased risk of death from causes not previously reported, such as infection, kidney disease and dementia. Additional studies are necessary to determine the degree to which excess causes of death are due to psoriasis, its treatments, associated behaviours, or other factors.
AB - Background Severe psoriasis is associated with excess mortality and increased risk of cardiovascular death. Population-based data evaluating cause-specific mortality in patients with psoriasis are limited. Objectives To describe cause-specific mortality in patients with severe psoriasis. Methods We performed a cohort study from 1987 to 2002 of patients ≥ 18 years using the General Practice Research Database. We compared patients with a psoriasis code and a history of systemic therapy consistent with severe psoriasis (n = 3603) with patients with no history of psoriasis (n =14 330). Age- and sex-adjusted Cox models were created for each of the leading causes of death defined by the Centers for Disease Control. Results Patients with severe psoriasis were at increased risk of death from cardiovascular disease [hazard ratio (HR) 1·57, 95% confidence interval (CI) 1·26-1·96], malignancies (HR 1·41, 95% CI 1·07-1·86), chronic lower respiratory disease (HR 2·08, 95% CI 1·24-3·48), diabetes (HR 2·86, 95% CI 1·08-7·59), dementia (HR 3·64, 95% CI 1·36-9·72), infection (HR 1·65, 95% CI 1·26- 2·18), kidney disease (HR 4·37, 95% CI 2·24-8·53) and unknownmissing causes (HR 1·43, 95% CI 1·09-1·89). The absolute and excess risk of death was highest for cardiovascular disease (61·9 and 3·5 deaths per 1000 patient-years, respectively). Conclusions Severe psoriasis is associated with an increased risk of death from a variety of causes, with cardiovascular death being the most common aetiology. These patients were also at increased risk of death from causes not previously reported, such as infection, kidney disease and dementia. Additional studies are necessary to determine the degree to which excess causes of death are due to psoriasis, its treatments, associated behaviours, or other factors.
KW - cancer
KW - cardiovascular epidemiology
KW - infection
KW - mortality
KW - psoriasis
UR - http://www.scopus.com/inward/record.url?scp=77955898585&partnerID=8YFLogxK
U2 - 10.1111/j.1365-2133.2010.09941.x
DO - 10.1111/j.1365-2133.2010.09941.x
M3 - Article
C2 - 20633008
AN - SCOPUS:77955898585
SN - 0007-0963
VL - 163
SP - 586
EP - 592
JO - British Journal of Dermatology
JF - British Journal of Dermatology
IS - 3
ER -