Patients with psoriasis may experience increased mortality rates attributed to cardiovascular comorbidities, according to a study published in the Journal of the American Academy of Dermatology.
“Psoriasis, a chronic inflammatory condition affecting approximately 3% of Western populations, bears a higher risk of mortality compared with healthy individuals, possibly by inducing systemic inflammation associated with numerous comorbidities, especially cardiovascular diseases, metabolic syndrome, and others,” wrote Saba Riaz, MD, BSc, and colleagues.
The researchers assessed the impact of various comorbidities and therapies on mortality risk among patients with psoriasis in Alberta, Canada. They identified psoriasis cases (n=18,618) and controls (ambulatory patients matched 1:3 by age and sex) from the Alberta Health Services Data Repository of Reporting database from 2012 to 2019. The investigators stratified patient cases based on Charlson Comorbidity Index scores and treatment modalities.
Per the findings, 1,058 patients with psoriasis died during the study period, with a shorter 5-year survival rate compared with the general population. In addition, the median age of death was 72 years in patients with psoriasis, compared with 74.4 years in matched controls. Higher Charlson Comorbidity Index scores and specific comorbidities such as drug-induced liver injury (HR, 1.8), affective bipolar disorder (HR, 1.6), and significant cardiovascular diseases such as myocardial infarction and cerebrovascular disease were strong predictors of mortality. “Surprisingly, the major cardiovascular disease was not, as widely assumed, the strongest risk factor. Liver disease was present only in 5.76% of all patients with psoriasis, but it carried the greatest mortality risk (HR, 1.94; P<0.05),” the researchers noted.
The authors concluded that hepatic injury, affective psychiatric disorders, and cardiovascular diseases significantly influenced overall survival in patients with psoriasis. “Our study confirmed that the excess of mortality in psoriasis seems to be related to the presence of comorbidities,” Dr. Riaz and colleagues concluded. “Elimination of unnecessary, hepatotoxic drugs, prevention, and targeted treatment of comorbidities might be robust strategies to improve psoriasis outcomes.”
