OBJECTIVE: To determine the risk of mortality in patients with psoriasis. DESIGN: Cohort study. SETTING: General practitioners participating in the General Practice Research Database in the United Kingdom, 1987-2002. PATIENTS: Mild psoriasis, defined as any patient with a diagnostic code of psoriasis but no history of systemic therapy; severe psoriasis, any patient with a diagnostic code of psoriasis and a history of systemic therapy consistent with severe psoriasis. The unexposed (control) population was composed of patients with no history of a psoriasis diagnostic code. Control patients were selected in a 5:1 ratio from the same practice and date in practice as the patients with psoriasis. MAIN OUTCOME MEASURE: Hazard ratio (HR) of time to death using Cox proportional hazards models adjusted for age and sex. RESULTS: There was no overall effect of mild psoriasis on mortality (HR, 1.0; 95% confidence interval [CI], 0.97-1.02), whereas patients with severe psoriasis demonstrated an increased overall mortality risk (HR, 1.5; 95% CI, 1.3-1.7). The association of severe psoriasis with mortality persisted after adjustment for risk factors for mortality (HR, 1.4; 95% CI, 1.3-1.6) and after exclusion of patients with inflammatory arthropathy (HR, 1.5; 95% CI, 1.3-1.8). Male and female patients with severe psoriasis died 3.5 (95% CI, 1.2-5.8) and 4.4 (95% CI, 2.2-6.6) years younger, respectively, than patients without psoriasis (P < .001). CONCLUSION: Severe but not mild psoriasis is associated with an increased risk of death.
OBJECTIVE: To determine the risk of mortality in patients with psoriasis. DESIGN: Cohort study. SETTING: General practitioners participating in the General Practice Research Database in the United Kingdom, 1987-2002. PATIENTS: Mild psoriasis, defined as any patient with a diagnostic code of psoriasis but no history of systemic therapy; severe psoriasis, any patient with a diagnostic code of psoriasis and a history of systemic therapy consistent with severe psoriasis. The unexposed (control) population was composed of patients with no history of a psoriasis diagnostic code. Control patients were selected in a 5:1 ratio from the same practice and date in practice as the patients with psoriasis. MAIN OUTCOME MEASURE: Hazard ratio (HR) of time to death using Cox proportional hazards models adjusted for age and sex. RESULTS: There was no overall effect of mild psoriasis on mortality (HR, 1.0; 95% confidence interval [CI], 0.97-1.02), whereas patients with severe psoriasis demonstrated an increased overall mortality risk (HR, 1.5; 95% CI, 1.3-1.7). The association of severe psoriasis with mortality persisted after adjustment for risk factors for mortality (HR, 1.4; 95% CI, 1.3-1.6) and after exclusion of patients with inflammatory arthropathy (HR, 1.5; 95% CI, 1.3-1.8). Male and female patients with severe psoriasis died 3.5 (95% CI, 1.2-5.8) and 4.4 (95% CI, 2.2-6.6) years younger, respectively, than patients without psoriasis (P < .001). CONCLUSION: Severe but not mild psoriasis is associated with an increased risk of death.
Authors: N M Seminara; K Abuabara; D B Shin; S M Langan; S E Kimmel; D Margolis; A B Troxel; J M Gelfand Journal: Br J Dermatol Date: 2011-02-03 Impact factor: 9.302
Authors: Erica D Dommasch; Katrina Abuabara; Daniel B Shin; Josephine Nguyen; Andrea B Troxel; Joel M Gelfand Journal: J Am Acad Dermatol Date: 2011-02-18 Impact factor: 11.527
Authors: Murat Icen; Cynthia S Crowson; Marian T McEvoy; Frank J Dann; Sherine E Gabriel; Hilal Maradit Kremers Journal: J Am Acad Dermatol Date: 2009-03 Impact factor: 11.527
Authors: Megha M Tollefson; Cynthia S Crowson; Marian T McEvoy; Hilal Maradit Kremers Journal: J Am Acad Dermatol Date: 2009-12-05 Impact factor: 11.527