Ashar Dhana1, Hsi Yen2, Hsuan Yen3, Eunyoung Cho4. 1. Division of Dermatology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa. Electronic address: ashardhana@live.com. 2. Department of Dermatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. 3. Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taoyuan, Taiwan. 4. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, Rhode Island.
Abstract
BACKGROUND: An overview of mortality risk associated with psoriasis is lacking. OBJECTIVE: To perform a systematic review and meta-analysis of mortality risk in psoriasis. METHODS: We included studies reporting all-cause or cause-specific mortality risk estimates in psoriasis patients compared with general population or subjects free of psoriasis. We calculated pooled relative risks (RRs) and 95% confidence intervals (CIs). RESULTS: We included 12 studies. The pooled RRs for all-cause mortality were 1.21 (95% CI 1.14-1.28) in psoriasis, 1.13 (95% CI 1.09-1.16) in mild psoriasis, and 1.52 (95% CI 1.35-1.71) in severe psoriasis. The pooled RRs for cardiovascular mortality were 1.15 (95% CI 1.09-1.21) in psoriasis, 1.05 (95% CI 0.92-1.20) in mild psoriasis, and 1.38 (95% CI 1.09-1.74) in severe psoriasis. For noncardiovascular causes, mortality risk from liver disease, kidney disease, and infection was significantly increased in psoriasis, regardless of disease severity. The mortality risk in liver and kidney disease was the highest. There was also a significantly increased mortality risk associated with neoplasms in severe psoriasis patients and chronic lower respiratory disease in all and mild psoriasis patients. LIMITATIONS: Although associations were consistent, their magnitude was heterogenous. CONCLUSION: Psoriasis is associated with an increased risk for mortality from all causes (in a dose-response manner with disease severity) and from several specific causes.
BACKGROUND: An overview of mortality risk associated with psoriasis is lacking. OBJECTIVE: To perform a systematic review and meta-analysis of mortality risk in psoriasis. METHODS: We included studies reporting all-cause or cause-specific mortality risk estimates in psoriasispatients compared with general population or subjects free of psoriasis. We calculated pooled relative risks (RRs) and 95% confidence intervals (CIs). RESULTS: We included 12 studies. The pooled RRs for all-cause mortality were 1.21 (95% CI 1.14-1.28) in psoriasis, 1.13 (95% CI 1.09-1.16) in mild psoriasis, and 1.52 (95% CI 1.35-1.71) in severe psoriasis. The pooled RRs for cardiovascular mortality were 1.15 (95% CI 1.09-1.21) in psoriasis, 1.05 (95% CI 0.92-1.20) in mild psoriasis, and 1.38 (95% CI 1.09-1.74) in severe psoriasis. For noncardiovascular causes, mortality risk from liver disease, kidney disease, and infection was significantly increased in psoriasis, regardless of disease severity. The mortality risk in liver and kidney disease was the highest. There was also a significantly increased mortality risk associated with neoplasms in severe psoriasispatients and chronic lower respiratory disease in all and mild psoriasispatients. LIMITATIONS: Although associations were consistent, their magnitude was heterogenous. CONCLUSION:Psoriasis is associated with an increased risk for mortality from all causes (in a dose-response manner with disease severity) and from several specific causes.
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