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All-cause and cause-specific mortality in psoriasis: A systematic review and meta-analysis - 12/04/19

Doi : 10.1016/j.jaad.2018.12.037 
Ashar Dhana, MBBCh, MPH a, , Hsi Yen, MD, MPH b, Hsuan Yen, MD, MPH c, Eunyoung Cho, ScD d, e
a Division of Dermatology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa 
b Department of Dermatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan 
c Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taoyuan, Taiwan 
d Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 
e Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, Rhode Island 

Correspondence to: Ashar Dhana, MBBCh, MPH, Division of Dermatology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa, 7935.Division of DermatologyGroote Schuur Hospital and University of Cape TownCape Town7935South Africa

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.

Le texte complet de cet article est disponible en PDF.

Key words : cardiovascular disease, cause of death, infectious disease, kidney disease, liver disease, malignancy, mortality, psoriasis, respiratory disease, systematic review

Abbreviations used : CI, RR, SMR


Plan


 Funding sources: None.
 Conflicts of interest: None disclosed.
 Reprints not available from the authors.


© 2018  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 80 - N° 5

P. 1332-1343 - mai 2019 Retour au numéro
Article précédent Article précédent
  • Ustekinumab treatment is associated with decreased systemic and vascular inflammation in patients with moderate-to-severe psoriasis: Feasibility study using 18F-fluorodeoxyglucose PET/CT
  • Byung-Soo Kim, Won-Ku Lee, Kyoungjune Pak, Junhee Han, Gun-Wook Kim, Hoon-Soo Kim, Hyun-Chang Ko, Moon-Bum Kim, Seong-Jang Kim
| Article suivant Article suivant
  • Secukinumab for moderate-to-severe palmoplantar pustular psoriasis: Results of the 2PRECISE study
  • Ulrich Mrowietz, Hervé Bachelez, A. David Burden, Michael Rissler, Christian Sieder, Roberto Orsenigo, Kamel Chaouche-Teyara

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