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Increased risk of migraine in patients with psoriasis: A Danish nationwide cohort study - 15/10/15

Doi : 10.1016/j.jaad.2015.08.039 
Alexander Egeberg, MD a, b, , Lotus Mallbris, MD, PhD c, Gunnar Hilmar Gislason, MD, PhD a, d, e, Lone Skov, MD, PhD, DMSc b, Peter Riis Hansen, MD, PhD, DMSc a
a Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark 
b Department of Dermato-Allergology, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark 
c Unit of Dermatology and Venereology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden 
d Danish Heart Foundation, Copenhagen, Denmark 
e National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark 

Reprint requests: Alexander Egeberg, MD, Department of Cardiology, Herlev and Gentofte Hospital, Kildegårdsvej 28, 2900 Hellerup, Denmark.

Abstract

Background

Psoriasis and migraine are common conditions with potential overlap of pathophysiological mechanisms. Both these diseases have been associated with increased cardiovascular risk but little is known about their interplay.

Objective

We sought to investigate the link between psoriasis, and the risk of new-onset migraine, in a nationwide cohort of the Danish population.

Methods

Data on all Danish citizens aged 18 years or older from January 1, 1997, to December 31, 2011, were linked at individual-level in nationwide registers. Incidence rates per 1000 person-years were calculated and crude and adjusted incidence rate ratios were estimated by Poisson regression models.

Results

The study comprised a total of 5,379,859 individuals, including 53,006 and 6831 patients with mild and severe psoriasis, respectively, and 6243 patients with psoriatic arthritis. Fully adjusted incidence rate ratios for migraine were 1.37 (95% confidence interval 1.30-1.45), 1.55 (95% confidence interval 1.29-1.86), and 1.92 (95% confidence interval 1.65-2.22) for mild psoriasis, severe psoriasis, and psoriatic arthritis, respectively. Stratification for sex revealed increased risk of migraine in both male and female patients.

Limitations

We were unable to distinguish between subtypes of migraine, eg, migraine with and without aura.

Conclusions

Psoriasis was associated with a disease severity-dependent increased risk of migraine independent of measured confounders. Further studies are warranted to determine the effects of antipsoriatic treatment on this association, and whether migraine modifies the psoriasis-associated risk of cardiovascular disease.

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Key words : epidemiology, headache, inflammation, migraine, psoriasis

Abbreviations used : ATC, CI, ICD-8, ICD-10, IRR


Plan


 Supported by a grant from Pfizer.
 Disclosure: Dr Hansen is supported by a grant from the LEO Foundation. Dr Gislason is supported by an unrestricted research scholarship from the Novo Nordisk Foundation. Drs Egeberg and Mallbris are currently employed by Pfizer and Eli Lilly and Company, respectively. Dr Skov has received consultancy and/or speaker honoraria from Abbvie, Pfizer, Janssen-Cilag, Merck Sharp & Dohme, and LEO Pharma and is a member of the advisory boards of Abbvie, Pfizer, Janssen-Cilag, Merck Sharp & Dohme, Eli Lilly and Company, Celgene, and Novartis. This research was performed independently through the authors' academic university affiliations. Pfizer, Eli Lilly and Company, Novo Nordisk, and LEO Pharma had no influence on data collection, no access to the data, and no influence on the decision to submit.


© 2015  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 73 - N° 5

P. 829-835 - novembre 2015 Retour au numéro
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