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Trends in mortality and cause-specific mortality among patients with psoriasis and psoriatic arthritis in Ontario, Canada - 10/04/21

Doi : 10.1016/j.jaad.2020.10.031 
Keith Colaco, MSc a, b, c, Jessica Widdifield, PhD c, d, e, Jin Luo, MSc d, Cheryl F. Rosen, MD b, c, Raed Alhusayen, MBBS c, e, J. Michael Paterson, MSc c, d, Willemina Campbell, LLB b, c, Karen Tu, MD, MSc b, c, f, Sasha Bernatsky, MD, PhD g, Dafna D. Gladman, MD b, c, Lihi Eder, MD, PhD a, c,
a Women's College Hospital, Toronto, Canada 
b University Health Network, Toronto, Canada 
c University of Toronto, Toronto, Canada 
d ICES, Toronto, Canada 
e Sunnybrook Health Sciences Centre, Toronto, Canada 
f North York General Hospital, Toronto, Canada 
g McGill University, Montréal, Canada 

Reprint requests: Lihi Eder, MD, PhD, Women's College Research Institute, Room 6326, Women's College Hospital, 76 Grenville Street, Toronto, Ontario, Canada, M5S 1B2.Women's College Research InstituteRoom 6326, Women's College Hospital, 76 Grenville StreetTorontoOntarioM5S 1B2Canada

Abstract

Background

There is limited information about mortality rates among patients with psoriasis and psoriatic arthritis (PsA) in North America and their change over the past 2 decades.

Objective

To compare all-cause and cause-specific mortality rates in patients with psoriasis to the general population in Ontario, Canada, from 1996 to 2016.

Methods

We conducted a population-based, retrospective cohort study of adult residents using administrative health data. All-cause and cause-specific standardized mortality rates, standardized mortality ratios, and excess mortality rates were calculated.

Results

176,858 (2,524 deaths) patients with psoriasis and 15,430 (221 deaths) patients with PsA were identified in 2016. Patients with psoriasis and PsA had standardized excess mortality rates of 1.44 and 2.43 per 1000 population, respectively. Standardized mortality rates decreased by approximately 30% over the study period in both disease groups but remained significantly elevated compared to the general population. The leading causes of death in psoriasis and PsA patients were cancer, circulatory disease, and respiratory conditions.

Limitations

We were unable to classify patients according to disease severity.

Conclusions

Despite improvements in psoriasis treatment, the relative excess mortality, which may be related to risk factors for psoriatic disease, remained unchanged, with an average of approximately 1 to 2 extra deaths per 1,000 patients in 2016.

Il testo completo di questo articolo è disponibile in PDF.

Key words : epidemiology, mortality, population-based studies, psoriasis, psoriatic arthritis

Abbreviations used : CI, PsA, PsD, SMR


Mappa


 Funding sources: Supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health. This study also received funding from the Canadian Initiative for Outcomes in Rheumatology Care, which played no role in the design or conduct of the study. Author Colaco is supported by the Enid Walker Estate, Women’s College Research Institute, Arthritis Society (grant #TGP-19-0446), and the Edward Dunlop Foundation. Dr Eder is supported by a Young Investigator Award from the Arthritis Society and an Early Researcher Award from the Ontario Ministry of Science and Innovation. Dr Tu received a Research Scholar Award from the Department of Family and Community Medicine, University of Toronto.
 Disclosure: Dr Rosen reports personal fees from Novartis and AbbVie, outside the submitted work. Dr Gladman reports grants and personal fees from AbbVie, grants and personal fees from Amgen, personal fees from Bristol Myers Squibb, grants and personal fees from Eli Lilly, personal fees from Gilead, personal fees from Galapagos, grants and personal fees from Janssen, grants and personal fees from Novartis, grants and personal fees from Pfizer, and grants and personal fees from UCB, outside the submitted work. Dr Eder reports grants and consultation fees from Novartis, Amgen, Eli Lilly, Pfizer, Janssen, AbbVie, and UCB. Authors Colaco, Luo, Dr Alhusayen, Dr Tu, Dr Widdifield, Paterson, and Campbell and Dr Bernatsky have no conflicts of interest to declare.
 IRB approval status: Not applicable.


© 2020  American Academy of Dermatology, Inc.. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 84 - N° 5

P. 1302-1309 - maggio 2021 Ritorno al numero
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