Mortalidad por Psoriasis

All-Cause and Cause-Specific Mortality in Psoriasis

Journal of the American Academy of Dermatology

TAKE-HOME MESSAGE

• This systematic review and meta-analysis of 12 studies evaluated the risk of mortality in people with psoriasis. Overall, psoriasis was associated with a higher risk for all-cause mortality, with a pooled relative risk (RR) of 1.21 (P<.001). The risk increased with psoriasis severity: mild psoriasis had a pooled RR of 1.13 (P=.048), whereas severe psoriasis had a RR of 1.52 (P<.001). The pooled RRs for cardiovascular mortality were 1.15 (P=.02) in psoriasis overall, 1.05 (P<.001) in mild psoriasis, and 1.38 (P<.001) in severe psoriasis. Regardless of the severity, the mortality risk from noncardiovascular causes, including liver disease, kidney disease, and infection, was significantly increased with the presence of psoriasis. Severe psoriasis was associated with a significantly increased mortality risk from neoplasms, whereas all degrees of psoriasis and mild psoriasis were associated with increased mortality risk from chronic lower respiratory disease.

• Psoriasis patients were found to have a higher risk for all-cause mortality, which increases with disease severity. Appropriate screening and preventive interventions should be a part of psoriasis patient counseling and management.

– InYoung Kim, MD, PhD

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 1.35-1.72) 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 from liver and kidney disease was the highest. There was also significantly increased mortality risk from neoplasms in severe psoriasis patients and from chronic lower respiratory disease in all and mild psoriasis patients.

LIMITATIONS

Although associations were consistent, their magnitude was heterogenous.

CONCLUSION

Psoriasis is associated with increased mortality from all-causes in a dose-response manner with disease severity and from several specific causes.

Journal of the American Academy of Dermatology

All-Cause and Cause-Specific Mortality in Psoriasis: A Systematic Review and Meta-Analysis

J Am Acad Dermatol 2018 Dec 24;[EPub Ahead of Print], A Dhana, H Yen, H Yen, E Cho 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 2224-0654
Momentum Escazu: 2101-9574

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