All-cause and cause-specific mortality in psoriasis: a systematic review and meta-analysis

Publication date: Available online 24 December 2018

Source: Journal of the American Academy of Dermatology

Author(s): Ashar Dhana, Hsi Yen, Hsuan Yen, Eunyoung Cho

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.

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