The following is a summary of “Negative impact of comorbidities on all-cause mortality of patients with psoriasis is partially alleviated by biologic treatment: A real-world case-control study,” published in the July 2024 issue of Dermatology by Riaz, et al.
Psoriasis is a chronic inflammatory skin condition that has been linked to various cardiovascular comorbidities, which are thought to contribute to increased mortality rates among patients. At the same time, systemic therapies for psoriasis may have a beneficial effect on overall survival. Understanding how different comorbidities and types of therapy influence mortality risk in patients with psoriasis is crucial for improving patient outcomes. For a study, researchers sought to assess the impact of cardiovascular comorbidities and systemic therapies on the mortality risk of patients with psoriasis in Alberta, Canada, which has a population of 4.37 million. The goal was to determine how different comorbidities and types of treatment affect mortality rates in this population.
They conducted a retrospective cohort study using Alberta Health Services Data Repository data covering 2012 to 2019. The study included 18,618 patients with psoriasis and a control group of patients with ambulatory matched 1:3 by age and sex. The psoriasis cohort was analyzed based on the Charlson Comorbidity Index and categorized by the type of systemic therapy received. The mortality rates of psoriasis patients were compared with those of controls to evaluate the effects of comorbidities and therapy on survival.
The analysis revealed that patients with psoriasis had a significantly higher mortality rate compared to the controls, with a median age of death of 72.0 years for patients with psoriasis versus 74.4 years for controls. Among the comorbidities, the Charlson Comorbidity Index strongly predicted mortality. Notable comorbid conditions that increased mortality risk included drug-induced liver injury (hazard ratio [HR] 1.8), affective bipolar disorder (HR 1.6), and major cardiovascular diseases. Conversely, patients receiving biological therapy had a lower mortality risk, with a hazard ratio of 0.54, compared to those not receiving biologics.
In the study, drug-induced liver injury, affective bipolar disorder, and major cardiovascular diseases were identified as significant determinants of mortality risk in patients with psoriasis. Additionally, using biological therapies was associated with a reduced mortality risk. The findings suggested that addressing specific comorbid conditions and considering biological treatment options may improve survival outcomes for patients with psoriasis.
Reference: jaad.org/article/S0190-9622(24)00382-7/fulltext
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