Background Data on cause-specific mortality in patients with psoriatic arthritis have been limited. Studies examining cause of death in PsA to date have been clinic- or hospital-based rather than population-based studies and none have included a reference group.

Objectives To examine cause-specific mortality in patients with psoriatic arthritis compared to the general population.

Methods A cohort study was performed using The Health Improvement Network, a medical record database within the United Kingdom, among patients aged 18-89. Data from 1994-2010 were included. PsA was defined by a single diagnosis code (positive predictive value 85%) and up to 10 unexposed controls (without psoriasis, PsA, or rheumatoid arthritis) matched on practice and start date within the practice were selected for each patient with PsA. Cause of death was classified using categories from UK death statistics and defined using diagnostic codes specifically labeled as the cause of death, codes on the date of death or codes entered within 60 days of the death date. Patients could have more than one cause of death. Each death was manually reviewed to ensure accurate classification. Causes of death were descriptively compared and then age- and sex- adjusted hazard ratios (HRs) were calculated using Cox proportional hazards models.

Results Among patients with PsA (N=8,709) and controls (N=82,170), 539 and 6,121 deaths were identified. The most common causes of death among patients with PsA and controls were heart disease (17.8% and 16.3% respectively) and cancer (17.3% and 15.1%). Respiratory disease (11.1% and 11.4%), infection (5.9% and 5.8%), gastrointestinal disease (3.5% and 3.6%), and accidents (1.1 and 1.5%) were also similar among the two groups. Cause of death was unknown in 28% and 30% respectively. Hazard ratios were not significant for any specific cause of death: cardiovascular disease (HR 1.18; 95%CI 0.95-1.47), cancer (HR 1.06; 95%CI 0.86-1.32), infection (HR 1.10; 95%CI 0.77-1.58), and respiratory disease (HR 1.02; 95%CI 0.78-1.34).

Conclusions In this cohort, we have previously reported that mortality risk was not elevated among patients with PsA. Similarly, cause-specific mortality is not significantly different among patients with PsA compared to controls.

References Ogdie A, Haynes K, Troxel AB, Love TJ, Hennessy S, Choi H, Gelfand JM. Risk of mortality in patients with psoriatic arthritis, rheumatoid arthritis and psoriasis: a longitudinal cohort study. Ann Rheum Dis. 2012 Dec 21. [Epub ahead of print]

Disclosure of Interest A. Ogdie: None Declared, S. Maliha: None Declared, T. Love: None Declared, H. Choi: None Declared, J. Gelfand Grant/research support from: Amgen, Novartis, Abbott, Pfizer, Genentech, Consultant for: Amgen, Centocor, Abbott, Celgene, Novartis, Pfizer, Paid instructor for: for CME work related to psoriasis