Mortality in PsA
| Study | Type of study | Comparison group | Subjects; total number (ascertainment procedures); gender distribution; age, years | Time period | Statistical analysis | Findings |
|---|---|---|---|---|---|---|
| Wong13 | Prospective cohort | General population of Ontario region, Canada | 428 PsA patients (inflammatory arthritis associated with psoriasis); 55% men; 43.7 years; (IQR 15.5–87.5) | 1978–93 | Overall and sex stratified SMR were calculated by multiplying the number of person-years per category of age and calendar period by the corresponding death rate of the Ontario population; patients lost to follow-up were considered alive at the end of the study period | 53 (12%) Deaths; increased overall mortality; SMR overall 1.6; (95% CI 1.2 to 2.1); SMR male 1.65; (95% CI 1.09 to 2.40); SMR female 1.59; (95% CI 1.04 to 2.33); cardiovascular disease was cause of death in 36% of the cases |
| Shbeeb15 | Population based | General population of the Olmsted Country, USA | 66 PsA patients (inflammatory arthritis with definite psoriasis); 48% men; 40.7 years; (IQR 20–81) | 1982–91 | Incidence and prevalence rate were calculated; Kaplan–Meier survival rates | No increased mortality; survival rate compared to general population (p=0.546) |
| Alamanos14 | Population based | Northwest Greek population (n=488 435) | 221 PsA patients (diagnosis based on European Spondylarthropathy Study Group criteria); 49% men; 47.7±14.6 years | 1982–2001 | Incidence and prevalence (95% CI) per 100 00 inhabitants were calculated | Four deaths (50% cardiovascular disease); SMR is not available |
| Ali11 | Prospective cohort | General population of Ontario region, Canada | 680 PsA patients (inflammatory arthritis associated with psoriasis); 57% men; 43.7±13.4 years | 1978–2004 | Poisson regression models were used to calculate by age and sex stratified SMR; time trend analyses: 10-year ‘rolling-average’ SMR were calculated; confounders: radiological damage, the interaction between sex and radiological damage, the logarithm of sex-standardised ESR, highest level of medication taken, hypertension, disease activity, smoking status | 106 (16%) Deaths; improved survival over four decades; SMR overall 1.4; (95% CI 1.1 to 1.6); cardiovascular disease was cause of death in 25%; survival over four decades: 1978–95: SMR 1.8; 1996–2004: SMR 1.2 |
| Buckley12 | Prospective cohort | General population of UK | 453 PsA patients (Moll and Wright criteria); 51% men; 49 years; (IQR 37–58) | 1985–2007 | Date and cause of death was confirmed; 5 year age-banded, overall and sex stratified SMR were calculated using data from the Office of National Statistics | 37 (8%) Deaths; no increased mortality; SMR 81.82%; (95% CI 57.61 to 112.78); cardiovascular disease was cause of death in 38% |
| Ahlehoff7 | Population based | General population of Denmark (n=4 003 265) | 607 PsA patients (ICD-8 and 10); age and gender distribution of PsA patients are lacking | 1997–2006 | RR and 95% CI; Poisson regression models adjusted for: age, calendar year, concomitant medication use, comorbidity, socio-economic data, gender | Increased mortality; RR 1.8 (95% CI 1.1 to 3.1); no difference with severe psoriasis |
ESR, erythrocyte sedimentation rate; ICD-8 and 10, International Classification of Diseases 8th and 10th revision; PsA, psoriatic arthritis; RR, rate ratio; SMR, standardised mortality rate.