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. 2014 Jan;73(1):149-53.
doi: 10.1136/annrheumdis-2012-202424. Epub 2012 Dec 21.

Risk of mortality in patients with psoriatic arthritis, rheumatoid arthritis and psoriasis: a longitudinal cohort study

Alexis Ogdie  1 , Kevin Haynes, Andrea B Troxel, Thorvardur Jon Love, Sean Hennessy, Hyon Choi, Joel M Gelfand
Affiliations

Risk of mortality in patients with psoriatic arthritis, rheumatoid arthritis and psoriasis: a longitudinal cohort study

Alexis Ogdie et al. Ann Rheum Dis. 2014 Jan.

Abstract

Background: There are conflicting reports in the literature of the mortality risk among patients with psoriatic arthritis (PsA). The objective of this study was to examine the risk of mortality in patients with PsA compared with matched controls, patients with psoriasis and those with rheumatoid arthritis (RA).

Methods: A longitudinal cohort study was performed in a large UK medical record database, The Health Improvement Network, among patients with PsA, rheumatoid arthritis (RA) or psoriasis with data from 1994 to 2010. Unexposed controls were matched on practice and start date within the practice for each patient with PsA. Cox proportional hazards models were used to calculate the relative hazards for death.

Results: Patients with PsA (N=8706), RA (N=41 752), psoriasis (N=138 424) and unexposed controls (N=82 258) were identified; 1 442 357 person-years were observed during which 21 825 deaths occurred. Compared with population controls, patients with PsA did not have an increased risk of mortality after adjusting for age and sex (disease-modifying antirheumatic drug (DMARD) users: HR 0.94, 95% CI 0.80 to 1.10; DMARD non-users: HR 1.06, 95% CI 0.94 to 1.19) whereas patients with RA had increased mortality (DMARD users: HR 1.59, 95% CI 1.52 to 1.66; DMARD non-users: HR 1.54, 95% CI 1.47 to 1.60). Patients with psoriasis who had not been prescribed a DMARD had a small increased risk of mortality (HR 1.08, 95% CI 1.04 to 1.12) while those who had been prescribed a DMARD, indicating severe psoriasis, were at increased risk (HR 1.75, 95% CI 1.56 to 1.95).

Conclusions: Patients with RA and psoriasis have increased mortality compared with the general population but patients with PsA do not have a significantly increased risk of mortality.

Keywords: Epidemiology; Psoriatic Arthritis; Rheumatoid Arthritis.

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Conflict of interest statement

Competing Interests Statement: Dr Gelfand serves as a consultant to Amgen, Abbott, Centocor, Celgene, Novartis, and Pfizer and has received honoraria; He has received grants from Amgen, Abbott, Pfizer, Novartis and Genentech. The remaining authors do not have competing interests.

Cegedim Strategic Data (CSD) Medical Research UK is an expert in UK anonymous patient data for the healthcare industry. CSD is a commercial organization that supplies data and trains and supports researchers in the use of primary care patient data. Data is available for use in medical research in the academic setting as well as in industry for a fee which varies depending on the type of data requested. Aside from undergoing ethical review by the Scientific Review Committee at Cegedim, independent academic groups who voluntarily act as an ethical review body, this protocol was not in any way discussed with Cegedim nor were any changes made by the company. We did not receive financial support or other forms of computational or analytical support from Cegedim/THIN. The data was collected by Cegedim and the general practitioners without knowledge of the study objectives and hypotheses.

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