A significantly increased risk for overall mortality was observed among patients with ankylosing spondylitis (AS), but not among those with psoriatic arthritis (PsA), according to findings from a systematic review and meta-analysis published in Arthritis Care & Research (Hoboken). However, cardiovascular-specific mortality was higher among both patients with PsA and AS compared with the general population.
Authors of the current analysis sought to examine the cause-specific and all-cause mortality in patients with PsA and AS, based on available literature.
A total of 3124 articles were screened by title and abstract, with 88 full-text articles selected for inclusion in the analysis. Overall, 19 studies met prespecified inclusion criteria, with 11 on PsA, 7 on AS, and 1 study discussing outcomes for both AS and PsA. The studies selected were conducted in 10 countries: Canada, Denmark, France, Hong Kong (China), Korea, Norway, Sweden, Taiwan, the United Kingdom, and the United States. The study period, including follow-up analyses, varied from 4 to 40 years.
Results showed that of the studies on PsA, no increased mortality was observed compared with the general population (relative risk [RR], 1.12; 95% CI, 0.96-1.30; n=10 studies). A higher all-cause mortality was reported among women with PsA compared with men with PsA (RR, 1.19; 95% CI, 1.04-1.36 vs RR, 1.02; 95% CI, 0.66-1.59, respectively). Although cardiovascular (CV), respiratory, and infection-specific mortality risks were significantly higher among patients with PsA (RR, 1.21; 95% CI, 1.06-1.38 vs RR, 3.37; 95% CI, 1.30-8.72; vs RR, 2.43; 95% CI, 1.01-5.84, respectively), cancer-associated mortality was not (RR, 1.01; 95% CI, 0.91-1.11).
A higher risk for all-cause death (RR, 1.64; 95% CI, 1.49-1.80; n=6 studies) and for death from CV causes (RR, 1.35; 95% CI, 1.01-1.81; n=3 studies) was reported among patients with AS compared with the general population. Further, in patients with AS, all-cause mortality was high among both men and women (RR, 1.56; 95% CI, 1.43-1.71 and RR, 1.85; 95% CI, 1.56-2.18, respectively).
The researchers concluded that the findings from this analysis underscore the importance of early screening and management of CV risk factors in patients with PsA and AS.
Chaudhary H, Bohra N, Syed K, Donato A, Murad MH, Karmacharya P. All-cause and cause-specific mortality in psoriatic arthritis and ankylosing spondylitis: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). Published online November 17, 2021. doi:10.1002/acr.24820