Patients with psoriasis and a concomitant diagnosis of gout have an increased risk for cardiovascular disease (CVD), independent of traditional risk factors, according to study results published in Frontiers in Immunology.
In a population-based cohort study, patients were identified from a national insurance database in Taiwan and stratified according to the presence of psoriasis and gout. Between 2000 and 2013, there were 97 patients with psoriasis and gout, 388 with psoriasis alone, 388 matched patients with gout alone and 388 matched control participants. Hazard ratios (HRs) for CVD were determined using Cox proportional hazard models and subgroup analyses adjusted for traditional risk factors.
Relative risk for the development of CVD among patients with gout alone and patients with combined psoriasis and gout was 2.44 (95% CI, 1.78-3.36) and 2.90 (95% CI, 1.88-4.48), respectively. Compared with a psoriasis diagnosis alone, a combined diagnosis of psoriasis and gout was associated with a 239% increase in relative risk for CVD. Cumulative incidence of CVD in patients with combined psoriasis and gout vs psoriasis alone was significantly increased (P <.001).
After adjusting for traditional risk factors, risk for CVD was increased in patients with gout alone (HR, 2.16; 95% CI 1.54-3.04) and patients with combined psoriasis and gout (HR, 2.72; 95% CI, 1.73-4.28).
Study limitations included the potential over- or underdiagnoses of psoriasis, gout, or CVD in clinical practice, the relatively small number of patients with psoriasis and gout, and the unavailability of laboratory data for factors such as erythrocyte sedimentation rate, C-reactive protein, and serum uric acid, as well as CVD lifestyle factors, such as smoking, diet, and body mass index.
Researchers concluded, “In addition to control of the traditional CVD risk factors, physicians should consider relevant education and management of gout/hyperuricemia in the care of patients with [psoriasis].”
Chen Z, Xu Y, Chen M, et al. Gout augments the risk of cardiovascular disease in patients with psoriasis: A population-based cohort study. Front Immunol. Published online July 15, 2021. doi:10.3389/fimmu.2021.703119conc