Mortality in patients with psoriatic arthritis in Sweden: a nationwide, population-based cohort study.
Ann Rheum Dis
; 83(4): 446-456, 2024 Mar 12.
Article
em En
| MEDLINE
| ID: mdl-38049985
ABSTRACT
OBJECTIVES:
To compare all-cause mortality and causes of death between patients with psoriatic arthritis (PsA) and the general population in Sweden.METHODS:
Adults with at least one main PsA diagnosis (International Classification of Diseases-10 L40.5/M07.0-M07.3) from outpatient rheumatology/internal medicine departments 2001-2017 were identified from the National Patient Register. Each case was matched to five population comparator-subjects on sex/county/age at the case's first arthritis diagnosis. Follow-up ran from 1 January 2007, or from first PsA diagnosis thereafter, until death, emigration or 31 December 2018. Mortality was assessed overall, and stratified by sex and duration since diagnosis (diagnosis before/after 1 January 2007), using matched Cox proportional hazard regression (excluding/including adjustments for comorbidity) or Breslow test, as appropriate. Incidence rate ratios (IRR) of death, overall and stratified by sex/duration since diagnosis/age, as well as causes of death in PsA cases and comparator-subjects were also described.RESULTS:
All-cause mortality was elevated in PsA (HR 1.11 (95% CI 1.07 to 1.16); IRR 1.18 (95% CI 1.13 to 1.22)), mainly driven by increased risks in women (HR 1.23 (95% CI 1.16 to 1.30)) and cases with longer time since diagnosis (HR 1.18 (95% CI 1.12 to 1.25)). IRR of death were significantly increased for all ages except below 40 years, with the numerically highest point-estimates for ages 40-59 years. When adjusted for comorbidity, however, the elevated mortality risk in PsA disappeared. Causes of death were similar among PsA cases/comparator-subjects, with cardiovascular disease and malignancy as the leading causes.CONCLUSIONS:
Mortality risk in PsA in Sweden was about 10% higher than in the general population, driven by excess comorbidity and with increased risks mainly in women and patients with longer disease duration.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doenças Cardiovasculares
/
Artrite Psoriásica
Limite:
Adult
/
Female
/
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
Ann Rheum Dis
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Suécia