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Mortality in patients with psoriatic arthritis in Sweden: a nationwide, population-based cohort study.
Exarchou, Sofia; Di Giuseppe, Daniela; Klingberg, Eva; Sigurdardottir, Valgerdur; Wedrén, Sara; Lindström, Ulf; Turesson, Carl; Jacobsson, Lennart T H; Askling, Johan; Wallman, Johan K.
Afiliação
  • Exarchou S; Department of Clinical Sciences Malmö, Rheumatology, Lund University, Malmö, Sweden.
  • Di Giuseppe D; Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden.
  • Klingberg E; Department of Rheumatology and Inflammation Research, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden.
  • Sigurdardottir V; Department of Rheumatology, Sahlgrenska University Hospital, Gothenburg, Sweden.
  • Wedrén S; Center for Clinical Research Dalarna, Uppsala University, Uppsala, Sweden.
  • Lindström U; Department of Rheumatology, Falun Hospital, Falun, Sweden.
  • Turesson C; Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden.
  • Jacobsson LTH; Department of Rheumatology, Karolinska University Hospital, Stockholm, Sweden.
  • Askling J; Department of Rheumatology and Inflammation Research, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden.
  • Wallman JK; Department of Clinical Sciences Malmö, Rheumatology, Lund University, Malmö, Sweden.
Ann Rheum Dis ; 83(4): 446-456, 2024 Mar 12.
Article em En | MEDLINE | ID: mdl-38049985
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.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doenças Cardiovasculares / Artrite Psoriásica Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doenças Cardiovasculares / Artrite Psoriásica Idioma: En Ano de publicação: 2024 Tipo de documento: Article