Psoriasis and Mortality: New Data on Life Expectancy

Announcer:

You're listening to On the Frontlines of Psoriasis on ReachMD. On this episode, we’ll hear from Dr. Robert Gniadecki, who’s a Professor and Director of the Division of Dermatology at the University of Alberta. He’ll be discussing his recent retrospective study that used the Alberta Health Services Data Repository of Reporting database to examine how psoriasis and its associated comorbidities increase the risk of mortality. Let’s hear from Dr. Gniadecki now.

Dr. Gniadecki: 

It has been found that psoriasis, which is basically inflammatory skin disease sitting in the skin, also seems to have a very negative effect on our health. So we wanted to focus on one particular thing: We wanted to see whether patients with psoriasis live as long as other ambulatory patients. I’d like to stress here our control group. Our control group was not the general population. Our control were patients coming to the outpatient clinics with other diseases than psoriasis with comparable health profile to dissect from those patient populations “Is psoriasis any worse?” And when you just look overall at the data, we found out that in the control group, about 3.8 percent of patients died during this observation time due to various reasons. We didn’t even go into the reasons. It’s very difficult to find out why patients die. But in the psoriasis group, it was 5.7 percent. So just looking at the numbers, it looked like it was higher mortality in the psoriasis group. We also found that the risk of death is 40 percent higher if you have psoriasis comparing to a similar patient who does not have psoriasis, and 40 percent is not nothing. It’s actually quite high. It’s difficult, actually, to translate this to a meaningful number for a patient, but if you are in medical research, a 40 percent higher chance of death is something you will pay attention to.

You can also look at this from a different angle. You can actually ask, “What is the age of death for a psoriasis patient?” And we found out the age of death for psoriasis is 72, which is significantly lower than the patient background population of that, which is 80. So basically, having psoriasis cuts your life expectancy by eight years, which is as much as some serious cancers. So we think that psoriasis is just a skin disease and does not need to be treated; it’s more cosmetic. It’s not true. Actually, it impacts the length of life. 

A big chunk of the impact is caused by cardiovascular and metabolic health. People that have metabolic syndrome also have a high incidence of heart disease. So we found that this is true for psoriasis patients, and also, those who have more of those comorbidities have a shorter lifespan. Of course, the question is, “What is the cause? What is the effect?” This study cannot solve this. For this, we will need a prospective study. Maybe a newer finding that was not picked up before was liver health. So we found that toxic liver disease—liver toxicity—is more common in psoriasis patients. It’s very rare, but if the patients have it, this is the strongest factor that reduces their lifespan.