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AS, but not PsA, has Increased Mortality Risk

Jan 19, 2023 2:41 pm

Inflammatory disorders are often accompanied by an increased mortality risk, either from secondary malignancy, infection or cardiovascular disease. A recent meta-analysis showed a significantly increased risk of overall mortality in ankylosing spondylitis (AS) but not psoriatic arthritis (PsA), largely associated with cardiovascular-specific mortality .

As individual studies on mortality in PsA and AS have yielded conflicting results, a metanalysis was performed and included 19 studies (11 of PsA, 7 of AS, 1 of both).

For PsA , there was no increased mortality compared to the general population (RR 1.12 [95% confidence interval (95% CI) 0.96–1.30]; n = 10 studies). Yet among PsA, women (but men) had a higher all-cause mortality in female (RR 1.19), and cardiovascular (RR 1.21), respiratory (3.37), and infection (RR 2.43) mortality risks were significantly higher for PsA patients. Yet cancer-related mortality was not increased (RR 1.01).

In AS, a higher mortality risk was seen for all causes (RR 1.64), and cardiovascular causes (RR 1.35) compared to the general population - in both males and females. 

Cardiovascular-specific mortality was higher for both PsA and AS, suggesting the importance of early screening and management of cardiovascular risk factors in these patients.

Disclosures
The author has no conflicts of interest to disclose related to this subject

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