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AS, but not PsA, has Increased Mortality Risk

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.


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