Alcohol May Contribute to Premature Mortality in Psoriasis Patients
Individuals with psoriasis have an approximately 60% greater risk of alcohol-related mortality, compared with peers of the same age and sex in the general population.
A team of researchers affiliated with the University of Manchester, England, investigated whether patients with psoriasis have an elevated risk of alcohol-related mortality. The study was instigated because it is known that psoriasis patients have an increased risk of premature mortality but the underlying reasons for this gap remain unclear.
The researchers compared a cohort of patients with psoriasis (≥18 years of age) drawn from several databases to 20 patients without psoriasis who were matched by age, sex, and general practice (n=55,537 and 854,314 respectively). The median (interquartile) age at index date was 47 (27) years and 408,230 of patients (44.9%) were male.
The patients were followed for a median (IQR) of 4.4 (6.2) years. During this time, the alcohol-related mortality rate was 4.8 per 10,000 person-years (95% CI, 4.1–5.6; n=152) for the psoriasis cohort, vs 2.5 per 10,000 (95% CI, 2.4–2.7; n=1118) for the comparison cohort.
In patients with psoriasis, the hazard ratio for alcohol-related death was 1.58 (95% CI, 1.31–1.91). The predominant causes of alcohol-related mortality were alcoholic liver disease (65.1%), fibrosis and cirrhosis of the liver (23.7%), and mental and behavioral alcohol-related disorders (7.9%).
The authors concluded their study demonstrates that alcohol appears to be a “key contributor” to premature death in people with psoriasis. They call for screening to occur in primary and secondary care in order to detect alcohol misuse among psoriasis patients.
Parisi R, Webb RT, Carr MJ, et al. Alcohol-Related Mortality in Patients With Psoriasis: A Population-Based Cohort Study. JAMA Dermatol. 2017 Sep 15. [Epub ahead of print]