PHILADELPHIA—What are the common causes of mortality in patients with psoriatic arthritis (PsA) compared with the general population and compared with patients with rheumatoid arthritis (RA)?

A report in the journal Rheumatology (Oxford) provided some answers.1

A study team including researchers from the Philadelphia VAMC performed a cohort study using The Health Improvement Network, focusing on patients 18-89 years with data from 1994 to 2010. PsA and RA were defined by medical codes, and up to 10 unexposed controls were matched on practice and start date within the practice.

Results indicated that, among patients with PsA (8706), RA (41,752) and unexposed controls (81,573), 470, 7,004 and 5,269 deaths were documented, respectively. The most-common causes of death among all patients were cardiovascular disease, followed by malignancy, respiratory deaths and infection, the report noted. Cause of death was unknown in about 25% of the patients.

Among PsA patients, cardiovascular (1.09, 0.91-1.32), respiratory (0.97, 0.79-1.20), malignancy (1.03, 0.86-1.25) and infection deaths (1.05, 0.79-1.39) were not elevated. Among patients with RA, however, cardiovascular (1.55, 1.44-1.66), respiratory (1.85, 1.72-2.01), malignancy (1.18, 1.08-1.28) and infection deaths (2.21, 2.00-2.44) were significantly elevated, compared with population controls.

Study authors pointed out that, although less common than other types of mortality, suicide deaths were elevated in both PsA and RA—hazard ratios 3.03 and 2.47, respectively.

“Overall mortality and cause-specific mortality risk were not elevated among patients with PsA, except for suicide deaths,” study authors concluded. “Patients with RA were at increased risk of deaths from cardiovascular, respiratory, cancer and infectious diseases.”

  1. Ogdie A, Maliha S, Shin D, Love TJ, Baker J, Jiang Y, Choi H, Gelfand JM. Cause-specific mortality in patients with psoriatic arthritis and rheumatoid arthritis. Rheumatology (Oxford). 2017 Jun 1;56(6):907-911. doi: 10.1093/rheumatology/kew502. PubMed PMID: 28158384.