Psoriasis Patients Are 60% More Likely to Die From Alcohol

Individuals with psoriasis have a 60% greater risk of alcohol-related mortality compared with the general population, according to a recent study.

Although psoriasis is known to be associated with a higher risk of premature mortality, the factors that contribute to this mortality gap have remained unclear.
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For their study, the researchers assessed 55,537 participants with psoriasis age 18 years or older and 854,314 participants without psoriasis. Median participant age at index date was 47 years, and 44.9% of participants were men. Patient data from 1998 to 2014 was obtained from the Clinical Practice Research Datalink (CPRD) and was linked to mortality records from Hospital Episode Statistics (HES) and the Office for National Statistics (ONS). Follow-up lasted a median of 4.4 years.

Participants with psoriasis were matched with up to 20 controls for age, sex, and general practice. Alcohol-related mortality was determined via ONS mortality records. The cause-specific hazard ratio for alcohol-related death was estimated using a stratified Cox proportional hazard model, and was adjusted for socioeconomic status.

At follow-up, the rate of alcohol-related mortality was 4.8 per 10,000 person-years (n = 152) among participants with psoriasis, compared with 2.5 per 10,000 (n = 1118) for patients without psoriasis. The hazard ratio for alcohol-related mortality was 1.58 among participants with psoriasis.

The most common causes of alcohol-related mortality were alcoholic liver disease (65.1%), fibrosis and cirrhosis of the liver (23.7%), and alcohol-related mental and behavioral disorders (7.9%).

“People with psoriasis have approximately a 60% greater risk of dying due to alcohol-related causes compared with peers of the same age and sex in the general population,” the researchers concluded. “This appears to be a key contributor to the premature mortality gap. These findings call for routine screening, identification and treatment, using the Alcohol Use Disorders Identification Test (AUDIT-C) in both primary and secondary care to detect alcohol consumption and misuse among people diagnosed with psoriasis.”

—Christina Vogt

Reference:

Parisi R, Webb RT, Carr MJ, et al. Alcohol-related mortality in patients with psoriasis: a population-based cohort study [Published online September 15, 2017]. JAMA Dermatol. doi:10.1001/jamadermatol.2017.3225.