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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

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Published on: July 11, 2013

Alcohol-Related Mortality in Patients With Psoriasis: A Population-Based Cohort Study.

Rosa Parisi¹, Roger T Webb², Matthew J Carr²

¹Centre for Pharmacoepidemiology and Drug Safety, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, England.

JAMA Dermatology

|September 16, 2017

Summary

Individuals with psoriasis face a significantly higher risk of alcohol-related death, contributing to premature mortality. Routine screening for alcohol use is recommended for psoriasis patients.

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Area of Science:

Dermatology
Public Health
Epidemiology

Background:

Psoriasis is linked to increased premature mortality, but the causes are not fully understood.
Alcohol-related mortality may be a significant factor contributing to this disparity.

Purpose of the Study:

To determine if patients diagnosed with psoriasis exhibit an elevated risk of death from alcohol-related causes.
To investigate the contribution of alcohol-related mortality to the overall mortality gap in psoriasis patients.

Main Methods:

A large incident cohort study using the Clinical Practice Research Datalink (CPRD), linked to Hospital Episode Statistics (HES) and Office for National Statistics (ONS) mortality records.
Patients with psoriasis were matched with up to 20 controls without psoriasis, with alcohol-related deaths ascertained via ONS records.
A Cox proportional hazard model was employed to estimate the cause-specific hazard ratio for alcohol-related death, adjusting for socioeconomic status.

Main Results:

The study included over 55,000 patients with psoriasis and over 850,000 controls.
Patients with psoriasis had a 58% increased hazard ratio for alcohol-related death (1.58; 95% CI, 1.31-1.91).
The primary causes of alcohol-related deaths in the psoriasis cohort were alcoholic liver disease, liver fibrosis/cirrhosis, and alcohol-related mental/behavioral disorders.

Conclusions:

Individuals with psoriasis have a substantially higher risk of mortality due to alcohol-related causes compared to the general population.
This increased risk appears to be a key driver of the premature mortality observed in psoriasis patients.
Routine screening for alcohol use disorders, such as with the Alcohol Use Disorders Identification Test (AUDIT-C), is recommended in primary and secondary care for individuals with psoriasis.