Trends in Psoriatic Arthritis and Axial Spondyloarthritis Hospitalizations and Deaths in Mexico From 2000 to 2023

To characterize 23-year mortality trends and 19-year hospitalization trends attributable to psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) in Mexico, overall and by sex and region.

We conducted a retrospective cross-sectional analysis of the Integrated Repository of Public Health Information. We extracted death certificates (2000 to 2023) and hospital discharges (2005 to 2022) that listed ICD-10 codes M07 (PsA) or M45 (axSpA) in adults aged 15 years or older. Annual age-standardized mortality rate (ASMR) and hospitalization rate (ASHR) per 100,000 were calculated using the 2010 Mexican census. Temporal changes were modeled using Joinpoint regression (with ≤2 joinpoints), estimating the annual percent change (APC) and the average APC (AAPC) overall and by stratum.

We identified 433 SpA-related deaths (69% male) and 3663 hospital discharges (63% male). From 2000 to 2023, the ASMR remained stable (AAPC 0.9%; 95% CI: -7.8 to 10.4; P =0.845), with no significant sex-specific differences. From 2005 to 2022, the ASHR exhibited a biphasic pattern: a nonsignificant increase until 2012, followed by a significant decline of 11.7% per year (95% CI: -15.2 to -8.1; P <0.05). Overall, hospitalizations decreased significantly (AAPC -5.0%; 95% CI: -9.5 to -0.2; P =0.040). Reductions were most pronounced in men (AAPC -7.1%) and in the Northern (-7.5%) and Southeast (-7.9%) regions.

In Mexico, SpA-related mortality remained stable over 2 decades, whereas hospitalizations decreased significantly after 2012. These diverging trends coincide with the expansion of therapeutic options and health care coverage, although regional disparities persist. Ongoing surveillance is required to determine whether morbidity gains will eventually translate into reduced mortality.