Reduced risk of mortality associated with systemic psoriasis treatment in the Psoriasis Longitudinal Assessment and Registry (PSOLAR): A nested case-control analysis
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Reduced risk of mortality associated with systemic psoriasis treatment in the Psoriasis Longitudinal Assessment and Registry (PSOLAR): A nested case-control analysis. / Langley, Richard G; Poulin, Yves; Srivastava, Bhaskar; Lafferty, Kimberly Parnell; Fakharzadeh, Steven; Langholff, Wayne; Augustin, Matthias.
in: J AM ACAD DERMATOL, Jahrgang 84, Nr. 1, 01.2021, S. 60-69.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Reduced risk of mortality associated with systemic psoriasis treatment in the Psoriasis Longitudinal Assessment and Registry (PSOLAR): A nested case-control analysis
AU - Langley, Richard G
AU - Poulin, Yves
AU - Srivastava, Bhaskar
AU - Lafferty, Kimberly Parnell
AU - Fakharzadeh, Steven
AU - Langholff, Wayne
AU - Augustin, Matthias
N1 - Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
PY - 2021/1
Y1 - 2021/1
N2 - BACKGROUND: The effects of systemic therapy on mortality risk among patients with psoriasis are not fully understood.OBJECTIVE: To evaluate the impact of systemic treatment on mortality risk in patients enrolled in the Psoriasis Longitudinal Assessment and Registry.METHODS: Nested case-control analyses were performed to estimate mortality risk. Cases were defined as patients who died while participating in the Psoriasis Longitudinal Assessment and Registry. Cases were matched (1:4) with controls by age, race, sex, and geographic region. Evaluated treatments included methotrexate, ustekinumab, and tumor necrosis factor α inhibitors. Exposure was defined as at least 1 dose of treatment within 3 months before death and was stratified by duration of therapy.RESULTS: Among 12,090 patients, 341 deaths occurred, matched to 1364 controls. Biologic treatment within the preceding 3 months was protective against mortality versus no exposure: odds ratio (OR) for exposure of less than 1 year, 0.08 (95% confidence interval [CI], 0.03-0.23); OR for exposure of 1 year or longer, 0.09 (95% CI, 0.06-0.13). Methotrexate was protective against mortality only with exposure for 1 year or longer (OR, 0.08; 95% CI, 0.02-0.28).LIMITATIONS: Observational studies are subject to unmeasured confounding.CONCLUSIONS: Biologic therapy was associated with reduced mortality risk in patients with moderate to severe psoriasis, regardless of treatment duration; methotrexate reduced risk only with exposure for 1 year or longer.
AB - BACKGROUND: The effects of systemic therapy on mortality risk among patients with psoriasis are not fully understood.OBJECTIVE: To evaluate the impact of systemic treatment on mortality risk in patients enrolled in the Psoriasis Longitudinal Assessment and Registry.METHODS: Nested case-control analyses were performed to estimate mortality risk. Cases were defined as patients who died while participating in the Psoriasis Longitudinal Assessment and Registry. Cases were matched (1:4) with controls by age, race, sex, and geographic region. Evaluated treatments included methotrexate, ustekinumab, and tumor necrosis factor α inhibitors. Exposure was defined as at least 1 dose of treatment within 3 months before death and was stratified by duration of therapy.RESULTS: Among 12,090 patients, 341 deaths occurred, matched to 1364 controls. Biologic treatment within the preceding 3 months was protective against mortality versus no exposure: odds ratio (OR) for exposure of less than 1 year, 0.08 (95% confidence interval [CI], 0.03-0.23); OR for exposure of 1 year or longer, 0.09 (95% CI, 0.06-0.13). Methotrexate was protective against mortality only with exposure for 1 year or longer (OR, 0.08; 95% CI, 0.02-0.28).LIMITATIONS: Observational studies are subject to unmeasured confounding.CONCLUSIONS: Biologic therapy was associated with reduced mortality risk in patients with moderate to severe psoriasis, regardless of treatment duration; methotrexate reduced risk only with exposure for 1 year or longer.
KW - Aged
KW - Case-Control Studies
KW - Cause of Death
KW - Dermatologic Agents/therapeutic use
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Methotrexate/therapeutic use
KW - Middle Aged
KW - Psoriasis/complications
KW - Registries
KW - Tumor Necrosis Factor-alpha/therapeutic use
KW - Ustekinumab/therapeutic use
U2 - 10.1016/j.jaad.2020.08.032
DO - 10.1016/j.jaad.2020.08.032
M3 - SCORING: Journal article
C2 - 32798580
VL - 84
SP - 60
EP - 69
JO - J AM ACAD DERMATOL
JF - J AM ACAD DERMATOL
SN - 0190-9622
IS - 1
ER -
