Centre for Occupational and Environmental Health, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, The University of Manchester, Devas Street, Ellen Wilkinson Building, Manchester, M13 9PL, UK.
Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
Acta Derm Venereol. 2022 Nov 1;102:adv00807. doi: 10.2340/actadv.v102.1962.
There is a recognized need to better understand changes in the epidemiology of psoriasis and psoriatic arthritis (PsA) over time in Asia. Using the Taiwan National Health Insurance claim records this population-based study examined changes in the prevalence, incidence, and mortality rates in patients with psoriasis or psoriatic arthritis in Taiwan over 12 years. Patients with ≥1 diagnosis code for psoriasis or psoriatic arthritis, recorded either by dermatologists or rheumatologists, were identified. Annual age- and sex-standardized prevalence and incidence rates were calculated using the Taiwan general population as reference. To investigate mortality, each patient in the incident cohort was matched to 10 comparators from the general population by sex and age (at diagnosis). The risk of mortality between study cohorts and comparators was analysed by Cox proportional hazard regression. The prevalence of psoriasis (0.18-0.86%) and psoriatic arthritis (0.01-0.08%) increased steadily between 2006 and 2017. The incidence rates, however, remained stable (psoriasis: 62-65 per 100,000 person-years; psoriatic arthritis: 6-5 per 100,000 person-years). The risk of all-cause mortality for patients with psoriasis (hazard ratio 1.16; 95% confidence interval: 1.13-1.19) was higher than the general population, despite a decreasing trend over time in the all-cause mortality rates for both groups. The steady increase in the prevalence of psoriasis despite stable incidence rates suggests that improvements in life expectancy may be the key determinant of this increase.
亚洲地区需要更好地了解银屑病和银屑病关节炎（PsA）的流行病学变化。本项基于人群的研究使用了台湾全民健康保险理赔记录，调查了台湾 12 年来银屑病或银屑病关节炎患者的患病率、发病率和死亡率的变化。通过皮肤科医生或风湿病医生记录的≥1 次银屑病或银屑病关节炎诊断代码的患者被确定为研究对象。使用台湾普通人群作为参考，计算了每年年龄和性别标准化的患病率和发病率。为了调查死亡率，发病队列中的每位患者均与普通人群中的 10 名对照者（按性别和年龄[诊断时]）相匹配。通过 Cox 比例风险回归分析研究队列和对照者之间的死亡率风险。2006 年至 2017 年间，银屑病（0.18-0.86%）和银屑病关节炎（0.01-0.08%）的患病率稳步上升。然而，发病率保持稳定（银屑病：62-65/100,000 人年；银屑病关节炎：6-5/100,000 人年）。尽管两组的全因死亡率呈下降趋势，但银屑病患者的全因死亡率风险（危险比 1.16；95%置信区间：1.13-1.19）高于普通人群。尽管发病率保持稳定，但银屑病的患病率稳步上升，这表明预期寿命的提高可能是导致这种上升的关键决定因素。
