Yang Yi, Zhang Qin, Huang Anning, Zhao Jinpeng, Yang Jianren, Wang Lulu, Xu Guomei
Graduate School of Beijing University of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
Department of Dermatology, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China.
Front Immunol. 2025 Jul 24;16:1610499. doi: 10.3389/fimmu.2025.1610499. eCollection 2025.
The objective of this meta-analysis is to assess the all-cause and cause-specific mortality in patients with psoriasis.
In accordance with PRISMA guidelines, a systematic search of PubMed, EMBASE, and the Cochrane Library (from inception to March 2025) was conducted. Eligible studies comprised English-language cohort studies comparing mortality risk (HR/OR/RR) in adults with psoriasis versus healthy/non-psoriasis controls. Two reviewers independently screened studies, extracted data, and assessed study quality using the Newcastle-Ottawa Scale. Hazard ratios (HRs) were synthesized using random-effects models in Stata 14.0. Sensitivity analyses, subgroup analyses, and assessments of publication bias (via funnel plots and Egger's test) were also performed.
A total of 20 studies involving 8825989 participants were included. Psoriasis patients demonstrated significantly increased risks of all-cause mortality [HR=1.19, 95% CI (1.11-1.28), P=0.000], cardiovascular mortality [HR = 1.32, 95% CI (1.11-1.58), P = 0.002], infection-related mortality [HR=1.24, 95% CI (1.13-1.36), P=0.000], and suicide mortality [HR=1.50, 95% CI (1.03-2.19), P=0.034]. The risk of mortality due to neoplasms was marginally elevated but not statistically significant [HR=1.05, 95% CI (0.98-1.12), P=0.151]. No significant associations were found for neurological disease mortality [HR=0.96, 95%CI (0.83-1.11), P=0.976] or accident-related mortality [HR=0.91, 95% CI (0.81-1.02), P=0.629]. Sensitivity analysis supports the findings. Subgroup analyses revealed higher all-cause mortality risks in Europe (HR=1.11) and Asia (HR=1.23), as well as an increased risk with greater disease severity (moderate-to-severe: HR=1.44; severe: HR=1.54). No publication bias was detected.
Psoriasis is associated with an increased risk of all-cause, cardiovascular, infection-related, and suicide mortality, highlighting the need for enhanced monitoring and targeted interventions to prevent adverse outcomes particularly for individuals with severe psoriasis.
https://www.crd.york.ac.uk/PROSPERO/view/CRD420251017192, identifier CRD420251017192.
本荟萃分析的目的是评估银屑病患者的全因死亡率和特定病因死亡率。
按照PRISMA指南，对PubMed、EMBASE和Cochrane图书馆（从创刊至2025年3月）进行了系统检索。符合条件的研究包括比较银屑病成人患者与健康/非银屑病对照者死亡率风险（HR/OR/RR）的英文队列研究。两名审阅者独立筛选研究、提取数据，并使用纽卡斯尔-渥太华量表评估研究质量。使用Stata 14.0中的随机效应模型合成风险比（HRs）。还进行了敏感性分析、亚组分析以及发表偏倚评估（通过漏斗图和Egger检验）。
共纳入20项研究，涉及8825989名参与者。银屑病患者的全因死亡率[HR=1.19，95%CI（1.11-1.28），P=0.000]、心血管死亡率[HR = 1.32，95%CI（1.11-1.58），P = 0.002]、感染相关死亡率[HR=1.24，95%CI（1.13-1.36），P=0.000]和自杀死亡率[HR=1.50，95%CI（1.03-2.19），P=0.034]显著增加。肿瘤导致的死亡率风险略有升高，但无统计学意义[HR=1.05，95%CI（0.98-1.12），P=0.151]。未发现与神经系统疾病死亡率[HR=至0.96，95%CI（0.83-1.11），P=0.976]或事故相关死亡率[HR=0.91，95%CI（0.81-1.02），P=0.629]有显著关联。敏感性分析支持这些发现。亚组分析显示，欧洲（HR=1.11）和亚洲（HR=1.23）的全因死亡率风险较高，且疾病严重程度越高风险增加（中度至重度：HR=1.44；重度：HR=1.54）。未检测到发表偏倚。
银屑病与全因、心血管、感染相关和自杀死亡率风险增加相关，这突出表明需要加强监测和针对性干预，以预防不良结局，特别是对于重度银屑病患者。
https://www.crd.york.ac.uk/PROSPERO/view/CRD420251017192，标识符CRD420251017192。
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