The risk of organ-based comorbidities in psoriasis: a systematic review and meta-analysis

ABSTRACT

Abstract Background: The close relationship between psoriasis and concomitant diseases is widely accepted. However, a comprehensive analysis of organ-based comorbidities in psoriasis is still lacking. Objective: The authors aimed to present the risk of organ-based comorbidities in psoriasis by comparing the general population. Methods: The authors retrieved a search of Pubmed, EMBASE, and Cochrane databases for studies reporting organ-based comorbidities in psoriasis versus the general population. Observational studies that met the following criteria were assessed 1) Psoriasis diagnosis; 2) Cardiovascular or kidney or liver or respiratory or cerebrovascular outcomes; 3) Comparison group of individuals without psoriasis. Pooled Relative Risks (pRRs) and 95% Confidence Intervals (CIs) were calculated by using the random-effect model. Results: Fifteen observational studies with 216,348 psoriatic patients and 9,896,962 individuals from the general population were included. Psoriasis showed a greater risk of organ-based comorbidities. Compared to the general population, pRR for all organ-based comorbidities was 1.20 (95% CI 1.11-1.31) in psoriasis, and pRR was lower in mild 0.61 (95% CI 0.46-0.81) than in moderate/severe patients. pRR was 1.20 (95% CI 1.11-1.30) for cardiovascular, 1.56 (95% CI 1.20-2.04), and 1.75 (95% CI 1.33-2.29) for cerebrovascular and liver diseases, respectively. pRR for coexisting renal and cardiovascular events was 1.09 (95% CI 1.01-1.18). pRR for coexisting renal and cerebrovascular events was 1.28 (95% CI 0.99-1.66). pRR for coexisting renal and liver diseases was 1.46 (95% CI 1.10-1.94). pRR for coexisting cardiovascular and liver diseases was 1.41 (95% CI 1.11-1.80). Study limitations: There is heterogeneity. Conclusion: Psoriasis has a higher risk of single and multiple organ-based comorbidities than the general population. The present study will further improve attention to psoriasis as a systemic inflammatory disease.