Background and objectives: Plaque psoriasis (Pso) and hidradenitis suppurativa (HS) are chronic inflammatory diseases associated with multiple comorbidities, including cardiovascular conditions, which may negatively impact survival. The aim of this study was to analyze mortality in patients with Pso and HS vs the general population and to each other, as well as the potential impact of biologic therapy on mortality.
Materials and methods: We conducted a retrospective cohort study based on electronic health records retrieved from the TriNetX platform. Patients diagnosed with Pso or HS, with or without biologic therapy, were compared with matched cohorts from the general population and with each other. Cohorts were matched using propensity score matching (PSM) and adjusted for age, sex, and comorbidities potentially affecting mortality, including smoking, diabetes, hyperlipidemia, hypertension, overweight and obesity, cardiovascular disease, pulmonary embolism, venous thrombosis, ischemic heart disease, and cerebrovascular disease. The mortality incidence rate was assessed using risk ratio (RR) and hazard ratio (HR), with 95% confidence intervals (CIs) during a 10-year follow-up.
Results: After adjustment, 76.191 patients with Pso and 52.354 with HS were included. Compared to the general population, patients with Pso showed a higher mortality risk (RR, 2.25; 95%CI, 2.18–2.32; HR, 2.02; 95%CI, 1.95–2.08), with a significant reduction in those treated with biologics (RR, 0.76; 95%CI, 0.70–0.83; HR, 0.62; 95%CI, 0.57–0.67). Similarly, patients with HS also exhibited a higher mortality risk (RR, 2.25; 95%CI, 2.14–2.37; HR, 2.28; 95%CI, 2.16–2.40), which was attenuated in those treated with biologics (RR, 0.80; 95%CI, 0.65–0.99; HR, 0.62; 95%CI, 0.49–0.77). When comparing both diseases, patients with HS had a higher mortality risk vs those with Pso (HR, 1.16; 95%CI, 1.11–1.22). The same trend was observed in biologic-treated subgroups (RR, 1.30; 95%CI, 1.00–1.68; HR, 1.45; 95%CI, 1.12–1.90).
Conclusions: both psoriasis (pso) and hidradenitis suppurativa (hs) are associated with an increased risk of mortality, which appears to be mitigated by biologic therapy. Early and comprehensive management of these conditions, including systemic inflammation control and comorbidity screening, may improve survival outcomes.
