J Rheum Dis.  2018 Jul;25(3):197-202. 10.4078/jrd.2018.25.3.197.

Overall and Sex-specific Mortality in Psoriatic Arthritis and Ankylosing Spondylitis: A Meta-analysis

• Lee YH
• Song GG

• KMID: 2415608
• DOI: http://doi.org/10.4078/jrd.2018.25.3.197

Abstract

OBJECTIVE
This study examined the all-cause and sex-specific standardized mortality ratios (SMRs) in patients with spondyloarthropathy.
METHODS
Studies examining the all-cause and/or cause-specific SMRs in patients with psoriatic arthritis (PsA) and ankylosing spondylitis (AS) compared to the general population were surveyed using MEDLINE, EMBASE, and Cochrane databases and manual searches. A meta-analysis of the all-cause and sex-specific SMRs in patients with rheumatic diseases was then performed.
RESULTS
In total, 7 comparisons (5 PsA and 2 AS) from 6 reports met the inclusion criteria. Disease-specific meta-analysis showed that the pooled SMR was 1.299 (95% confidence interval [CI] 1.092-1.605, p=0.015) for PsA and 1.784 (95% CI 1.576-2.020, p < 0.001) for AS. Meta-analysis showed that the SMRs of PsA and AS were significantly higher (1.299 to 1.784 times) than those in the general population. The age- and sex-adjusted SMR was highest for AS (1.784), followed by PsA (1.299). Moreover, sex-specific meta-analysis showed that the all-cause SMRs were increased in female and male patients with PsA. On the other hand, mortality increased in male patients with AS (SMR 1.834), whereas there was no significant increase in female patients with AS.
CONCLUSION
All-cause mortality is higher in patients with PsA and AS compared to the general population. On the other hand, the mortality was higher in males with AS but not in females.

Keyword

Psoriatic arthritis; Ankylosing spondylitis; Mortality; Meta-analysis

MeSH Terms

Arthritis, Psoriatic*
Female
Hand
Humans
Male
Mortality*
Rheumatic Diseases
Spondylarthropathies
Spondylitis, Ankylosing*

Figure

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  Figure 1. Study flow chart of the article selection process.

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  Figure 2. Meta-analysis of the all-cause standardized mortality ratios in patients with PsA and AS. PsA: psoriatic arthritis, AS: ankylosing spondylitis, SMR: standardized mortality ratio, CI: confidence interval.

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  Figure 3. Meta-analysis of the all-cause standardized mortality ratios in male (A) and female (B) patients with PsA and AS. PsA: psoriatic arthritis, AS: ankylosing spondylitis, SMR: standardized mortality ratio, CI: confidence interval.

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