Patients With Psoriasis Face Greater Risk of Alcohol-Related Mortality

Individuals with psoriasis face a greater risk of dying because of an alcohol-related death compared with people in the general population, according to recent research.

A study published in JAMA Dermatology investigated the association between patients with psoriasis and alcohol-related mortality. The researchers collected patient data from the United Kingdom’s Clinical Practice Research Datalink (CPRD), which includes information from 711 general practices in the United Kingdom. The psoriasis cohort in the study incorporated adult patients from the CPRD who had their first psoriasis diagnosis between January 1, 1998, and March 3, 2014. Each participant was paired to an unaffected comparison patient.

“Recently, we have shown that, despite an overall decrease in mortality over the last 15 years, people with psoriasis nonetheless still die pre- maturely vs individuals without the disease. These findings call for a greater understanding of excess mortality linked with psoriasis,” the authors explained. “Excessive alcohol consumption is recognized in as many as one-third of patients with moderate to severe psoriasis.”

The researchers categorized alcohol consumption into categories of nondrinkers, former drinkers, occasional drinkers, moderate drinkers, and heavy drinkers. Therefore, the study could categorize the extent of alcohol consumption to an individual died of an alcohol-related cause.

A total of 55,537 patients with psoriasis were included in the study and matched to a comparison cohort of 854,314 patients. At a follow-up of a median of 4.4 years, the psoriasis cohort had an alcohol-related mortality rate of 4.8 per 10,000 person-years, while the comparison cohort’s rate was 2.5 per 10,000. Among the psoriasis cohort, the hazard ratio was 1.58 and the main causes of alcohol-related deaths were alcohol liver disease (65.1%), fibrosis and cirrhosis of the liver (23.7%) and mental and behavior disorders due to alcohol (7.9%).

Overall, people with psoriasis have about a 60% greater risk of alcohol-related death compared with those of the general population. Primary and secondary care should make an effort to detect alcohol consumption misuse among those diagnosed with psoriasis, the study suggested.

“Routine screening, identification and treatment, using the simple, shortened form (AUDIT-C) of the Alcohol Use Disorders Identification Test screening tool, developed by the World Health Organization to detect the early signs of hazardous, harmful, and dependent alcohol consumption should be implemented in both primary and secondary care to detect alcohol misuse among all people diagnosed with psoriasis,” the authors concluded.