Psoriasis Linked to Increased Cardiovascular, Suicide Related Mortality Risk

Psoriasis is associated with increased risks of all-cause, cardiovascular, infection-related, and suicide mortality, according to findings from a recent study.1

The systematic review and meta-analysis included 20 cohort studies with > 8 million participants and sheds light on the need for enhanced monitoring and targeted interventions to prevent adverse outcomes in this patient population, particularly for individuals with severe psoriasis.1

“Recent evidence underscores an elevated risk of all-cause and cause-specific mortality in psoriasis patients, largely driven by chronic inflammation and immune dysregulation,” Guomei Xu, of the department of dermatology at Beijing University of Chinese Medicine Third Affiliated Hospital, and colleagues wrote.1 “[There is an] urgent need for integrated management strategies that address both the cutaneous manifestations and systemic complications of psoriasis.”

Psoriasis affects 125 million people worldwide, representing 2-3% of the total population, according to the World Psoriasis Day consortium. In the US, an estimated 8 million people are living with psoriasis. It is commonly associated with a range of systemic comorbidities, and current therapeutic approaches like topical treatments, conventional systemic therapies, biologics targeting specific cytokines, and phototherapy often exhibit high recurrence rates and suboptimal long-term efficacy1,2

To assess all-cause and cause-specific mortality risks associated with psoriasis, investigators systematically searched PubMed, EMBASE, and the Cochrane Library databases from inception to March 2025. For inclusion, studies were required to meet the following criteria:

• Prospective or retrospective cohort study design
• Patients diagnosed with psoriasis, ≥ 18 years of age, regardless of disease duration or nationality
• A control group consisting of healthy individuals or non-psoriasis patients
• The primary outcome of mortality risk, reported as hazard ratio (HR), or odds ratio (OR), relative risk (RR) during the follow-up period
• Studies published in English

A preliminary literature search yielded 3315 relevant records., 2623 of which remained after removing duplicates. After screening for relevancy, 44 articles underwent full-text review and 20 were ultimately deemed eligible for inclusion.1

The 20 cohort studies included a total sample size of 8,825,989 participants, comprising 851,942 psoriasis patients and 797,4047 controls. Of the included studies, 10 were conducted in Europe, 7 in America, and 4 in Asia. Investigators assessed the quality of these studies using the Newcastle-Ottawa Scale (NOS) and calculated an average NOS score of 7.6, indicating the overall quality of the studies included in the meta-analysis was high.1

Upon analysis, psoriasis patients demonstrated significantly increased risks of all-cause mortality (HR, 1.19; 95% CI, 1.11–1.28; P =.000) and cause-specific mortality, including cardiovascular mortality (HR, 1.32; 95% CI, 1.11–1.58; P = .002), infection-related mortality (HR, 1.24; 95% CI, 1.13–1.36; P = .000), and suicide mortality (HR, 1.50; 95% CI, 1.03–2.19; P = .034). Investigators noted the risk of mortality due to neoplasms was marginally elevated but did not meet statistical significance (HR, 1.05; 95% CI, 0.98–1.12; P = .151).1

No significant associations were found for neurological disease mortality (HR, 0.96; 95% CI, 0.83–1.11; P = .976) or accident-related mortality (HR, 0.91; 95% CI, 0.81–1.02; P = .629).1

Subgroup analyses revealed greater 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).1

“Our findings underscore the necessity of multidisciplinary interventions, particularly in severe cases,” investigators concluded.1 “Future studies should further elucidate the underlying pathophysiological mechanisms to facilitate the development of more effective preventive strategies and therapeutic approaches for patients with psoriasis.”

References

1. Yang Y, Zhang Q, Huang A, et al. All-cause and cause-specific mortality in psoriasis patients: a systematic review and meta-analysis. Front. Immunol. 16:1610499. doi:10.3389/fimmu.2025.1610499

2. National Psoriasis Foundation. Psoriasis Statistics. December 21, 2022. Accessed August 14, 2025. https://www.psoriasis.org/psoriasis-statistics/