Treatment of psoriasis in end-stage renal disease patients is associated with decreased mortality: A retrospective cohort study
Psoriasis impairs the quality of life of approximately 7.5 million Americans and is associated with serious comorbidities. Because of chronic vascular access and epidermal dysfunction, end-stage renal disease (ESRD) patients with psoriasis may be at greater risk for infection, and psoriasis treatmen...
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| Veröffentlicht in: | The American journal of the medical sciences 2021-07, Vol.362 (1), p.24-33 |
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| container_title | The American journal of the medical sciences |
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| creator | Schwade, Mark J. Tien, Lillie Waller, Jennifer L. Davis, Loretta S. Baer, Stephanie L. Mohammed, Azeem Young, Lufei Kheda, Mufaddal F. Bollag, Wendy B. |
| description | Psoriasis impairs the quality of life of approximately 7.5 million Americans and is associated with serious comorbidities. Because of chronic vascular access and epidermal dysfunction, end-stage renal disease (ESRD) patients with psoriasis may be at greater risk for infection, and psoriasis treatment could affect this risk.
A retrospective cohort analysis was performed using the United States Renal Data System from 2004-2011 to investigate the association of psoriasis with infections common to ESRD patients, as well as the effect of psoriasis treatment on infection risk as well as mortality.
A total of 8,911 psoriasis patients were identified. Psoriasis was associated with a significantly increased risk for all queried infections, especially cellulitis (adjusted relative risk = 1.55), conjunctivitis (1.47), and onychomycosis (1.36). Psoriasis treatment (systemic, local, and light) was associated with a significantly decreased risk of some infections. Psoriasis treatment was also correlated with a significantly decreased risk of mortality, with systemic therapies (biologics and other immunosuppressants) showing the greatest reduction (adjusted hazard ratio = 0.55).
These results suggest that psoriasis-ESRD patients may have an increased risk of infection and treatment of psoriasis is associated with a reduced risk of some infections and improved survival. |
| doi_str_mv | 10.1016/j.amjms.2021.03.009 |
| format | Article |
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A retrospective cohort analysis was performed using the United States Renal Data System from 2004-2011 to investigate the association of psoriasis with infections common to ESRD patients, as well as the effect of psoriasis treatment on infection risk as well as mortality.
A total of 8,911 psoriasis patients were identified. Psoriasis was associated with a significantly increased risk for all queried infections, especially cellulitis (adjusted relative risk = 1.55), conjunctivitis (1.47), and onychomycosis (1.36). Psoriasis treatment (systemic, local, and light) was associated with a significantly decreased risk of some infections. Psoriasis treatment was also correlated with a significantly decreased risk of mortality, with systemic therapies (biologics and other immunosuppressants) showing the greatest reduction (adjusted hazard ratio = 0.55).
These results suggest that psoriasis-ESRD patients may have an increased risk of infection and treatment of psoriasis is associated with a reduced risk of some infections and improved survival.</description><identifier>ISSN: 0002-9629</identifier><identifier>EISSN: 1538-2990</identifier><identifier>DOI: 10.1016/j.amjms.2021.03.009</identifier><identifier>PMID: 33798461</identifier><language>eng</language><publisher>NEW YORK: Elsevier Inc</publisher><subject>Dialysis ; End-stage renal disease ; Epidemiology ; General & Internal Medicine ; Life Sciences & Biomedicine ; Medicine, General & Internal ; Psoriasis ; Science & Technology ; USRDS</subject><ispartof>The American journal of the medical sciences, 2021-07, Vol.362 (1), p.24-33</ispartof><rights>2021</rights><rights>Copyright © 2021. Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>9</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000671244100009</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c359t-9ab77cd32df28c2c1420154e6ee0342632e955c62a00bd457a14fc6d6c960e1f3</citedby><cites>FETCH-LOGICAL-c359t-9ab77cd32df28c2c1420154e6ee0342632e955c62a00bd457a14fc6d6c960e1f3</cites><orcidid>0000-0003-3146-162X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27929,27930,39263</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33798461$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schwade, Mark J.</creatorcontrib><creatorcontrib>Tien, Lillie</creatorcontrib><creatorcontrib>Waller, Jennifer L.</creatorcontrib><creatorcontrib>Davis, Loretta S.</creatorcontrib><creatorcontrib>Baer, Stephanie L.</creatorcontrib><creatorcontrib>Mohammed, Azeem</creatorcontrib><creatorcontrib>Young, Lufei</creatorcontrib><creatorcontrib>Kheda, Mufaddal F.</creatorcontrib><creatorcontrib>Bollag, Wendy B.</creatorcontrib><title>Treatment of psoriasis in end-stage renal disease patients is associated with decreased mortality: A retrospective cohort study</title><title>The American journal of the medical sciences</title><addtitle>AM J MED SCI</addtitle><addtitle>Am J Med Sci</addtitle><description>Psoriasis impairs the quality of life of approximately 7.5 million Americans and is associated with serious comorbidities. Because of chronic vascular access and epidermal dysfunction, end-stage renal disease (ESRD) patients with psoriasis may be at greater risk for infection, and psoriasis treatment could affect this risk.
A retrospective cohort analysis was performed using the United States Renal Data System from 2004-2011 to investigate the association of psoriasis with infections common to ESRD patients, as well as the effect of psoriasis treatment on infection risk as well as mortality.
A total of 8,911 psoriasis patients were identified. Psoriasis was associated with a significantly increased risk for all queried infections, especially cellulitis (adjusted relative risk = 1.55), conjunctivitis (1.47), and onychomycosis (1.36). Psoriasis treatment (systemic, local, and light) was associated with a significantly decreased risk of some infections. Psoriasis treatment was also correlated with a significantly decreased risk of mortality, with systemic therapies (biologics and other immunosuppressants) showing the greatest reduction (adjusted hazard ratio = 0.55).
These results suggest that psoriasis-ESRD patients may have an increased risk of infection and treatment of psoriasis is associated with a reduced risk of some infections and improved survival.</description><subject>Dialysis</subject><subject>End-stage renal disease</subject><subject>Epidemiology</subject><subject>General & Internal Medicine</subject><subject>Life Sciences & Biomedicine</subject><subject>Medicine, General & Internal</subject><subject>Psoriasis</subject><subject>Science & Technology</subject><subject>USRDS</subject><issn>0002-9629</issn><issn>1538-2990</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><recordid>eNqNkU2LFDEQhoMo7rj6CwTJUZBuK0l3uiN4WAa_YMHLeg6ZpNrN0N1pk_Quc9q_bsYZ9yieUpDnrUqeIuQ1g5oBk-_3tZn2U6o5cFaDqAHUE7JhregrrhQ8JRsA4JWSXF2QFyntARjvmXhOLoToVN9ItiEPNxFNnnDONAx0SSF6k3yifqY4uypl8xNpxNmM1PmEJiFdTPaFL0yiJqVgvcno6L3Pt9ShjUfI0SnEbEafDx_oVWmQY0gL2uzvkNpwWy5pyqs7vCTPBjMmfHU-L8mPz59utl-r6-9fvm2vrisrWpUrZXZdZ53gbuC95ZY1HFjboEQE0XApOKq2tZIbgJ1r2s6wZrDSSaskIBvEJXl76rvE8GvFlPXkk8VxNDOGNWneQt_20ElWUHFCbXlzijjoJfrJxINmoI_m9V7_Ma-P5jUIXcyX1JvzgHU3oXvM_FVdgP4E3OMuDMkWhxYfsbIq2THeNKxUoLY-F8th3oZ1ziX67v-jhf54orH4vPMY9TnhfCwb0C74f_7kN303uKY</recordid><startdate>20210701</startdate><enddate>20210701</enddate><creator>Schwade, Mark J.</creator><creator>Tien, Lillie</creator><creator>Waller, Jennifer L.</creator><creator>Davis, Loretta S.</creator><creator>Baer, Stephanie L.</creator><creator>Mohammed, Azeem</creator><creator>Young, Lufei</creator><creator>Kheda, Mufaddal F.</creator><creator>Bollag, Wendy B.</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3146-162X</orcidid></search><sort><creationdate>20210701</creationdate><title>Treatment of psoriasis in end-stage renal disease patients is associated with decreased mortality: A retrospective cohort study</title><author>Schwade, Mark J. ; Tien, Lillie ; Waller, Jennifer L. ; Davis, Loretta S. ; Baer, Stephanie L. ; Mohammed, Azeem ; Young, Lufei ; Kheda, Mufaddal F. ; Bollag, Wendy B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-9ab77cd32df28c2c1420154e6ee0342632e955c62a00bd457a14fc6d6c960e1f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Dialysis</topic><topic>End-stage renal disease</topic><topic>Epidemiology</topic><topic>General & Internal Medicine</topic><topic>Life Sciences & Biomedicine</topic><topic>Medicine, General & Internal</topic><topic>Psoriasis</topic><topic>Science & Technology</topic><topic>USRDS</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schwade, Mark J.</creatorcontrib><creatorcontrib>Tien, Lillie</creatorcontrib><creatorcontrib>Waller, Jennifer L.</creatorcontrib><creatorcontrib>Davis, Loretta S.</creatorcontrib><creatorcontrib>Baer, Stephanie L.</creatorcontrib><creatorcontrib>Mohammed, Azeem</creatorcontrib><creatorcontrib>Young, Lufei</creatorcontrib><creatorcontrib>Kheda, Mufaddal F.</creatorcontrib><creatorcontrib>Bollag, Wendy B.</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of the medical sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schwade, Mark J.</au><au>Tien, Lillie</au><au>Waller, Jennifer L.</au><au>Davis, Loretta S.</au><au>Baer, Stephanie L.</au><au>Mohammed, Azeem</au><au>Young, Lufei</au><au>Kheda, Mufaddal F.</au><au>Bollag, Wendy B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment of psoriasis in end-stage renal disease patients is associated with decreased mortality: A retrospective cohort study</atitle><jtitle>The American journal of the medical sciences</jtitle><stitle>AM J MED SCI</stitle><addtitle>Am J Med Sci</addtitle><date>2021-07-01</date><risdate>2021</risdate><volume>362</volume><issue>1</issue><spage>24</spage><epage>33</epage><pages>24-33</pages><issn>0002-9629</issn><eissn>1538-2990</eissn><abstract>Psoriasis impairs the quality of life of approximately 7.5 million Americans and is associated with serious comorbidities. Because of chronic vascular access and epidermal dysfunction, end-stage renal disease (ESRD) patients with psoriasis may be at greater risk for infection, and psoriasis treatment could affect this risk.
A retrospective cohort analysis was performed using the United States Renal Data System from 2004-2011 to investigate the association of psoriasis with infections common to ESRD patients, as well as the effect of psoriasis treatment on infection risk as well as mortality.
A total of 8,911 psoriasis patients were identified. Psoriasis was associated with a significantly increased risk for all queried infections, especially cellulitis (adjusted relative risk = 1.55), conjunctivitis (1.47), and onychomycosis (1.36). Psoriasis treatment (systemic, local, and light) was associated with a significantly decreased risk of some infections. Psoriasis treatment was also correlated with a significantly decreased risk of mortality, with systemic therapies (biologics and other immunosuppressants) showing the greatest reduction (adjusted hazard ratio = 0.55).
These results suggest that psoriasis-ESRD patients may have an increased risk of infection and treatment of psoriasis is associated with a reduced risk of some infections and improved survival.</abstract><cop>NEW YORK</cop><pub>Elsevier Inc</pub><pmid>33798461</pmid><doi>10.1016/j.amjms.2021.03.009</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-3146-162X</orcidid></addata></record> |
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| subjects | Dialysis End-stage renal disease Epidemiology General & Internal Medicine Life Sciences & Biomedicine Medicine, General & Internal Psoriasis Science & Technology USRDS |
| title | Treatment of psoriasis in end-stage renal disease patients is associated with decreased mortality: A retrospective cohort study |
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