Genetic Markers Sought for Psoriasis, Comorbidity Links

VIENNA — Patients with psoriasis are at a higher risk for comorbidities including arthritis, heart disease, diabetes, cancer, and hypertension than is the general population, according to new data presented by Dr. Wayne P. Gulliver at the 16th Congress of the European Academy of Dermatology and Venereology.

The Newfoundland and Labra-dor Centre for Health Information database contains health records for more than 3,200 patients with psoriasis from this genetically distinct founder population.

Analysis of data from this cohort is expected to advance understanding of the genetics and pathophysiology of complex diseases such as psoriasis, said Dr. Gulliver, chairman and medical director of a medical research organization in St. John's, Nfld.

Since the 1960s, it's been known that psoriasis patients are at risk for concomitant disease, with the first associations found to be gout and sarcoidosis. Studies in Sweden during the 1980s found associations with excess rates of viral infections, alcoholism, hypertension, pneumonia, cirrhosis, urti- caria, and rheumatoid arthritis in men and women; with iritis and ankylosing spondylitis in men; and with lung cancer, diabetes, obesity, myocardial infarction, and asthma in women (Dermatologica 1986;172:298–304).

German studies showed that diabetes, obesity, hypertension, and heart failure were overrepresented in psoriasis patients (J. Am. Acad. Dermatol. 1995;32:982–6).

More recently, studies have suggested a link between psoriasis and increased rates of metabolic syndrome and hyperlipidemia—as well as a resulting increase in cardiovascular risk, Dr. Gulliver wrote in a poster.

This observation has now been confirmed in the Newfoundland and Labrador psoriasis population, with heart disease being elevated in mild to moderate and severe psoriasis patients, compared with the general population. Of 100 patients aged 50 years and older with mild to moderate psoriasis, 28% had heart disease, whereas 21% of 100 patients with severe psoriasis had heart disease; in the general population aged 30–64 years, heart disease rate was 17%.

Mortality also reflects the increased prevalence of these comorbidities, with 44.4% of the 169 reported deaths in psoriasis patients relating to cardiovascular disease, compared with 36.1% of deaths in the general population of Newfoundland and Labrador, noted Dr. Gulliver, who is also chairman of the dermatology division, Memorial University of Newfoundland, St. John's.

Moreover, psoriasis patients in this cohort died about 10 years earlier than the general population. The mean age at death in men with psoriasis was 68.8 years, whereas the national average was 77.4 years. The mean age at death for women with psoriasis was 72.7 years, compared with 82.5 years in women in the general population.

Pharmacokinetic studies are ongoing, with certain genetic markers for psoriasis having recently been identified. If further analyses can identify genetic linkages between psoriasis and comorbidities, genetic screening could be used for early recognition, Dr. Gulliver noted.

VIENNA — Patients with psoriasis are at a higher risk for comorbidities including arthritis, heart disease, diabetes, cancer, and hypertension than is the general population, according to new data presented by Dr. Wayne P. Gulliver at the 16th Congress of the European Academy of Dermatology and Venereology.

The Newfoundland and Labra-dor Centre for Health Information database contains health records for more than 3,200 patients with psoriasis from this genetically distinct founder population.

Analysis of data from this cohort is expected to advance understanding of the genetics and pathophysiology of complex diseases such as psoriasis, said Dr. Gulliver, chairman and medical director of a medical research organization in St. John's, Nfld.

Since the 1960s, it's been known that psoriasis patients are at risk for concomitant disease, with the first associations found to be gout and sarcoidosis. Studies in Sweden during the 1980s found associations with excess rates of viral infections, alcoholism, hypertension, pneumonia, cirrhosis, urti- caria, and rheumatoid arthritis in men and women; with iritis and ankylosing spondylitis in men; and with lung cancer, diabetes, obesity, myocardial infarction, and asthma in women (Dermatologica 1986;172:298–304).

German studies showed that diabetes, obesity, hypertension, and heart failure were overrepresented in psoriasis patients (J. Am. Acad. Dermatol. 1995;32:982–6).

More recently, studies have suggested a link between psoriasis and increased rates of metabolic syndrome and hyperlipidemia—as well as a resulting increase in cardiovascular risk, Dr. Gulliver wrote in a poster.

This observation has now been confirmed in the Newfoundland and Labrador psoriasis population, with heart disease being elevated in mild to moderate and severe psoriasis patients, compared with the general population. Of 100 patients aged 50 years and older with mild to moderate psoriasis, 28% had heart disease, whereas 21% of 100 patients with severe psoriasis had heart disease; in the general population aged 30–64 years, heart disease rate was 17%.

Mortality also reflects the increased prevalence of these comorbidities, with 44.4% of the 169 reported deaths in psoriasis patients relating to cardiovascular disease, compared with 36.1% of deaths in the general population of Newfoundland and Labrador, noted Dr. Gulliver, who is also chairman of the dermatology division, Memorial University of Newfoundland, St. John's.

Moreover, psoriasis patients in this cohort died about 10 years earlier than the general population. The mean age at death in men with psoriasis was 68.8 years, whereas the national average was 77.4 years. The mean age at death for women with psoriasis was 72.7 years, compared with 82.5 years in women in the general population.

Pharmacokinetic studies are ongoing, with certain genetic markers for psoriasis having recently been identified. If further analyses can identify genetic linkages between psoriasis and comorbidities, genetic screening could be used for early recognition, Dr. Gulliver noted.

VIENNA — Patients with psoriasis are at a higher risk for comorbidities including arthritis, heart disease, diabetes, cancer, and hypertension than is the general population, according to new data presented by Dr. Wayne P. Gulliver at the 16th Congress of the European Academy of Dermatology and Venereology.

The Newfoundland and Labra-dor Centre for Health Information database contains health records for more than 3,200 patients with psoriasis from this genetically distinct founder population.

Analysis of data from this cohort is expected to advance understanding of the genetics and pathophysiology of complex diseases such as psoriasis, said Dr. Gulliver, chairman and medical director of a medical research organization in St. John's, Nfld.

Since the 1960s, it's been known that psoriasis patients are at risk for concomitant disease, with the first associations found to be gout and sarcoidosis. Studies in Sweden during the 1980s found associations with excess rates of viral infections, alcoholism, hypertension, pneumonia, cirrhosis, urti- caria, and rheumatoid arthritis in men and women; with iritis and ankylosing spondylitis in men; and with lung cancer, diabetes, obesity, myocardial infarction, and asthma in women (Dermatologica 1986;172:298–304).

German studies showed that diabetes, obesity, hypertension, and heart failure were overrepresented in psoriasis patients (J. Am. Acad. Dermatol. 1995;32:982–6).

More recently, studies have suggested a link between psoriasis and increased rates of metabolic syndrome and hyperlipidemia—as well as a resulting increase in cardiovascular risk, Dr. Gulliver wrote in a poster.

This observation has now been confirmed in the Newfoundland and Labrador psoriasis population, with heart disease being elevated in mild to moderate and severe psoriasis patients, compared with the general population. Of 100 patients aged 50 years and older with mild to moderate psoriasis, 28% had heart disease, whereas 21% of 100 patients with severe psoriasis had heart disease; in the general population aged 30–64 years, heart disease rate was 17%.

Mortality also reflects the increased prevalence of these comorbidities, with 44.4% of the 169 reported deaths in psoriasis patients relating to cardiovascular disease, compared with 36.1% of deaths in the general population of Newfoundland and Labrador, noted Dr. Gulliver, who is also chairman of the dermatology division, Memorial University of Newfoundland, St. John's.

Moreover, psoriasis patients in this cohort died about 10 years earlier than the general population. The mean age at death in men with psoriasis was 68.8 years, whereas the national average was 77.4 years. The mean age at death for women with psoriasis was 72.7 years, compared with 82.5 years in women in the general population.

Pharmacokinetic studies are ongoing, with certain genetic markers for psoriasis having recently been identified. If further analyses can identify genetic linkages between psoriasis and comorbidities, genetic screening could be used for early recognition, Dr. Gulliver noted.