Priority 9 from the Psoriasis PSP

UNCERTAINTY: Is a person with psoriasis more likely to develop other health conditions (either as a consequence of psoriasis or due to the effect of treatments for psoriasis)?  If so, which ones? (JLA PSP Priority 9)
Overall ranking 9
JLA question ID 0072/9
Explanatory note Not available for this PSP
Evidence

Abbott, 2015 Evidence that TNF-α inhibitor therapy reduces depression in people who have chronic diseases (including those with psoriasis) though the effects are small.    Limited data available.  Further studies investigating a more detailed timeline of changes in depression, inflammatory biomarkers and disease activity status in patients with psoriasis (and other chronic diseases) are required. 

Alinaghi, 2019 This study found that 1 in 5 patients with psoriasis have PsA.  There were high levels of heterogeneity between the studies which were included in the analysis and very few studies from certain geographical regions – eg Africa and Australia.  Studies were excluded if they were not written in English which may have introduced publication bias.  Further studies required. 

Armstrong 2013a Some evidence that mild and severe psoriasis is associated with an increased risk of myocardial infarction and stroke.  Severe psoriasis is also associated with an increased risk of cardiovascular mortality.  Some limitations documented.  Future studies needed - these should include more complete covariate adjustment and characterisation of psoriasis severity. 

See data sheet for a further list of evidence considered.

Health Research Classification System category Skin
Extra information provided by this PSP
Original uncertainty examples What makes someone with psoriasis likely to develop PsA?
Submitted by 147 uncertainties were submitted around this question
PSP information
PSP unique ID 0072
PSP name Psoriasis
Total number of uncertainties identified by this PSP. 55  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 17 September 2018