Risk for Type 2 Diabetes, Cardiovascular Disease Elevated in Patients With Psoriatic Arthritis
The development of type 2 diabetes was higher among patients with PsA compared with patients who had psoriasis or with the general population.
There is an increased risk for type 2 diabetes (T2D), ischemic heart disease, and peripheral vascular disease among patients with psoriatic arthritis (PsA) compared with the general population, after adjusting for traditional risk factors, according to the results from the PROMPT study published in Rheumatology.
The investigators sought to determine the risk for T2D and cardiovascular disease (CVD) in patients with PsA compared with the general population and with patients with psoriasis. An incident population of patients with PsA aged 18 to 89 years was identified in the United Kingdom Clinical Practice Research Datalink between 1998 and 2014. All patients with PsA were matched in a 1:4 ratio with a general population cohort (patients with no PsA and no psoriasis) and to a psoriasis cohort. The incidence of T2D, ischemic heart disease, peripheral vascular disease, and cerebrovascular disease was calculated in each of the cohorts.
A total of 6783 incident cases of PsA were identified. The risk for T2D was significantly higher in the PsA group compared with the general population arm (adjusted relative risk [RR], 1.40; 95% CI, 1.15-1.70; P =.0007) and the psoriasis group (adjusted RR, 1.53; 95% CI, 1.19-1.97; P =.0009).
The incidence of ischemic heart disease (P =.02), peripheral vascular disease (P =.04), and the 3 CV outcomes combined (P =.0005) in the PsA cohort was significantly higher than in the general population. There were no significant differences in risk observed, however, between the PsA and psoriasis cohorts for any of the CV outcomes.
The development of T2D is an important comorbidity that has been reported following the onset of PsA. The investigators concluded that there is an increased risk for CVD in patients with PsA, which is similar to that observed among patients with psoriasis. To reduce CV risk among patients with PsA, it is important to treat the inflammatory disease as well as to screen and treat traditional risk factors early in the course of the disease.
Charlton R, Green A, Shaddick G, et al; PROMPT study group. Risk of type 2 diabetes and cardiovascular disease in an incident cohort of people with psoriatic arthritis: a population-based cohort study [published online September 6, 2018]. Rheumatology (Oxford). doi:10.1093/rheumatology/key286