Psoriasis and Vascular Disease Risk

Research published in the journal JAMA Dermatology indicates that psoriasis patients may be at increased risk for new-onset peripheral vascular disease (PVD) and venous thromboembolism (VTE). The researchers further suggest that risk factors such as physical inactivity, obesity, and varicose veins should be identified and treated in psoriasis patients. Also, caution should be taken while prescribing medications like hormone-related therapies.

Psoriasis, peripheral vascular disease, and venous thromboembolism have similar mechanisms that involve chronic inflammation. However, there is no clarity on the associations between the three (psoriasis and PVD or VTE). To shed light on the same, Tai-Li Chen, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan, and colleagues conducted a systematic review and meta-analysis to determine the association of psoriasis with incident VTE and PVD.

For this purpose, the researchers systematically searched the online databases for relevant publications from their respective inception through May 21, 2021. Cohort studies that investigated the risk for incident VTE or PVD in patients with psoriasis were selected independently by two authors.

Only 13 initially identified studies met the selection criteria for qualitative review and only 9 of these for quantitative analysis. A total of 13 cohort studies with 12,435,982 participants were included.

Key Findings

• The meta-analysis demonstrated a significantly increased risk for incident VTE (pooled HR, 1.26) and PVD (pooled HR, 1.27) among patients with psoriasis.
• Subgroup analyses illustrated increased risk for incident VTE among participants with psoriatic arthritis (pooled HR, 1.24), women (pooled HR), and those in Asia (pooled HR, 2.02) and Europe (pooled HR, 1.28).

"The results suggest that there is an association of psoriasis with venous thromboembolism and peripheral vascular disease; however, there is a need for further research to understand how best to mitigate the potential increased risk of venous thromboembolism and peripheral vascular disease among patients with psoriasis and psoriatic arthritis," wrote the researchers.

"Typical presentations of VTE or PVD should not be overlooked in patients with psoriasis," they concluded.

Reference

Chen T, Lee L, Huang H, et al. Association of Psoriasis With Incident Venous Thromboembolism and Peripheral Vascular Disease: A Systematic Review and Meta-analysis. JAMA Dermatol. Published online December 01, 2021. doi:10.1001/jamadermatol.2021.4918