Parisi R, et al. - This research ascertained if patients with psoriasis presented with an elevated risk of alcohol-related mortality. Such patients reported a 60% increased risk of dying due to alcohol-related causes compared with peers of the same age and sex in the general cohort. It serves as a vital contributor to the premature mortality gap. Hence, routine screening, detection and treatment were recommended, using the Alcohol Use Disorders Identification Test (AUDIT-C) in both primary and secondary care to determine the alcohol consumption and misuse among people diagnosed with psoriasis.

Methods

• The enrollment comprised of patients with psoriasis aged 18 years and older.
• This cohort was delineated for 1998 through 2014 using the Clinical Practice Research Datalink (CPRD) and linked to Hospital Episode Statistics (HES) and Office for National Statistics (ONS) mortality records.
• Patients with psoriasis were matched with up to 20 comparison patients without psoriasis on age, sex, and general practice.
• The main measure included the determination of alcohol-related deaths through the Office for National Statistics mortality records.
• A stratified Cox proportional hazard model measured the cause-specific hazard ratio for alcohol-related death, with adjustment for socioeconomic status.

Results

• 55537 with psoriasis and 854314 patients without psoriasis were recruited.
• Median (interquartile) age at index date was 47 (27) years; 408230 of total patients (44.9%) were men.
• During a median (IQR) of 4.4 (6.2) years of follow-up, the alcohol-related mortality rate was 4.8 per 10000 person-years (95% CI, 4.1-5.6; n = 152) for the psoriasis cohort, vs 2.5 per 10000 (95% CI, 2.4- 2.7; n = 1118) for the comparison cohort.
• The hazard ratio for alcohol-related death in patients with psoriasis was 1.58 (95% CI, 1.31-1.91).
• Alcoholic liver disease (65.1%), fibrosis and cirrhosis of the liver (23.7%), and mental and behavioral disorders due to alcohol (7.9%) determined as the predominant causes of alcohol-related deaths.