SYSTEMATIC REVIEW article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1622159
Mortality in patients with psoriatic arthritis: A systematic review and meta-analysis
Provisionally accepted
- First Hospital, Peking University, Beijing, China
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Objective. The debate persists regarding whether patients with psoriatic arthritis (PsA) face an increased risk of mortality. We aimed to ascertain the magnitude of all-cause mortality risk in patients with PsA compared to the general population through a systematic review and meta-analysis. Methods. We conducted a comprehensive search of PubMed, EMBASE and Cochrane Library for studies published from inception to June 2025. STATA meta-analysis software was used to calculate the pooled risk estimates for mortality, represented as standardized mortality ratio (SMR). Results. Among the 4,502 articles identified in our research, 20 studies were included for analysis. Overall, our findings revealed a 1.12-fold increased risk of death among PsA patients compared with the general population (meta-SMR: 1.12, 95% CI 1.09-1.15). Subgroup analyses showed that mortality risks were elevated in Asian countries (meta-SMR: 1.28, 95% CI 1.04-1.57), within population-based studies (meta-SMR: 1.13, 95% CI 1.02-1.25), and among the studies including over 1000 patients (meta-SMR: 1.12, 95% CI 1.01-1.25). Malignancy, cardiovascular and cerebrovascular diseases, as well as infection/respiratory diseases, emerged as the most frequent causes of mortality. Conclusion. Our analysis suggested a modestly elevated mortality in patients with PsA compared with the general population, though heterogeneity warrants cautious interpretation. Malignancy, cardiovascular and cerebrovascular diseases, and infection/respiratory disease were frequent causes of mortality and warrant further investigation.
Keywords: psoriatic arthritis, Systematic review, Meta-analysis, Mortality, Causes of mortality
Received: 02 May 2025; Accepted: 21 Jul 2025.
Copyright: © 2025 Huang, Xie, Geng, Fan and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhuoli Zhang, First Hospital, Peking University, Beijing, China
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