TY - JOUR T1 - Is Psoriatic Arthritis Associated With Higher Risk of Mortality? JF - The Journal of Rheumatology JO - J Rheumatol SP - 128 LP - 131 DO - 10.3899/jrheum.210963 VL - 49 IS - 2 AU - Ying-Ying Leung Y1 - 2022/02/01 UR - http://www.jrheum.org/content/49/2/128.abstract N2 - Psoriatic arthritis (PsA) is a systemic inflammatory disease affecting domains beyond the musculoskeletal system, and may lead to disability and impaired quality of life. It is associated with comorbidities such as hypertension, diabetes mellitus, obesity, metabolic syndrome, and increased risk of cardiovascular events. Studies on whether PsA may lead to higher mortality are still controversial. Earlier studies from tertiary rheumatology centers have revealed an increase in mortality among patients with PsA compared to the general population, whereas more recent studies did not reveal an increased risk. It is also unclear whether an observed increased morality in patients with PsA is due to the association between PsA and cardiovascular risk factors, or to PsA per se.In this issue of The Journal of Rheumatology, Haddad et al reported the results of a large population-based cohort study on 5275 patients with PsA compared to 21,011 controls after a mean follow-up of 7.2 years in Israel.1 The authors found no increased risk in all-cause mortality in patients with PsA compared to those without, after adjustment of comorbidities. The leading cause of death was malignancy, followed by ischemic heart disease; this was in line with the order of the causes of death in the general population. The strength of this study lies in the large sample size and data from a population-based cohort, the Clalit Health Services, which is the largest healthcare provider in Israel, covering 52% of Israel’s population. A rich dataset including demographics, smoking, BMI, comorbidities, and use of conventional (c-) and biologic (b-) disease-modifying antirheumatic drugs (DMARDs) was collected. As the association of PsA with metabolic comorbidities and ischemic heart disease is well known, the controlling of these confounding variables allows the … Address correspondence to Dr. Y.Y. Leung, Department of Rheumatology and Immunology, Singapore General Hospital, The Academia, Level 4, 20 College Road, Singapore 169856. Email: katyccc{at}hotmail.com. ER -