Psoriatic arthritis (PsA) is a chronic inflammatory condition affecting the joints, tendons, and skin. While it does not directly cause death, it can significantly increase the risk of developing other serious health conditions, known as comorbidities, which can impact an individual’s lifespan. Understanding these associated risks is important for managing the condition effectively and improving overall health outcomes.
Psoriatic Arthritis Beyond Joint Pain
Psoriatic arthritis is a systemic disease, meaning its effects extend beyond localized joint pain and skin rashes. Chronic inflammation throughout the body is the underlying cause, impacting various organ systems. This widespread inflammation contributes to the development of other health issues over time.
This systemic inflammation can affect the cardiovascular system, metabolic processes, and the immune response. Individuals with PsA may therefore face an elevated risk of developing conditions not directly related to arthritis. Recognizing PsA as a broader systemic disorder is important for understanding its influence on long-term health.
How Psoriatic Arthritis Increases Mortality Risk
Psoriatic arthritis increases mortality risk primarily through its association with various medical conditions. Systemic inflammation, a hallmark of PsA, contributes to cardiovascular disease, including heart attack, stroke, and heart failure. Patients with PsA have a higher prevalence of cardiovascular disease, with one study noting it in 41% of patients compared to 31% of controls. This increased risk is a leading cause of death in individuals with PsA.
Metabolic syndrome, a cluster of conditions including high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels, is also more common in PsA patients. This syndrome raises the risk of type 2 diabetes and cardiovascular events. Chronic inflammation in PsA can contribute to insulin resistance, a precursor to type 2 diabetes.
Individuals with PsA, particularly those on immunosuppressive therapies, face an increased risk of infections like pneumonia. These medications can weaken the immune system, making the body more susceptible to bacterial, viral, and fungal infections. Severe infections can lead to life-threatening complications.
Mental health issues, such as depression and anxiety, are prevalent in people with PsA. Chronic pain and the disease’s impact on daily life can contribute to these conditions. While not a direct cause of death, severe depression can indirectly affect health outcomes by impacting adherence to treatment plans.
Other organ involvement can also contribute to health risks. For example, some medications used to treat PsA can affect the liver or kidneys. These side effects add to the complexity of care and can lead to serious complications if not monitored.
Factors Affecting Individual Risk
Several factors can influence an individual’s mortality risk with psoriatic arthritis. The severity and activity of the disease play a role, with extensive skin involvement or severe joint damage correlating with higher risk. Higher levels of acute phase reactants, which indicate inflammation, have also been associated with increased mortality.
The duration of the disease and any delay in diagnosis or treatment can also affect outcomes. Long-standing PsA, for instance, has shown an increased mortality risk compared to controls. This suggests that cumulative effects from chronic systemic inflammation over time can contribute to higher risk.
The presence of other pre-existing comorbidities affects an individual’s risk. Conditions like obesity, smoking, and high blood pressure, when combined with PsA, can compound health risks. Chronic kidney disease, for instance, increases the risk of death in PsA patients.
Adherence to treatment and lifestyle choices are also influential. Patients who consistently follow their medical regimen and adopt healthy lifestyle practices may experience better disease control and reduced risk. Conversely, poor adherence or unhealthy habits can exacerbate inflammation and contribute to negative health outcomes.
Reducing Mortality Risk Through Management
Proactive strategies and consistent interventions can mitigate the mortality risks associated with psoriatic arthritis. Early diagnosis and consistent, appropriate medical treatment are important. This includes disease-modifying antirheumatic drugs (DMARDs) and biologics, which target the inflammatory pathways involved in PsA. Effective management of inflammation can help prevent or reduce the development of comorbidities.
Managing existing comorbidities is also a key part of risk reduction. Regular screening for cardiovascular disease, diligent blood pressure control, and effective diabetes management are important. Healthcare providers should routinely monitor these conditions to intervene early.
Lifestyle modifications play an important role in improving prognosis. Adopting a healthy diet, engaging in regular physical activity, and quitting smoking can reduce cardiovascular risk and improve overall health. Limiting alcohol intake also supports liver health and reduces potential interactions with medications.
Regular monitoring and follow-ups with healthcare providers are necessary to track disease activity, assess treatment effectiveness, and screen for new or worsening comorbidities. This ongoing oversight allows for timely adjustments to treatment plans and proactive management of emerging health concerns. Addressing mental health proactively, through therapy or medication, can also improve overall well-being and adherence to physical health treatments.