Page 12 - Vasoclick emagazine Issue2

Had an exposure group that had patients with
Association of Psoriasis with Incident Venous Thromboembolism and Peripheral Vascular Disease
psoriasis, and outcomes of interest (VTE and
PVD). 2
The adjusted risk estimates, including hazard
ratios (HRs), risk ratios (RRs), and
standardized incidence ratios (SIRs), with 95%
confidence intervals (CIs). 2
Data Synthesis:
The meta-analyses were conducted using
Review Manager version 5.4.1 (The Cochrane
Collaboration), and Stata, version 17
(StataCorp). A P value of <0.05 was defined as
statistically significant. 2
HRs and SIRs were used for meta-analysis to
analyse risk for the entire study period. The
adjusted risk estimates of subgroups were
pooled when overall effects were not Figure 1: Study selection for qualitative review
available. 2
Crude risk estimates with 95% CI were
calculated when not available in the studies. 2
I statistic was used to quantify between-study Risk for Incident VTE:
2
heterogeneity with I >50% indicating moderate
2
heterogeneity. 2
Results:
Study Selection and their characteris-
tics:
A total of 1836 records were retrieved from
the literature search, 13 cohort studies
(12,435,982 participants) out of which were
selected for qualitative review (Figure 1).
Out of the 13 studies selected, 9 (69.2%)
reported the risk estimates of incident VTE,
and 4 (30.8%) reported the risk estimates of
incident PVD (Figure 1).
This review and meta-analysis followed the
psoriasis and a non-exposure group that had
Meta-analysis of Observational Studies in
patients without psoriasis.
Epidemiology (MOOSE) reporting guideline
4
Reported the risk estimates of VTE and/or
group19 and the Preferred Reporting Items for
PVD.
Systematic
Meta-analyses
and
Studies with confirmed clinical diagnoses of
(PRISMA) reporting 2020 guideline.
5
psoriasis, VTE, and PVD.
Data Sources:
Studies excluded:
MEDLINE, Embase, Cochrane Library, Web of
Cross-sectional studies, case-control studies,
Science, and the Cumulative Index to Nursing
case reports, editorials, review articles, and
and Allied Health Literature were searched for
nonhuman studies were excluded.
publications that studied the associations of
2
psoriasis with VTE or PVD from their
Data Extraction:
respective inception to May 21, 2021.
2
First author, year of publication, country,
database, study period, patient characteristics
Study Selection Criteria:
(sample size, mean age, and sex), definition of
Cohort
studies
11 Methods: Reviews that examined the associations of psoriasis with VTE or PVD.
There were 9 (69.2%) studies that reported The pooled risk estimates differed with incident VTE in patients with psoriasis but
HR or SIR and were selected for quantitative geographic locations, with studies done in not in the US (Table 1).
2
meta-analysis (Figure 1). Asia and Europe showing an increased risk of
1836 records identified
13 studies selected
Qualitative Quantitative
review Meta-analysis
VTE: 7
VTE:9
PVD:4 PVD: 2
and quantitative meta-analysis 2
VTE: Venous Thromboembolism PVD: Peripheral vascular disease
Based on the 9 studies (12,052,781
participants) examined, patients with
psoriasis had a 1.26-fold increased risk for
incident VTE than those without psoriasis
(pooled HR, 1.26; 95%, CI 1.08-1.48; I = 93%)
2
(Figure 2). 2
The association remained significant in
patients with psoriatic arthritis but did not
increase significantly in patients with
psoriasis alone (Table 1). 2
The studies done on women showed an
increased risk for VTE as opposed to those
done on men(Table 1). 2