Risk of stroke in patients with psoriatic disease: a systematic review and meta-analysis

Abstract

Stroke is a neurologic disease caused by sudden disturbance of cerebral blood circulation. Studies have shown that patients with psoriatic disease (PsD) (psoriasis and psoriatic arthritis (PsA)) may have an increased risk of stroke, but the results are inconsistent. The aim of this study was to provide an updated meta-analysis about the risk of stroke in PsD. Electronic databases was searched to identify relevant studies. Random-effects model was used to analyze the risk of stroke in patients with PsD. Subgroup analyses were conducted to identify sources of heterogeneity between studies and further explore risk relationships. This meta-analysis found an increased risk of stroke in patients with PsD, with the pooled relative risk (RR) of 1.23 (95% confidence interval (CI): 1.20-1.27). In subgroup analysis stratified by severity of psoriasis, the risk of stroke was higher in severe (RR = 1.42, 95% CI: 1.22-1.65) than in mild psoriasis (RR = 1.12, 95% CI: 1.03-1.21). In the subgroup analysis of stroke type, PsD patients had a greater risk of ischemic (RR = 1.49, 95% CI: 1.26-1.76) than hemorrhagic stroke (RR = 1.30, 95% CI: 0.80-2.11). The RRs of stroke in PsD patients from Asia, Europe, and the United States were 1.26 (95% CI: 1.08-1.46), 1.19 (95% CI: 1.08-1.31), and 1.28 (95% CI: 0.75-2.17), respectively. Patients with PsD have an increased risk of stroke. Severe psoriasis patients may have a higher risk of stroke than mild. Trial registration: This study was registered at international prospective register of systematic reviews (PROSPERO), registration number: CRD42022365700.