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Hidradenitis suppurativa may confer independent risk of all-cause mortality

Patients with hidradenitis suppurativa who were white, obese and/or aged 40 to 49 years had higher odds of mortality compared with control subjects, according to researchers.

“Hidradenitis suppurativa also has an overall comorbidity burden that is greater than that of psoriasis and that has been linked to mortality,” Amit Garg, MD, of the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, and colleagues wrote.

In the retrospective cohort study, researchers utilized a multi-health system data analytics and research platform encompassing 27 participating health care organizations and more than 56 million people. Of patients aged 18 to 90 years, researchers identified 13,289 patients with hidradenitis suppurativa (HS) and 685,573 controls.

The mean age of patients with HS was 42.6 years; 77% were women, 56.5% were white and 36.9% were black.

In patients with HS, the overall crude 5-year mortality rate was 2.4% (321 of 13,289) compared with 2.7% (18,508 of 685,573) among controls. After adjusting for age, sex and race, those with HS had a 77% (95% CI, 1.62-1.93) increase in mortality risk compared with controls.

Researchers discovered a 14% (95% CI, 1.01-1.28) increase in mortality risk for patients with HS, after accounting for BMI, smoking status and Charlson Comorbidity Index (CCI) score. Over the 5-year study period, researchers reported 3.1 more deaths per 1,000 patients (95% CI, 0.2-6.0) in the HS cohort.

When compared with control subjects, there were greater odds of mortality in:

• HS patients aged 40 to 49 years, 64% increase (95% CI, 1.26-2.12);
• white HS patients, 25% increase (95% CI, 1.07-1.46);
• obese HS patients, 20% increase (95% CI, 1.03-1.40); and
• HS patients with a CCI score of at least 5, 31% increase (95% CI, 1.08-1.59).

As for study limitations, the researchers could not establish causation of mortality. In this cohort, patients may have had more severe disease.

“Although HS imparts an independent mortality risk, prevention, early identification and management of modifiable factors may decrease mortality among patients with HS,” Garg and colleagues wrote.

Previous researchers have suggested that chronic inflammation may predispose patients to accelerated atherosclerosis and increased cardiovascular mortality, according to researchers. – by Abigail Sutton

Disclosures: Garg reports he has served as an advisor for AbbVie, Asana Biosciences, Janssen, Pfizer and UCB and has received honoraria. The other authors report no relevant financial disclosures.