Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Risk of Chronic Fatigue in Psoriasis

Psoriasis is associated with an elevated risk of subsequent chronic fatigue syndrome (CFS), which is differentiated by sex and age, a new study found. 2,616 patients aged ≥20 years with newly diagnosed psoriasis during 2004-2008 and 10,464 participants without psoriasis were identified. Both groups were followed up until the diagnoses of CFS were made at the end of 2011. Researchers found:

  • The incidence density rates were 2.27 and 3.58 per 1,000 person-years among the non-psoriasis and psoriasis populations, respectively.
  • In stratified analysis, the psoriasis group were consistently associated with a higher risk of CFS in male sex and age group of ≥60 years (hazard ratio, 2.32).
  • Significantly increased risk of CFS among patients with psoriasis was attenuated after they received phototherapy and/or immunomodulatory drugs.

Citation:

Tsai SY, et al. Increased risk of chronic fatigue syndrome following psoriasis: A nationwide population-based study. [Published online ahead of print May 14, 2019]. J Transl Med. doi:10.1186/s12967-019-1888-1.

Commentary:

This retrospective cohort study reports that psoriasis significantly increases the incidence of chronic fatigue syndrome compared with the control group. Fatigue is symptom that has largely gone unrecognized when inquiring about signs and symptoms in psoriatic patients. Fatigue is more commonly associated with people with psoriatic arthritis and elevated levels of inflammatory markers such as C-reactive protein. Often times, systemic or biologic therapy can make a person feel less tired at the beginning of therapy. Previous clinical trials with biologic agents that target tumor necrosis factor have shown reductions in the severity of fatigue in psoriasis patients. Further studies will be needed to address fatigue and its true correlation in psoriasis with regards to psoriatic arthritis. —Paul S. Yamauchi, MD, PhD; Clinical Assistant Professor of Dermatology David Geffen School of Medicine at UCLA; Harbor-UCLA Medical Center Division of Dermatology; Adjunct Associate Professor John Wayne Cancer Institute.