Increased risk of migraine in patients with psoriasis: A Danish nationwide cohort study

TY - JOUR

T1 - Increased risk of migraine in patients with psoriasis

T2 - A Danish nationwide cohort study

AU - Egeberg, Alexander

AU - Mallbris, Lotus

AU - Hilmar Gislason, Gunnar

AU - Skov, Lone

AU - Riis Hansen, Peter

N1 - Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

PY - 2015/11

Y1 - 2015/11

N2 - BACKGROUND: Psoriasis and migraine are common conditions with potential overlap of pathophysiological mechanisms. Both these diseases have been associated with increased cardiovascular risk but little is known about their interplay.OBJECTIVE: We sought to investigate the link between psoriasis, and the risk of new-onset migraine, in a nationwide cohort of the Danish population.METHODS: Data on all Danish citizens aged 18 years or older from January 1, 1997, to December 31, 2011, were linked at individual-level in nationwide registers. Incidence rates per 1000 person-years were calculated and crude and adjusted incidence rate ratios were estimated by Poisson regression models.RESULTS: The study comprised a total of 5,379,859 individuals, including 53,006 and 6831 patients with mild and severe psoriasis, respectively, and 6243 patients with psoriatic arthritis. Fully adjusted incidence rate ratios for migraine were 1.37 (95% confidence interval 1.30-1.45), 1.55 (95% confidence interval 1.29-1.86), and 1.92 (95% confidence interval 1.65-2.22) for mild psoriasis, severe psoriasis, and psoriatic arthritis, respectively. Stratification for sex revealed increased risk of migraine in both male and female patients.LIMITATIONS: We were unable to distinguish between subtypes of migraine, eg, migraine with and without aura.CONCLUSIONS: Psoriasis was associated with a disease severity-dependent increased risk of migraine independent of measured confounders. Further studies are warranted to determine the effects of antipsoriatic treatment on this association, and whether migraine modifies the psoriasis-associated risk of cardiovascular disease.

AB - BACKGROUND: Psoriasis and migraine are common conditions with potential overlap of pathophysiological mechanisms. Both these diseases have been associated with increased cardiovascular risk but little is known about their interplay.OBJECTIVE: We sought to investigate the link between psoriasis, and the risk of new-onset migraine, in a nationwide cohort of the Danish population.METHODS: Data on all Danish citizens aged 18 years or older from January 1, 1997, to December 31, 2011, were linked at individual-level in nationwide registers. Incidence rates per 1000 person-years were calculated and crude and adjusted incidence rate ratios were estimated by Poisson regression models.RESULTS: The study comprised a total of 5,379,859 individuals, including 53,006 and 6831 patients with mild and severe psoriasis, respectively, and 6243 patients with psoriatic arthritis. Fully adjusted incidence rate ratios for migraine were 1.37 (95% confidence interval 1.30-1.45), 1.55 (95% confidence interval 1.29-1.86), and 1.92 (95% confidence interval 1.65-2.22) for mild psoriasis, severe psoriasis, and psoriatic arthritis, respectively. Stratification for sex revealed increased risk of migraine in both male and female patients.LIMITATIONS: We were unable to distinguish between subtypes of migraine, eg, migraine with and without aura.CONCLUSIONS: Psoriasis was associated with a disease severity-dependent increased risk of migraine independent of measured confounders. Further studies are warranted to determine the effects of antipsoriatic treatment on this association, and whether migraine modifies the psoriasis-associated risk of cardiovascular disease.

KW - Adult

KW - Arthritis, Psoriatic

KW - Cohort Studies

KW - Comorbidity

KW - Denmark

KW - Female

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Migraine Disorders

KW - Psoriasis

KW - Risk Factors

KW - Severity of Illness Index

KW - Sex Factors

KW - Young Adult

U2 - 10.1016/j.jaad.2015.08.039

DO - 10.1016/j.jaad.2015.08.039

M3 - Journal article

C2 - 26386630

SN - 0190-9622

VL - 73

SP - 829

EP - 835

JO - American Academy of Dermatology. Journal

JF - American Academy of Dermatology. Journal

IS - 5

ER -