“The main finding of our study was a psoriasis severity-dependent increased risk of new-onset migraine, and patients with severe skin psoriasis and psoriatic arthritis appeared to have the highest risk,” Dr. Alexander Egeberg from Herlev and Gentofte Hospital in Hellerup told Reuters Health by email.
“Thus, focus on migraine in patients with psoriasis, including during cardiovascular risk assessments may be warranted,” he said.
Both psoriasis and migraine have been associated with cardiovascular disease, and their pathophysiological mechanisms may overlap, Dr. Egeberg and colleagues note in the Journal of the American Academy of Dermatology, online Sept. 16
The researchers collected data on all Danes over 18 from 1997 through 2011 using nationwide registers. During follow-up, they identified 66,080 patients with incident psoriasis and 220,970 with incident migraine.
Psoriasis was classified as mild in 53,006 patients and as severe in 6,831; 6,243 patients had psoriatic arthritis. The migraine incidence rate was 3.86 per 1,000 person-years for the reference population, 5.25 for those with mild psoriasis, 6.41 for those with severe psoriasis and 9.27 for those with psoriatic arthritis.
The fully adjusted rates in mild psoriasis, severe psoriasis and psoriatic arthritis were 1.37, 1.55 and 1.92, respectively, the researchers found. Risks were increased for both men and women.
The authors further note, “the psoriasis severity-dependent increased risk of migraine was independent of measured cardiovascular risk factors, eg, diabetes, hypertension, hyperlipidemia, and socioeconomic status, suggesting that shared pathogenic pathways may be located further upstream or downstream.”
The authors noted several limitations of the study, including inability to determine causality, and the facts that subtypes of migraine with or without aurora were not distinguished and that the Danish population is mostly Caucasian.
The study was supported by a grant from Pfizer. The authors report ties to Pfizer and other drugmakers.