{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T13:42:55Z","timestamp":1775050975263,"version":"3.50.1"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The debate persists regarding whether patients with psoriatic arthritis (PsA) face an increased risk of mortality. We aimed to ascertain the magnitude of all-cause mortality risk in patients with PsA compared to the general population through a systematic review and meta-analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a comprehensive search of PubMed, EMBASE, and the Cochrane Library for studies published from inception to June 2025. STATA meta-analysis software was used to calculate the pooled risk estimates for mortality, represented as the standardized mortality ratio (SMR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 4,502 articles identified in our research, 20 studies were included in the analysis. Overall, our findings revealed a 1.12-fold increased risk of death among patients with PsA compared to the general population (meta-SMR: 1.12, 95% CI 1.09-1.15). Subgroup analyses showed that mortality risks were elevated in Asian countries (meta-SMR: 1.28, 95% CI 1.04-1.57), in population-based studies (meta-SMR: 1.13, 95% CI 1.02-1.25), and among studies including over 1,000 patients (meta-SMR: 1.12, 95% CI 1.01-1.25). Malignancy, cardiovascular and cerebrovascular diseases, and infection\/respiratory diseases emerged as the most frequent causes of mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our analysis suggested modestly elevated mortality in patients with PsA compared to the general population, though heterogeneity warrants cautious interpretation. Malignancy, cardiovascular and cerebrovascular diseases, and infection\/respiratory disease were frequent causes of mortality and warrant further investigation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic review registration<\/jats:title><jats:p><jats:uri>https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:uri>, identifier CRD42021275209.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2025.1622159","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T05:27:25Z","timestamp":1755494845000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Mortality in patients with psoriatic arthritis: a systematic review and 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