High incidence of uveitis in patients with psoriatic disease

1. Patients with psoriasis and psoriatic disease were more likely to have uveitis and vice versa.

Evidence Rating Level: 2 (Good)

Study Rundown: Psoriasis is an inflammatory skin condition that in more severe cases may also involve the joints. Uveitis is an inflammatory disorder of the middle layer of the eye, which shares a similar immune response as psoriasis. While there is likely a relationship between these disorders, the risk of uveitis in patients with psoriasis or psoriatic arthritis has been limited. In a study aimed to better under this relationship, authors found a bi-directional association between both psoriasis and psoriatic arthritis with uveitis. The use of nationwide databases allowed for a large cohort for such analysis, which strengthened the study. However, the study was limited to the Danish population, which was previously known to have a higher burden of uveitis than other geographical areas, and therefore the group’s findings may not be generalizable to the general population.

Click to read the study in JAMA Dermatology

Relevant Reading: Sarcoidosis and Psoriasis: A case series and Review of the Literature Exploring Co-incidence vs Coincidence

In-Depth [retrospective cohort]: Nation-wide databases in Denmark were utilized to identify 74,129 cases of psoriasis and psoriatic arthritis and 13,114 cases of uveitis. Over five million patients were used in the reference comparison groups for both the populations at risk for psoriatic disease and at risk for uveitis. The cohort included relevant patients from the entire Danish population greater than 18 years of age starting from January 1997 until December 2011. Because authors wanted to better understand the temporal relationship between exposure and outcome, patients who already carried a diagnosis of psoriasis or uveitis at baseline were excluded from the study. The incidence ratio (IR) of uveitis in the reference population, in those with mild psoriasis, severe psoriasis and psoriatic arthritis, respectively was 2.02 (1.99-2.06); 2.88 (2.33-3.56); 4.23(2.40-7.45), and 5.49 (3.36-8.96). Adjusted IRs for uveitis in patient’s with mild psoriasis, severe psoriasis, and psoriatic arthritis was 1.38 (1.11-1.70, p= 0.02); 1.40 (0.70-2.81, p=0.34); and 2.50 (1.53-4.08, p<0.001), respectively.

Image: PD

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