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Risk of Uveitis Among People With Psoriasis: A Nationwide Cohort Study
Ching-Chi Chi1, Tao-Hsin Tung2, Jui Wang3
1Department of Dermatology, Chang Gung Memorial Hospitals, Linkou, Taiwan2Department of Dermatology, Chang Gung Memorial Hospitals, Chiayi, Taiwan3College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Importance:
Uveitis has been associated with psoriatic arthritis, but to our knowledge, the relationship between uveitis and psoriasis is unsettled among researchers.
Objective:
To evaluate the risk of incident uveitis among people with psoriasis.
Design, Setting, And Participants:
This nationwide, retrospective cohort study conducted in Taiwan from January 1, 2000, to December 31, 2012 included 147 954 people with psoriasis (including 10 107 with concomitant psoriatic arthritis and 137 847 without psoriatic arthritis) and 147 954 nonpsoriatic controls.
Exposure:
Psoriasis.
Main Outcomes And Measures:
Risk of incident uveitis.
Results:
The mean (SD) age of the 295 908 study participants was 44.4 (19.8) years, and 41.2% (n = 121 878) were women. We found that the group with severe psoriasis with psoriatic arthritis had the greatest risk of incident uveitis compared with the nonpsoriatic controls (adjusted hazard ratio, 2.40; 95% CI, 1.90-3.02). The group with severe psoriasis without psoriatic arthritis and the group with mild psoriasis with psoriatic arthritis also had an increased risk of incident uveitis (adjusted hazard ratio, 1.42; 95% CI, 1.23-1.64; and 1.42; 95% CI, 1.03-1.96; respectively). However, an increased risk for incident uveitis with mild psoriasis without psoriatic arthritis was not identified (adjusted hazard ratio, 1.09; 95% CI, 1.00-1.20).
Conclusions And Relevance:
People with severe psoriasis and those with mild psoriasis have an increased risk of uveitis. Clinicians may use this finding as a guide for uveitis risk stratification among patients with different inflammatory presentations on the spectrum of psoriatic disease.