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The association between psoriasis, psoriasis severity, and inflammatory bowel disease: a population-based analysis
Uria Shani1,2,3, Niv Ben-Shabat2,3, Roula Qassem3,4
1Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Israel.
Therapeutic Advances in Gastroenterology
|January 29, 2024
Summary
Patients with psoriasis have a higher risk of developing inflammatory bowel diseases (IBD), with severe psoriasis significantly increasing this risk. Age, male gender, Jewish ethnicity, and certain spondyloarthropathies are also risk factors for IBD in psoriasis patients.
Area of Science:
- Dermatology and Gastroenterology
- Immunodermatology and Inflammatory Bowel Diseases
- Skin-Gut Axis Research
Background:
- The skin-gut axis describes bidirectional communication between the skin and gastrointestinal tract.
- This axis is implicated in the pathogenesis of psoriasis and inflammatory bowel diseases (IBD).
- Understanding the link between psoriasis and IBD is crucial for patient management.
Purpose of the Study:
- To investigate the association between psoriasis and IBD.
- To identify predictors of IBD development in individuals with psoriasis.
- To explore the influence of psoriasis severity on IBD risk.
Main Methods:
- Retrospective cohort study utilizing an electronic health database (Meuhedet Health Maintenance Organization, Israel).
- Psoriasis severity categorized based on treatment (systemic agents or phototherapy).
- Logistic regression analyses performed to identify IBD predictors, adjusting for confounders.
Main Results:
- A cohort of 61,003 adult psoriasis patients was analyzed.
- Psoriasis patients exhibited a significantly higher prevalence of IBD (2.4%) compared to the non-psoriasis group (1.6%), with an adjusted OR of 1.47 (p < 0.001).
- Severe psoriasis showed a markedly higher likelihood of IBD (OR: 16.03, p < 0.001); increased age, male gender, Jewish ethnicity, psoriatic arthritis, and ankylosing spondylitis were significant risk factors.
Conclusions:
- A significant association exists between psoriasis and IBD, including Crohn's disease and ulcerative colitis.
- Psoriasis severity, indicated by treatment modality, appears to influence the risk of developing IBD.
- These findings suggest a need for heightened monitoring of IBD in patients with severe psoriasis.
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