Researchers have uncovered a bidirectional relationship between psoriatic disease – psoriasis and psoriatic arthritis – and uveitis, with either condition significantly increasing the risk of the other.
A Danish nationwide cohort study of 74,129 individuals with psoriasis, including 6,735 with psoriatic arthritis, showed that patients with mild psoriasis had a 38% increased risk of uveitis, while those with psoriatic arthritis had a 2.5-fold increase in risk and those with psoriatic spondylitis had a greater than eight-fold increased risk, according to a paper published online in JAMA Dermatology.
Elsevier 2009
There was a nonsignificant increase in the risk of uveitis in patients with severe psoriasis, but this failed to reach significance because of the small number of patients.
Similarly, patients with uveitis had a 59% greater risk of mild psoriasis, a twofold greater risk of severe psoriasis, a nearly fourfold increase in the risk of psoriatic arthritis, and an eightfold increase in the risk of psoriatic spondylitis (JAMA Dermatol. 2015 July 29 doi: 10.1001/jamadermatol.2015.1986).
The authors suggested that an increased focus on eye symptoms in patients with psoriasis and psoriatic arthritis and on skin and joint symptoms in patients with uveitis may be appropriate.
“The bidirectional relationship between psoriasis and psoriatic arthritis and uveitis suggests a shared pathogenic pathway, and increased systemic inflammation may contribute to the observed relationship,” wrote Dr. Alexander Egeberg of Pfizer and his coauthors. Dr. Egeberg was at the University of Copenhagen, Hellerup, when the study was conducted.
The study was supported by Pfizer, the LEO Foundation, and the Novo Nordisk Foundation. One author is employed by Eli Lilly. No other conflicts of interest were declared.