Newly diagnosed psoriatic disease associated with autoimmune disease risk

Key takeaways:

• Individuals with psoriatic disease were at the highest risk for developing ankylosing spondylitis.
• Adjusted risk ratios showed higher psoriatic disease severity linked to an increased autoimmune disease risk.

Newly diagnosed psoriatic disease may bring with it a significantly increased risk for autoimmune disease incidences, according to a study.

“Consistent with the involvement of autoimmunity in the pathogenesis of psoriatic disease, various autoimmune diseases ... have been reported to be associated with psoriatic disease,” Joon Min Jung, MD, PhD, of the department of dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea, and colleagues wrote. “However, the association between psoriatic disease and autoimmune diseases has not been consistently reported in previous studies.”

In a population-based cohort study, Jung and colleagues investigated the association between psoriatic disease and autoimmune diseases as well as the risk for autoimmune diseases in patients that were newly diagnosed with psoriatic disease.

Using the Korean National Health Insurance Service database, they compiled data from 2007 to 2019 on 321,354 individuals with mild (79.4%) or moderate (20.6%) psoriatic disease and the same number of matched controls.

Results showed that individuals with psoriatic disease were at the highest risk for developing ankylosing spondylitis (adjusted HR = 2.32; 95% CI, 1.95-2.77) followed by Crohn’s disease (aHR = 1.95; 95% CI, 1.42-2.67) and systemic lupus erythematosus (aHR = 1.86; 95% CI, 1.34-2.57) compared with controls.

Individuals with psoriatic disease vs. controls were also more likely to develop ulcerative colitis (aHR = 1.65; 95% CI, 1.39-1.96), rheumatoid arthritis (aHR = 1.63; 95% CI 1.52-1.76) and alopecia (aHR = 1.41; 95% CI, 1.35-1.46).

Type 1 diabetes was also significantly associated with newly diagnosed psoriatic disease (aHR = 1.23, 95% CI, 1.11-1.37).

The incidence rates of all these autoimmune diseases were higher in both mild and moderate psoriatic severity groups compared with controls. However, in considering disease severity in adjusted models, the risk for rheumatoid arthritis (aHR, 1.53; 95% CI 1.39-1.7), ankylosing spondylitis (aHR, 1.52; 95% CI 1.23-1.87), and type 1 diabetes (aHR, 1.22; 95% CI 1.04-1.44) remained significantly higher in patients with moderate vs. mild psoriatic disease.

“In comparison with the findings of previous studies based on prevalent cases of psoriatic disease, the results of the current study strongly indicated a shared autoimmune-related pathomechanism between psoriatic disease and autoimmune diseases,” the authors concluded.