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Psoriasis increases uveitis risk by 80%, driven primarily by severe disease and coexisting spondyloarthritis.
According to the outcomes of a large population-based study, psoriasis substantially heightens the risk of developing uveitis, with disease severity and systemic inflammatory burden playing a central role.
In this analysis using electronic health records from Clalit Health Services, Israel’s largest healthcare organization, researchers evaluated 157,360 people with dermatologist-verified psoriasis and 156,927 age- and gender-matched controls between 2002 and 2024. Over a median follow-up of 12.6 years, the incidence of uveitis was considerably higher in the psoriasis group, with an adjusted hazard ratio (aHR) of 1.80, indicating an 80% increased risk compared to those without psoriasis.
Stratified analysis illustrated a clear severity-dependent pattern. Those with mild psoriasis exhibited no significant increase in uveitis risk (aHR 1.01). In contrast, those with severe psoriasis had a substantially elevated risk (aHR 1.59). The highest risk was noted in those with concomitant spondyloarthritis, where the risk more than doubled (aHR 2.21). Within the psoriasis cohort, multivariable logistic regression identified numerous independent determinants of incident uveitis, including spondyloarthritis, diabetes mellitus, systemic lupus erythematosus, and sarcoidosis
The findings of this retrospective cohort study reinforce the contribution of systemic immune dysregulation to ocular inflammation. Treatment-related analysis illustrated that exposure to biologic therapies was related to increased odds of uveitis. Notably, etanercept use was linked to a higher likelihood of uveitis (odds ratio 3.37). However, this association was likely influenced by confounding by indication, as biologics are typically prescribed for patients with more severe disease.
Overall, psoriasis-related uveitis risk is not uniform but is strongly influenced by disease severity and comorbid inflammatory conditions. Clinicians are advised to maintain heightened vigilance for ocular symptoms, particularly in those with severe psoriasis or coexisting spondyloarthritis, to enable early diagnosis and timely intervention.
Diagnostics (Basel)
Increased Risk of Incident Uveitis Among Patients with Psoriasis: A Nationwide Population-Based Cohort Study
Scott Ehrenberg et al.
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