TOPLINE:

An analysis comparing patients with psoriasis prescribed biologic agents with those prescribed nonbiologic systemic treatments found biologics were associated with a reduced risk for inflammation of the ocular surface and cornea. The most notable reductions were seen in dry eye disease, conjunctivitis, and keratitis, with protective effects lasting up to 10 years.

METHODOLOGY:

• Researchers performed a large-scale retrospective cohort study using the TriNetX Global Collaborative Network to assess whether biologic therapy is associated with a reduced risk for ocular diseases in patients with psoriasis.
• They compared 25,278 patients with psoriasis initiating biologic therapy with an equal number of matched patients receiving nonbiologic systemic agents (methotrexate, cyclosporine, acitretin, apremilast, and dimethyl fumarate); the mean age of patients was roughly 50 years, and more than half were female.
• The analyzed ocular outcomes were grouped into three categories: external eye diseases, retinal and vitreous diseases, and cataract and other ocular diagnoses.
• For each cohort, the index event was the first recorded prescription of any listed medication.
• The follow-up period ranged from 6 to 120 months after the index date, during which ocular outcomes were assessed.

TAKEAWAY:

• Biologic therapy was associated with a reduced risk for conjunctivitis (hazard ratio [HR], 0.71; P = .01), dry eye syndrome (HR, 0.55; P = .0007), and keratitis (HR, 0.40; P = .0007), with these associations persisting throughout the 10-year window of analysis.
• Biologic therapy was not consistently associated with a reduced risk for retinal or vitreous disease.
• In patients with arthropathic psoriasis, biologic therapy was associated with lower risks for keratitis (HR, 0.70; P = .0009), age-related cataract (HR, 0.88; P = .011), age-related macular degeneration (HR, 0.72; P = .0001), glaucoma (HR, 0.86; P = .0499), and dry eye syndrome (HR, 0.83; P = .0008).

IN PRACTICE:

“Our findings indicate the importance of collaboration between dermatologists, rheumatologists, and ophthalmologists in the care of patients with psoriasis,” the researchers of the study reported.

SOURCE:

The study was led by Shoham Kubovsky and Natan Lishinsky-Fischer, Ophthalmology Department, Hadassah Medical Center, Jerusalem, Israel. It was published online on February 5 in Eye.

LIMITATIONS:

Diagnoses were based on standard codes derived from electronic health records, which may have been prone to misclassification or underreporting. Residual confounding related to disease severity, treatment adherence, and socioeconomic factors could not be excluded. The study’s use of broad diagnostic categories encompassing multiple subdiagnoses may have affected the validity of the results.

DISCLOSURES:

One author reported receiving speaker honoraria, consultancy fees, or travel support from various pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.