Dataset Information

Risk of Uveitis Among People With Psoriasis: A Nationwide Cohort Study.

ABSTRACT:

Importance

Uveitis has been associated with psoriatic arthritis, but to our knowledge, the relationship between uveitis and psoriasis is unsettled among researchers.

Objective

To evaluate the risk of incident uveitis among people with psoriasis.

Design, setting, and participants

This nationwide, retrospective cohort study conducted in Taiwan from January 1, 2000, to December 31, 2012 included 147 954 people with psoriasis (including 10 107 with concomitant psoriatic arthritis and 137 847 without psoriatic arthritis) and 147 954 nonpsoriatic controls.

Exposure

Psoriasis.

Main outcomes and measures

Risk of incident uveitis.

Results

The mean (SD) age of the 295 908 study participants was 44.4 (19.8) years, and 41.2% (n = 121 878) were women. We found that the group with severe psoriasis with psoriatic arthritis had the greatest risk of incident uveitis compared with the nonpsoriatic controls (adjusted hazard ratio, 2.40; 95% CI, 1.90-3.02). The group with severe psoriasis without psoriatic arthritis and the group with mild psoriasis with psoriatic arthritis also had an increased risk of incident uveitis (adjusted hazard ratio, 1.42; 95% CI, 1.23-1.64; and 1.42; 95% CI, 1.03-1.96; respectively). However, an increased risk for incident uveitis with mild psoriasis without psoriatic arthritis was not identified (adjusted hazard ratio, 1.09; 95% CI, 1.00-1.20).

Conclusions and relevance

People with severe psoriasis and those with mild psoriasis have an increased risk of uveitis. Clinicians may use this finding as a guide for uveitis risk stratification among patients with different inflammatory presentations on the spectrum of psoriatic disease.

SUBMITTER: Chi CC

PROVIDER: S-EPMC5846892 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND:Anterior uveitis is the most common extra-articular manifestation of ankylosing spondylitis (AS). AS-related anterior uveitis frequently presents as acute, recurrent iridocyclitis; therefore, AS is often initially suspected by an ophthalmologist, not by a rheumatologist. In this study, we aimed to investigate the relationship between the recurrence of anterior uveitis and the subsequent incidence of AS. METHODS:From a national sample cohort, 10,483 patients with new-onset uveitis between 2004 and 2013 and 52415 matched control subjects who had never experienced uveitis were selected. Among the patients with new-onset uveitis, a subpopulation of patients with recurrent uveitis, defined as a minimum 120-day reported interval between consecutive claims of uveitis (based on diagnostic codes) treated with local or systemic steroids or immune-modulating drugs, was identified. The incidence rates of AS were calculated according to the number of episodes of uveitis, and the incidence rate ratios (IRRs) were derived on the basis of the incidence rate in the control group. RESULTS:The incidence rate per 100,000 person-years of AS after the first uveitis episode was 121.5, whereas the incidence in the control group was 16.9 (IRR, 7.40; 95% CI, 4.99-10.98); after the second uveitis episode, the IRR increased to 17.71 (95% CI, 10.44-30.06). In male and female patients with recurrent uveitis, the incidence rates of AS were 284.1 and 268.7 per 100,000 person-years, respectively. In patients aged under 40 years, the IRR of the recurrent uveitis group was 46.78 (95% CI, 19.61-111.61). In patients aged over 59 years, AS incidence in the recurrent uveitis group did not differ from that in the control group. CONCLUSIONS:The risk of subsequent AS increased with the number of episodes of anterior uveitis. This quantitative evidence could contribute to the establishment of a rationale for ancillary workup for possible systemic associations in patients with recurrent uveitis.