Psoriasis tied to greater risk of serious infections
Accessing an electronic medical records database, researchers assessed 187,258 patients with mild psoriasis (mean age 46.4±17.5 years; 48.4 percent male) and 12,442 patients with moderate-to-severe disease (mean age 49.4±15.1 years; 48.7 percent male). Cox proportional hazards regression analyses were performed to evaluate the risk of serious infection according to psoriasis severity.
The incidence rate of psoriasis in patients without psoriasis (n=954,315) was 78.5 per 10,000 person-years, which was lower than that in all psoriasis patients (88.9 per 10,000 person-years). Analysis by disease severity showed that incidence rate was highest in those with moderate-to-severe vs mild psoriasis (145.7 vs 85.7 per 10,000 person-years).
This trend was confirmed through multivariable analysis, which showed that compared with no psoriasis controls, patients with moderate-to-severe psoriasis (adjusted hazard ratio [HR], 1.63; 95 percent CI, 1.52–1.75) are at a greater risk of serious infections than those with mild disease (adjusted HR, 1.18; 1.16–1.21).
The findings were further confirmed in a subsequent analysis of a second cohort that consisted of 83,543 no psoriasis controls, 4,437 mild psoriasis patients and 4,132 moderate-to-severe psoriasis patients.
Incidence of serious infections was likewise greatest in the mild-to-moderate psoriasis group relative to the mild and no psoriasis groups (110.9 vs 97.6 and 75.6 per 10,000 person-years; adjusted HR, 1.27; 1.10–1.47).