Psoriatic patients on biologic therapy not likely to be diagnosed with psychiatric illness

The risk of several medical and psychiatric illnesses is higher in patients with psoriasis, but those prescribed biologic agents are less likely to develop the latter as compared to those not prescribed medications, according to a study.

“Most likely because of treatment selection, individuals with psoriasis prescribed biologic therapy are not currently at increased risk of a psychiatric outcome,” the investigators said.

This retrospective electronic medical records cohort study sought to determine if patients with psoriasis or those exposed to biologics were more likely to develop a psychiatric illness.

A history of several medical (eg, cardiovascular diseases) and psychiatric (depression, suicide) illnesses was significantly more common among individuals with psoriasis than those without. Among patients with psoriasis, prescription of a biologic therapy resulted in a significantly lower likelihood of being diagnosed with a psychiatric illness (hazard ratio [HR], 0.52, 95 percent CI, 0.51–0.53; p<0.0001).

“With respect to any psychiatric illness, this finding was confirmed when comparing biologic therapy vs methotrexate treatment (HR, 0.80, 0.76–0.84; p<0.0001),” the investigators said.

A recent study also suggests that patients with moderate-to-severe psoriasis have a higher prevalence of psychiatric disorders than the general population, with a substantial incremental burden of treated anxiety or depression. Additionally, treatments that improve psychiatric symptoms appear to benefit patients and reduce their economic burden. [J Med Econ 2019;doi:10.1080/13696998.2019.1638788]

The present study was limited by findings that were likely attributable to treatment selection bias.