Abstract
ObjectiveTo evaluate whether the risk of subsequent psoriasis and psoriatic arthritis development is increased in patients with uveitis.MethodsIn Taiwan’s national health insurance research database, we identified 195,125 patients with new-onset uveitis between 2001 and 2013. We randomly selected 390,250 individuals without uveitis who were matched 2:1 to uveitis cases based on age, sex and year of enrolment. The characteristics of the two groups were compared. Using multivariate Cox regression, hazard ratios (HRs) for psoriasis or psoriatic arthritis corresponding to uveitis were computed after adjustment for age, sex, insurance cost and comorbidities. In subgroup analyses, separate HRs for mild psoriasis, severe psoriasis and psoriatic arthritis were calculated.ResultsThe mean age of the study cohort was 50.2 ± 17.2 years. Hypertension, diabetes, hyperlipidaemia and obesity were more prevalent in the uveitis group (all p < 0.0001). The hazard of psoriasis or psoriatic arthritis development was significantly greater in the uveitis group than in the non-uveitis group (p < 0.0001); this increased risk persisted after adjustment for confounders [adjusted HR = 1.41; 95% confidence interval (CI), 1.33–1.48]. Adjusted HRs showed an increasing trend from mild psoriasis (1.35; 95% CI, 1.28–1.44) to severe psoriasis (1.59; 95% CI, 1.30–1.94) and psoriatic arthritis (1.97; 95% CI, 1.60–2.42).ConclusionsThis nationwide population-based cohort study revealed that patients with uveitis have an increased risk of subsequent psoriasis or psoriatic arthritis development.
Highlights
Uveitis is an intraocular inflammatory disease with many causes, such as infection, immune reaction, genetic predisposition and environmental precipitation
This nationwide population-based cohort study revealed that patients with uveitis have an increased risk of subsequent psoriasis or psoriatic arthritis development
Genetic studies have revealed a link between human leukocyte antigen (HLA)-B27 and uveitis [3, 4], indicating that uveitis may be a manifestation of systemic diseases associated with this antigen, such as spondyloarthropathies and reactive arthritis [5,6,7,8]
Summary
Uveitis is an intraocular inflammatory disease with many causes, such as infection, immune reaction, genetic predisposition and environmental precipitation. It is usually classified according to the main location of involvement in the eye. Leukocytes in the anterior chamber of the eye may be visible on slit-lamp examination. The intermediate and posterior forms of uveitis are diagnosed upon direct visualisation of chorioretinal inflammation and/or leukocytes in the vitreous by ophthalmoscopy. Higher levels of cytokines, such as interleukin (IL)-17 and tumour necrosis factor (TNF)α, have been found in the aqueous humour of patients with uveitis, suggesting that T [T helper (Th) and Th17] cells are involved in the immunopathogenesis of the disease [1, 2]. Genetic studies have revealed a link between human leukocyte antigen (HLA)-B27 and uveitis [3, 4], indicating that uveitis may be a manifestation of systemic diseases associated with this antigen, such as spondyloarthropathies and reactive arthritis [5,6,7,8]
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