Biologic Therapy Linked to Reduced Ocular Surface Disease Risk in Psoriasis
Overview
A large retrospective cohort study found that biologic therapy in psoriasis patients is associated with a lower risk of several ocular surface diseases compared to nonbiologic systemic treatments. The strongest protective effects were observed for dry eye disease, keratitis, and conjunctivitis, with benefits evident as early as 6 months and persisting up to 10 years.
Background
Psoriasis is a chronic inflammatory skin condition often requiring systemic therapy. Ocular complications, including dry eye disease and keratitis, are recognized comorbidities that can impact quality of life. Biologic therapies targeting specific immune pathways have transformed psoriasis management, but their effects on ocular outcomes remain incompletely understood. This study leveraged a large global database to compare ocular risks between biologic and nonbiologic systemic treatments in psoriasis patients.
Data Highlights
Parameter
Biologic Therapy Group
Nonbiologic Therapy Group
Sample Size
Patients
30,911
35,832
66,743 total
Follow-up Duration
6 months to 10 years
Ocular Outcomes Assessed
68 different conditions
Key Findings
Biologic therapy was associated with significantly lower risk of dry eye disease, keratitis, and conjunctivitis compared to nonbiologic systemic therapy.
Reduced risk for other external eye diseases such as blepharitis was also observed with biologics.
Variable reductions in glaucoma and age-related cataract risk were noted among biologic users.
No consistent overall reduction in retinal or vitreous diseases was found, though some regional analyses showed lower risk for age-related macular degeneration.
Outcomes may vary by biologic class, particularly for conjunctivitis and iridocyclitis.
Protective associations appeared by 6 months and persisted through 10 years of follow-up.
Clinical Implications
These findings suggest that biologic therapies may confer ocular protective effects in psoriasis patients, particularly for surface eye diseases. Clinicians should consider ocular risks when selecting systemic treatments and collaborate with ophthalmologists for comprehensive management. However, as the study is observational, causality cannot be confirmed, and individual patient factors must guide therapy decisions.
Conclusion
Biologic therapy in psoriasis is linked to a lower risk of several ocular surface diseases, supporting its potential role in reducing ocular comorbidities. Further prospective studies are needed to confirm these associations and clarify mechanisms.
References
Kubovsky et al. 2024 -- Biologic therapy and ocular outcomes in psoriasis
