Biologic Psoriasis Treatment May Prevent Ocular Surface Disease

Psoriasis is a prominent manifestation of systemic inflammatory processes that can also include ocular ones such as AMD, blepharitis and dry eye. This study found secondary benefits for some anterior segment inflammatory conditions in psoriasis patients treated with biologics. Photo: Cleveland Clinic. Click image to enlarge. The autoimmune skin condition psoriasis has links to ocular conditions, though biologic therapy may reduce its ocular impact, researchers say.Using patient medical data from the TriNetX database, the researchers examined hazard ratios (HRs) for treatment progression from patients diagnosed with psoriasis, who they split into two groups: Those in the biologic group were prescribed TNF inhibitors, IL-12/23 inhibitors, IL-17A inhibitors, IL-17A/F inhibitors and IL-23 inhibitors, and those in the non-biologic group were prescribed methotrexate, cyclosporine, acitretin, apremilast or dimethyl fumarate. They excluded patients with no follow-up or a follow-up period of less than six months, ending with a total of 30,911 biologic patients and 35,832 non-biologic patients. In addition, they included an assortment of other conditions—such as appendicitis, wrist and hand fractures, and dental cavities—as negative control outcomes in order to monitor how psoriasis affected non-ocular biological functions.In total, 73.1% of the patients receiving biologic treatments were white and 52.7% were female. Among those not receiving biologics, 59.4% were white and 55.3% were female. Other factors that the researchers considered within the data included nicotine use, steroid use, diabetes and a family history of ocular disorders. Results indicated that “across all intervals, biologic therapy was consistently associated with lower HRs for corneal and external eye diseases, including keratitis, blepharitis and conjunctivitis,” the researchers wrote in Eye, remaining consistent “from six months to 120 months.” The reduction did not apply to all observed ocular conditions, however—retinal and vitreous diseases had average hazard ratios “approaching 1.0 in longer follow-up.” The negative control outcomes also remained largely unaffected, with the researchers claiming that there was no difference among them after treatment.The study’s most prominent limitation was its use of data primarily from the US, Europe and Middle East (EMEA). The researchers explained that although they looked at data from the Asia-Pacific and Latin-America regions, “[o]nly the US and EMEA networks contained sufficient data,” a reduction that may have led to data that does not accurately represent the treatment experiences of a diverse worldwide population.Perhaps the study’s most relevant outcome is the necessity of observing how psoriasis and other skin conditions affect eye health and factoring in ocular issues when creating psoriasis treatment plans for patients. Because psoriasis is linked to eye disease, dermatologists and others who address the condition should be made aware of what other harms come with it and refer patients to optometric practices appropriately before they experience vision damage or permanent vision loss.Click here for the journal source. Kubovsky S, Lishinsky-Fischer N, Chowers I, et al. Biologic therapy is associated with reduced ocular disease in psoriasis: a real-world study. Eye. January 26, 2026. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.