Dementia Risk in Psoriasis Patients Treated with Biologics: A Propensity Score-matched Population-based Cohort Study

Abstract

Translational research and animal models suggest that psoriasis treatments may have neuroprotective effects and reduce dementia risk. This study evaluates the association between biologic therapies for psoriasis and dementia incidence. A retrospective cohort included patients aged 65 or older with psoriasis, divided into 2 groups: those receiving biologic therapy following systemic treatment and those on systemic treatment alone. Patients with prior dementia were excluded. Dementia diagnosis was assessed at least 12 months after biologic initiation. Propensity score matching yielded 1,766 patients (883 per group). Biologic therapy was associated with a 53% reduced dementia risk (hazard ratio 0.47, 95% confidence interval 0.323-0.699), supported by a multivariate Cox model (adjusted hazard ratio 0.52, 95% confidence interval 0.392-0.699). These findings suggest that biologic therapies targeting tumour necrosis factor-alpha, interleukin-17, and interleukin-23 may reduce the risk of dementia, even after adjusting for age and other confounders.

Fig. 1

Flow diagram of patient selection process. The initial cohort included 151,919 patients. After applying inclusion and exclusion criteria, 883 patients were retained in the study group, with 4,797 matched controls.

Fig. 2

Cumulative incidence of dementia in propensity score-matched patients with psoriasis. The blue curve represents patients treated with biologic therapies following systemic treatment, while the red curve represents patients treated with systemic therapy alone. Hazard ratio=2.11, 95% confidence interval 1.43–3.10.