Psoriasis and Increased Risk for Autoimmune Thyroid Disease

The rate of autoimmune thyroid disease (AITD) is significantly increased in patients with psoriasis, according to study data published in BMJ Open.

Researchers conducted a meta-analysis of the current evidence regarding the relationship between psoriasis and AITD after performing a literature search for relevant observational studies published before November 1, 2021. Eligible studies included at least 50 patients with psoriasis and control individuals.

A total of 11 studies with 253,313 patients with psoriasis and 1,376,533 control individuals were included in the final analysis. Among the included studies, 2 were cohort studies, 8 were case-controlled studies, and 1 was a cross-sectional study.

Patients with psoriasis had a higher prevalence of AITD compared with control individuals (odds ratio [OR] 1.76; 95% CI, 1.35 to 2.28; Z = 4.25; P < .01). The prediction interval was 0.79 to 2.73, with severe heterogeneity observed (I² = 92.72%).

Patients with psoriasis had a higher prevalence of hypothyroidism compared with control individuals (OR 1.21; 95% CI, 1.12-1.30; Z = 4.80; P < .01), with no significant heterogeneity (I² = 0.00%). Patients with psoriasis also had an increased prevalence of hyperthyroidism vs control individuals (OR 1.20; 95% CI, 1.12-1.30; Z = 4.78, P < .01), with no significant heterogeneity (I² = 0.00%).

A significantly higher rate of thyroglobulin antibodies (TgAb) was observed in patients with psoriasis vs control individuals (OR 1.98; 95% CI, 1.27-3.10; Z = 3.00; P < .01), with mild heterogeneity (I² = 41.54%). The positive rate of thyroid peroxidase antibodies (TPOAb) was significantly elevated in patients with psoriasis compared with control individuals (OR 2.15; 95% CI, 1.31-3.52; Z = 3.05; P < .01), with moderate heterogeneity (I² = 56.27%).

Among several study limitations cited by the researchers were that the included studies had different designs with considerable heterogeneity; drug exposure is a confounding factor.

“We recommend that every dermatologist be conscious of this association and suggest necessary examinations and intervention be considered as soon as possible when patients with psoriasis have suspicious AITD-related symptoms,” the study authors advised.

Reference

Zhang X, Zhang S, Wu R, Li S, Su Y, Zhang P. Prevalence of autoimmune thyroid disease in patients with psoriasis: a meta-analysis. BMJ Open. 2022;12(1):e055538. doi:10.1136/bmjopen-2021-055538