Biologics in Psoriasis Linked to Lower Risk of Ocular Surface Diseases: Study

A new study published in the recent issue of Eye journal revealed that among patients with psoriasis, use of biologic drugs (advanced treatments that target specific components of the immune system) was associated with a lower risk of ocular surface conditions such as dry eye, conjunctivitis, and keratitis when compared to other systemic treatments. However the association with retinal and vitreous diseases remained less clear.

This study used data from over 160 million patients in the TriNetX Global Collaborative Network to explore whether biologic therapies might influence the risk of ocular disease in people with psoriasis.

The study compared over 30,000 adults with psoriasis who began biologic therapy to more than 35,000 patients treated with non-biologic systemic medications. The two groups were matched using propensity scoring based on demographic and clinical factors and tracked 68 different eye-related outcomes over periods ranging from 6 months to 10 years.

The risk of dry eye disease was nearly cut in half, with a hazard ratio of 0.55. Similarly, conjunctivitis risk was reduced by about 29%, and keratitis showed an even stronger reduction, with risk lowered by 60%. These findings revealed a consistent and significant reduction in the risk of several ocular surface conditions among patients receiving biologic therapies.

These protective associations appeared as early as 6 months after starting biologic treatment and remained evident throughout the decade-long follow-up period. This suggests that biologic therapies may offer sustained benefits beyond their known effects on skin symptoms and systemic inflammation.

However, the study did not find a consistent reduction in diseases affecting deeper structures of the eye, like the retina or vitreous body. While biologics may help protect the surface of the eye, their influence on more complex ocular conditions remains unclear.

Traditionally, treatment decisions have focused on skin clearance and reducing risks of cardiovascular or joint-related complications. This study suggests that eye health in conditions like dry eye and corneal inflammation, should also be part of the conversation. The findings caution that, as an observational study, these results do not prove causation. Still, the large sample size and long follow-up period strengthen the evidence for a potential protective effect.

Reference:

Kubovsky, S., Lishinsky-Fischer, N., Chowers, I., Ramot, Y., & Levy, J. (2026a). Biologic therapy is associated with reduced ocular disease in psoriasis: a real-world study. Eye (London, England), 40(5), 676–681. https://doi.org/10.1038/s41433-026-04274-x