Psoriasis Patients Face Higher Risk of ANCA-Associated Vasculitis, Study Finds
Taiwan: Patients with psoriasis face a significantly higher risk of developing anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), a recent study published in ImmunoTargets and Therapy has shown.
"We found that psoriasis was linked with increased risks of eosinophilic granulomatosis with polyangiitis (hazard ratio [HR] 1.84) and granulomatosis with polyangiitis (HR 2.11) compared with matched controls. Notably, the use of biologic therapy did not appear to raise the likelihood of developing AAV (HR 1.31)," the researchers reported. These findings highlight the need for vigilant monitoring of patients with psoriasis for early signs of vasculitis.
The study was conducted by Ran Cui and colleagues from the Department of Rheumatology and Immunology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. Using a large electronic health record (EHR) network, the researchers assessed whether individuals with psoriasis are more prone to AAV compared to the general population. AAV encompasses a group of rare autoimmune conditions, including eosinophilic granulomatosis with polyangiitis (EGPA), granulomatosis with polyangiitis (GPA), and microscopic polyangiitis (MPA), all of which are characterized by inflammation and damage of small- to medium-sized blood vessels.
For this purpose, Cui and team carried out a population-based, propensity score-matched study spanning 2006 to 2024. The analysis included 436,201 psoriasis patients and an equal number of non-psoriasis controls. Individuals with a prior diagnosis of AAV were excluded. The risk of AAV was assessed using Cox proportional hazard models, while the cumulative incidence of AAVs was visualized through Kaplan–Meier survival curves. The impact of biologic therapies on vasculitis risk was also examined.
The study led to the following findings:
- During follow-up, 281 new cases of AAV occurred in psoriasis patients compared with 122 cases in the non-psoriasis group.
- The overall risk of AAV was nearly doubled in psoriasis patients (HR 2.01).
- The risk of eosinophilic granulomatosis with polyangiitis (EGPA) was higher in psoriasis patients (HR 1.84).
- The risk of granulomatosis with polyangiitis (GPA) was also significantly elevated (HR 2.11).
- No significant increase in AAV risk was observed in patients receiving biologic therapy, indicating that biologics may not contribute to vasculitis onset.
The researchers note that while the study provides robust evidence due to its large sample size and propensity score matching, the authors cautioned about certain limitations. Misclassification of diagnoses within the EHR system cannot be completely excluded. The severity of psoriasis was not accounted for, as relevant data were unavailable. Additionally, the study design did not allow for exploration of a causal relationship between psoriasis and AAV due to the absence of genetic data.
The findings suggest that psoriasis may predispose patients to vasculitic conditions, warranting greater clinical awareness and early detection strategies. At the same time, biologic agents, a cornerstone of modern psoriasis therapy, do not appear to increase this risk. The researchers recommend that further studies explore the underlying mechanisms linking psoriasis to vasculitis and confirm these associations across diverse patient populations.
Reference:
Cui R, Wang Q, Kang ZJ, Du Y, Chen M, Wang YH, Wei JC, Dai S. Psoriasis Increases the Risk of ANCA Associated Vasculitis: Insights from A Propensity Score-Matched Study. Immunotargets Ther. 2025;14:1087-1095. https://doi.org/10.2147/ITT.S527251
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