Association of Multiple Sclerosis with Psoriasis: A Systematic Review and Meta-Analysis of Observational Studies

Am J Clin Dermatol. 2019 Apr;20(2):201-208. doi: 10.1007/s40257-018-0399-9.

Abstract

Background: Previous studies have reported the occurrence of psoriasis together with multiple sclerosis (MS). Although similar predisposing genes and pathomechanisms have been hypothesized, the relationship between the two remains obscure.

Objective: The aim of this systematic review and meta-analysis was to investigate the association between psoriasis and MS.

Methods: We searched MEDLINE, Embase, and CENTRAL in July 2018 for case-control, cross-sectional, or cohort studies that examined either the odds or risk of psoriasis in subjects with multiple sclerosis. The risk of bias of included studies was assessed using the Newcastle-Ottawa Scale. A random-effects model meta-analysis was used to calculate the odds ratio (OR) for case-control/cross-sectional studies and hazard ratio (HR) for cohort studies.

Results: We included 10 publications that reported a total of 11 studies (5 case-control, 4 cross-sectional and 2 cohort studies). The case-control and cross-sectional studies included 18,456 MS patients and 870,149 controls, while the two cohort studies involved 25,187 MS patients and 227,225 controls in total. Three studies were rated with a high risk of bias in comparability, non-response rate, and selection of controls. MS was associated with increased odds (OR 1.29; 95% confidence interval [CI] 1.14-1.45) and risk for psoriasis (HR 1.92; 95% CI 1.32-2.80).

Conclusion: Patients with MS display both increased prevalence and incidence of psoriasis.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Animals
  • Bias
  • Humans
  • Incidence
  • Multiple Sclerosis / complications
  • Multiple Sclerosis / epidemiology*
  • Prevalence
  • Psoriasis / epidemiology*
  • Psoriasis / etiology
  • Research Design*
  • Risk