Increased Risk of Antiphospholipid Syndrome in Patients with Psoriasis: A Retrospective Cohort Study

Qian Wang¹Ran Cui¹Yu Du¹Yu Hsun Wang²James Cheng-Chung Wei³Sheng-Ming Dai^1*

• ¹Department of Rheumatology and Immunology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
• ²Department of Medical Research, Chung Shan Medical University Hospital,, Taichung, Taiwan
• ³Institute of Medicine, College of Medicine, Chung Shan Medical University, Taichung, Taiwan

Objectives Psoriasis is associated with systemic inflammation and immune dysregulation, raising concerns about its potential link to antiphospholipid syndrome (APS). However, evidence on the risk of APS in psoriasis patients remains limited. Materials and methods This retrospective cohort study utilized data from the TriNetX US Collaborative Networks (2002–2022). Propensity score matching (1:1) was performed to balance demographic variables, comorbidities, and medication use between 288,678 psoriasis and non-psoriasis patients. The univariate Cox proportional hazard model and subgroup analyses were used to estimate the hazard ratio for APS. The Kaplan-Meier method was used to plot the cumulative incidence curves. Results After matching, each cohort included 288,678 patients. Psoriasis patients exhibited significantly higher APS incidence (1,349 cases vs. 673 in controls; HR: 1.71, 95% CI: 1.56–1.88). Psoriatic arthritis (PsA) further amplified risk (HR: 1.91, 95% CI: 1.58–2.31). Subgroup analyses identified elevated APS susceptibility in older adults, females, Black/African American individuals, and those with chronic comorbidities. Conclusions Psoriasis and psoriatic arthritis are significant risk factors for APS, highlighting the need for targeted screening and management strategies in these populations.