For psoriasis patients, treatment with biologics was associated with a reduced incidence of depressive symptoms compared to conventional therapy, according to findings from the PSOLAR study published in the Journal of the American Academy of Dermatology.

While several studies have shown that patients with psoriasis may be at increased risk for depression and suicidality, few have looked into the impact of treatment on risk. For this study, the researchers used a study population within the Psoriasis Longitudinal Assessment and Registry to measure the incidence of depressive symptoms and adverse events of depression. Patients were grouped based on treatment received (biologics, conventional systemic therapies, or phototherapy) and were evaluated at 6-month intervals. 

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The researchers found that the incidence rates of depressive symptoms were 3.01 per 100 patient-years (PYs) (95% CI, 2.73–3.32) for biologics, 5.85 per 100 PYs (95% CI, 4.29–7.97) for phototherapy, and 5.70 per 100 PYs (95% CI, 4.58–7.10) for conventional systemic therapies. Biologics were associated with a reduced risk for depressive symptoms, when compared with conventional therapy (hazard ratio [HR], 0.76; 95% CI, 0.59–0.98). Of the biologics evaluated, the strongest association was found with adalimumab; ustekinumab and infliximab also trended toward lower risk, but the association was not statistically significant.  

With regard to adverse events of depression, the incidence rates were 0.21 per 100 PYs (95% CI, 0.15–0.31), 0.55 per 100 PYs (95% CI, 0.21–1.47), and 0.14 per 100 PYs (95% CI, 0.03–0.55) for biologics, phototherapy, and conventional therapy, respectively.

“Overall, this study contributes to the body of literature suggesting that treatment with biologic agents may reduce the risk for development of depressive symptoms among patients with moderate-to-severe psoriasis,” the authors concluded. Future studies are needed to better understand this relationship in order to better optimize treatment in patients with psoriasis.

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