Supplemental Material: Systemic therapy targeting psoriatic inflammation associates with decreased incidence of dementia: An observational retrospective cohort study.
Description
This is a retrospective observational cohort study conducted with TriNetx that examines elderly psoriasis patients and the impact of systemic therapies on the incidence of different types of dementia. Our hypotheses were 1. Psoriasis is associated with an increased likelihood of dementia and 2. Treatment with systemic therapies will attenuate the likelihood of developing dementia among patients with psoriasis. We utilized de-identified data from the TriNetX Research Network between 2005-2025. Individuals aged 65-95 without prior history of dementia were included in the analysis. Two primary cohorts were created: 1) psoriasis patients receiving systemic therapies and 2) psoriasis patients managed without systemic therapies and each matched 1:1 to a control group of patients without psoriasis. Primary outcomes were the incidence of Alzheimer’s disease, vascular, and nonvascular dementia assessed over a period of up to 20-years. We identified 4,378,994 patients without psoriasis, 45,713 untreated psoriasis patients, and 14,664 treated psoriasis patients. After meeting index event inclusion criteria and 1:1 PSM, cohorts were matched to their respective non-psoriasis controls (eTable3-8). Over a 20-year follow-up, untreated psoriasis patients were >33% more likely to develop Alzheimer’s (668 vs 474; OR=1.42[1.26-1.60]), vascular (415 vs 313; OR=1.33[1.15-1.54]), and nonvascular dementia (1,985 vs 1,498; OR=1.35[1.26-1.44]) compared to non-psoriasis patients (Table 1). Conversely, treated psoriasis patients were 38% less likely to develop Alzheimer’s (117 vs 189; OR=0.62[0.49-0.78]), 32% less likely to develop vascular dementia (85 vs 124; OR=0.68[0.52-0.90]), and 18% less likely to develop nonvascular dementia (454 vs 554; OR=0.82[0.72-0.93]) compared to non-psoriasis controls (Table 1). In conclusion, Untreated psoriasis is associated with a significantly higher likelihood of dementia compared to non-psoriatic individuals. However, in the presence of systemic therapy for psoriasis, the likelihood of dementia diagnosis is markedly reduced.