Antihypertensive drug use and psoriasis: A systematic review, meta- and network meta-analysis

Gonjin Song, Ha Young Yoon, Jeong Yee, Myeong Gyu Kim, Hye Sun Gwak

Research output: Contribution to journalReview articlepeer-review

Abstract

Aims: Diverse genetic and/or external factors may induce psoriasis. Drug exposure is 1 such prominent external factor; antihypertensive drugs are reportedly associated with psoriasis, but study results have been inconsistent. In this context, we investigated the associations between antihypertensive drugs and incidence if psoriasis via a systematic literature review and meta-analysis. Methods: Literature search in databases such as PubMed, Embase and Web of Science was conducted on 8 January 2021, and obtained data were pooled for meta- and network meta-analysis. Fixed- or random effect models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for evaluating the strength of the associations between antihypertensive drugs and psoriasis incidence. In addition to meta-analysis, Bayesian network meta-analysis was performed. ResultsThirteen eligible studies were included for meta-analysis with 6 378 116 individuals and 8 studies for network meta-analysis with 5 615 918 individuals. All antihypertensive drugs were significantly associated with psoriasis incidence. In a meta-analysis, the pooled ORs were 1.67 (95% CI: 1.31–2.13) for angiotensin-converting enzyme (ACE) inhibitors, 1.40 (95% CI: 1.20–1.63) for β-blockers, 1.53 (95% CI: 1.23–1.89) for calcium-channel blockers (CCBs), and 1.70 (95% CI: 1.40–2.06) for thiazide diuretics. For the comparative risks of psoriasis among antihypertensive drugs in the network meta-analysis, ORs were 2.09 (95% CI: 1.39–3.18) for ACE inhibitors, 1.35 (95% CI: 0.99–1.91) for BBs, 1.53 (95% CI: 1.07–2.24) for CCBs and 1.80 (95% CI: 1.23–2.66) for thiazide diuretics. Conclusion: This study confirmed the associations between antihypertensive drugs and psoriasis; ACE inhibitors, BBs, CCBs and thiazide diuretics increased the risk of psoriasis. Therefore, antihypertensive drug users should be carefully monitored for psoriasis.

Original languageEnglish
JournalBritish Journal of Clinical Pharmacology
DOIs
StateAccepted/In press - 2021

Keywords

  • adverse events
  • antihypertensive drugs
  • meta-analysis
  • network meta-analysis
  • psoriasis
  • systematic review

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