Beta-Blockers Not Linked to Increased Psoriasis Risk, Study Finds

A new multi-method analysis challenges long-standing concerns regarding beta-blockers and their role in triggering or worsening psoriasis. Using data from the US National Health and Nutrition Examination Survey (NHANES), the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS), and Mendelian randomization, researchers found no clinically meaningful association between beta-blocker use and psoriasis risk.

While isolated case reports have implicated beta-blockers as potential triggers, epidemiologic evidence has been inconsistent. In this study, investigators applied propensity score matching and multivariable logistic regression to US NHANES data and found no significant link between beta-blocker use and psoriasis development (odds ratio [OR]: 1.49; 95% CI: 0.76–2.92; P = 0.250).

The team also analyzed data from the FDA’s FAERS dashboard, identifying 300 psoriasis-related reports involving beta-blockers. However, no safety signal was detected (reporting odds ratio: 0.34; 95% CI: 0.30–0.38), even after accounting for possible false negatives.

Importantly, a two-sample Mendelian randomization study—designed to assess potential causal relationships—showed a small but statistically significant association between beta-blocker use and a reduced risk of psoriasis (OR: 0.9985; 95% CI: 0.9978–0.9991; P < 0.001).

“The observed epidemiological association likely stems from confounding by cardiovascular indications for beta-blockers, rather than a direct causal effect,” the authors noted.

They emphasized the complexity of neuroimmune pathways involving sympathetic activity and β1/β2 adrenergic receptors on immune cells and keratinocytes, which may theoretically influence psoriatic pathways but are not yet well understood.

For dermatologists, the key takeaway is that routine use of beta-blockers should not be considered a psoriasis risk factor in most patients. As the authors concluded, “We found that beta-blockers did not significantly elevate the risk of psoriasis. In clinical practice, labeling beta-blockers as drug-induced psoriasis may be inappropriate.”

This study supports a more nuanced approach to patient counseling and medication management, particularly for individuals with comorbid cardiovascular disease and psoriasis.

Reference
Zheng X, Sun J, Wang Z, Cao K, Feng C, Lv R. Revisiting the association between beta-blockers and psoriasis: evidence from real-world data. Endocr Metab Immune Disord Drug Targets. Published online August 26, 2025. doi:10.2174/0118715303383036250807095142