New research from Italy indicates that patients with psoriasis who have been treated with biologic therapies may have a lesser risk of developing psoriatic arthritis compared to those treated with phototherapy.
The researchers reported that "the delay between the onset of skin manifestations of psoriasis and joint disease may provide a therapeutic window of clinical opportunity for preventing the progression from psoriasis to PsA."
The study, published online ahead of print in Annals of the Rheumatic Diseases (June 18, 2021), looked at a total of 464 patients treated with biological disease-modifying antirheumatic drugs (bDMARDs) (n=234) and narrow-band UVB (n=230) who were followed between January 2012 and September 2020.
The patients all had at least five years of bDMARDs or at least three nb-UVB phototherapy courses and did not have a diagnosis of PsA at study enrolment. A rheumatologist assessed each patient for the development of PsA using the Classification for Psoriatic Arthritis criteria. The hazard risk of developing PsA was assessed using Cox proportional hazards models after adjustment for confounders.
In this study, variables independently associated with a higher risk of PsA were older age (adjusted HR 1.04, 1.02–1.07), nail psoriasis (adjusted HR 3.15, 1.63–6.06) and psoriasis duration >10 years (adjusted HR 2.02, 1.09–3.76). However, patients treated with bDMARDs had a lower risk of incident PsA (adjusted HR 0.27, 0.11–0.66).