Treatment of Psoriasis with Biologics Dramatically Reduces the Rates of Psoriatic Arthritis.

Use of TNFI, IL17, IL12, OR IL12/23 INHIBITORS REDUCES THE RISK OF PROGRESSION FROM Psoriasis to Psoriatic Arthritis.

A new study reminds us of the advantages that may come with a more aggressive treatment protocol for our patients with psoriasis. Specifically, the study showed that the use of TNFI, IL17, IL12, OR IL12/23 inhibitors reduced the risk of progression from psoriasis to psoriatic arthritis.

The study was a single-center study from Italy and included 1023 patients. The study showed that patients treated at least once with biologics had a significantly lower risk of developing psoriatic arthritis compared to patients never treated with biologics (8.9% vs 26.1%, P < 0.001).  In multivariate analysis, these findings were still significant (P < 0.01) with a 77% reduced risk (i.e. adjusted odds ratio of 0.228) of developing PsA. The risk reduction seemed greatest with the IL-17 inhibitors (adjOR 0.051) followed by the IL12/23 and IL-23 inhibitors (adjOR 0.167) and TNF inhibitors (adjOR 0.206).

Conclusions

This study provides additional evidence to the current review that the aggressive treatment of psoriasis may reduce the risk of psoriatic arthritis.

This study is an important reminder of the multisystem nature of many of our immune-based diseases. We have only started to appreciate all the comorbidities that exist with various immune-based diseases.

REFERENCE

Floris A et al. Treatment of psoriasis with different classes of biologics reduces the likelihood of peripheral and axial psoriatic arthritis development. Rheumatology (Oxford). 2024 May 23:keae2