Progression from Psoriasis to Psoriatic Arthritis Save
The question of whether psoriasis is a state or pre-clinical psoriatic arthritis has been addressed by several studies; with one suggesting that biologic use in psoriasis may aver the future development of psoratic arthritis (PsA).
A retrospecitve analysis of non-randomized moderate-to-severe plaque psoriasis patients who were prescribed at least 5 years of bDMARDs or at least three narrow-band ultraviolet light B (nb-UVB) phototherapy courses, looked at the future incidence of psoriatic arthritis (PsA).
From a total of 464 psoriasis (no PsA) patients (bDMARDs, n=234 and nb-UVB, n=230) followed for nearly 1500 person-years, the found and annual incidence of PsA to be 1.20 cases versus 2.17 cases of PsA per 100 patients/year in the bDMARDs versus UVB groups, respectively (HR 0.29, 0.12–0.70; p=0.006).
A higher risk of PsA was seen with older age (adjusted HR 1.04), nail psoriasis (adjusted HR 3.15) and psoriasis duration >10 years (adjusted HR 2.02).
Interestingly bDMARDs treatment was associated with a 73% lower risk of incident PsA (adjusted HR 0.27, 0.11–0.66).
These retrospective data suggest that bDMARDs treatment may reduce the risk of incident PsA in patients with moderate-to-severe chronic plaque psoriasis.