Studies on Psoriatic Arthritis Prevention Save

Psoriatic arthritis (PsA) is a sequelae to chronic skin psoriasis. Whether cutaneous psoriasis is the pre-clinical phase of what may become PsA is oft debated and has been inadequately researched, largely using claims data or retrospective data sets.

While the shared immunopathology between psoriatic skin and joint and entheseal disease is compelling. Better studies, nomenclature or nosology is necessary to understand the potential continuum. Recently a EULAR proposal suggests there be three stages of development:

• At risk of PsA
• Subclinical PsA 
• Early PsA

Such classification may allow for effective study and potential interventions to ‘prevent’ the appearance of PsA. 

Several recent retrospective observational studies have demonstrated disease interception feasibility, with several noting the use of biologic disease-modifying drugs in PSO may abrogate the risk of PsA. 

This review in Rheumatology, by Lopez-Medina, et al. explores current initiatives that will examine the if PsA may be prevented and lists the previous research in this area noting the need for "Ongoing randomized placebo-controlled, interventional, preventive trials will provide stronger evidence on the role of bDMARDs in preventing clinical musculoskeletal inflammation".