Worse joint pain in psoriasis patients with PsA boosts analgesic use

Psoriasis patients, especially those with concomitant psoriatic arthritis (PsA), suffer from worse joint pain, leading to higher analgesic use rates than the general population, a recent study has found.

Drawing from the Danish Skin Cohort, researchers conducted a cross-sectional analysis of 4,016 psoriasis patients (mean age 59.4 years, 55.8 percent women), of whom 847 had PsA. Outcomes included symptoms, disease severity (self-reported body surface area [BSA]), general health (EuroQoL 5 Dimensions 5 Levels [EQ-5D-5L]), and use of analgesics. Itch, skin pain, and joint pain were assessed using a numerical rating scale (NRS).

Compared to 3,490 general population controls (mean age 54.7 years, 55.4 percent women), median itch (1 vs 0), skin pain (1 vs 0), and joint pain (4 vs 2) NRS scores were higher in psoriasis patients. The effect was even stronger when looking at the subgroup of patients with PsA (itch: 1, skin pain: 2, joint pain: 6).

Similarly, general health was significantly worse in psoriasis patients than in controls (median EQ-5D-5L 0.86 vs 0.90; p<0.001). Those with PsA also saw significantly lower median EQ-5D-5L scores than comparators without PsA (0.80 vs 0.87; p<0.001). Itch, skin pain, and joint pain were all associated with poorer general health even after adjusting for confounders.

Opioid use within the last 12 months was likewise higher in psoriasis patients with (22.7 percent) and without (14.2 percent) concomitant PsA, as compared with general population controls (9.0 percent). Joint pain emerged as a significant indicator of high analgesic use (odds ratio, 3.72, 95 percent confidence interval, 2.69–5.14; p<0.0001).