Biologics may stop psoriatic arthritis in its tracks

In patients with psoriasis, treatment with biologics helps cut the risk of developing psoriatic arthritis (PsA), as reported in a study.

The analysis included 1,719 psoriasis patients, who contributed a total of 14,721 patient/years (py) of data. These patients were PsA-free at baseline and grouped according to their therapy, as follows: topics (topics, phototherapy, or no treatment), conventional disease-modifying antirheumatic drugs (cDMARDs; methotrexate, and cyclosporine), and biologic (b)DMARDs (tumour necrosis factor inhibitors [TNFi], interleukin 17 inhibitors [IL-17i], and IL-12-23i). Incident case of PsA was attributed to one treatment if it occurred while the patient was taking that treatment.

Majority of the patients (n=1,387, 81 percent) were on topics, while 229 (13 percent) were on cDMARDs and 103 (6 percent) on bDMARDs. A total of 239 (14 percent) incident cases of PsA were recorded during follow-up, of which 231 were under topics, six cDMARDs, and two bDMARDs.

The global incidence of PsA was 1.6 per 100 py. The risk of developing PsA in psoriasis patients treated with bDMARDs was much lower than those on topics (incidence rate ratio [IRR], 0.26, 95 percent confidence interval [CI], 0.03–0.94; p=0.0111) but not when compared with those on cDMARDs (IRR, 0.35, 95 percent CI, 0.035–1.96; p=0.1007).

On Cox proportional hazards analysis, factors such as male sex, nail involvement, and higher body mass index were associated with risk increase in PsA. On the other hand, the use of biologics was protective (hazard ratio, 0.19, 95 percent CI, 0.05–0.81).