Does pharmacological intervention prevent or delay the onset of psoriatic arthritis among psoriasis patients?

Figures & data

Figure 1. Certain risk factors serve to identify subpopulations of patients with psoriasis and risk of PsA (obesity, severe psoriasis, nail disease, etc). On the other hand, patients with psoriasis and arthralgia (not explained by another reason) and/or evidence of entheso-synovial inflammation in imaging tests (ultrasound, MRI), but without clinical evidence of PsA, are a high-risk group for PsA in the short term. Certain preventive measures (healthy lifestyle habits, systemic treatments for psoriasis, etc.) could reduce or stop the progression toward PsA (intervention toward prevention). On the other hand, a few studies demonstrate that the intervention with biological therapies could have the potential to stop the evolution from the subclinical to the clinical phase of PsA (treatment toward interception).

Table 1. Summary of studies of PsA as a paradoxical reaction to biologics.

Type of study	Year of publication	Type of biologics	New onset PsA	Study period
Retrospective	2017	Anti-TNFα, Anti-IL12/23	22/327 (6.7%)	2011–2015
Prospective	2020	Anti-TNFα, Anti-IL12/23, Anti-IL17	32/342 (9.4%)	2005–2018
Retrospective	2017	Anti IL12/23	8/179 (4.5%)	2011–2015
Prospective	2021	Anti-TNFα, Anti-IL12/23, Anti-IL17, Anti-IL23	10/118 (8.5%)	2019–2021

Case reports and case series are excluded. Modified from reference [12].

Megna M, Ocampo-Garza SS, Potestio L, et al. New-onset psoriatic arthritis under biologics in psoriasis patients: ¿An increasing challenge? Biomedicines. 2021;9(10):1482. doi: 10.3390/biomedicines9101482

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